Diagnosis and management of pneumonia in the emergency department.

Pneumonia is a condition that is often treated by emergency physicians. This article reviews the diagnosis and management of pneumonia in the emergency department and highlights dilemmas in diagnostic testing, use of blood and sputum cultures, hospital admission decisions, infection control, quality measures for pneumonia care, and empiric antimicrobial therapy

Utjecaj morfološkog tipa stanica na ekspresiju bcl-2, Ki-67 i p-53 u uvealnim melanomima

Uveal melanomas are known to be less aggressive malignant tumors compared with melanoma of other localizations but the same morphological characteristics. We hypothesized that immunohistochemical determination of expression of the known proliferation markers bcl-2 and ki-67, and p-53 as a suppressor gene marker, could better explain the biological behavior of uveal melanoma vs. melanoma of other localizations. Thirty cases of primary uveal melanoma of two levels of invasion were tested retrospectively for the presence of bcl-2, Ki-67 and p-53 proteins with the indirect peroxidase-antiperoxidase immunoenzyme method and three step ABC/AP method. The intensity of reaction was assessed by semiquantiative method.Usprkos morfološkoj građi sličnoj drugim melanomima, poznato je da uvealni melanomi imaju daleko bolju prognozu od melanoma drugih lokalizacija. Upravo stoga pretpostavili smo da bi određivanje ekspresije bcl-2, Ki-67 kao poznatih čimbenika proliferacije, te p-53 proteina u stanicama uvealnih melanoma moglo protumačiti ovakvo biološko ponašanje uvealnih melanoma. U tu svrhu ispitano je retrogradno 30 primarnih uvealnih melanoma stadija pT2 i pT3 na prisutnost bcl-2, Ki-67 i p-53 proteina indirektnom metodom peroksidaze-anti-peroksidaze i trofaznom metodom ABC/AP. Stupanj reaktivnosti određen je semikvantitativnom metodom

Antibiotic Prescribing Practices of Emergency Physicians and Patient Expectations for Uncomplicated Lacerations

<p>Introduction: Prophylactic antibiotics have not been found to have a benefit in the setting of uncomplicated lacerations. We evaluated the proportion of patients with uncomplicated lacerations who are prescribed prophylactic antibiotics in the emergency department (ED), factors that physicians considered when prescribing antibiotics, and factors associated with patient satisfaction.</p> <p>Methods: Adults and children presenting to 10 academic EDs with acute lacerations were enrolled. Enrolled patients were interviewed before and after their physician encounter in the ED and 2 weeks later. Physicians were interviewed in the ED after the patient encounter about factors that influenced their management decisions, including their perceptions of patients’ expectations. We included patients with uncomplicated lacerations (without contamination, infection, bone, tendon, or joint involvement) for analysis.</p> <p>Results: Of 436 patients enrolled, 260 had uncomplicated lacerations, and of these, 55 (21%) were treated with antibiotics in the ED or by prescription. Physicians were more likely to use antibiotics when the wound was more than 8 hours old, involved a puncture or amputation, and when the patient lacked medical insurance. A treatment course of 7 days or greater was given to 24 of 45 patients (53%) receiving outpatient prescriptions. Patient satisfaction was not associated with antibiotic use.</p> <p>Conclusion: Antibiotics were used for about one fifth of ED patients with uncomplicated lacerations despite a lack of evidence for efficacy. [West J Emerg Med. 2011;12(4):375–380.]</p

Synthesis, transport, and ionophoric properties of α,ω- diphosphorylated aza podands: IV. Induced membrane transport of alkali and alkaline-earth metal ions

Membrane transport of alkali and alkaline-earth metal ions by polyether podands containing terminal α-(phosphinoylalkylamino) fragments is studied. Some features of the relationship between the structure of the polyether bridge and substituents at the phosphorus atom, on the one hand, and transport properties of the carrier, on the other, are revealed. Transport efficiency is found to tend to correlate with transported ion size and distance between carrier donor centers. © 2008 MAIK Nauka

Synthesis of novel mono- and bisaminophosphoryl compounds and their membrane transport properties for acidic substrates

Some novel aminophosphoryl compounds were synthesized by the Kabachnik-Fields reaction. Their membrane transport properties for mono-and polyfunctional carboxylic acids with different number of functional groups were studied to establish that the transport rate of acidic substrates through liquid impregnated membranes increases in going from mono-to diphosphoryl carriers. Additional hydrophilic groups in the substrate molecule, too, affect transport efficiency. © 2008 MAIK Nauka

Effect of the structure of functionalized phosphoryl carriers on the membrane transport of proton-donor substrates

