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The use of hyperbaric oxygen (HBO2) in the field of traumatic brain injury (TBI) is becoming more widespread and increasing yearly, however there are few prognostic reports on long-term functional efficacy. The aim of this study was to assess the functional prognosis of patients with moderate-to-severe TBI 5–8 years following HBO2 treatments and to explore the optimal HBO2 regimen associated with prognosis, using a retrospective study. Clinical data were retrospectively collected as a baseline for patients with moderate-to-severe TBI treated with HBO2 during inpatient rehabilitation from January 2014 to December 2017. The primary outcome measure was the Disability Rating Scale (DRS) and the secondary outcome measure was the Glasgow Outcome Scale. A total of 133 patients enrolled, with 9 (6.8%) dying, 41 (30.8%) remaining moderately disabled or worse (DRS scores 4–29), 83 (62.4%) remaining partially/mildly disabled or no disability (DRS scores 0–3). Logistic regression analysis revealed that age at injury (odds ratio (OR), 0.96; 95% confidence interval (CI), 0.92–0.99), length of intensive care unit stay (OR, 0.94; 95% CI, 0.88–0.99), and HBO2 sessions (OR, 0.97; 95% CI, 0.95–0.99) were variables that independently influenced long-term prognosis. Cubic fitting models revealed that 14 and 21.6 sessions of HBO2 could be effective for moderate and severe TBI, respectively. This study highlighted that HBO2 in moderate-to-severe TBI may contribute to minimize death and reduce overall disability in the long-term. However, clinicians should be cautious of the potential risk of adverse long-term prognosis from excessive HBO2 exposure when tailoring individualized HBO2 regimens for patients with moderate-to-severe TBI. The study was registered on ClinicalTrials.gov (NCT05387018) on March 31, 2022. [ABSTRACT FROM AUTHOR]

Background Cefalexin, a first-generation cephalosporin, is commonly used as oral continuation therapy for paediatric bone and joint infections (BJIs). The standard four times daily cefalexin dose makes treatment adherence challenging. A pharmacokinetic modelling study found that a cefalexin dose of 45 mg/kg (maximum 1.5 g) three times daily achieves the same pharmacodynamic target. Objectives To evaluate the efficacy and tolerability of three times daily cefalexin dosing in children with BJIs. Patients and methods Retrospective audit of children aged 1–18 years who received cefalexin at a dose of 40–50 mg/kg (maximum 1.5 g) three times daily as oral continuation therapy for a haematogenous BJI at a quaternary paediatric hospital in Australia over a 4 year period (January 2019 to December 2022). Results Of 149 children with BJIs treated with three times daily cefalexin dosing, the majority (147/149; 99%) achieved cure, with two experiencing recurrence of their infection. Most children tolerated the higher cefalexin dose; 4 children experienced gastrointestinal symptoms and 13 developed neutropenia, which was mild in most cases with no associated complications. Conclusions A reduced frequency dosing regimen using a high cefalexin dose of 45 mg/kg (maximum 1.5 g) three times daily is effective and well tolerated in most children with BJIs. [ABSTRACT FROM AUTHOR]

Objectives To describe the population pharmacokinetics of cefazolin in infected hospitalized patients requiring intermittent haemodialysis (IHD). Methods This prospective population pharmacokinetic study was conducted in IHD patients prescribed cefazolin 2 g three times weekly. Plasma samples were collected at prespecified timepoints and assayed for total and unbound concentrations using validated LC. Pharmacokinetic modelling and dosing simulations were performed using Pmetrics®. PTA in plasma suitable for MSSA (unbound trough concentrations of ≥2 mg/L for the final 24 h of a 72 h interval) were simulated for different dosing regimens. A PTA of ≥95% was deemed acceptable. Results A total of 260 cefazolin concentrations (130 total, 130 unbound) were collected from 16 patients (14 female) with a median age of 51 years. The median (IQR) pre-dialysis unbound cefazolin concentration for a 3 day dose interval trough was 17.7 (13.5–31.4) mg/L. The median (IQR) unbound fraction was 0.38 (0.32–0.46). The lowest pre-dialysis unbound concentration was 9.1 mg/L. A two-compartment model with a complex protein-binding component adequately described the data. The mean unbound cefazolin CL during IHD was 16.4 ± 4.26 L/h, compared with 0.40 ± 0.19 L/h when dialysis was off. Duration of time on haemodialysis (TOH) was the only covariate supported in the final model. The 2 g three-times-weekly regimen was associated with a PTA of 99.7% on dosing simulations to maintain unbound concentrations of ≥2 mg/L with TOH of 6 months. The 1 g three-times-weekly post-dialysis was associated with a PTA of 95.4%. Conclusions A 2 g three-times-weekly post-dialysis cefazolin regimen is supported for MSSA infections. [ABSTRACT FROM AUTHOR]

Background: Minimizing harm from antimicrobials requires use of the narrowest spectrum drug, at an effective dose for the minimum effective duration. Many prescribers are not currently following these guidelines. To address suboptimal antimicrobial use, the underlying reasons must be understood. Objectives: To identify factors influencing choices of antimicrobial drug, dose, and duration for companion animals. Subjects: Twenty‐two veterinarians treating companion animals in Australia. Diversity of participants was deliberately sought. Methods: Semistructured interviews were conducted online. Two case studies were discussed, and then a range of broader questions was posed. Transcripts were analyzed thematically, using an inductive approach. Results: Few participants chose guideline‐concordant management for the case studies. Prescribing choices were influenced by a complex array of factors associated with the clinical case, pet owner, drug, veterinarian, veterinary colleagues, and external factors. Key factors driving broad‐spectrum antimicrobial use included a sense of safety, habit, ease of administering the drug (especially in cats), pharmaceutical marketing, and the self‐perpetuating dispensary cycle. Many participants were concerned about antimicrobial resistance, but insufficiently informed about how to minimize this risk. Several participants believed that longer duration of treatment and ensuring patients finish a predetermined course would decrease the risk of antimicrobial resistance and improve clinical outcomes. Conclusions and Clinical Importance: Veterinarians are engaged with the concept of antimicrobial stewardship, but face numerous practical barriers and require more information. In particular, improved education is needed on enhancing patient safety by minimizing both spectrum of activity and duration of treatment, and dispelling myths about "finishing the course." [ABSTRACT FROM AUTHOR]

