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31.
Nanotechnology has gained significant penetration to different fields of medicine including drug delivery, disease interrogation, targeting and bio-imaging. In recent years, efforts have been put forth to assess the use of this technology in biodetoxification. In this review, we will discuss the current status of nanostructured biomaterials/nanoparticle (NP)-based technologies as a candidate biodetoxifying agent. Patient hospitalization due to illicit drug consumption, suicidal attempts and accidental toxin exposure are major challenges in the medical field. Overdoses of drugs/toxic chemicals or exposure to bacterial toxins or poisons are conventionally treated by voiding the stomach, administering activated charcoal or by using specific antidotes, if the toxin is known. Because of the limitations of these methods for safe and effective detoxification, advancements in nanotechnology may offer novel ways in intoxication support by using nanostructured biomaterials, such as liposomes, micellar nanocarriers, liquid crystalline nanoassemblies and ligand-based NPs.  相似文献   
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Health care professionals need to approach their profession with a view to life long learning. They need to develop a strategy to meet their learning needs in a reflective and effective manner. Continuous medical educational (CME) is the traditional tool for learning and updating knowledge. Most of them are in the forms of courses, conferences, journal clubs and workshops. They are mostly didactic sessions and evidence suggests that they are not effective to improve the clinical skills and attitude. Systematic review of teaching evidence-based medicine shows that interactive and clinically integrated learning is the most effective form of learning. It enhances knowledge and skills. Professionals should view CME in a holistic manner in the context of continuous professional development (CPD) and even in the wider concept of knowledge translation, which encompasses both CME and CPD. e Learning is one of the most important forms of non-traditional CME. It provides an efficient and increasingly interactive delivery system that can handle complex and layered information. More work needs to be done to see its effectiveness for practising clinicians.  相似文献   
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Acute left main coronary artery occlusion is a catastrophic and mostly fatal event. Patients may present with sudden death or cardiogenic shock. Intra-aortic balloon pump support and emergency revascularization is indicated to preserve the left ventricular function. We describe a case of left main thrombus in a health 24-year-old young male with no risk factors for coronary atherosclerosis.  相似文献   
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OBJECTIVE: To describe our experience of post-transplant infections in allogeneic stem cell transplants at the Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan. METHODS: From July 2001 to September 2006, patients with malignant and non-malignant hematological disorders having human leukocyte antigen (HLA)-matched sibling donors were selected for transplant. Pre-transplant infection surveillance was carried out, and strict prophylaxis against infection was observed. After admission to the hospital, patients were kept in protective isolation rooms, equipped with a HEPA filter positive-pressure laminar airflow ventilation system. Bone marrow and/or peripheral blood stem cells were used as the stem cell source. Cyclosporin and prednisolone were used as prophylaxis against graft-versus-host disease (GVHD). The engraftment was monitored with cytogenetic/molecular analysis and change of blood group. Survival was calculated from the date of transplant to death or last follow-up. RESULTS: One hundred and fifty-four patients received allogeneic stem cell transplants from HLA-matched siblings for various hematological disorders at the Armed Forces Bone Marrow Transplant Centre, Rawalpindi, Pakistan between July 2001 and September 2006. Indications for transplant included aplastic anemia (n=66), beta-thalassemia major (n=40), chronic myeloid leukemia (n=33), acute leukemia (n=8), and miscellaneous disorders (n=7). One hundred and twenty patients were male and 34 were female. The median age of the patient cohort was 14 years (range 1 1/4-54 years). One hundred and thirty-six patients and 135 donors were cytomegalovirus (CMV) IgG-positive. One hundred and forty patients (90.9%) developed febrile episodes in different phases of post-transplant recovery. Infective organisms were isolated in 150 microbiological culture specimens out of 651 specimens from different sites of infections (23.0% culture positivity). Post-transplant infections were confirmed in 120 patients (77.9%) on the basis of clinical assessment and microbiological, virological, and histopathological examination. Mortality related to infections was 13.0%. Fatal infections included CMV disease (100% mortality, 6/6), disseminated aspergillosis (66.7% mortality, 4/6), pseudomonas septicemia (42.9% mortality, 9/21), and tuberculosis (25% mortality, 1/4). CONCLUSIONS: More than 90% of our patients developed febrile episodes with relatively low culture yield. The majority of infections were treated effectively, however CMV, aspergillosis, and pseudomonas infections remained problematic with high mortality.  相似文献   
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Zinc acetate is recrystallized as lumber-shaped tetragonal rods by a novel recrystallization technique. Subsequently, the recrystallized zinc acetate is converted into ZnO nanorods in a glass vial by the simplest and cheapest method without utilizing any expensive instrumentation. Carbon is doped in ZnO nanorods during the preparation ZnO nanorods without any extra steps, chemicals, or effort. The carbon-doped ZnO nanorods can be dispersed in a solvent at very high concentrations and are also stable for a very long time, which are comparatively higher than those of the other existing ZnO nanoparticles. The higher dispersion concentration and higher stability of ZnO nanoparticles are explained by a scheme that demonstrates the suspending mechanism of the ZnO nanoparticles at higher concentrations with higher stabilities in a solvent through the anchoring groups of carbon. No materials are used for surface modification; no surface coatings, ionic materials, or pH controlling materials are used to increase the dispersion concentration and stability. This is the first observation of the doped carbon playing a significant role in the dispersion of ZnO nanoparticles at higher concentrations by withholding them in the solvent. Therefore, doped carbon at the surface of ZnO nanoparticles prevents the self-aggregation of ZnO nanoparticles in the solution phase by interfacial barrier layers among ZnO nanorods and interfacial interactive layer between ZnO nanorod and solvent.

Dispersed ZnO hexagonal nanorods in ethanol solvent and its interfacial behavior in this liquid phase.  相似文献   
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Heart Failure Reviews - Amyloidosis is a multisystem disease which continues to present in later stages due to delayed diagnosis. Once the disease is identified, the coordination of ongoing care...  相似文献   
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The Medical Patients with Enoxaparin (MEDENOX) trial was a randomized, placebo-controlled study that defined the risk of venous thromboembolism (VTE) in acutely ill, immobilized, general medical patients and the efficacy of the low-molecular-weight heparin, enoxaparin, in preventing thrombosis. We performed a post-hoc analysis to evaluate the effect of 40 mg enoxaparin once daily on MEDENOX patient outcome in different types of acute medical illness (heart failure, respiratory failure, infection, rheumatic disorder and inflammatory bowel disease) and pre-defined risk factors (chronic heart and chronic respiratory failure, age, immobility, previous VTE and cancer). The primary outcome was the occurrence of documented VTE between days 1 and 14. The relative risk reduction [95% confidence intervals (CI)] for VTE comparing 40 mg enoxaparin with placebo in the subgroups were: acute heart failure, 0.29 (95% CI, 0.10-0.84); acute respiratory failure, 0.25 (95% CI, 0.10-0.65); acute infectious disease, 0.28 (95% CI, 0.09-0.81); and acute rheumatic disorder, 0.48 (95% CI, 0.11-2.16). The relative risk reduction for VTE in the pre-defined risk factor subgroups were: chronic heart failure, 0.26 (95% CI, 0.08-0.92); chronic respiratory failure, 0.26 (95% CI, 0.10-0.68); age, 0.22 (95% CI, 0.09-0.51); immobility, 0.53 (95% CI, 0.14-1.72); previous VTE, 0.49 (95% CI, 0.15-1.68); and cancer, 0.50 (95%o CI, 0.14-1.72). The beneficial effects of enoxaparin extend to a wide range of acutely ill medical patients.  相似文献   
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