Spontaneous appearance of de novo intracranial arteriovenous malformation in hepatic cirrhosis

BACKGROUND Intracranial arteriovenous malformations (AVMs) are rare lesions that can be congenital or acquired in early childhood, with fatal outcome in approximately 30% of cases. De novo formation during adulthood without established predisposing vascular pathology or previous brain insult is even less frequent. CASE DESCRIPTION We present a case of de novo brain AVM in an alcoholic Child-B cirrhosis setting. Thirty previously reported cases presented de novo AVM in patients of all ages that had another previous brain pathology or insult, such as AVM resection. Seventeen of those cases occurred in adult patients, with only 2 showing no significant predisposing factor. The present pathophysiological review covers and completes Mullan's hemodynamic "two-hit" model, associating probable thrombotic predisposition to AVM with brain insult triggering a later stage based on angiogenic stimuli. CONCLUSIONS This case report and literature review renews previously discussed hemodynamic theories and contributes to a fuller understanding of the pathogenesis and progression of AVM. We postulate a causal link between hepatopathy and de novo AVM, which should be strengthened and interpreted based on recent genetic data and future prospective studies

Monolithic large-signal transimpedance amplifier for use in multi-gigabit, short-range optoelectronic interconnect applications

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Defeitos congênitos do palato em cães. Relato de três casos

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Knowledge, attitude and practice of Lebanese community pharmacists with regard to self-management of low back pain

Purpose: To determine the knowledge, attitude and reported practice of Lebanese community pharmacists who advise persons who present with low back pain.Methods: This was a multi-center cross-sectional study conducted in over 300 community pharmacies across Lebanon from December 2017 to May 2018. Pharmacists working at a community pharmacy were considered eligible, and those who volunteered to participate completed the questionnaire. The questionnaire was designed for self-completion by the pharmacist and included demographic questions about the respondent, questions that assessed knowledge and attitude toward low back pain, and questions about treatment to reflect and characterize the nature of practice. The primary outcome was to determine the knowledge, attitude and reported practice of the Lebanese pharmacists advising people who presented with low back pain. The secondary outcome was to assess factors that affect knowledge, attitude, and practice.Results: The response of 320 community pharmacists was analysed. The proportion of pharmacists with good knowledge about low back pain (51. 7 %) was slightly higher than those with poor knowledge (48. 3 %). Oral therapy was the most prescribed dosage form for back pain compared to local patch and cream. Among oral dosage forms, non-steroidal anti-inflammatory drugs were the most prescribed medications (42 %). Of the patients’ referral to the physician if necessary, 73.1 % of the referrals were by pharmacists.Conclusion: Community pharmacists in Lebanon demonstrate an acceptable level of knowledge of back pain, yet major gaps still exist, particularly in terms of the quality of advice. Hence, more education is needed to provide better quality of advice. Keywords: Attitude, Knowledge, Low back pain, Reported practice, Quality of advic

Prediction of the mechanical response of canine humerus to three-point bending using subject-specific finite element modelling

Subject-specific finite element models could improve decision making in canine long-bone fracture repair. However, it preliminary requires that finite element models predicting the mechanical response of canine long bone are proposed and validated. We present here a combined experimental–numerical approach to test the ability of subject-specific finite element models to predict the bending response of seven pairs of canine humeri directly from medical images. Our results show that bending stiffness and yield load are predicted with a mean absolute error of 10.1% (±5.2%) for the 14 samples. This study constitutes a basis for the forthcoming optimization of canine long-bone fracture repair

Utjecaj jednokratne intravenske primjene ofloksacina na kinetiku raspodjele meloksikama u koza.

The objective of the present study was to investigate the effect of ofloxacin (10 mg/kg) on the pharmacokinetics of meloxicam (0.5 mg/kg) in goats, when administered concurrently by intravenous route. Meloxicam concentration in plasma was measured using HPLC assay. The pharmacokinetics of meloxicam were best described by the two-compartment open model. Following concurrent administration of meloxicam and ofloxacin, the mean plasma level of meloxicam was only found to be significantly higher (P<0.05) at 15 min compared to its alone administration. Statistical analysis of data revealed that there were no statistically significant differences in PK parameters between the two treatments, except K21. Therefore, the results of the present study suggest that concurrent administration of ofl oxacin and meloxicam in goats does not require any adjustment in dosage regimens. Based on PK determinants, meloxicam may be administered by i.v. route at 0.86 and 0.65 mg/kg, as loading and maintenance doses respectively, and is to be repeated at 8 h intervals.Istražen je učinak ofloksacina (10 mg/kg) na farmakokinetiku meloksikama (0,5 mg/kg) u koza pod uvjetima istodobne intravenske primjene. Koncentracija meloksikama u plazmi utvrđena je visokotlačnom tekućinskom kromatografijom. Kao najbolji model za opis njegove farmakokinetike korišten je otvoreni model s dvama odjeljcima. Istodobnom primjenom meloksikama i ofloksacina, srednja razina meloksikama u plazmi bila je statistički značajno viša (P<0,05) samo 15 minuta u usporedbi s primjenom samog meloksikama. Statistička analiza podataka pokazala je da između dva načina primjene ne postoje značajne razlike farmakokinetičkih pokazatelja, osim za K21. Rezultati istraživanja pokazuju da kod koza doziranje ofloksacina i meloksikama prilikom njihove istovremene primjene ne treba mijenjati. Na temelju farmakokinetičkih pokazatelja, meloksikam se može primijeniti intravenski u početnoj dozi od 0,86 mg/kg, te u dozi za održavanje od 0,65 mg/ kg, uz ponavljanje u vremenskim razmacima od 8 sati

Unilateral ganglionectomy technique on the sheep's cranial cervical ganglion as a support for morphofunctional and quantitative studies

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A self-consistent phase-space distribution function for the anisotropic dark matter halo of the Milky Way

Dark Matter (DM) direct detection experiments usually assume the simplest possible ‘Standard Halo Model’ for the Milky Way (MW) halo in which the velocity distribution is Maxwellian. This model assumes that the MW halo is an isotropic, isothermal sphere, hypotheses that are unlikely to be valid in reality. An alternative approach is to derive a self-consistent solution for a particular mass model of the MW (i.e. obtained from its gravitational potential) using the Eddington formalism, which assumes isotropy. In this paper we extend this approach to incorporate an anisotropic phase-space distribution function. We perform Bayesian scans over the parameters defining the mass model of the MW and parameterising the phase-space density, implementing constraints from a wide range of astronomical observations. The scans allow us to estimate the precision reached in the reconstruction of the velocity distribution (for different DM halo profiles). As expected, allowing for an anisotropic velocity tensor increases the uncertainty in the reconstruction of f (v), but the distribution can still be determined with a precision of a factor of 4-5. The mean velocity distribution resembles the isotropic case, however the amplitude of the high-velocity tail is up to a factor of 2 larger. Our results agree with the phenomenological parametrization proposed in Mao et al. (2013) as a good fit to N-body simulations (with or without baryons), since their velocity distribution is contained in our 68% credible interval