Introduction: Labor induction exhibits considerable variations in protocols and medication regimens. Limited studies compare vaginal dinoprostone inserts with different oral misoprostol dosages, considering parity influence. This study explores the distinctions among 10 mg vaginal dinoprostone inserts and oral misoprostol 25 μg every 2 and every 4 h for labor induction, stratified by parity. Material and Methods: This retrospective cohort study involved 607 participants across two hospitals. The primary outcome, time from induction to delivery, and secondary outcomes, including mode of delivery and maternal and fetal safety, were assessed. Results: Patient characteristics revealed differences in indication for labor induction, with the dinoprostone cohort having fewer post‐term and premature rupture of membranes cases but more intrauterine growth restriction/small‐for‐gestational age. Both oral misoprostol regimens showed a shorter time to delivery interval compared to the dinoprostone cohort (median: 1380 min [IQR 1381.0] and 1127.0 min [IQR 1214.0] vs 1631.5 [IQR 1736.2], p < 0.001 and p = 0.014). Only the difference between oral misoprostol q2h and vaginal dinoprostone remained significant for nulliparous but not multiparous women, losing significance over all the population after adjusting for confounding factors. The proportion of women giving birth within 24 h did not significantly differ between misoprostol q2h and dinoprostone after adjusting for confounders. When comparing misoprostol q4h with dinoprostone after confounder adjustment, an increased time to delivery interval for misoprostol q4h was found (p = 0.001). Both oral misoprostol regimens exhibited fewer meconium‐stained liquor (miso q4h: OR 0.44, miso q2h: OR 0.34) and cesarean sections (miso q4h: OR 0.48, miso q2h: OR 0.53) compared to dinoprostone, even after adjustment for confounders. Conclusions: Our study suggests that oral misoprostol 25 μg q4h is less effective than 10 mg vaginal dinoprostone for labor induction if parity and indication for induction are adjusted for, particularly in multiparous women. In terms of side effects, oral misoprostol regimens seem superior to vaginal dinoprostone. Our data support the individualized use of different agents for labor induction according to parity, indication for induction, bishop score, and women's preference. [ABSTRACT FROM AUTHOR]

Objectives The optimal dosing regimen of caspofungin in adolescents undergoing allogeneic haematopoietic stem cell transplantation against Candida spp. is unknown. The study aimed to compare body surface area (BSA)-based and fixed dosing regimens through population pharmacokinetic (PPK) analysis and to optimize dosing regimens likely to achieve therapeutic exposures. Methods Opportunistic sampling was used to collect plasma concentrations through a prospective observational pharmacokinetic study. PPK analysis and Monte Carlo simulations (n  = 1000) were performed using NONMEM. Results A total of 86 samples of 30 adolescents (12–17 years old) were best described by a two-compartment pharmacokinetic model. BSA is the only covariate on clearance and central volume of distribution. For Candida glabrata and Candida albicans , a standard dosing regimen could achieve at least a 90% probability of target attainment for the indicator of AUC0–24/MIC90. Dosing regimen simulations identified a BSA cut-off value of 1.3 m2, where a fixed loading dose (LD) is preferred when BSA ≥ 1.3 m2 and a BSA-based LD is preferred when BSA < 1.3 m2. For maintenance dose (MD), however, the BSA-based dose was proposed, regardless of BSA. The current maximum dosing regimen of LD 70 mg/day and MD 70 mg/day could not result in sufficient antifungal exposure for Candida parapsilosis with MIC90 of 1 mg/L. Furthermore, an LD of 70 mg/day and MD of 60 mg/m2/day rendered 90.4% steady-state trough concentration (C trough) over 1 mg/L in the virtual population. Conclusions Our study proposed optimized dosing regimens of caspofungin based on AUC0–24/MIC90 or C trough, which may support further individualized treatment. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a particularly crucial period of physical, emotional, and social development and adaptation, rendering these formative years rather challenging for individuals with chronic conditions like type 1 diabetes (T1D). Despite rapid improvement in diabetes therapies, adolescents with T1D are characterized by poorer adherence to treatment regimens compared with other pediatric age groups. Insufficient adherence is strongly related to low diabetes control, increasing morbidity, and risk for premature mortality. This study aimed to provide a comprehensive overview of adolescents' most common barriers to T1D adherence, stressing the need for a deep and comprehensive understanding of these barriers. The complexity of these barriers is underscored by the diverse factors contributing to poor T1D adherence in adolescents. Methods: A narrative review was conducted, surveying four databases (PubMed, Scopus, EMBASE, and Web of Science) for full-text articles in the English language published up to June 2024. All studies related to barriers to T1D adherence in adolescents were considered. The literature was selected using selection and exclusion criteria and extracted and organized using Mendeley. Exclusion criteria included studies with insufficient data and non-peer-reviewed articles. This review revealed that adolescents face numerous obstacles to T1D adherence related to psychological factors, flux in family dynamics, perceived social pressures, therapy-related factors, transitioning responsibility, risk-taking behaviors, and pubertal changes. Conclusions: Navigating the adaptations to the different aspects of T1D, from treatment to complications and adolescents' personal growth, effectively requires a thorough understanding of the barriers of a treatment regimen that patients at this critical age face. [ABSTRACT FROM AUTHOR]

Objective To recommend precision dosing and improve therapeutic efficacy against invasive fungal disease, a physiologically based pharmacokinetic model (PBPK) of oral isavuconazole (ISA) was established and used to explore its disposition across populations in different physiological and pathological states. Methods Twenty-five pharmacokinetic (PK) studies of oral ISA were identified through a systematic search of PubMed. Concentration–time data were extracted using WebPlotDigitizer. Physiochemical parameters were obtained from published literature and DrugBank. Model development and simulation used the Simcyp population-based simulator, and visual predictive check and predictive error were used for the model evaluation. Probability of target attainment and the cumulative fraction of response analyses were performed for dose optimization. Results The developed PBPK model was successfully validated in different populations. Most predicted concentration–time points aligned with the observed data, with acceptable predictive errors for the critical parameters. We predicted the PK profiles and parameters of ISA in a population with severe hepatic impairment (HI), a population with obesity and paediatric patients aged 1 to less than 6 years old. The probability of target attainment and cumulative fraction of response analyses indicated that the population with severe HI should have half the maintenance dose. The population with obesity and population with severe HI should have a loading dose of 300 mg every 8 h for 2 days. For paediatric patients aged 1 to less than 6 years old, a weight-based dosing regimen (5.38 mg/kg) of ISA was suggested. Conclusion The predicted value aligns with observations, suggesting ISA's potential predictability in PK profiles for other populations. The recommended dosing regimens increase our understanding of the use of ISA in special populations. [ABSTRACT FROM AUTHOR]

