Phenytoin Interaction with Enteral Feedings Administered through Nasogastric Tubes

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142072/1/jpen0513.pd

What are the problems of industry?

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Modeling drug release from dynamically swelling poly(hydroxyethyl methacrylate-co-methacrylic acid) hydrogels

Drug release from a swelling hydrogel matrix is a complicated process where diffusion of drug molecules is coupled to the swelling kinetics. The swelling influences the diffusional flux of drug molecules by increasing the diffusion coefficient and diffusional pathlength. Release of phenylpropanolamine from a poly(hydroxyethyl methacrylate-co-methacrylic acid) hydrogel, initially at low pH, is highly influenced by swelling in a neutral pH medium. Swelling in these ionizing gels is a very long process, even in the absence of a glassy core, indicating that the swelling is not a simple Fickian process. In this paper, a novel approach is introduced to model the phenylpropanolamine release from these swelling gels. Through a free volume relationship, the experimentally determined swelling kinetics are coupled to a diffusion mechanism for the drug molecules. This model was shown to give an accurate prediction of phenylpropanolamine release from poly(hydroxyethyl methacrylate-co-methacrylic acid) gels.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28600/1/0000408.pd

Phosphorus Nutrition Affects Temperature Response of Soybean Growth and Canopy Photosynthesis

In nature, crops such as soybean are concurrently exposed to temperature (T) stress and phosphorus (P) deficiency. However, there is a lack of reports regarding soybean response to T × P interaction. To fill in this knowledge-gap, soybean was grown at four daily mean T of 22, 26, 30, and 34°C (moderately low, optimum, moderately high, and high temperature, respectively) each under sufficient (0.5 mM) and deficient (0.08 mM) P nutrition for the entire season. Phosphorus deficiency exacerbated the low temperature stress, with further restrictions on growth and net photosynthesis. For P deficient soybean at above optimum temperature (OT) regimes, growth, and photosynthesis was maintained at levels close to those of P sufficient plants, despite a lower tissue P concentration. P deficiency consistently decreased plant tissue P concentration ≈55% across temperatures while increasing intrinsic P utilization efficiency of canopy photosynthesis up to 147%, indicating a better utilization of tissue P. Warmer than OTs delayed the time to anthesis by 8–14 days and pod development similarly across P levels. However, biomass partitioning to pods was greater under P deficiency. There were significant T × P interactions for traits such as plant growth rates, total leaf area, biomass partitioning, and dry matter production, which resulted a distinct T response of soybean growth between sufficient and deficient P nutrition. Under sufficient P level, both lower and higher than optimum T tended to decrease total dry matter production and canopy photosynthesis. However, under P-deficient condition, this decrease was primarily observed at the low T. Thus, warmer than optimum T of this study appeared to compensate for decreases in soybean canopy photosynthesis and dry matter accumulation resulting from P deficiency. However, warmer than OT appeared to adversely affect reproductive structures, such as pod development, across P fertilization. This occurred despite adaptations, especially the increased P utilization efficiency and biomass partitioning to pods, shown by soybean under P deficiency

Medical and Financial Risks Associated with Surgery in the Elderly Obese

OBJECTIVE: To study the medical and financial outcomes associated with surgery in elderly obese patients and to ask if obesity itself influences outcomes above and beyond the effects from comorbidities that are known to be associated with obesity. BACKGROUND: Obesity is a surgical risk factor not present in Medicare\u27s risk adjustment or payment algorithms, as BMI is not collected in administrative claims. METHODS: A total of 2045 severely or morbidly obese patients (BMI ≥ 35 kg/m, aged between 65 and 80 years) selected from 15,914 elderly patients in 47 hospitals undergoing hip and knee surgery, colectomy, and thoracotomy were matched to 2 sets of 2045 nonobese patients (BMI = 20-30 kg/m). A limited match controlled for age, sex, race, procedure, and hospital. A complete match also controlled for 30 additional factors such as diabetes and admission clinical data from chart abstraction. RESULTS: Mean BMI in the obese patients was 40 kg/m compared with 26 kg/m in the nonobese. In the complete match, obese patients displayed increased odds of wound infection: OR (odds ratio) = 1.64 (95% CI: 1.21, 2.21); renal dysfunction: OR = 2.05 (1.39, 3.05); urinary tract infection: OR = 1.55 (1.24, 1.94); hypotension: OR = 1.38 (1.07, 1.80); respiratory events: OR = 1.44 (1.19, 1.75); 30-day readmission: OR = 1.38 (1.08, 1.77); and a 12% longer length of stay (8%, 17%). Provider costs were 10% (7%, 12%) greater in obese than in nonobese patients, whereas Medicare payments increased only 3% (2%, 5%). Findings were similar in the limited match. CONCLUSIONS: Obesity increases the risks and costs of surgery. Better approaches are needed to reduce these risks. Furthermore, to avoid incentives to underserve this population, Medicare should consider incorporating incremental costs of caring for obese patients into payment policy and include obesity in severity adjustment models

Resistance to autosomal dominant Alzheimer's disease in an APOE3 Christchurch homozygote: a case report.

