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Berlin Brandenburg

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  • 1
    In: British Medical Journal, Oct 13, 2001, Vol.323(7317), p.841
    Description: The most effective treatments for asthma are reviewed based on the scientific evidence. Topics include spacer devices vs. nebulizers, short courses of oral corticosteroids, ipratropium bromide, beta agonists, continuous vs. intermittent use of bronchodilators, oxygen supplementation, intravenous magnesium sulfate, mechanical ventilation, specialist vs. generalist care, and education.
    Keywords: Asthma -- Care And Treatment
    ISSN: 1759-2151
    ISSN: 09598146
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  • 2
    Language: English
    In: Chest, August 2013, Vol.144(2), pp.428-435
    Description: Patients with a history of asthma-related hospitalizations are at high risk of readmission and generally consume a large amount of health-care resources. It is not clear if the secondary care provided by specialists after an episode of asthma-related hospitalization is associated with better outcomes compared with the primary care provided by general practitioners. Using population-based administrative health data from the province of British Columbia, Canada, we created a propensity-score-matched cohort of individuals who received primary vs secondary care in the 60 days after discharge from asthma-related hospitalization. Total direct asthma-related medical costs (primary outcome) and health service use and measures of medication adherence (secondary outcomes) were compared for the next 12 months. Two thousand eighty-eight individuals were equally matched between the primary and secondary care groups. There was no difference in the direct asthma-related costs (difference $567; 95% CI, −$276 to $1,410) and rate of readmission (rate ratio [RR] = 1.06; 95% CI, 0.85-1.32) between the secondary and the primary care groups. Patients under secondary care had a higher rate of asthma-related outpatient service use (RR = 1.22; 95% CI, 1.11-1.35) but a lower rate of short-acting β-agonist dispensation (RR = 0.91; 95% CI, 0.85-0.98). The proportion of days covered with a controller medication was higher among the secondary care group (difference of 3.2%; 95% CI, 0.4%-6.0%). Compared with those who received only primary care, patients who received secondary care showed evidence of more appropriate treatment. Nevertheless, there were no differences in the costs or the risk of readmission. Adherence to asthma medication in both groups was poor, indicating the need for raising the quality of care provided by generalists and specialists alike.
    Keywords: Medicine
    ISSN: 0012-3692
    E-ISSN: 1931-3543
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  • 3
    Language: English
    In: JAMA, 27 January 2015, Vol.313(4), pp.409-10
    Description: The article discusses the advantages offered by decision curve analysis (DCA), a method of evaluating the benefits of a diagnostic test across a range of patient preferences for accepting risk of undertreatment and overtreatment to facilitate decisions about test selection and use. The use of DCA by Siddiqui and colleagues to evaluate3 prostate biopsy strategies is highlighted.
    Keywords: Image-Guided Biopsy -- Methods ; Magnetic Resonance Imaging -- Methods ; Prostatic Neoplasms -- Diagnosis ; Ultrasonography, Interventional -- Methods
    ISSN: 00987484
    E-ISSN: 1538-3598
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  • 4
    Language: English
    In: Environmental health perspectives, August 2011, Vol.119(8), pp.1062-9
    Description: The Deepwater Horizon (DH) blowout resulted in fisheries closings across the Gulf of Mexico. Federal agencies, in collaboration with impacted Gulf states, developed a protocol to determine when it is safe to reopen fisheries based on sensory and chemical analyses of seafood. All federal waters have been reopened, yet concerns have been raised regarding the robustness of the protocol to identify all potential harmful exposures and protect the most sensitive populations. We aimed to assess this protocol based on comparisons with previous oil spills, published testing results, and current knowledge regarding chemicals released during the DH oil spill. We performed a comprehensive review of relevant scientific journal articles and government documents concerning seafood contamination and oil spills and consulted with academic and government experts. Protocols to evaluate seafood safety before reopening fisheries have relied on risk assessment of health impacts from polycyclic aromatic hydrocarbon (PAH) exposures, but metal contamination may also be a concern. Assumptions used to determine levels of concern (LOCs) after oil spills have not been consistent across risk assessments performed after oil spills. Chemical testing results after the DH oil spill suggest PAH levels are at or below levels reported after previous oil spills, and well below LOCs, even when more conservative parameters are used to estimate risk. We recommend use of a range of plausible risk parameters to set bounds around LOCs, comparisons of post-spill measurements with baseline levels, and the development and implementation of long-term monitoring strategies for metals as well as PAHs and dispersant components. In addition, the methods, results, and uncertainties associated with estimating seafood safety after oil spills should be communicated in a transparent and timely manner, and stakeholders should be actively involved in developing a long-term monitoring strategy.