Copyright of Revista Filosofía en la Red is the property of Plataforma de Divulgacion Filosofica, S.A.S. de C.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose of Review: Glucocorticoids are a mainstay in acute lymphoblastic leukemia treatment and lack of early response is predictive for overall disease prognosis. Given the vital position of glucocorticoids and well known long and short-term side effects associated with differing glucocorticoids, we aim to highlight the wide breadth of historical and more contemporary data to describe the current landscape of glucocorticoid use in this arena. Recent Findings: Emerging studies aim to overcome issues such as steroid resistance and to optimize the antileukemic effects of glucocorticoids while aiming to mitigate the risks and side effects associated with their exposure. Summary: Glucocorticoids have and likely always will be a fundamental component of acute lymphoblastic leukemia treatment and understanding how to navigate short- and long-term effects and how to optimize regimens is at the heart of continued treatment success. [ABSTRACT FROM AUTHOR]

Background: Surgical treatment of complex giant pituitary adenomas (GPAs) presents significant challenges. The efficacy and safety of combining transsphenoidal and transcranial approaches for these tumors remain controversial. In this largest cohort of patients with complex GPAs, we compared the surgical outcomes between those undergoing a combined regimen and a noncombined regimen. We also examined the differences in risks of complications, costs, and logistics between the two groups, which might offer valuable information for the appropriate management of these patients. Patients and Methods: This was a multicenter retrospective cohort study conducted at 13 neurosurgical centers. Consecutive patients who received a combined or non-combined regimen for complex GPAs were enrolled. The primary outcome was gross total resection, while secondary outcomes included complications, surgical duration, and relapse. A propensity score-based weighting method was used to account for differences between the groups. Results: Out of 647 patients [298 (46.1%) women, mean age: 48.5 ± 14.0 years] with complex GPAs, 91 were in the combined group and 556 were in the noncombined group. Compared with the noncombined regimen, the combined regimen was associated with a higher probability of gross total resection [50.5% vs. 40.6%, odds ratio (OR): 2.18, 95% confidence interval (CI): 1.30-3.63, P = 0.003]. The proportion of patients with life-threatening complications was lower in the combined group than in the non-combined group (4.4% vs. 11.2%, OR: 0.25, 95% CI: 0.08-0.78, P = 0.017). No marked differences were found between the groups in terms of other surgical or endocrine-related complications. However, the combined regimen exhibited a longer average surgery duration of 1.3 h (P < 0.001) and higher surgical costs of 22,000 CNY (~ 3,000 USD, P = 0.022) compared with the noncombined approach. Conclusions: The combined regimen offered increased rates of total resection and decreased incidence of life-threatening complications, which might be recommended as the first-line choice for these patients. [ABSTRACT FROM AUTHOR]

Copyright of Foro Revista de Derecho is the property of Universidad Andina Simon Bolivar, Sede Ecuador and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Trashumante. Revista Americana de Historia Social is the property of Universidad de Antioquia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acne vulgaris is a common inflammatory condition that can be associated with profound psychosocial impacts. Conventional treatment includes topical retinoids, benzoyl peroxide, and antimicrobials, and some may cause irritation and skin dryness. In this 8-week open-label study, we examined the effects of a botanical skin care regimen (Codex Labs Shaant Balancing regimen) on mild to moderate facial and truncal acne. Twenty-four male and female subjects between the ages of 12 and 45 years were assessed for eligibility, 20 were enrolled, and 15 completed all study visits. Facial and truncal acne lesion counts, skin hydration, sebum excretion rate, and mood were assessed at baseline, week 4, and week 8. Total facial lesion counts (inflammatory and non-inflammatory lesions) decreased by 20.5% at week 4 (p = 0.06) and by 25.2% at week 8 (p < 0.05). Inflammatory lesion counts on the trunk were found to decrease at week 8 relative to baseline by 48% (p < 0.05). Forehead sebum excretion rate decreased by 40% at week 4 (p = 0.07) and 22% at week 8 (p = 0.08), and cheek skin hydration increased by 27.6% at week 4 (p = 0.14) and 65% at week 8 (p = 0.10). Participants also experienced significant improvement in components of a positive effect, such as feeling "strong" and "inspired", and a decrease in negative effects, such as feeling "irritable." Overall, the botanical skin care regimen was found to be well-tolerated. Our study suggests that a botanical skin care regimen may reduce facial and truncal acne lesion counts, increase skin hydration, reduce sebum production, and augment positive effects and moods in those with mild to moderate facial and truncal acne.

Clozapine is recognized as the gold standard medication for treatment-resistant schizophrenia. Despite the general recommendation of administering in a divided dosing regimen, clozapine is often prescribed once daily at night in clinical practice. This study aims to compare patient characteristics, psychiatric symptoms, side effects, and plasma concentration of clozapine between once-daily dosing and divided dosing regimens. This cross-sectional study included 159 participants with treatment-resistant schizophrenia or schizoaffective disorder. Participant's demographic information, anthropometric data, and medical history were collected. Their psychiatric symptoms, cognition, functioning, and side effects were evaluated. Once-daily dosing regimen was associated with younger age and competitive employment. Lower clinical symptom severity, better functioning and cognitive performance were observed in the once-daily dosing group. Lower daily dose of clozapine, trough plasma concentrations of clozapine and norclozapine were also significantly associated with once-daily dosing regimen. The study results support once-daily dosing of clozapine as a viable option to selected patients in clinical practice, as no association of severe symptoms or side effects were associated with once-daily dosing regimen. More studies are needed to examine the relationship between clinical outcomes and clozapine dosing regimen. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this paper I focus on the dietetic discussion at the end of the Timaeus (86b–90d) and read it against the background of the medical dietetics of its day. I try to show that Plato's version of dietetics is deeply rooted in the preceding medical tradition and that it draws in particular on ideas attested in the Hippocratic treatises On Regimen and Airs, Waters, Places. On the other hand, I also argue that Plato is most likely the first author ever to identify intellectuals as a specific dietetic category and to propose a preventive regimen adapted to the specific needs of mathematicians, philosophers, and other men of letters. Therefore, his dietetic discussion in the Timaeus deserves recognition as an important contribution to the history of dietetic therapy and prevention. [ABSTRACT FROM AUTHOR]