We identified a PSEN1 (presenilin 1) mutation carrier from the world's largest autosomal dominant Alzheimer's disease kindred, who did not develop mild cognitive impairment until her seventies, three decades after the expected age of clinical onset. The individual had two copies of the APOE3 Christchurch (R136S) mutation, unusually high brain amyloid levels and limited tau and neurodegenerative measurements. Our findings have implications for the role of APOE in the pathogenesis, treatment and prevention of Alzheimer's disease

Rapidly measured indicators of recreational water quality and swimming-associated illness at marine beaches: a prospective cohort study

<p>Abstract</p> <p>Introduction</p> <p>In the United States and elsewhere, recreational water quality is monitored for fecal indicator bacteria to help prevent swimming-associated illnesses. Standard methods to measure these bacteria take at least 24 hours to obtain results. Molecular approaches such as quantitative polymerase chain reaction (qPCR) can estimate these bacteria faster, in under 3 hours. Previously, we demonstrated that measurements of the fecal indicator bacteria <it>Enterococcus </it>using qPCR were associated with gastrointestinal (GI) illness among swimmers at freshwater beaches. In this paper, we report on results from three marine beach sites.</p> <p>Methods</p> <p>We interviewed beach-goers and collected water samples at marine beaches affected by treated sewage discharges in Mississippi in 2005, and Rhode Island and Alabama in 2007. Ten to twelve days later, we obtained information about gastrointestinal, respiratory, eye, ear and skin symptoms by telephone. We tested water samples for fecal indicator organisms using qPCR and other methods.</p> <p>Results</p> <p>We enrolled 6,350 beach-goers. The occurrence of GI illness among swimmers was associated with a log₁₀-increase in exposure to qPCR-determined estimates of fecal indicator organisms in the genus <it>Enterococcus </it>(AOR = 2.6, 95% CI 1.3-5.1) and order <it>Bacteroidales </it>(AOR = 1.9, 95% CI 1.3-2.9). Estimates of organisms related to <it>Clostridium perfringens </it>and a subgroup of organisms in the genus <it>Bacteroides </it>were also determined by qPCR in 2007, as was F+ coliphage, but relationships between these indicators and illness were not statistically significant.</p> <p>Conclusions</p> <p>This study provides the first evidence of a relationship between gastrointestinal illness and estimates of fecal indicator organisms determined by qPCR at marine beaches.</p

Liposomal Formulations of Inflammatory Bowel Disease Drugs: Local versus Systemic Drug Delivery in a Rat Model

Based on adherence to intestinal mucosa, intralumenally administered liposomal formulations of 5-aminosalicylate (5-ASA) and 6-mercaptopurine (6-MP) were studied for their potential to enhance local drug delivery to intestinal tissue for the treatment of inflammatory bowel disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41509/1/11095_2005_Article_5376.pd

The pattern of amyloid accumulation in the brains of adults with Down syndrome.

INTRODUCTION: Adults with Down syndrome (DS) invariably develop Alzheimer's disease (AD) neuropathology. Understanding amyloid deposition in DS can yield crucial information about disease pathogenesis. METHODS: Forty-nine adults with DS aged 25-65 underwent positron emission tomography with Pittsburgh compound-B (PIB). Regional PIB binding was assessed with respect to age, clinical, and cognitive status. RESULTS: Abnormal PIB binding became evident from 39 years, first in striatum followed by rostral prefrontal-cingulo-parietal regions, then caudal frontal, rostral temporal, primary sensorimotor and occipital, and finally parahippocampal cortex, thalamus, and amygdala. PIB binding was related to age, diagnostic status, and cognitive function. DISCUSSION: PIB binding in DS, first appearing in striatum, began around age 40 and was strongly associated with dementia and cognitive decline. The absence of a substantial time lag between amyloid accumulation and cognitive decline contrasts to sporadic/familial AD and suggests this population's suitability for an amyloid primary prevention trial.This research was generously supported by a grant from the Medical Research Council (grant ID number: 98480). Additional support came from the NIHR Cambridge Biomedical Research Centre, the NIHR Collaborations in Leadership for Applied Health Research and Care (CLAHRC) for the East of England, the NIHR Cambridge Dementia Biomedical Research Unit, The Down Syndrome Association, and The Health Foundation.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.jalz.2015.07.49