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Questions related to Treatment
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Symptomatology, treatment , prognosis
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Hi,It available at Google
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I have a patient of cogan sd who lost her audition in first pregnancy,would like to get pregnant again,do you advice any treatment or precaution during the second pregnancy.?
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The patient needs to be checked for the Neuroinvasive viral induces controlling neuronal infection that has caused her previous pregnancy to miscarriage.
We have the whole protocol set up here at the:
NIDS Treatment & Research Center: Lahore, Pakistan.
Prof. Dr. Shahid H. Sheikh 
92-300-481-6677  
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A friend of mine sufferss from lung cancer. Do you know good herbal treatment?
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Btw i just found a research paper suggesting that resveratrol may be effective for cancer treatment. What do you think? Thanks
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Is there any Ayurvedic Evidence Based Preventive treatment for encephalitis?
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Should such lapses be viewed seriously
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I believe that this is important for people's trust in the system as well as quality of care. Accountability should be part of health professionals training. Different jurisdictions have different mechanisms to address these issues. In many jurisdictions there are already systems in place to monitor and address serious/untoward incidents. Low and middle income countries probably lag behind in developing system of accountability.
I have no doubt that practitioners and institutions should be responsible for any serious lapses in treatment.
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I performed a study aiming to define if the predictive criteria of diabetic patient will be controlled by treatment with DPP-4 inhibitors using patient parameters (sex,age,postprandial GLP-1 level, c-peptide, fpg,2hppg,lipid profile, BMI, duration of DM and other treatment ,diseases or complication), using DPP-4 inhibitors as add on therapy 
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Plum can be treated with 10ppm ethylene for 24 hours at 20-25C.  One treatment will be sufficient.
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Which chemotherapy drug(S) do U propose as co-therapeutics with Dox
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For solid cancer therapy,the nanoparticles conbined with anti cancer- therapy is the future for treatment of solid cancer and for recurrence of disease and for metastasis
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Would you treat a patient with a CT verified uncomplicated (CRP 150, WBC 15) diverticulitis with antibiotics?
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Hi Maziar
The approach to the treatment of diverticulitis can be broadly classified into either uncomplicated disease or complicated disease, with a few other special considerations to take into account. Acute uncomplicated diverticulitis is successfully treated in 70-100% of patients with conservative management.
Acute diverticulitis tends to be more severe in very elderly people and in patients who are immunocompromised or who have debilitating comorbid conditions, such as diabetes and renal failure.
Patients with mild diverticulitis, typically with Hinchey stage I disease, can be started on an outpatient treatment regimen. This consists of a clear liquid diet and 7-10 days of oral broad-spectrum antimicrobial therapy, which covers anaerobic microorganisms, such as Bacteroides fragilis and Peptostreptococcus and Clostridium organisms , as well as aerobic microorganisms, such as Escherichia coli and Klebsiella, Proteus, Streptococcus, and Enterobacter organisms. Single and multiple antibiotic regimens are equally effective as long as both groups of organisms are covered. According to the World Gastroenterology Organisation (WGO) 2007 practice guidelines for diverticular disease, such a regimen should result in improvement within 48-72 hours.For more please read at the following links.
Best Regards
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Does any one have ANN application paper on biological treatment methods on water and waste-water treatments?
Please send the copy if any. 
Thanks in advance
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Dear Gadekar,
I have one paper with ANN application for WWTP control, you can find it attached.
Regards,
Juan
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I have done some research and found a few researches who proved that cognitive behavioral therapy has worked. I would like to know if the researchers: Allen, Woolfolk et. al. and Smith were good researcher for this study.I want to know if there were any other related sources about the use of cognitive therapy treatment and intervention for somatic complaints from patients.
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This does not answer your question, but a similar one: any effective treatment for somatization disorder needs to dissolve the stresses caused by trauma and other overloads of experience and stored in the nervous system.
