The Role of Veterinary Sciences In Chemical Disasters and Emergencies

1989 ◽  
Vol 4 (2) ◽  
pp. 155-159 ◽  
Author(s):  
A. Mantovani
Keyword(s):  
Health Status ◽  
Biological Monitoring ◽  
Food Chain ◽  
Chemical Pollution ◽  
Veterinary Services ◽  
Animal Populations ◽  
Contingency Plans ◽  
Definition Of

AbstractThe roles of the veterinary sciences in disasters and emergencies related to exposures of the environment to harmful chemicals are reviewed. Characteristics of chemical emergencies which require the use of the veterinary sciences are discussed. Veterinary services are important in the: 1) definition of the kind and severity of the pollution through biological monitoring; 2) use of animals as monitors of the environment; 3) use of changes in the health status of animals for identification of pathophysiologic changes to man and other animals (sentinels); 4) maintenance of the hygiene of elements of the food chain; 5) evacuation and management of animal populations; 6) disposal of carcasses; and 7) treatment and follow-up of involved animal populations. Veterinary services are important components of responses to incidents marked by chemical pollution and must be included in the development of contingency plans to meet the demands created by chemical pollution.

scholarly journals Role of personality traits in reporting the development of adverse drug reactions: a prospective cohort study of the Estonian general population

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022428 ◽  
Author(s):  
Anu Realo ◽  
Henriët van Middendorp ◽  
Liisi Kööts-Ausmees ◽  
Jüri Allik ◽  
Andrea W M Evers
Keyword(s):  
Cohort Study ◽  
Health Status ◽  
Personality Traits ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Drug Reactions ◽  
Ffm Personality Traits ◽  
Time Point

ObjectiveTo examine the role of the Five Factor Model (FFM) personality traits in reporting the development of adverse drug reactions (ADRs) when controlling for sociodemographic variables and health status.DesignProspective cohort study.SettingThe Estonian Biobank of the Estonian Genome Centre, University of Tartu.Participants814 women and 543 men (mean age=47.9 years;SD=15.2) who after the initial enrolment in the Estonian Biobank were re-contacted for follow-up purposes about 5.3 years after the enrolment and for whom both self- and informant-reported personality data were available.Main outcome measureParticipants who did not report having any ADRs at baseline but who reported ADRs at the follow-up about 5.3 years later versus participants who did not report any ADRs at either time point. The reports of developing ADRs were predicted from the FFM personality traits after statistically controlling for sociodemographic variables (age, gender and education), baseline indicators of health status (number of diagnoses and medicines taken, body mass index and blood pressure), and the change in health status between the two measurements.ResultsThe results of a hierarchical binary logistic regression analysis showed that participants who reported the development of ADRs between the two measurements had higher levels of conscientiousness, were more likely to be women, were taking more medicines at baseline and had a higher increase in the number of medicines taken during the study period than participants who did not report any ADRs at either time point (all p values <0.05). Higher neuroticism (p=0.067) and a higher number of diagnosed diseases at baseline (p=0.053) also made marginal contributions to predicting the development of ADRs.ConclusionsThis study shows for the first time that higher levels of conscientiousness and neuroticism are associated with reporting the development of ADRs.

Definition of the Role of Contemporary Surgical Management in Cisternal and Parenchymatous Cysticercosis Cerebri

Neurosurgery ◽  
1991 ◽  
Vol 28 (2) ◽  
pp. 231-237 ◽  
Author(s):  
William T. Couldwell ◽  
Chi-Shing Zee ◽  
Michael L. J. Apuzzo
Keyword(s):  
Symptomatic Improvement ◽  
Brain Parenchyma ◽  
Cystic Mass ◽  
Increased Intracranial Pressure ◽  
Focal Neurological Deficit ◽  
Definition Of ◽  
Mass Lesions ◽  
The Brain

