Aim
The purpose of the present study was to collate examples of end‐of‐life care guidelines from various counties, examine their contents, and gain an overall picture of how end‐of‐life care guidance ...is offered to physicians and care providers internationally.
Methods
In this study, eight researchers worked independently to source and examine national‐level end‐of‐life care guidelines from different countries and regions. Data collected by each researcher were gathered into a unified table. The items in the table included basic information (publisher, year, URL etc.) and more specific items, such as the presence/absence of legal information and family's role in decision‐making. These data were then used to identify trends, and examine the mechanics and delivery of guidance on this topic.
Results
A total of 54 guidelines were included in the study. All the guidelines were published between 2000 and 2016, and 60% (n = 33) were published after 2012. The length of the guidelines varied from two to 487 pages (median 38 pages), and had different target audiences – both lay and professional. A total of 38 (70%) of the guidelines included information about the relevant laws and legal issues, 47 (87%) offered advice on withholding and withdrawing treatment, 46 (85%) discussed the family's role in decision‐making and 46 (85%) emphasized the teamwork aspect of care.
Conclusions
The present findings show that end‐of‐life care guidelines are generally made reactively in response to the trend toward patient‐centered care, and that to create effective guidelines and implement them requires multilevel cooperation between governmental bodies, healthcare teams, and patients and their families. Geriatr Gerontol Int 2019; 19: 847–853.
•Low cost tubular digesters adapted to cold climate are monitored.•Thermal performance of cold climate tubular digester is monitored.•PET rings inside the reactor as biofilm carriers are ...evaluated.•The biogas production is increased in 44% when PET rings are added to reactor.•Passive solar design increased slurry temperature in +8.5°C above the mean ambient one.
The aim of this research is to evaluate the increase of biogas production with low cost tubular digesters in cold climates using PET rings inside the reactor. Two similar digesters have been operated and monitored in cold weather conditions and have been fed with cow manure. Digester 1 was filled with PET – rings as a biofilm carrier, Digester 2 was kept as a reference. Through the PET – rings the functional surface could be increased by a factor 4.2. The results show that 44% more biogas per KgSV has been produced with the biofilm carrier in use (0.33m3/kgSV) (reference digester −0.23m3/kgSV), at an organic load rate of 0.26kgSV/m3/d. The thermal performance shows that with an adaptation of the low cost tubular digester the slurry temperature can be raised up to 16.6°C (average) by surrounding temperature of 6.1°C (average) without using any active heating system.
Pain has become the most common accompanying symptom in patients seeking medical advice, and it is one of the main issues in public health. In Spain, there are no reliable data about the impact of ...pain in general population. The aim of the study was to estimate the prevalence of acute and chronic pain in the Spanish general population. An epidemiological observational population-based cross-sectional study was carried out by means of a telephone survey. Multistep stratified quota-adjusted sampling was performed with people aged 18–95 years. A computer-assisted questionnaire was administered, covering physical pain symptoms, site, frequency, perceived cause, therapeutic measures and interference with daily life activities. There were 11980 useful contacts, with 5000 effective interviews (42% of useful sample). Of the interviewees, 29.6% (95% confidence interval, 28.3–30.8%) reported having had pain the day before (women, 37.6%; men, 20.9%) and 43.2% the week before. Most common pain sites were lower extremities (22.7%) and back (cervical and lumbar levels) (21.5%), followed by head (20.5%). Frequency of pain increased with age, reaching 42.6% for people older than 65 years. Among people complaining of pain during the last day or week, duration of symptoms was higher than 3 months in 54% (chronic pain), representing 23.4% of the Spanish general population; most common causes of chronic pain were arthritis, rheumatism and migraine. Regarding treatment, 61.7% of people complaining of pain said they were taking drugs. Source of drug treatment advice was a physician or a nurse in 66.4% of cases and self-prescription in 29%. It is concluded that pain, particularly chronic pain, has a high prevalence in the Spanish general population and a significant impact on occupational and social relationships.
BACE1 activity, inhibition of Aβ aggregation, and disaggregation of preformed Aβ fibrils constitute the three major targets in the development of small-molecule lipophilic new drugs for the treatment ...of Alzheimer’s disease (AD). Quinones are widely distributed among natural products and possess relevant and varied biological activities including antitumor and antibiotic, inhibition of HIV-1 reverse transcriptase, antidiabetic, or COX-inhibition, among others. We report herein the interaction of several arylquinones and their derivatives with the amyloidogenic pathway of the amyloid precursor protein processing. Our studies put forward that these compounds are promising candidates in the development of new drugs which are effective simultaneously towards the three major targets of AD.
•Cu54Zr40Al6 alloy was characterized by mechanical spectroscopy at low temperature.•Flexural and ultrasonic methods showed peaks associated to rearrangement of clusters.•The peaks less stable were ...associated with annihilation of Zr or Cu clusters.•MHz range can be favors the formation of Cu an Al-centered icosahedral structures.•TEM images show an increase in the size and number of crystal in amorphous matrix.
A mechanical spectroscopy study of Cu54Zr40Al6 bulk metallic glasses composites was carried out in the kHz and MHz frequency ranges, by means of flexural and ultrasonic methods, respectively, in the temperature interval 150–300K. In internal friction and attenuation curves at low temperature were observed peaks which were associated with distortions in the configuration of atomic clusters, which absorbed different quantities of energy due to short and medium order rearrangements. Changes within the clusters or atomic jumps between clusters occurring in the specimen induced the onset of polyamorphic peaks, since electronic interactions and bonding changed abruptly.