I am a meditation teacher, not a therapist, but in my experience somatic symptoms begin to dissolve as soon as transcending begins to be practiced. Transcending is an effortless mental process that produces a state of deep rest in which mental alertness is not lost.
Our experience and published research show that transcending gradually eliminates all stored stresses, leaving the nervous system strong and resistant to acquiring new stresses.
Several psychiatrists and psychologists regularly refer some patients to instruction in transcending, which takes several hours spread over several days.
There are two main sources of instruction in transcending, Transcendental Meditation (TM) and Natural Stress Relief (NSR).
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It relates to treatment of disease.
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The smaller dose (D) which is given after the loading dose (D*) is called “maintenance dose”
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Mild Bph is sometimes treated by watchful waiting so, could one introduce dutastaride if the prostate volume is above 50mls?
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In case of mild BPH, urinary symptoms absent, no treatment need. If  symptoms present it may be use. Dutasteride,is a dual 5-α reductase inhibitor that inhibits conversion of testosterone to dihydro testosterone (DHT). It increases the risk of erectile dysfunction  and decreased sexual desire.
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Still without strong evidence
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While waiting for the results of ongoing trials, neoadjuvant treatment cannot be discussed as a clinical option for resectable pancreas adenocarcinomas. There is a serious risk of having initially operable patients becoming metastatic or locally non-resectable during the chemotherapy period. In older patients this can be up to 30% (Cooper AB. J Am Coll Surg. 2014)
For borderline pancreatic cancer we know that the results of adjuvant chemotherapy are encouraging as a surgical resection can be achieved in 54-90% with good rates of R0 resection (Chandhok NS. JOP. 2014).
The answer becomes more difficult since published phase II trials sometimes mix patients with borderline and patients with initially resectable pancreatic cancer. And then there is the question concerning the choice of chemotherapy. I believe that for borderline pancreatic cancers, most teams use oxaliplatine based chemotherapy (Folfirinox) which has a rather high patient toxicity. Gemcitabine seems to be effective too and better tolerated. Any oncologists out there care to give their insight?
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Any help please
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Dear Ba,
The nitric acid/sulfuric acid mixture is an oxidizing mixture. So, nitrate in acidic media goes to lower oxidized states, and oxygen atoms are attached to carbon. This is the reason why you obatain from carboxylic to alcohol groups in the CNT after oxidation (nitro groups too).
After the oxidation took place, the new groups at the surface interact with water molecules and the CNTs are more dispersable in water. Water does not oxidize anything.
SALUT!
Tony
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I Need research around MS so i need help
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Could anyone explain to me why researchers use drugs which have non overlapping side effects in any treatment.... let us say cancer. Thanks in advance.
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Hi Sandeep
Combinations of chemotherapy drugs, called regimens, may produce more anticancer responses and improve the outcomes of patients with advanced renal cell cancer than treatment with any single therapy. Combination therapy can take advantage of potential drug synergies and non overlapping side effects to improve clinical benefit. Clinical trials are ongoing evaluating combinations of Avastin, newer targeted therapies, and immunotherapy in order to determine whether combinations can improve the outcome of patients compared with the use of any single drug.For more please read at the following links.
Best regards
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hydrothermal pretreatment of biomass
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hemofiltration has been used for treatment of ethylene glycol poisoning and should be considered as an alternative modality. Formic acid and lactic acid are responsible for the severe metabolic acidosis and presumably also for most of the toxicity. The same mechanism explains the prolongation of the half-life of methanol to more than 30 hours (compared with the glycol intoxication), most likely the result of both an increased NADH/NAD ratio and a reduction in tissue perfusion.
Ref: Principles and Practice of Dialysis
By William L. Henrich
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Mild treatment for the lysis of the cells for protein extraction.
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to rempove glass beads centrifuge at 10000 rpm for 5 min.
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It is related to treatment.
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Thanks & Good Dr. Joanne E.L. VanDerNagel. Of course, the multiple dose regimen
is the pharmacokinetic aspects of treatment schedules which involve more than one dose of a drug.
