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Dynamics of respiratory symptoms during infancy and associations with wheezing at school age Children with frequent respiratory symptoms in infancy have an increased risk for later wheezing, but the association with symptom dynamics is unknown. We developed an observer-independent method to characterise symptom dynamics and tested their association with subsequent respiratory morbidity. In this birth-cohort of healthy neonates, we prospectively assessed weekly respiratory symptoms during
ISGF3 with reduced phosphorylation is associated with constitutive expression of interferon-induced genes in aging cells During cellular aging, many changes in cellular functions occur. A hallmark of aged cells is secretion of inflammatory mediators, which collectively is referred to as the senescence-associated secretory phenotype (SASP). However, the mechanisms underlying such changes are unclear. Canonically, the expression of interferon (IFN)-stimulated genes (ISGs) is induced by IFNs (...) through the formation of the tripartite transcriptional factor ISGF3, which is composed of IRF9 and the phosphorylated forms of STAT1 and STAT2. However, in this study, the constitutive expression of ISGs in human-derived senescent fibroblasts and in fibroblasts from a patient with Werner syndrome, which leads to premature aging, was mediated mainly by the unphosphorylated forms of STATs in the absence of INF production. Under homeostatic conditions, STAT1, STAT2, and IRF9 were localized
Prevalence of potentially inappropriate prescribing in olderpeople in primary care and its association with hospital admission: longitudinal study. To determine whether hospital admission is associated with potentially inappropriate prescribing among older primary care patients (aged ≥65 years) and whether such prescribing was more likely after hospital admission than before.Longitudinal study of retrospectively extracted data from general practice records.44 general practices in Ireland (...) in 2012-15.Adults aged 65 years or over attending participating practices.Admission to hospital (any hospital admission versus none, and post-admission versus pre-admission).Prevalence of potentially inappropriate prescribing assessed using 45 criteria from the Screening Tool for Older Persons' Prescription (STOPP) version 2, analysed both as rate of distinct potentially inappropriate prescribing criteria met (stratified Cox regression) and binary presence of potentially inappropriate prescribing
The Johns Hopkins Department of Pathology Novel Organizational Model: A 25-Year-Old Ongoing Experiment In 1993, the present Department of Pathology at Johns Hopkins was established with the leadership of a new chair (ie, referred to as department director at Hopkins) and upon the integration of 3 separate and independent departments at the Johns Hopkins School of Medicine (Pathology) and the Johns Hopkins Hospital (Pathology, Laboratory Medicine). This new department was organized into 17
-dwelling older adults.A cluster randomized trial (D-PRESCRIBE [Developing Pharmacist-Led Research to Educate and Sensitize Community Residents to the Inappropriate Prescriptions Burden in the Elderly]) that recruited community pharmacies in Quebec, Canada, from February 2014 to September 2017, with follow-up until February 2018, and randomly allocated them to intervention or control groups. Patients included were adults aged 65 years and older who were prescribed 1 of 4 Beers Criteria medications (...) Effect of a Pharmacist-Led Educational Intervention on Inappropriate Medication Prescriptions in Older Adults: The D-PRESCRIBE Randomized Clinical Trial. High rates of inappropriate prescribing persist among older adults in many outpatient settings, increasing the risk of adverse drug events and drug-related hospitalizations.To compare the effectiveness of a consumer-targeted, pharmacist-led educational intervention vs usual care on discontinuation of inappropriate medication among community
Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15â€“64 over the 9-year period 2007â€“2015 in North Queensland, Australia Traumatic brain injury (TBI) is a leading cause of disability worldwide. Previous studies have shown that males have a higher incidence than females, and Indigenous populations have a higher rate than non-Indigenous. To date, no study has compared the incidence rate of TBI between Indigenous and non (...) -Indigenous Australians for any cause. Here we add to this rather sparse literature.Retrospective analysis of data from North Queensland Emergency Departments between 2007 and 2015 using Australian Bureau of Statistics population estimates for North Queensland residents aged 15-64 years as denominator data. Outcome measures include incidence rate ratios (IRR) for TBI presentations by Indigenous status, age, sex, year of presentation, remoteness, and socio-economic indicator.Overall incidence of TBI