Copyright of Páginas. Revista digital de la Escuela de Historia de la Universidad Nacional de Rosario is the property of PAGINAS Revista digital de la Escuela de Historia de la Universidad Nacional de Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this research, a study is conducted on tax reforms in Ecuador from 2020 to 2023, in order to know the evolution that has existed in these reforms year after year and their impact on tax collection despite the events that have appeared. In Ecuador, tax reforms have undergone significant changes, as well as the enactment of new laws such as: the Organic Law for Tax Simplification and Progressivity, the Organic Law for Humanitarian Support and the Organic Law for Economic Development and Fiscal Sustainability after the Covid-19 pandemic. In addition, the Microenterprise Regime (RIM) and Simplified Regime (RISE) have been replaced with the Microenterprise and Popular Business Regime (RIMPE) for the benefit of small and large entrepreneurs. This work has a bibliographic review of sources such as journal articles and statistical data from official pages (SRI), from which the information on the subject was reviewed. [ABSTRACT FROM AUTHOR]

Introduction: Newer regimens are needed and expected to have a shorter therapeutic time to increase drug adherence to completion in drug sensitive tuberculosis (DS-TB) patients. Methods: We conducted first a systematic review and meta-analysis of prior studies to evaluate the effectiveness of rifapentine-containing regimens in treating DS-TB patients. Various search engines and keywords based on the PICOS framework for article selection were applied. Using Cochrane's risk-ofbias (RoB 2), data were independently extracted and the quality of the data was evaluated. Efficacy and safety data were evaluated by risk ratio and odds ratio, respectively. Results: Five eligible studies met the inclusion criteria. The rifapentinecontaining regimen had improved significantly the rate of sputum conversion (OR=0.04; 95% CI: 0.03–0.07). The rifapentine-containing regimen did not have a significant difference in both efficacy (RR=1.02; 95% CI: 0.96–1.09) and adverse events (RR=0.96; 95% CI: 0.78–1.18) to the standard regimen. Rifapentine-containing regimen with optimal dosage of 1200 mg had an overall non-significant sputum conversion rate difference to previous regimens. Conclusions: To our knowledge, this is the first systematic review and meta-analysis that studied the efficacy and safety of a rifapentine-containing regimen for DS-TB. The shorter duration (4 months) of the rifapentinecontaining regimen, suggested by WHO, may give superior benefit of adherence and lower resistance compared to past therapeutic suggestions. The novel once per day rifapentine-containing regimen is effective and safe, with significantly shorter treatment durations and is not inferior compared to standard regimens (RHZE) for the treatment of DS-TB. [ABSTRACT FROM AUTHOR]

¿Por qué no se soluciona la crisis carcelaria en Ecuador? Esta pregunta lleva a explorar la problemática penitenciaria desde sus orígenes hasta llegar al contexto ecuatoriano actual. El objetivo es reflexionar y demostrar que las prisiones y la privación de libertad han mantenido la misma dinámica desde sus orígenes, causando sufrimiento y dolor a los reclusos, en contraposición a la fnalidad resocializadora de la pena; el contexto actual demuestra que la gestión penitenciaria no ha evolucionado, pese al desarrollo científico y normativo de esta rama. El enfoque cualitativo y socio-jurídico son la base de la investigación porque a través del diseño narrativo se describe de forma secuencial la historia del sistema penitenciario, el avance normativo y se compara con la realidad social; es decir, se hace un acercamiento del derecho a la sociedad a través de la revisión documental de fuentes secundarias. En definitiva, se concluye que no existe la voluntad política del Estado para abordar el problema de forma técnica y con el personal especializado, tal como sugiere la doctrina; al contrario, la crisis carcelaria en Ecuador tiene un tinte anacrónico, deshumanizante y alejado de la finalidad de la pena; es decir, no hay rehabilitación ni resocialización.

Introduction: Rabies is a zoonotic disease that can be fatal and continues to impose a significant financial burden on developing countries. Recently, there have been advancements in the introduction of cell culture vaccines and immunoglobulin, as well as the approval of Intradermal (ID) schedules for vaccine administration. Aim: To assess the knowledge of doctors in Rewa District regarding the National Guidelines for Rabies Prophylaxis in 2019. Materials and Methods: A cross-sectional study was conducted, involving doctors from tertiary healthcare centres, district hospitals, and private practices. Data were collected over a period of one month from 206 doctors using a Google form, which included information about their field of practice and their knowledge of recent guidelines on Rabies prophylaxis. Data analysis was performed using the Chi-square test. Results: Out of the 206 doctors surveyed, 92 (44.7%) were male. A 56.7% of the doctors were aware of the regimen and dosage for ID administration of the Anti Rabies Vaccine, (ARV) and 44.6% were knowledgeable about the modification of Post-Exposure Prophylaxis (PEP) to Pre-Exposure Prophylaxis (PrEP) in the Essen regimen. Furthermore, 70.9% of the doctors were familiar with the dosage of Human Rabies Immunoglobulin (HRIG), while 42.7% knew how to manage animal bites in immunocompromised patients. Conclusion: The study revealed a lack of sufficient knowledge on various aspects of rabies management among the doctors surveyed. This underscores the need for reorientation programs and Continuing Medical Education (CMEs) training to be provided to doctors to enhance their knowledge of rabies and improve the effective management of animal bites.

AbstractBackground Multiple myeloma (MM) is an incurable malignancy. Venetoclax (VEN) shows a meaningful effect in MM patients who are relapsed or refractory (RR) to previous standard therapies.Objective This study aimed to assess the efficacy and safety of VEN-based treatments in RR MM patients.Materials and methods Comprehensive studies were searched in PubMed, Embase, Web of Science and Cochrane library. Efficacy was assessed by overall response rate (ORR), strict complete response rate (sCR), complete response rate (CR), very good partial response rate (VGPR) and partial response rate (PR).Results Seven studies containing 482 subjests were included. The pooled ORR, ≥ CR (sCR + CR), VGPR and PR were 68% (51%–85%), 24% (13%–35%), 25% (17%–34%) and 17% (11%–24%) respectively. Multi-drug treatments were superior to VEN ± dexamethasone (Dex) treatments in ORR (82% vs 42%, p = .003) and ≥ CR (36% vs 7%, p