Abstract With increasing immigration from endemic regions, the incidence of neurocysticercosis in North America is rising. This retrospective study was undertaken to examine the role of surgery in those cases presenting with large cystic parenchymal and cisternal lesions in the current era of anthelminthic agents administered orally. A total of 237 patients presented with newly diagnosed neurocysticercosis to our institution over a recent 5-year period (mean age, 31.2 years). Among those who presented with cystic mass lesions predominantly affecting the brain parenchyma and cisternal spaces. 20 (8.4%; mean age, 40.2 years) with large cystic lesions subsequently underwent surgical intervention, either because of an emergent presentation or because they were refractory to medical management. Clinical presentation included increased intracranial pressure, focal neurological deficit, and seizure. Radiographic imaging (computed tomography and/or magnetic resonance imaging) demonstrated 12 cases with cisternal lesions, 7 with parenchymal lesions, and 1 involving both compartments. Based on imaging guidelines, 30 operative procedures (excluding shunt revisions) were performed (14 craniotomies, 8 cerebrospinal fluid diversions, 7 stereotactic procedures, and 1 burr hole drainage). Fifteen (75%) showed neurological or symptomatic improvement over a median follow-up period of 36.4 months. There were three surgery-related complications and no deaths.

scholarly journals Higher Hemoglobin Levels Are Associated With Better Physical Performance Among Older Adults Without Anemia: A Longitudinal Analysis

2021 ◽  
Author(s):  
Ligiana Pires Corona ◽  
Flavia Cristina Drummond Andrade ◽  
Tiago Silva Alexandre ◽  
Tábatta Renata Pereira Brito ◽  
Daniella Pires Nunes ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Performance ◽  
Well Being ◽  
World Health ◽  
Aging Study ◽  
Definition Of ◽  
Health Organization ◽  
The Impact

Abstract Background Anemia is the most common hematological abnormality among older adults, and it is associated with decreased physical performance. But the role of hemoglobin in the absence of anemia remains unclear. Thus, this study aimed to assess the impact of hemoglobin levels on physical performance in Brazilian older adults without anemia. Methods The study is longitudinal in that it relies on two waves of the Saúde, Bem-Estar e Envelhecimento (SABE; Health, Well-being, and Aging) study: 2010 and 2015–2016. Mixed-effects linear regression was used to determine the effects of the hemoglobin concentrations on the Short Physical Performance Battery-SPPB over time among the 1,020 who had complete data and did not have anemia in 2010. In the follow-up, there were 562 without anemia. Analyses were stratified by sex. Results In analyses adjusted for age, education, grip strength, comorbidities, and body mass index, hemoglobin levels were positively associated with physical performance scores among older women (β = 0.15, p < 0.05) and men (β = 0.18, p < 0.05) without anemia. Conclusion Our study demonstrates that higher hemoglobin levels were associated with better physical performance among older men and women without anemia. This finding is important because, in clinical practice, most health professionals focus on the World Health Organization definition of anemia. Our study suggests the importance of hemoglobin levels among older adults, even those without anemia.

scholarly journals The Contribution of Mechanistic Understanding to Phenotypic Screening for First-in-Class Medicines

2013 ◽  
Vol 18 (10) ◽  
pp. 1186-1192 ◽  
Author(s):  
David C. Swinney
Keyword(s):  
Drug Discovery ◽  
Recent Analysis ◽  
Phenotypic Screening ◽  
Central Feature ◽  
Molecular Mechanism Of Action ◽  
Mechanistic Understanding ◽  
Definition Of ◽  
The U.S

The level of mechanistic understanding required for drug discovery is a central feature of most strategies. However, an understanding of mechanism is not required for regulatory approval. This paradox is particularly relevant to the role of phenotypic assays in drug discovery. A recent analysis revealed that phenotypic drug discovery strategies were more successful for first-in-class medicines, whereas target-based molecular strategies were more successful for followers ( Nat. Rev. Drug Discov.2011, 10, 507–519). The rationale for the success of phenotypic screening was the unbiased identification of the molecular mechanism of action. In this follow-up analysis, the format and mechanistic information used to establish the phenotypic assays that led to the first-in-class small-molecule new molecular entities approved by the U.S. Food and Drug Administration between 1999 and 2008 were analyzed and compared with those approved in 2012. Not surprisingly, some level of mechanistic understanding was used to select the assay formats and chemicals screened. It is concluded that mechanism takes on different connotations depending on context and perspective and that a target need not always be the exclusive definition of mechanism.