    Keywords: Food Safety ; Seafood ; Environmental Monitoring -- Methods ; Risk Assessment -- Methods
    ISSN: 00916765
    E-ISSN: 1552-9924
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  • 5
    Language: English
    In: Tetrahedron Letters, 2011, Vol.52(17), pp.2162-2164
    Description: The application of a Pummerer-initiated tandem reaction cascade leads to the highly stereoselective formation of the tetracyclic core of nakadomarin A.
    Keywords: Alkaloid ; Pummerer ; Tandem Reactions ; Nakadomarin ; Manzamine ; Chemistry
    ISSN: 0040-4039
    E-ISSN: 1873-3581
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  • 6
    Language: English
    In: The Journal of Allergy and Clinical Immunology, Feb, 2010, Vol.125(2), p.307(5)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jaci.2009.12.978 Byline: J. Mark FitzGerald, Neal Shahidi Abbreviations: ICS, Inhaled corticosteroid; LABA, Long-acting [beta]-adrenergic agonist; LTRA, Leukotriene receptor antagonist; RR, Relative risk Abstract: Patients with moderate asthma are symptomatic on an ongoing basis. They are usually treated initially with low-dose inhaled corticosteroids (ICSs) supplemented with a short-acting bronchodilator as a rescue medication. Most steroid-naive patients will achieve good control with this strategy. For patients in whom adherence, inhaler technique, environmental control, and comorbidities have been addressed but who still have uncontrolled symptoms, the addition of a long-acting [beta]-adrenergic agonist should be considered. Some patients might require a higher dose of ICS. Leukotriene receptor antagonists might be considered as alternate initial therapy or as an add-on to maintenance therapy with an ICS. All patients should receive a structured education program emphasizing the need for ongoing maintenance treatment, even when control is achieved. Patients should also be provided with a written action plan that clearly explains which additional anti-inflammatory therapy should be taken if asthma symptoms worsen. The most effective strategy in this situation has been shown to be the quadrupling of the maintenance dose of ICS. Author Affiliation: University of British Columbia Respiratory Division and the Centre for Lung Health (www.centreforlunghealth.ca), University of British Columbia, Vancouver, British Columbia, Canada Article History: Received 8 September 2009; Revised 7 December 2009; Accepted 8 December 2009 Article Note: (footnote) J.M.F. is a Michael Smith Foundation for Health Research Distinguished Scholar and a Canadian Institute for Health Research and BC Lung Scientist and is funded in part by the National Sanitarium Association., Disclosure of potential conflict of interest: J. M. FitzGerald is on advisory boards for GlaxoSmithKline, Astra Zeneca, Novartis, Pfizer, Boehringer-Ingelheim, Nycomed, Merck-Dome Sharpe, and Topigen; is on the speakers' bureau for GlaxoSmithKline, Astra Zeneca, Boehringer-Ingelheim, Pfizer, and Merck-Dome Sharpe; has received research support (paid directly to the University of British Columbia) from the Canadian Institute of Health Research, the Michael Smith Foundation for Health Research, the Centre for Disease Control Atlanta, AllerGen NCE, the BC Lung Association, the National Sanitarium Association, Astra Zeneca, GlaxoSmithKline, Boehringer-Ingelheim, Merck-Dome Sharp, Wyeth, Schering-Plough, Genentech, and Topigen; and is a member of the Global Initiative for Asthma (GINA) Executive and chair of the GINA Science Committee and a Member of Canadian Thoracic Society Asthma Committee. N. Shahidi had declared that he has no conflict of interest.
    Keywords: Asthma -- Care And Treatment ; Glucocorticoids
    ISSN: 0091-6749
    Source: Cengage Learning, Inc.