AIM: To assess the long-term outcomes of treating macular edema (ME) associated with central retinal vein occlusion (CRVO) with a regimen of “5+pro re nata (PRN)”. METHODS: This retrospective study included 27 eyes of 27 patients with ME associated with non-ischemic CRVO (non-iCRVO group, n=15) and ischemic CRVO (iCRVO group, n=12). The eyes were treated with five consecutive intravitreal injections of conbercept or ranibizumab, followed by reinjections as needed or PRN. Retinal laser photocoagulation or intravitreal dexamethasone implants (DEX) were implemented in both groups when necessary. The best-corrected visual acuity (BCVA, logMAR) and central retinal thickness (CRT) were recorded at baseline, at 1, 2, 3, 4, 5, 6, and 12mo, and at the final visit. The efficacy rates of BCVA and CRT before and after treatment were calculated. The number of injections at each visit and the incidence of adverse events were also recorded. RESULTS: The patients, aged 59.4±15.1y, were followed up for 24.7±8.8mo (range: 15-42mo). After treatment, BCVA improved significantly from 1.04±0.56 logMAR at baseline to 0.59±0.36 logMAR (P=0.038) at the final visit in all patients. Both the non-iCRVO and the iCRVO groups achieved improved BCVA compared to the baseline at all visit points, but there was no statistical significance (P=0.197 and 0.33, respectively). The mean CRT was statistically reduced compared to baseline at all visit points in all the eyes and in both groups (all P0.05). Laser treatment was applied to all eyes in the iCRVO group, while only 5 patients in the non-iCRVO group. Six patients in the non-iCRVO group and 3 patients in the iCRVO group had a drug switch. DEX was applied to 4 eyes in the non-iCRVO group and 5 eyes in the iCRVO group. CONCLUSION: The 5+PRN anti-vascular endothelial growth factor (VEGF) regimen is found to be safe and effective for both iCRVO and non-iCRVO, especially in the iCRVO group. The best regimen for such patients needs to be further investigated. Adjuvant laser therapy and DEX are necessary in some cases.

Guidelines vary for the age at which to begin breast cancer screening and the interval between examinations. A validated computer model was used to compare estimated outcomes between various screening regimens. The OncoSim-Breast microsimulation model (Canadian Partnership Against Cancer) was used to simulate a cohort of 1.53 million Canadian women born in 1975. The effect of screening regimen on absolute breast cancer mortality rates, stage at diagnosis, number needed to be screened to avert a breast cancer death or save a life year, abnormal recall rates and negative biopsy rates was examined for unscreened women or those entering screening at age 40 or 50 and screened annually or biennially to age 74. Compared to no screening, absolute mortality reduction was 4.6 (biennial 50–74), 5.9 (biennial 40–74) and 7.9 (annual 40–74) fewer deaths per 1000 women. The absolute rate of diagnosis of advanced cancers (Stage 2, 3 and 4) falls in favor of earlier stages as the number of lifetime screens increases. Annual screening beginning at age 40 until age 74 would provide an additional reduction of 2 and 3.3 breast cancer deaths per 1000 women compared to biennial screening beginning at ages 40 and 50, respectively. There is a corresponding drop in the absolute number of Stage 2, 3 and 4 cancers diagnosed.

Simple Summary: In practical terms, pet owners' lack of awareness regarding weight reduction protocols, coupled with the high costs of commercial prescription diets, often makes it difficult for them to adhere to such programs in the long term. This study addressed the costs of weight loss per kilogram of metabolic weight in dogs and cats, considering various dietary regimens. The weight reduction protocol, supervised by veterinarians, involved eight dogs and ten cats. The results indicated that the monthly and total cost per kilogram of metabolic weight was significantly lower when using commercial dry foods compared to homemade diets (p < 0.001), reducing costs by 40.88% and 41.01% for dogs and cats, respectively. Despite owners' lack of awareness and associated costs, it is concluded that commercial prescription diets offer greater financial benefit for pet weight reduction protocols, emphasizing the importance of considering economic factors when implementing weight control strategies. These findings underscore the economic challenges associated to pet weight loss and emphasize the necessity for cost-effective solutions to promote sustained owner compliance. In the context of the rising prevalence of obesity among pets, this study aimed to assess the economic aspects of weight reduction protocols for dogs and cats, considering the lack of information and the varying costs of commercial and homemade diets. The results indicated an average weekly weight loss rate of 1.02% for dogs and 0.92% for cats, with a reduction in body fat mass (p < 0.005). The cost analysis included an evaluation of both dry and wet commercial prescription diets as well as homemade diets. The results unveiled higher expenses associated to wet commercial diets, followed by homemade and dry commercial diets (p < 0.001). The study demonstrated that despite the initial investment, the long-term benefits of weight loss, including improved health and reduced financial burdens for owners, justify the expenses incurred. This comprehensive analysis provides veterinarians and pet owners with valuable insights into the economic considerations of weight reduction protocols, facilitating informed decision making and promoting pet well-being. [ABSTRACT FROM AUTHOR]

Introduction: Rabies is a zoonotic disease that can be fatal and continues to impose a significant financial burden on developing countries. Recently, there have been advancements in the introduction of cell culture vaccines and immunoglobulin, as well as the approval of Intradermal (ID) schedules for vaccine administration. Aim: To assess the knowledge of doctors in Rewa District regarding the National Guidelines for Rabies Prophylaxis in 2019. Materials and Methods: A cross-sectional study was conducted, involving doctors from tertiary healthcare centres, district hospitals, and private practices. Data were collected over a period of one month from 206 doctors using a Google form, which included information about their field of practice and their knowledge of recent guidelines on Rabies prophylaxis. Data analysis was performed using the Chi-square test. Results: Out of the 206 doctors surveyed, 92 (44.7%) were male. A 56.7% of the doctors were aware of the regimen and dosage for ID administration of the Anti Rabies Vaccine, (ARV) and 44.6% were knowledgeable about the modification of Post-Exposure Prophylaxis (PEP) to Pre-Exposure Prophylaxis (PrEP) in the Essen regimen. Furthermore, 70.9% of the doctors were familiar with the dosage of Human Rabies Immunoglobulin (HRIG), while 42.7% knew how to manage animal bites in immunocompromised patients. Conclusion: The study revealed a lack of sufficient knowledge on various aspects of rabies management among the doctors surveyed. This underscores the need for reorientation programs and Continuing Medical Education (CMEs) training to be provided to doctors to enhance their knowledge of rabies and improve the effective management of animal bites. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Cerebral ventriculitis might be caused by Gram-negative bacteria, including ESBL producers. Temocillin may be a useful treatment option in this scenario; however, no consistent data are available regarding its penetration into the CSF. Objectives To describe the population pharmacokinetics of temocillin in plasma and CSF and to determine the probability for different simulated dosing regimens to achieve pharmacokinetic/pharmacodynamic (PK/PD) targets in the CSF. Methods Ten post-neurosurgical critically ill adult patients requiring continuous drainage of CSF were included in this monocentric, prospective, open-label, non-randomized study. They received 2 g loading dose temocillin over 30 min IV infusion, followed by a 6 g continuous infusion over 24 h. Total and unbound concentrations were measured in plasma (n = 88 and 86) and CSF (n = 88 and 88) samples and used to build a population PK model. Monte Carlo simulations were performed to estimate the PTA at 100% C ss>MIC (steady state concentration above the MIC) in CSF. Results All patients were infected with Enterobacterales with temocillin MICs ≤8 mg/L. The median (min-max) temocillin penetration in CSF was 12.1% (4.3-25.5) at steady state. Temocillin unbound plasma pharmacokinetics were best described by a one-compartment model. PTA for the applied dosing regimen was >90% for bacteria with MIC ≤ 4 mg/L. Conclusions The currently approved dose of 6 g by continuous infusion may be adequate for the treatment of ventriculitis by Enterobacterales with MIC ≤ 4 mg/L if considering 100% C ss>MIC as the PK/PD target to reach. Higher maintenance doses could help covering higher MICs, but their safety would need to be assessed. [ABSTRACT FROM AUTHOR]