A large prospective trial of children with unilateral retinoblastoma with and without histopathologic high-risk features and the role of adjuvant chemotherapy: A Children’s Oncology Group (COG) study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9515-9515 ◽  
Author(s):  
Murali M. Chintagumpala ◽  
Bryan Langholz ◽  
Ralph Eagle ◽  
Daniel Albert ◽  
Mohammed Javed Ali ◽  
...  
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Prospective Trial ◽  
International Study ◽  
Excellent Outcome ◽  
Preliminary Results ◽  
Number Of Patients ◽  
Definition Of

9515 Background: The definition of histopathologic high-risk features (HRF) in enucleated eyes of children with unilateral retinoblastoma and their contribution to metastases is controversial. The COG completed a large, prospective international study to determine the prevalence of strictly defined histopathologic HRF that are predictors of recurrence and the role of chemotherapy to prevent recurrences. Methods: All patients who underwent enucleation for unilateral retinoblastoma were eligible for the study. Pathology slides were submitted for central review within 21 days of enucleation. Patients with evidence of one or more high-risk features (posterior uveal invasion grades IIC and D, concurrent optic nerve and choroid involvement and post-lamina optic nerve involvement) as determined by central review, received 6 cycles of chemotherapy consisting of carboplatin, vincristine and etoposide. All others were observed. All patients were followed for extraocular recurrences. Results: Patients were enrolled from February of 2005 until May 2010. As of July 2011, the median follow-up from enrollment was 1.9 years (max=5.3 years). Of 312 patients with central histopathology review, 49 patients had their risk classification changed (13% with no HRF had HRF, 24% with HRF had no HRF). Two patients developed extraocular disease and one patient died of unknown cause. The death and one of the extraocular relapses occurred among the 93 (2/93=2.2%, upper 95% CI 3.4%) patients assigned by the central review to receive chemotherapy, while one patient experienced extraocular relapse among the 209 (1/209=0.5%, upper 95% CI 0.6%) assigned to observation only. There is no evidence of a difference in the EFS and OS in these two groups. Conclusions: Preliminary results strongly suggest that a central review of pathology can spare a significant number of patients from exposure to chemotherapy. Chemotherapy may have contributed to fewer relapses in patients with high-risk features as defined in this study. The preliminary results from this study indicate an excellent outcome with this approach.

scholarly journals Management of obstetrics tears

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
F. Bogliatto ◽  
M. Miletta ◽  
L. Leidi
Keyword(s):  
Postnatal Period ◽  
Review Of Literature ◽  
Correct Definition ◽  
Labour Epidural Analgesia ◽  
Definition Of ◽  
Perineal Care ◽  
Anatomical Alignment ◽  
Obstetric Injuries

