18F-fluorodeoxyglucose (18FDG) uptake measured by positron emission tomography (PET) allows assessment of neutrophil activity in vivo and is increased in patients with airway inflammation or ...infection. Because infection but not rejection elicits a highly neutrophilic response, we assessed the ability of this non-invasive technique to differentiate these two events in lung transplant recipients. 18FDG-PET was measured in 15 patients classified by clinical, radiologic, and pathologic criteria. 18FDG-PET signal was increased with proven infection but not when no infection was identified (mean standard error of mean: 8.00 1.81 and 3.16 0.61, respectively P = 0.021. Rejection alone did not increase the signal. These data confirm that neutrophil activation is not a feature of acute rejection and indicate that a high 18FDG-PET signal is indicative of infection but not rejection in lung transplant recipients. This non-invasive and repeatable test could reduce the number of transbronchial biopsies required during episodes of breathlessness after lung transplantation.
The United States opioid crisis has been declared a public health emergency due to deaths related to drug overdose which have increased in almost all demographics (e.g. gender, race, and age groups). ...In order to track opioid prescribing, individual states - with assistance from the Centers for Disease Control and Prevention (CDC) (2017) - created prescription drug monitoring programs. The goal was to create an innovative guideline to improve safety for patients taking chronic opioids by: 1) Establishing a clinic protocol for the care team to conduct a pre-evaluation of the patient's risk of opioid use. 2) Providing tools for ongoing evaluation of patient's opioid use. 3)Increasing the team's awareness of the patient's morphine equivalent dose and naloxone prescribing. ...the Current Opioid Misuse Measure, a 17-item selfreported tool, helps the care team monitor suspected aberrant behavior over the course of the opioid treatment (National Institutes of Health, 2008).
The best business writing 2013 Starkman, Dean; Hamilton, Martha M; Chittum, Ryan ...
2013., 20130618, 2013, 2013-05-21
eBook
An anthology Malcolm Gladwell has called "riveting and indispensable," The Best Business Writing is a far-ranging survey of business's dynamic relationship with politics, culture, and life. This ...year's selections include John Markoff (New York Times) on innovations in robot technology and the decline of the factory worker; Evgeny Morozov (New Republic) on the questionable value of the popular TED conference series and the idea industry behind it; Paul Kiel (ProPublica) on the ripple effects of the ongoing foreclosure crisis; and the infamous op-ed by Greg Smith, published in the New York Times, announcing his break with Goldman Sachs over its trading practices and corrupt corporate ethos. Jessica Pressler (New York) delves into the personal and professional rivalry between Tory and Christopher Burch, former spouses now competing to dominate the fashion world. Peter Whoriskey (Washington Post) exposes the human cost of promoting pharmaceuticals off-label. Charles Duhigg and David Barboza (New York Times) investigate Apple's unethical labor practices in China. Max Abelson (Bloomberg) reports on Wall Street's amusing reaction to the diminishing annual bonus. Mina Kimes (Fortune) recounts the grisly story of a company's illegal testing—and misuse—of a medical device for profit, and Jeff Tietz (Rolling Stone) composes one of the most poignant and comprehensive portraits of the financial crisis's dissolution of the American middle class.
BACKGROUND Metformin has been proffered as a therapy for adolescent obesity, although long-term controlled studies have not been reported. OBJECTIVE To test the hypothesis that 48 weeks of daily ...metformin hydrochloride extended release (XR) therapy will reduce body mass index (BMI) in obese adolescents, as compared with placebo. DESIGN Multicenter, randomized, double-blind, placebo-controlled clinical trial. SETTING The 6 centers of the Glaser Pediatric Research Network from October 2003 to August 2007. PARTICIPANTS Obese (BMI≥95th percentile) adolescents (aged 13-18 years) were randomly assigned to the intervention (n = 39) or placebo groups. INTERVENTION Following a 1-month run-in period, subjects following a lifestyle intervention program were randomized 1:1 to 48 weeks' treatment with metformin hydrochloride XR, 2000 mg once daily, or an identical placebo. Subjects were monitored for an additional 48 weeks. MAIN OUTCOME MEASURE Change in BMI, adjusted for site, sex, race, ethnicity, and age and metformin vs placebo. RESULTS After 48 weeks, mean (SE) adjusted BMI increased 0.2 (0.5) in the placebo group and decreased 0.9 (0.5) in the metformin XR group (P = .03). This difference persisted for 12 to 24 weeks after cessation of treatment. No significant effects of metformin on body composition, abdominal fat, or insulin indices were observed. CONCLUSION Metformin XR caused a small but statistically significant decrease in BMI when added to a lifestyle intervention program. TRIAL REGISTRATION clinicaltrials.gov Identifiers: NCT00209482 and NCT00120146Arch Pediatr Adolesc Med. 2010;164(2):116-123-->
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