A series of phosphoryl compounds functionalized in the side chain were synthesized, and their membrane-transport properties with respect to proton-donor substrates of various acidity were studied. It was found that the efficiency of phase transport of the strong monobasic perchloric acid correlates with the basicity of the phosphoryl carriers in a series of carriers containing oxygen-containing functional groups. The transport flow sharply increases in going to phosphorylated amines, whereas phosphoramidates in their efficiency are closer to phosphonates than to amines. The efficiency of transport of dibasic acids (oxalic and tartaric) is low, since the hydroxy and carboxy groups not bound to the carrier make ionic associates highly hydrophilic. Fine details of the structure-transport acitivity relationship in the series of phosphorus compounds were discussed. Three-dimensional correlation analysis was used to compare the structure of the carriers with their characteristics: basicity of amine centers, atomic charges of oxygen and nitrogen, and hardness and hydrophobicity parameters. © Nauka/Interperiodica 2006

Synthesis of new liophilic functionalized aminomethylphosphine oxides and their acid-base and membrane-transport properties toward acidic substrates

A large number of new lipophilic mono- and bisphosphinylamines including those possessing additional potential centers of coordination was synthesized on the basis of the Kabachnik-Fields reaction, and acid-base and membrane transport properties of the synthesized compounds toward the mono- and polybasic carboxylic acids were studied. By their basicity all the synthesized aminophosphine oxides were shown to be inferior to their aliphatic amine precursors. Introduction of the second phosphinyl group so strongly decreases the basicity that the determination of pKa by potentiometric method becomes impossible. Interrelation between the structure of aminophosphinyl carrier and substrate and the efficiency of the membrane transport of acidic substrates are discussd. © 2009 Pleiades Publishing, Ltd

Survival and Cardioprotective Benefits of Long-Term Blueberry Enriched Diet in Dilated Cardiomyopathy Following Myocardial Infarction in Rats

Despite remarkable progress in treatment of chronic heart failure (CHF) over the last two decades, mortality, personal suffering and cost remain staggering, and effective interventions are still a challenge. Previously we reported that a blueberry-enriched diet (BD) attenuated necroapoptosis and inflammation in periinfarct area in a rat model of myocardial infarction (MI).To test the hypothesis that BD will attenuate the course of CHF, including mortality and cardiac remodeling during the first year after induction of MI in rats.Two weeks after coronary artery ligation, rats were divided into two groups of similar average MI size, measured by echocardiography, and then 12-mo dietary regimens were initiated as follows: ad libitum regular diet (control, CD, n = 27) and isocaloric food with 2% blueberry supplement (BD, n = 27) also available ad libitum. These dietary groups were compared to each other and to sham group (SH). Mortality over the 12 mo was reduced by 22% in BD compared with CD (p<0.01). In the course of developing CHF, BD had no effect on the body weight, heart rate or blood pressure. Bi-monthly Echo revealed significant attenuation of the LV chamber remodeling, LV posterior wall thinning, and MI expansion in BD compared with CD. In fact, BD arrested the MI expansion.This is the first experimental evidence that a blueberry-enriched diet has positive effects on the course of CHF and thus warrants consideration for clinical evaluation

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Physiological and biochemical aspects of using black lion fly larvae as a source of biologically active and nutrient substances

Introduction. Functional foods are products that, in addition to taste and nutritional value, have a physiological effect on the human body. ω-6 and ω-3 fatty acids, when consumed in the form of triglycerides from various food sources, undergo digestion in the small intestine, allowing absorption and transport into the blood and subsequent assimilation into the body, including the brain, retina, heart and other tissues. Amino acids must be obtained from food because the human body lacks the metabolic pathways necessary to synthesize some amino acids. In nutrition, amino acids are classified as essential and non-essential. Aim. To determine the fatty acid and amino acid composition of black soldier fly larvae for use as a dietary supplement. Materials and methods. In the experiment, the fatty acid and amino acid composition of the larvae of the black soldier fly (Hermetia illucens) was studied with the subsequent goal of using the insect as a component in dietary supplements. We assessed the amino acid and fatty acid composition of the larvae. Hermetia illucens were grown on four different diets; the group with the highest weight obtained was taken to determine the amino acid and fatty acid composition. To determine amino acids, Hermetia illucens were selected at the pre-pupa stage, dried in a SNOL 58/350 cabinet at 105 oC, and analyzed on an lc-20ad prominence liquid chromatograph. Amino acid analysis was carried out on an lc-20ad prominence liquid chromatograph, lysine 4.3%, valine 1.4%, leucine 4.6%, arginine 6.7%, isoleucine 2.8%, histidine 2.0%, methionine 2 were obtained %, phenylalanine 3.4%, tryptophan 1.7%, threonine 2.9%. Results. Dried samples in a SNOL 58/350 cabinet at 105 °C were obtained by extracting the crushed mass of larvae with petroleum ether. The sample was examined on a Chromatek-Crystal 9000 chromatograph No.: 2191672 and contains lauric acid up to 53%, myristic acid 5%, palmitic acid 5%, oleic acid up to 5%, omega-3 and omega-6