<p>Objective: Aim of the study is to analyse the literature about the management of obstetric</p><p>tears, in order to optimize clinicians work and women perineal care after</p><p>spontanous delivery.</p><p>Methodology: Review of literature</p><p>Results: After a correct definition of obstetric injuries (1,2,3,4, degree), we describe main risk</p><p>factors (birth weight, nulliparity, induction of labour, epidural analgesia), the role of</p><p>episiotomy (midline or mediolateral one), the correct clinical conduction of labour in</p><p>the care of perineum and the principles and techniques (over lapping or end-to-end</p><p>techinques, for sphinterial repair) of obstetric suturing. We define also the correct</p><p>clinical management of severe obstetric injuries repair (suture as soon as possible to</p><p>reduce bleeding and risk of infection, check equipment and count swabs before</p><p>starting the procedures, good lighting, ask for more experienced assistance if in doubt</p><p>regarding the extent of trauma or structures involved, use general anesthesia, ensure</p><p>good anatomical alignment of the wound, rectal examination after completing the</p><p>repair of III-IV degrees) and the corret management in postnatal period (follow up in</p><p>prevision of other pregnancies).</p><p>Conclusions: Improving surgical skills of clinicians could preserve perineal dysfunction.</p>

scholarly journals Management of severe hyperinflammation in the COVID-19 era: the role of the rheumatologist

Rheumatology ◽  
2020 ◽  
Author(s):  
Charalampia Papadopoulou ◽  
Muthana Al Obaidi ◽  
Elena Moraitis ◽  
Sandrine  Compeyrot-Lacassagne ◽  
Despina Eleftheriou ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Incomplete Kawasaki Disease ◽  
Retrospective Case ◽  
Therapeutic Success ◽  
Paediatric Rheumatologist ◽  
Current Definition ◽  
Definition Of ◽  
A Current

Abstract Objectives The objectives of this study were (i) to describe the clinical presentation, treatment and outcome of paediatric inflammatory multisystem syndrome temporally related to Sars-CoV-2 (PIMS-TS) in children; (ii) to propose a framework to guide multidisciplinary team (MDT) management; and (iii) to highlight the role of the paediatric rheumatologist in this context. Methods This study involved a retrospective case notes review of patients referred to a single specialist paediatric centre with suspected PIMS-TS, with a focus on clinical presentation, laboratory parameters, treatment, and outcome in the context of an MDT framework. Results Nineteen children of median age 9.1 years fulfilled the definition of PIMS-TS and were managed within an MDT framework: 5/19 were female; 14/19 were of Black, Asian or minority ethnicity; 9/19 also fulfilled diagnostic criteria for complete or incomplete Kawasaki disease (KD). Severe systemic inflammation, shock, and abdominal pain were ubiquitous. Treatment was stratified within an MDT framework and included CSs in all; i.v. immunoglobulin in all; anakinra in 4/19; infliximab in 1/19; and antiviral (aciclovir) in 4/19. Conclusions We observed significant diagnostic equipoise using a current definition of PIMS-TS, overlapping with KD. Outside of clinical trials, an MDT approach is vital. The role of the paediatric rheumatologist is to consider differential diagnoses of hyperinflammation in the young, to advise on empiric immunomodulatory therapy, to set realistic therapeutic targets, to gauge therapeutic success, to oversee timely step-down of immunomodulation, and to contribute to the longer-term MDT follow-up of any late inflammatory sequelae.

scholarly journals Crisis consultations as a component of political management

2018 ◽  
Vol 21 (7) ◽  
pp. 24-30
Author(s):  
S. V. Stavchenko
Keyword(s):  
Risk Management ◽  
Crisis Management ◽  
Strategy Development ◽  
Maximum Increase ◽  
Crisis Prevention ◽  
Political Management ◽  
Definition Of