Copyright of Farmacie Pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Multiple myeloma (MM) is an incurable malignancy. Venetoclax (VEN) shows a meaningful effect in MM patients who are relapsed or refractory (RR) to previous standard therapies. This study aimed to assess the efficacy and safety of VEN-based treatments in RR MM patients. Comprehensive studies were searched in PubMed, Embase, Web of Science and Cochrane library. Efficacy was assessed by overall response rate (ORR), strict complete response rate (sCR), complete response rate (CR), very good partial response rate (VGPR) and partial response rate (PR). Seven studies containing 482 subjests were included. The pooled ORR, ≥ CR (sCR + CR), VGPR and PR were 68% (51%–85%), 24% (13%–35%), 25% (17%–34%) and 17% (11%–24%) respectively. Multi-drug treatments were superior to VEN ± dexamethasone (Dex) treatments in ORR (82% vs 42%, p =.003) and ≥ CR (36% vs 7%, p < 0.00001). Subgroup analysis indicated patients achieve higher ORR who harboring t(11;14) translocation or containing high BCL-2 expression. VEN-containing regimens could be suggested as effective and safe treatments to RR MM patients with t(11;14) or high BCL-2 levels. [ABSTRACT FROM AUTHOR]

Guidelines vary for the age at which to begin breast cancer screening and the interval between examinations. A validated computer model was used to compare estimated outcomes between various screening regimens. The OncoSim-Breast microsimulation model (Canadian Partnership Against Cancer) was used to simulate a cohort of 1.53 million Canadian women born in 1975. The effect of screening regimen on absolute breast cancer mortality rates, stage at diagnosis, number needed to be screened to avert a breast cancer death or save a life year, abnormal recall rates and negative biopsy rates was examined for unscreened women or those entering screening at age 40 or 50 and screened annually or biennially to age 74. Compared to no screening, absolute mortality reduction was 4.6 (biennial 50–74), 5.9 (biennial 40–74) and 7.9 (annual 40–74) fewer deaths per 1000 women. The absolute rate of diagnosis of advanced cancers (Stage 2, 3 and 4) falls in favor of earlier stages as the number of lifetime screens increases. Annual screening beginning at age 40 until age 74 would provide an additional reduction of 2 and 3.3 breast cancer deaths per 1000 women compared to biennial screening beginning at ages 40 and 50, respectively. There is a corresponding drop in the absolute number of Stage 2, 3 and 4 cancers diagnosed. [ABSTRACT FROM AUTHOR]

This paper proposes that resources from philosophy as a way of life (PWL), in particular the prescription of targeted 'spiritual exercises' (Hadot) can be used in palliative counselling, addressing Alexandrova's critique that philosophy as 'big picture' theories alone are insufficient. Part I shows how the disciplines of philosophy and medicine for a long time intersected, in particular in competing prescriptive notions of 'regimen' or 'way of life' (diaitês) in the ancient world, in which philosophy was considered widely as PWL. Part II applies PWL work on the ancient philosophical spiritual exercises to contemporary clinical settings. We show how six ancient spiritual exercises respond to patients' needs as persons, whose quality of life is importantly shaped by their beliefs and sense‐making, as they face profound existential or spiritual challenges, as well as forms of physical disability and diminished capabilities which they may never have previously countenanced. [ABSTRACT FROM AUTHOR]

Background: Melphalan was poorly available in mainland China. The aim of this study is to explore the dose-adjusted busulfan/cyclophosphamide (BU/CY) as an alternative regimen in auto stem cell transplantation (ASCT) for multiple myeloma (MM). Methods: A total of 105 newly diagnosed MM patients undergoing ASCT during May 2012 and August 2017 were retrospectively analyzed. The BU/CY regimen was applied to 64 patients. Busulfan (9.6 mg/kg or 8.0 mg/kg in total) and cyclophosphamide (3.6 g/m2 or 3.0 g/m2 in total) were administered according to the creatinine clearance rate (CCR). A high-dose melphalan (HDMEL) regimen (200 mg/m2) was given to the other 41 patients. Results: At a median follow-up of 65 (1~119) months, estimated overall survival (OS) and progression-free survival (PFS) at 104 months in the BU/CY and HDMEL groups were 35.6% vs. 20.5% (p = 0.263) and 20.2% vs. 2.4% (p = 0.035), respectively. The median overall survival (OS) and PFS of the HDMEL and BU/CY groups were 55 vs. 70.5 months and 26 vs. 46.5 months, respectively. In multivariate analysis, the BU/CY regimen was found to be the only protective factor for PFS. No lethal toxicity was found in the BU/CY group, and treatment-related mortality (TRM) in 100 days was similar to the HDMEL group. Conclusions: MM patients may also benefit from the dose-adjusted BU/CY regimen. [ABSTRACT FROM AUTHOR]

Este trabajo explora algunas de las derivas, apropiaciones y disputas en torno al vocablo “oligarquía” que se referenciaron en matrices conceptuales y culturas políticas variadas y que ofrecieron una serie de lenguajes políticos entre finales del siglo XIX y comienzos del siglo XX. El acceso a la presidencia del radicalismo en 1916 no implicó una desaparición del término de los dispositivos discursivos sino, en todo caso, una reformulación sobre la presencia de las “oligarquías” que, expectantes, podían diseñar nuevas maneras de entorpecer el proceso de regeneración política propuesto por el radicalismo. Este artículo analiza la utilización de argumentos de raíz “moral” referidos a la definición de grupos minoritarios que detentaban y usufructuaban una posición dominante en la sociedad y la política de manera arbitraria. Procura, además, estudiar las apropiaciones diversas del término “oligarquía” realizada por una variedad de actores a lo largo de las primeras décadas del siglo XX y aplicadas a la esfera “política”, principalmente durante el período de las presidencias radicales. Esta distinción es fundamentalmente operativa y no faltarán los casos en que políticos, periodistas e intelectuales entremezclen y articulen elementos “morales” y “políticos” en su análisis de las elites dirigentes.