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  • 7
    In: Medical Journal of Australia, October 2010, Vol.193(8), pp.436-437
    Description: The various causes, consequences and treatment of the cerebro vascular disease in Australia are analyzed. The various guidelines that can be followed to address the complexities of the disorder are also discussed.
    Keywords: Emergency Medicine ; Nervous System Diseases
    ISSN: 0025-729X
    E-ISSN: 1326-5377
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  • 8
    In: Journal of the American Geriatrics Society, November 2015, Vol.63(11), pp.2438-2440
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13786/abstract Byline: Gary Blanchard, Erika Oleson, Mark Fitzgerald, Jerry H. Gurwitz ***** No abstract is available for this article. *****
    Keywords: Medical Students;
    ISSN: 0002-8614
    E-ISSN: 1532-5415
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  • 9
    Language: English
    In: The Journal of Allergy and Clinical Immunology, July 2013, Vol.132(1), pp.63-69
    Description: Recent evidence suggests that the use of leukotriene receptor antagonists (LTRAs) in addition to inhaled corticosteroids (ICSs) in asthmatic patients provides comparable benefits to the addition of long-acting β-agonists (LABAs) to ICSs. We sought to compare, in a unified framework, adherence, outcomes, and costs associated with ICS+LTRA versus ICS+LABA as step-up therapies for asthma. Using the administrative databases of British Columbia, Canada (years 1997-2007), we created a propensity score-matched sample of asthmatic patients (12-45 years old) receiving ICS+LTRA therapy versus ICS+LABA therapy after a period of monotherapy with an ICS. We compared the outcomes using 2 analyses: an intention-to-treat (ITT) analysis that followed subjects for a fixed period of 2 years and an uninterrupted treatment analysis that followed subjects for as long as they continuously dispensed their index medications. The matched cohort consisted of 1032 subjects in each group (mean age at entry, 27.4 years; 52.5% female). Adherence, which was defined as the proportion of days covered, was higher in the ICS+LABA group compared with the ICS+LTRA group. In both the ITT and uninterrupted treatment analyses, use of ICS+LTRA therapy was associated with more asthma-related outpatient visits, asthma-related medication dispensations, and dispensation of reliever medications. Dispensation of oral corticosteroids and rate of asthma exacerbations were higher in the ICS+LTRA group in the uninterrupted treatment analysis but not in the ITT analysis. In a real-world clinical setting subjects were more adherent to ICS+LABA therapy than ICS+LTRA therapy. ICS+LABA therapy seems to be more effective than ICS+LTRA therapy in the management of asthma, regardless of adherence.
    Keywords: Asthma ; Leukotriene Receptor Antagonists ; Long-Acting Β-Agonists ; Inhaled Corticosteroids ; Outcome Research ; Costs ; Administrative Data ; Canada ; Medicine
    ISSN: 0091-6749
    E-ISSN: 1097-6825
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  • 10
    In: Journal of Forensic Sciences, September 2011, Vol.56(5), pp.1143-1149
    Description: The organic peroxide explosive triacetone triperoxide (TATP) is regularly encountered by law enforcement agents in various stages of its production. This study utilizes solid‐phase microextraction (SPME) and gas chromatography/mass spectrometry (GC/MS) to examine sulfuric acid‐, hydrochloric acid‐, and nitric acid‐catalyzed TATP syntheses during the initial 24 h of these reactions at low temperatures (5–9°C). Additionally, aging of the reaction mixtures was examined at both low and ambient temperatures (19–21°C) for a further 9 days. For each experiment, TATP could be readily identified in the headspace above the reaction mixture 1 h subsequent to the combination of reagents; at 24 h, TATP and diacetone diperoxide (DADP) were prominent. TATP degraded more rapidly than DADP. Additionally, chlorinated acetones chloroacetone and 1,1,‐dichloroacetone were identified in the headspace above the hydrochloric acid‐catalyzed TATP reaction mixture. These were not present when the catalyst was sulfuric acid or nitric acid.
    Keywords: Forensic Science ; Analytical Chemistry ; Triacetone Triperoxide ; Diacetone Diperoxide ; Gas Chromatography Mass Spectrometry ; Improvised Explosive
    ISSN: 0022-1198
    E-ISSN: 1556-4029
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