It is determined that crisis consultations represent a set of measures aimed at stabilizing the situation of a particular subject, solving a set of problems associated with the maximum increase in the efficiency of the activity. The following types of crisis consultations are singled out: direct consultations of managers; implementation of advisory activities (consultations on emerging problems, diagnosis of the organization, definition of a crisis strategy, development of a plan of measures for crisis prevention, risk assessment and follow-up of its implementation, support of the organization during the implementation of the plan for crisis prevention, development of preventive measures in relation to avoidance of crisis phenomena); crisis reflexive games (training of managers and staff); case study review; use of benchmarking methods. The role of crisis analysis in conducting crisis consultations has been determined. It was emphasized that crisis analysis enables to prevent and plan possible crisis situations, ways of their neutralization and overcoming with minimal expenses for the organization. The role functions of crisis advisers are determined. The stages of crisis management (according to R. Heath) are revealed: prevention – prevention of crisis risks, analysis of losses for business; readiness – awareness of the probability of crises, staff training; salvation – drawing up plans, preventing consequences; recovery – recovery of effective production, assessment of the crisis. The types of crisis management are distinguished: preventive, aimed at analyzing the indicators of the crisis and identifying its causes and factors for timely prevention or minimization of possible crisis processes; an anticipatory, the essence of which is to develop goals and objectives for leadership in order to prevent crisis phenomena. A demarcation of crisis management and risk management has been conducted: if crisis management is primarily a process of responding to already existing serious threats to one or another organization or to events that have already occurred, risk management is associated with the process of identifying certain risks mainly for future activities organization, as well as the appropriate acceptance of these risks or their elimination.

Radiation therapists’ perspectives of the role of reflection in clinical practice

2010 ◽  
Vol 9 (3) ◽  
pp. 131-141 ◽  
Author(s):  
Angela Cashell
Keyword(s):  
Clinical Practice ◽  
Focus Groups ◽  
Personal Growth ◽  
Daily Practice ◽  
Perceived Barriers ◽  
Professional Lives ◽  
Small Group Teaching ◽  
Definition Of

AbstractA recurring theme from the literature is that the definition of reflection is nebulous and/or complex. Many authors have suggested that more research needs to be conducted to better understand an individual’s perception of reflection and reflective practice, and how these concepts affect their clinical practice as well as their personal growth and development. This paper offers the findings of a qualitative study of radiation therapists in Canada. The aim of the study was to explore radiation therapist’s understanding of the concept of reflection, and to understand how they incorporated it into their daily practice. Secondary objectives were to examine some of the perceived barriers to its use, and the possible challenges of implementing reflective writing. Two focus groups were initially conducted, and a follow-up questionnaire was developed using the themes generated from the focus groups. The questionnaire was distributed to radiation therapists at two large cancer centres in Toronto, Canada. Most participants indicated that it is an integral part of their practice and professional lives, and that they use a variety of different methods for engaging in reflection. It is not without its barriers, but many of these can be overcome by providing time, coaching and a supportive work environment. Respondents were divided as to whether they would benefit from being taught reflection; however, small group teaching would be the favoured method. Further study is suggested to determine whether there are any improvements to patient care and in particular patient outcomes.

scholarly journals Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature

2012 ◽  
Vol 70 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Antonio Carlos Martins Maia Jr. ◽  
Antonio José da Rocha ◽  
Bernardo Rodi Barros ◽  
Charles Peter Tilbery
Keyword(s):  
Cognitive Abilities ◽  
Resonance Imaging ◽  
Gadolinium Enhancement ◽  
Inflammatory Lesions ◽  
Radiologically Isolated Syndrome ◽  
Asymptomatic Patients ◽  
Definition Of ◽  
Brazilian Cohort

Despite the definition of specific diagnostic criteria to identify radiologically isolated syndrome (RIS) suggestive of multiple sclerosis, its natural history remains incompletely understood. We retrospectively analyzed a Brazilian cohort of 12 patients to clarify their features and to emphasize the role of imaging predictors in clinical conversion. We demonstrated that, although some individuals did not exhibit progression over a lengthy follow-up period (16.7%), most patients will progress clinically or radiologically in the initial years of the follow-up (83.3%). Infratentorial and spinal cord involvement, as well as the total number of lesions, were more relevant predictors of progression than gadolinium enhancement. Further studies remain necessary to define the risk of conversion in males and to clarify the cognitive abilities of RIS patients. This study may provide an improved understanding of the natural course and evolution of incidental magnetic resonance imaging lesions, and further assists with the management of RIS in clinical practice.

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