La estabilidad económica y alimentaria de los países, depende en gran parte de su sector primario. En México la gran diversidad de microclimas distribuidos en todo el territorio nacional hace que podamos producir gran variedad de alimentos, pues las características apropiadas para cultivos con alta resistencia a la falta de agua (Gobierno de México, 2023). El objetivo de esta investigación es analizar los beneficios contables y fiscales en el régimen de las Actividades Agrícolas, ganaderas, silvícolas y pesqueras aplicables a las personas físicas y morales. Es importante mencionar que los empresarios que tributen en este régimen conozcan las obligaciones que le corresponden presentar, así como también las nuevas disposiciones fiscales su época y periodo de presentación.

Background: There are no data on the daily regimen of compression therapy in patients with chronic venous disease. This systematic review aimed to establish the optimal daily duration of compression treatment. Methods: A systematic search of CENTRAL and MEDLINE was performed to identify RCTs, non-RCTs, reviews, systematic reviews, meta-analyses, and guidelines evaluating the use of compression regimens in the treatment of varicose veins. Results: Thirty-two RCTs, three non-RCTs, four observational studies, and two crossover trials reporting the duration and regimes of compression treatment fulfilled the inclusion criteria. The daily duration of compression was reported in patients after invasive treatment, for venous ulcer treatment, in patients with venous symptoms. The quality of the studies varied. We could not conduct a meta-analysis due to the heterogeneity of the research data and their quality. Twenty-three studies reported results of compression usage after invasive procedures. Eight studies reported daily duration regimens in patients with venous ulcers. Nine studies reported the impact of compression on venous symptoms and/or edema or limb volume change. One study was conducted to assess if compression improves QoL in venous patients. While there was a clear difference found in the daily duration depending on the clinical scenario, no data in support of exact regimens were found. Conclusions: There are no reliable data supporting exact daily regimens of compression treatment in various cohorts of CVD patients. [ABSTRACT FROM AUTHOR]

Objective: We examined the protocol for drug selection and bone mineral density follow up for a sample of osteoporosis patients in Bahrain. Methods: This was a retrospective study. Data was collected from three hospitals in Bahrain over the period 2016-2018. We collected subject's demographic data, osteoporosis drug therapy, and the schedule of dual-energy X-ray absorptiometry (DXA) scan before and after therapy. Results: The number of subjects who were included in this study was 4572 (mean age 59.36 years: 92.5% females, 7.5% males). We found that 41.8% of the patients used osteoporosis medications, whereas the rest were not on any pharmacotherapy (58.2%). The following drugs were used: Vitamin D (82.4%), Calcium (76.6%), Denosumab (14.9%), Bisphosphonate (4.5%) and Tamoxifen (4.3%). Almost all subjects were offered BMD scan before therapy (96.5%), but minority received a follow up after starting medications (17.2%). The follow up scan was performed 2-3 years following therapy in 46.9% of subjects, whereas for the rest, it was requested 1-2 years (31.1%) or 3 years (17.1%) later. Pharmacotherapy was associated with age (p<0.001), female gender (p<0.05) and being postmenopausal (p<0.001). Follow up BMD was positively associated with age (p<0.001), postmenopausal status (p<0.001) and medication use (p<0.001). Conclusions: Osteoporosis patients were undertreated with anti-resorptive drugs and most of them were not offered a follow up DXA scan to assess response to therapy. Protocol for pharmacotherapy and follow up of osteoporosis in Bahrain needs review. [ABSTRACT FROM AUTHOR]

Purpose We intend to evaluate the efficacy of salvage treatments for relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL) through meta-analysis. Materials and Methods R/R DLBCL trials were divided into two groups based on eligibility for autologous stem-cell transplantation (ASCT), and meta-analysis of each group was performed. Random effects models were used to estimate the 1-year progression-free survival (PFS) rate, and chimeric antigen receptor (CAR) T-cell therapy was used as reference treatment. Results Twenty-six ASCT-eligible cohorts from 17 studies comprising 2,924 patients and 59 ASCT-ineligible cohorts from 53 studies comprising 3,617 patients were included in the pooled analysis. In the ASCT-eligible group, the pooled 1-year PFS rate was 0.40 (95% confidence interval [CI], 0.15 to 0.65) for the CAR T-cell group and 0.34 (95% CI, 0.30 to 0.37) for the group with chemotherapy followed by ASCT intention. The two treatments were not significantly different in meta-regression analysis. In the ASCT-ineligible group, the pooled 1-year PFS was 0.40 (95% CI, 0.35 to 0.46) for CAR T-cell, and the highest primary outcome was 0.47 (95% CI, 0.37 to 0.57) for the tafasitamab group. CAR T-cell therapy showed significantly better outcomes than chemotherapy and therapies based on ibrutinib, lenalidomide, and selinexor. However, loncastuximab, polatuzumab plus bendamustine and rituximab, and the tafasitamab group showed no different efficacy than CAR T-cell therapy after adjusting for median number of previous lines of treatment. Conclusion Although several regimens were crudely grouped for classification, CAR T-cell therapy did not outperform chemotherapy followed by ASCT in the second-line setting or several recently developed agents in the ASCT-ineligible setting. [ABSTRACT FROM AUTHOR]

No abstract available.

