Balance Control and Energetics of Powered Exoskeleton-Assisted Sit-to-Stand Movement in Individuals With Paraplegic Spinal Cord Injury

Objective

To quantify the effects of initial hip angle and angular hip velocity settings of a lower-limb wearable robotic exoskeleton (WRE) on the balance control and mechanical energy requirements in patients with paraplegic spinal cord injuries (SCIs) during WRE-assisted sit-to-stand (STS).

Effectiveness of Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease With Different Degrees of Static Lung Hyperinflation

Objective

To evaluate the effect of pulmonary rehabilitation (PR) on exercise performance and quality of life in patients with chronic obstructive pulmonary disease (COPD) with different degrees of static lung hyperinflation (LH).

19530例泌尿生殖道感染患者支原体感染及药敏结果分析

目的：分析该地区泌尿生殖道支原体感染及耐药状况,为临床合理用药提供依据。方法采用支原体培养、鉴定、药敏试剂盒对19530例泌尿生殖道感染患者的送检标本进行检测,分析支原体感染及药敏情况。结果19530例送检样本中,支原体阳性11178例,阳性率为57.24%,其中解脲支原体(Uu)、人型支原体(Mh)、Uu+Mh 混合感染阳性率分别为44.63%、0.44%和12.17%;女性支原体阳性率高于男性,差异有统计学意义(P <0.05);2008~2014年支原体阳性率呈上升趋势;支原体对交沙霉素、强力霉素、米诺环素、克拉霉素敏感率分别为88.57%、84.32%、76.09%、71.53%,对喹诺酮类抗菌药物耐药率高;Uu、Mh 和 Uu+Mh 3类感染对12种抗菌药物的耐药种数递增。结论泌尿生殖道感染以 Uu 感染为主,Mh 感染多以混合感染方式出现;交沙霉素、强力霉素是该地区治疗支原体的首选药物,临床可参考药敏结果合理用药。支原体多重耐药情况严重,应引起临床重视。     

Mortality outcomes based on ED qSOFA score and HIV status in a developing low income country

Objective

To evaluate the utility of the quick Sepsis-related Organ Failure Assessment (qSOFA) score to predict risks for emergency department (ED) and hospital mortality among patients in a sub-Saharan Africa (SSA) setting.

The influence of esmolol on septic shock and sepsis: A meta-analysis of randomized controlled studies

Background

Esmolol may have some potential in treating septic shock and sepsis. However, the results remain controversial. We conduct a systematic review and meta-analysis to explore the efficacy of esmolol in patients with septic shock and sepsis.

Serum carbohydrate antigen 153 and renal function in patients with type 2 diabetes mellitus

Objective

The aim of our study was to investigate the correlation between serum carbohydrate antigen 153 (CA153) and renal function in patients with type 2 diabetes mellitus (T2DM).

Methods

A total of 184 patients with T2DM were included, and renal function was assessed by the modification of diet in renal disease (MDRD) formula adjusted coefficient of the Chinese people.

Results

Serum CA153 concentrations were positively correlated with blood glucose (BG) and glycated hemoglobin (HbA1c) (r = .204, P = .005; r = .165, P = .025) in patients with T2DM. There was a negative correlation between serum CA153 and estimated glomerular filtration rate (GFR) (r = −.229, P = .002) in whole patients with T2DM; similarly, the correlations were observed in both women and men (r = −.228, P = .028 for women, r = −.231, P = .028 for men). Multiple linear regression analysis suggested that serum CA153 was still significantly correlated with estimated GFR (beta = −0.286, P < .001).

Conclusions

Serum CA153 is negatively correlated with estimated GFR in patients with T2DM, and serum CA153 may be a potentially useful clinical biomarker to assess renal function in the study population.

     

Electronic Inventory Systems and Barcode Technology: Impact on Pharmacy Technical Accuracy and Error Liability

Purpose:

To measure the effects associated with sequential implementation of electronic medication storage and inventory systems and product verification devices on pharmacy technical accuracy and rates of potential medication dispensing errors in an academic medical center.

Methods:

During four 28-day periods of observation, pharmacists recorded all technical errors identified at the final visual check of pharmaceuticals prior to dispensing. Technical filling errors involving deviations from order-specific selection of product, dosage form, strength, or quantity were documented when dispensing medications using (a) a conventional unit dose (UD) drug distribution system, (b) an electronic storage and inventory system utilizing automated dispensing cabinets (ADCs) within the pharmacy, (c) ADCs combined with barcode (BC) verification, and (d) ADCs and BC verification utilized with changes in product labeling and individualized personnel training in systems application.

Results:

Using a conventional UD system, the overall incidence of technical error was 0.157% (24/15,271). Following implementation of ADCs, the comparative overall incidence of technical error was 0.135% (10/7,379; P = .841). Following implementation of BC scanning, the comparative overall incidence of technical error was 0.137% (27/19,708; P = .729). Subsequent changes in product labeling and intensified staff training in the use of BC systems was associated with a decrease in the rate of technical error to 0.050% (13/26,200; P = .002).

Conclusions:

Pharmacy ADCs and BC systems provide complementary effects that improve technical accuracy and reduce the incidence of potential medication dispensing errors if this technology is used with comprehensive personnel training.     

CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects

Aims

Ketamine analgesia is limited by low intrinsic efficacy compounded by large interindividual variability in drug responses, possibly due to the heterogeneity in drug concentration. The CYP2B6*6 allele is associated with substantially reduced ketamine metabolism in vitro and, therefore, may affect ketamine clearance. Our aims were to examine the impact of the CYP2B6*6 allele on ketamine plasma clearance and on adverse effects in chronic pain patients.

Methods

CYP2B6 genotypes were identified in 49 chronic pain patients who received 24 h continuous subcutaneous infusions of ketamine. Steady-state plasma concentrations of ketamine (C_ss,k) and norketamine (C_ss,nk) were determined using HPLC.

Results

The median plasma clearance of ketamine after 100 mg 24 h^–1 dose was significantly lower in patients with the CYP2B6*6/*6 (21.6 l h^–1) and CYP2B6*1/*6 (40.6 l h^–1) genotypes compared with patients with the CYP2B6*1/*1 genotype (68.1 l h^–1, P < 0.001). The ketamine : norketamine plasma metabolic ratio was significantly higher in patients with the CYP2B6*6/*6 genotype than in those with the CYP2B6*1/*6 and the CYP2B6*1/*1 genotypes (P < 0.001). Patients who experienced adverse effects had lower plasma clearance (45.6 l h^-1) than those who did not (52.6 l h^-1, P = 0.04). The CYP2B6*6 genotype and age, and their combined impact explained 40%, 30% and 60% of the variation in C_ss,k, respectively. Similar results were observed after higher doses.

Conclusions

The CYP2B6*6 allele is associated with a substantial decrease in steady-state ketamine plasma clearance in chronic pain patients. The decreased clearance and resultant higher plasma concentrations may be associated with a higher incidence of ketamine adverse effects.