CA1 Nampt knockdown recapitulates hippocampal cognitive phenotypes in old mice which nicotinamide mononucleotide improves Cognitive dysfunction is one of the most concerning outcomes in global population aging. However, the mechanisms by which cognitive functions are impaired during aging remain elusive. It has been established that NAD+ levels are reduced in multiple tissues and organs, including the brain. We found that NAD+ levels declined in the hippocampus of mice during the course (...) of aging, and whereas we observed minimal age-related effects on spatial learning/memory capabilities in old mice, we discovered that they developed cognitive hypersensitivity in response to aversive stimulation during contextual fear conditioning tests. This cognitive hypersensitivity appears to be associated with alterations in emotionality (fear/anxiety) and sensory processing (shock sensitivity), rather than reflect genuine conditioning/retention effects, during aging. Supplementation
Unintentional injuries among children aged 1â€“5Â years: understanding the burden, risk factors and severity in urban slums of southern India Globally, 5.82 million deaths occurred among children under the age of five years in 2015 and injury specific mortality rate was 73 per 100,000 population. In India, injury specific mortality rate is around 2.1 per 1000 live births contributing to 4% of the total under 5 mortality rate. This study aims to estimate the burden and understand factors (...) associated with unintentional injuries among children aged 1-5 years residing in urban slums of Vellore, southern India. We also attempted to assess the hazards posed by the living environment of these children and study their association with unintentional injury patterns.This cross-sectional study was conducted in eight urban slums of Vellore, southern India and primary caregivers of children aged 1-5 years were interviewed with a questionnaire to obtain the details of injuries sustained in the past
Risk of Serious Trauma with Glucose-Lowering Drugs in Older Persons: A Nested Case-Control Study To assess the risk of hospitalization for trauma associated with use of hypoglycemic glucose-lowering drugs (GLDs) in individuals aged 65 and older.Observational, nested, case-control study.The Echantillon Généraliste de Bénéficiaires claims database, a 1/97th representative sample of the population covered by French healthcare insurance.All persons with a first hospitalization for trauma between (...) 2009 and 2015 were considered as potential cases. They were selected if they had been followed for 365 days or longer at index date, were aged 65 and older, and had no diagnosed cancer. Cases (n=10,743) were matched with up to 10 randomly selected controls on age, sex, and length of follow-up (n=106,629).GLD exposure was considered globally and according to use of hypoglycemic GLDs alone, nonhypoglycemic GLDs alone, or both types of GLDs. Risk of hospitalization for trauma was estimated using
Effects of Gestational Age on Early Survivability in Neonates With Hypoplastic Left Heart Syndrome Prematurity increases pre- and postoperative mortality in children with congenital heart disease. There are no large, multicentered, studies that have evaluated this relation specifically in neonates with hypoplastic left heart syndrome (HLHS). We sought to determine the impact of gestational age (GA) on survival to Stage 1 palliation surgery and hospital discharge in infants with HLHS. We
A Simple Screening Tool to Predict Outcomes in Older Adults Undergoing Emergency General Surgery To determine whether the Flemish version of the Triage Risk Screening Tool (fTRST) can be used to accurately assess frailty in an emergency setting.Prospective observational study.of a tertiary referral hospital.All individuals aged 70 and older consecutively admitted to the emergency surgery unit with an urgent need for abdominal surgery between December 2015 and May 2016 who met inclusion criteria (...) (N=110).Individuals were screened with the fTRST and additional metrics such as the age-adjusted Charlson Comorbidity Index and American Society of Anesthesiology score. Thirty- and 90-day postoperative complications where recorded. Regression analyses were performed to identify possible preoperative predictors of adverse outcomes.Thirty-day major complications (Clavien-Dindo Classification 3-5) occurred in 28.2% of participants (n=31). fTRST had the highest correlation with major complications
Pittsburgh Fatigability Scale: One-Page Predictor of Mobility Decline in Mobility-Intact Older Adults To evaluate the Pittsburgh Fatigability Scale (PFS) as a predictor of performance and functional decline in mobility-intact older adults.Longitudinal analysis of Baltimore Longitudinal Study of Aging data.National Institute on Aging, Clinical Research Unit, Baltimore, Maryland.Mobility-intact men (46.8%) and women aged 60 to 89 with concurrent PFS administration and performance and functional (...) . Covariates included age, age2 , sex, race, visit status, baseline function, and follow-up time. We defined meaningful decline as 0.05 m/s per year for usual gait speed, 0.07 m/s per year for fast gait speed, 0.02 chair stands/s per year and 1 point or more for walking ability index.Over a mean 2.2 years, 20.5% to 37.7% of participants experienced meaningful decline across assessments. Independent of covariates, higher PFS physical and mental scores were most consistently associated with greater decline