The prompt administration of post-exposure prophylaxis (PEP) is one of the key strategies for ending human deaths from rabies. A delay in seeking the first dose of rabies PEP, or failure to complete the recommended dosage, may result in clinical rabies and death. We assessed the efficacy of short message system (SMS) phone texts in improving the adherence to scheduled PEP doses among bite patients in rural eastern Kenya. We conducted a single-arm, before-after field trial that compared adherence among bite patients presenting at Makueni Referral Hospital between October and December 2018 (control) and between January and March 2019 (intervention). Data on their demographics, socio-economic status, circumstances surrounding the bite, and expenditures related to the bite were collected. A total of 186 bite patients were enrolled, with 82 (44%) in the intervention group, and 104 (56%) in the control group. The odds of PEP completion were three times (OR 3.37, 95% CI 1.28, 10.20) more likely among patients who received the SMS reminder, compared to the control. The intervention group had better compliance on the scheduled doses 2 to 5, with a mean deviation of 0.18 days compared to 0.79 days for the control group (p = 0.004). The main reasons for non-compliance included lack of funds (30%), and forgetfulness (23%) on days for follow-up treatment, among others. Nearly all (96%, n = 179) the bite patients incurred indirect transport costs, at an average of USD 4 (USD 0–45) per visit. This study suggests that the integration of SMS reminders into healthcare service delivery increases compliance with PEP, and may strengthen rabies control and elimination strategies. [ABSTRACT FROM AUTHOR]

Bladder cancer (BC) is the sixth most common type of cancer with epithelial/urothelial and non-urothelial origins. Urothelial carcinoma (UC) involves neoplastic cells of epithelial origin and accounts for 90% of all BC cases. Current review aims to discuss the latest advances and challenges in the treatment of UC with an emphasis on clinical pharmacology considerations. Data including clinical efficacy and safety outcomes as well as precautions reported in published clinical studies obtained from PubMed and package inserts were collected and summarized in the review. Recent decade saw the approval of multiple drugs for the treatment of BC in both adjuvant/neoadjuvant setting as well as for unresectable tumors. Checkpoint blockers (pembrolizumab, nivolumab, atezolizumab, and avelumab), antibody drug conjugates (enfortumab vedotin and sacituzumab govitecan) and targeted therapies (erdafitinib) are now available in first-line (cisplatin-ineligible), second-line and third-line settings along with conventional platinum-based chemotherapy. While the survival outcomes have improved especially in refractory and unresponsive patients, the response rates are relatively low and patient safety needs further optimization. Additional studies on combination therapies, dose adjustments in special populations and impact of anti-drug antibodies on drug exposure are needed to further improve clinical outcomes. [ABSTRACT FROM AUTHOR]

To explore the suitable regimens of induced termination of second-trimester pregnancy in women with prior cesareans. A total of 204 s-trimester pregnant women with prior cesareans at the Third Affiliated Hospital of Zhengzhou University from January 2019 to December 2020 were included in this retrospective study. Group A included pregnant women who were administered mifepristone with misoprostol, Group B included those administering mifepristone with misoprostol as well as a transcervical Cook double-balloon catheter, Group C included those receiving mifepristone with an intra-amniotic injection of ethacridine lactate, and Group D included those receiving mifepristone, transcervical Cook double-balloon catheter, and intra-amniotic injection of ethacridine lactate. Their characteristics, clinical outcomes, and complications among the four groups were compared. All women had similar profiles in maternal age, gravidity, and previous cesarean delivery (p >.05). There was no significant difference in successful abortion among the four groups (p >.05). Group C had a significantly shorter induction-to-abortion interval than Group D (p <.01). The blood loss after abortion at 2 h in Group B was much less than Group A (p <.05). It made a significant difference between Group B and Group D regarding the blood loss after abortion at 2 h (p <.01). With regard to total incidences of adverse reactions, there were much fewer in the group B than the group A (p <.05). The four regimens are all effective for the termination of second-trimester pregnancy in women with prior cesareans. The use of transcervical Cook double-balloon could reduce the risks caused by misoprostol, and the combination of these is feasible to induce second-trimester pregnancy termination in women with prior cesareans. [ABSTRACT FROM AUTHOR]

Philadelphia chromosome‐positive acute myeloid leukemia (Ph + AML) is a rare type of AML with a low survival rate and poor prognosis. We first report a Ph + AML patient who remained in long‐term remission after the combination of flumatinib and venetoclax, which could provide corresponding treatment ideas for clinical practice. The figure shows the treatment process of the patient and the dynamic changes in blood cell count during venetoclax and flumatinib. The BCR::ABL1 transcript was negative after two courses of the combination of venetoclax anf flumatinib. No serious adverse events occurred during the treatment, although hematological toxicity was observed. [ABSTRACT FROM AUTHOR]

This article examines the ways in which, in the last centuries of the Middle Ages, the emergence of a literature aimed at preserving health by means of dietary rules or advice establishes a connection between the physician's authority in matters of health and the capacity of patients and readers to take care of themselves when they are in good health. Born at the same time of social demand and medical necessity (the latter due to the dangers and uncertainties of therapeutic practice), these regimina sanitatis disseminate to a literate public the principles of good hygiene. Some regimina are even adapted to the singularity of a given individual. But the agency of readers, characterized by their capacity for choice and deliberation, also clashes with the claim that a medical authority is necessary for the governance of health. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the changes in glaucoma prescriptions during a single visit in real-world situation at Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan. METHODS: This cross-sectional descriptive study was conducted at Glaucoma Department of Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan from September 1st, 2015 to February 29th, 2016 after the ethical approval. Of total 876 consecutive participants, 868 were included in the study. Complete ocular examination was carried out for each subject including intraocular pressure (IOP) by Goldmann, visual field and nerve fiber analysis if it was scheduled. Ocular and systemic co-morbidities as well as ocular surgeries were also noted. Number of topical medications including anti-glaucoma and other drugs were recorded before and after their visit. The changes in anti-glaucoma medications were then categorized as unchanged, changed, added or deleted. The results were analyzed via SPSS version-24. RESULTS: A total 1600 eyes of 868 patients were included in this study. Out of 868 patients, 507 (58.41%) were males and 291 (33.52%) were in 61-70 years age group. Majority of patients (n=680/868: 78.34%) had open-angle glaucoma. Out of 1600 eyes studied, 574 (35.87%) had moderate and 556 (34.75%) had severe stage of glaucomatous optic neuropathy. During single visit, glaucoma-related prescriptions were unchanged, changed, added and deleted in 618/868 (71.20%), 84/868 (9.68%), 95/868 (10.94%) & 71/868 (8.18%) patients respectively. In our study, 911/1600 (56.94%) eyes achieved target IOP ≤14 mmHg. CONCLUSION: In real-world situation, most of our glaucoma patients were stable and required no changes to their prescriptions in single visit.