Neutral-current production of K^{+} by atmospheric neutrinos is a background in searches for the proton decay p→K^{+}νover ¯. Reactions such as νp→νK^{+}Λ are indistinguishable from proton decays ...when the decay products of the Λ are below detection threshold. Events with K^{+} are identified in MINERvA by reconstructing the timing signature of a K^{+} decay at rest. A sample of 201 neutrino-induced neutral-current K^{+} events is used to measure differential cross sections with respect to the K^{+} kinetic energy, and the non-K^{+} hadronic visible energy. An excess of events at low hadronic visible energy is observed relative to the prediction of the neut event generator. Good agreement is observed with the cross section prediction of the genie generator. A search for photons from π^{0} decay, which would veto a neutral-current K^{+} event in a proton decay search, is performed, and a 2σ deficit of detached photons is observed relative to the genie prediction.
Neutrino-induced charged-current coherent kaon production ν_{μ}A→μ^{-}K^{+}A is a rare, inelastic electroweak process that brings a K^{+} on shell and leaves the target nucleus intact in its ground ...state. This process is significantly lower in rate than the neutrino-induced charged-current coherent pion production because of Cabibbo suppression and a kinematic suppression due to the larger kaon mass. We search for such events in the scintillator tracker of MINERvA by observing the final state K^{+}, μ^{-}, and no other detector activity, and by using the kinematics of the final state particles to reconstruct the small momentum transfer to the nucleus, which is a model-independent characteristic of coherent scattering. We find the first experimental evidence for the process at 3σ significance.
In vitro antiamyloidogenic properties of 1,4-naphthoquinones Bermejo-Bescós, Paloma; Martín-Aragón, Sagrario; Jiménez-Aliaga, Karim L. ...
Biochemical and biophysical research communications,
09/2010, Letnik:
400, Številka:
1
Journal Article
Recenzirano
► 1,4-NQ with OH groups at the quinoid or benzenoid rings were BACE inhibitors. ► 2- and 3-Aryl 1,4-NQ derivatives showed BACE inhibitory activity. ► Halogenated 1,4-NQ inhibited the amyloid ...aggregation. ► 1,4-Naphthoquinone, 6-OH-1,4-naphthoquinone and 2-(3,4-dichlorophenyl)-1,4-naphthoquinone were active on amyloid aggregation process. ► Juglone and 3-(
p-OH-phenyl)-5-methoxy-1,4-napththoquinone were active on all targets.
The aim of this study is to find out whether several 1,4-naphthoquinones (1,4-NQ) can interact with the amyloidogenic pathway of the amyloid precursor protein processing, particularly targeting at β-secretase (BACE), as well as at β-amyloid peptide (Aβ) aggregation and disaggregating preformed Aβ fibrils. Compounds bearing hydroxyl groups at the quinoid (
2) or benzenoid rings (
5,
6) as well as some 2- and 3-aryl derivatives (
11–
15) showed BACE inhibitory activity, without effect on amyloid aggregation or disaggregation. The halogenated compounds
8 and
10 were selective for the inhibition of amyloid aggregation. On the other hand, 1,4-naphthoquinone (
1), 6-hydroxy-1,4-naphthoquinone (
4) and 2-(3,4-dichlorophenyl)-1,4-naphthoquinone (
26) did not show any BACE inhibitory activity but were active on amyloid aggregation and disaggregation preformed Aβ fibrils. Juglone (5-hydroxy-1,4-naphthoquinone (
3), and 3-(
p-hydroxyphenyl)-5-methoxy-1,4-napththoquinone (
19) were active on all the three targets. Therefore, we suggest that 1,4-NQ derivatives, specially
3 and
19, should be explored as possible drug candidates or lead compounds for the development of drugs to prevent amyloid aggregation and neurotoxicity in Alzheimer’s disease.
Combinación de opioides Salvador, E.; Aliaga, L.
Revista de la Sociedad Española del Dolor,
06/2016, Letnik:
23, Številka:
3
Journal Article
Recenzirano
Odprti dostop
La premisa básica de una combinación analgésica es que los dos fármacos actúen a través de diferentes mecanismos de acción; de esta manera, la combinación puede resultar una reducción de los efectos ...adversos relacionados con la dosis. Sin embargo, la utilidad de la administración conjunta de fármacos del mismo grupo farmacológico es un argumento controvertido pero resulta eficaz en algunas enfermedades, como la depresión y la epilepsia. La rápida necesidad de intensificar las dosis de opioides es un reto para los médicos y representa una fase crítica para los pacientes que tienen un mal control del dolor a pesar de recibir progresivamente crecientes dosis de opioides. La administración de pequeñas dosis de un segundo opioide en pacientes con una respuesta desfavorable durante la escalada con el opioide previo se ha encontrado eficaz en un informe preliminar donde se añadieron: morfina oral, fentanilo transdérmico y la metadona oral a fentanilo transdérmico, la morfina oral y morfina bucal, respectivamente. Así, aunque en la práctica clínica múltiples opioides se administran a menudo de forma simultánea por diferentes razones, hay pocos estudios que hayan evaluado este tema específico.
Calciphylaxis is a frequent entity in patients with chronic renal failure of diverse etiology. The main pathogenic mechanism of calciphylaxis is impairment of either calcium and phosphate metabolism ...or plasma levels of parathyroid hormone. There are communications of patients with normal renal function, and in some cases with chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE) and antiphospholipid syndrome. We report a patient with SLE and no renal failure or hyperparathyroidism who developed severe calciphylaxis.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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