Old) trial randomly assigned patients to a standard induction regimen with lomustine added or to a consolidation regimen with cytarabine and idarubicin.Adults age 60 years or older with previously untreated AML who were fit to receive intensive chemotherapy and who were without unfavorable cytogenetics received standard chemotherapy with lomustine (idarubicin, cytarabine, and lomustine [ICL]) or without (idarubicin and cytarabine [IC]). The primary objective of the study was overall survival (OS (...) Improved Survival by Adding Lomustine to Conventional Chemotherapy for Elderly Patients With AML Without Unfavorable Cytogenetics: Results of the LAM-SA 2007 FILO Trial Acute myeloid leukemia (AML) in elderly patients has a poor prognosis. In an attempt to improve outcome for these patients, the prospective open-label phase III LAM-SA 2007 (Adding Lomustine to Chemotherapy in Older Patients With Acute Myelogenous Leukemia (AML), and Allogeneic Transplantation for Patients From 60 to 65 Years
that , remains in effect 2 . As outlined in the guidance, obstetrician-gynecologists and other health care providers are encouraged to welcome conversations with women older than 26 years who are interested in receiving the HPV vaccine 2 . In patients aged 27 to 45 years, their decision to be vaccinated should be individually based using shared decision making and clinical judgment based on those patients’ circumstances, preferences, and concerns. The vaccine is safe and is effective in preventing new (...) infections with HPV in women aged 27-45 years 3 . This Practice Advisory was developed by the American College of Obstetricians and Gynecologists’ Immunization, Infectious Disease, and Public Health Preparedness Expert Work Group with Linda O’Neal Eckert, MD, and Kevin Ault, MD. References Food and Drug Administration. FDA approves expanded use of Gardasil 9 to include individuals 27 through 45 years old [press release]. Silver Spring (MD): FDA; 2018. Available at: . Retrieved October 18, 2018. Human
Assistants (AAPA), Association of Black Cardiologists (ABC), American College of Preventive Medicine (ACPM), American Diabetes Association (ADA), American Geriatrics Society (AGS), American Pharmacists Association (APhA), American Society for Preventive Cardiology (ASPC), National Lipid Association (NLA), and Preventive Cardiovascular Nurses Association (PCNA). Appendix 1 of the present document lists writing committee members’ relevant relationships with industry and other entities. For the purposes (...) recommendations are summarized in Online Data Supplement 1. COR LOE Recommendations I B-NR 1. In adults who are 20 years of age or older and not on lipid-lowering therapy, measurement of either a fasting or a nonfasting plasma lipid profile is effective in estimating ASCVD risk and documenting baseline LDL-C (S2.2-1– S2.2-6). I B-NR 2. In adults who are 20 years of age or older and in whom an initial nonfasting lipid profile reveals a triglycerides level of 400 mg/dL (=4.5 mmol/L) or higher, a repeat lipid
in patients with atrial ?brillation. Arch Intern Med. 1996;156:409-416. 6. Liu X, Huang H, Yu J, et al. Warfarin compared with aspirin for older Chinese patients with stable coronary heart diseases and atrial ?brillation complications. Int J Clin Pharmacol Ther. 2014;52:454-459. 7. Mant J, Hobbs F, Fletcher K, et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial ?brillation (the Birmingham Atrial Fibrillation Treatment of Aged Study, BAFTA): a randomized (...) Is the Risk of Bleeding Among Older Adults With Atrial Fibrillation Lower With Antiplatelet Compared With Oral Anticoagulants? TAKE-HOME MESSAGE Older adults have a lower risk of any severity of bleeding (includes both major and minor bleeding) when treated with aspirin or clopidogrel compared to warfarin. However, if minor bleeding is excluded, only the subgroup of patients aged 80 years or older demonstrate a lower risk the of major bleeding with antiplatelet agents. Is the Risk of Bleeding
Sarecycline (Seysara) - To treat inflammatory lesions of non-nodular moderate to severe acne vulgaris in patients 9 years of age and older Drug Approval Package: Seysara (sarecycline) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: Seysara (sarecycline) Company: Allergan, Inc. Application Number: 209521 Approval Date: 10/01/2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA (...) Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) (PDF) Date created: October 18, 2018 Vision impaired people having problems accessing certain pages of a PDF file may call (301) 796-3634 for assistance. Note: Documents in PDF format require the . Note: If you need help accessing information in different file formats, see . Language Assistance Available: | | | | | | | | | | | | | | | FDA Popular Content Product Areas
Acutely Limping Child Up To Age 5 Revised 2018 ACR Appropriateness Criteria ® 1 Acutely Limping Child Up To Age 5 American College of Radiology ACR Appropriateness Criteria ® Acutely Limping Child Up To Age 5 Variant 1: Child up to age 5. Acute limp. Nonlocalized symptoms. No concern for infection. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography tibia/fibula Usually Appropriate ? Radiography femur May Be Appropriate ?? Radiography foot May Be Appropriate (...) contrast Usually Not Appropriate O MRI whole-body without and with IV contrast Usually Not Appropriate O MRI whole-body without IV contrast Usually Not Appropriate O Tc-99m 3-phase bone scan whole-body Usually Not Appropriate ???? Variant 2: Child up to age 5. Acute limp. Pain. Localized symptoms. No concern for infection. Initial imaging. Procedure Appropriateness Category Relative Radiation Level Radiography lower extremity area of interest Usually Appropriate ?? MRI lower extremity area of interest