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It relates to treatment.
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Loading dose is a larger dose (D*) as compared to the normal dose administered as the first in a series of doses, the others of which are smaller than D* but equal to each other. The “loading dose” is administered in order to achieve a therapeutic amount in the body more rapidly than would occur only by accumulation of the repeated smaller doses.
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 I will also treat them with methyl mercury, LPS and Polyunsaturated fatty acids.
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......... ??????????
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Hello Nihal, If you go to the Cochrane library there are lots of systematic reviews that show better outcomes with multiple drugs.  Look at some of the asthma reviews and you'll see corticosteroids, combined with preventers and symptom controllers also. Thanks Debbie
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Dear colleagues! In Russia we can see an effective treatments at a lower cost. So, why the level of development of medical tourism in Russia is low?
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In this aspect Moldova is also a reasonable option.
I can guarantee a pretty high level of neurosurgery in Moldova
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Does any one explain the mechanism of Glucophage in the treatment of T2DM ? 
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Dear Dr. Abdul Khaleque thank you very much.I would like to ask about pacifically how does Metformin decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization? How does Metformin do it if you know?
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Removing a broken guidewire in the hip joint: treatment
options and recommendations for preventing an avoidable
surgical catastrophe
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I read some papers suggesting that Cognitive Behavioral Therapy is effective for treatment of Internet Addiction Disorder. Does anybody here have experience with CBT for Internet Addiction? What do you think? Thanks
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Hi Victor,
A lot has been written on this topic.  See Mark Griffiths and Halley Pontes who are both on Research Gate, as well as Kimberly Young http://netaddiction.com/kimberly-young/.  Having worked with many youth and families with Internet addiction or excessive video gaming, I would say the answer is not simple. The research shows that the approach is effective, however, in my clinical opinion one approach in and of itself does not necessarily treat the problem. Those who are seeking services in treatment centres often have complex presentations (mood disorders, social anxiety, ASD, ADHD, and more).  There are often strained relationships with parents/family and social isolation.  It is optimal when centres have integrated mental health + addiction services, along with family psychoeducation/support and family counselling.  Mindfulness is another approach that has shown promising results.
I am pasting a couple of sources.
King, D. L., Delfabbro, P. H., Griffiths, M. D., & Gradisar, M. (2012). Cognitive‐behavioral approaches to outpatient treatment of Internet addiction in children and adolescents. Journal of clinical psychology, 68(11), 1185-1195.
Pontes et al.  (2015).  The Clinical Psychology of Internet Addiction: A Review of its Conceptualization, Prevalence, Neuronal Processes, and Implications for Treatment.  Neuroscience and Neuroeconomics.
Toula
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How far has stem cell research come?
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Hi Charlotte-The attached publication surveys progress with stem cells in neurological, immunological, and autoimmune diseases.
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I know this is a huge topic, but how far do we think they will go in the field of regenerative medicine? What are the hurdles that we are facing before we get to that stage? what IS the likelihood of stem cells compared to what the media portrays?
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I have carbon fiber which was treated with HNO3, I want to check the effect of that treatment. Actually researchers observe sample with FT-IR (Fourier Transform InfraRed) for bulk or powder material, and they will get some good pick which show these kinds of chemical group. Because Carbon Fiber is very small fiber (like hair), do you have idea to characterization that sample?
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I agree fully with Dr. Celzard. The best method for your samples is almost certainly ATR-IR (attenuated total reflectance). Be sure to run a good background spectrum (before treatment) because carbon usually absorbs across most frequencies. A germanium ATR crystal is usually recommended for carbon-based samples, but you might see something with diamond, if that's what you have access to. Good luck!
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"Don't ice that ankle sprain" Does anybody have experience with this method ankle treatment? (Please show film).
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Similar but not the band and not a wrap over a shoe.  Generally just compressing the talofibular lig, flexor retinaculum, medial arch and peroneal insertion at the prox 5th MTP. in conjunction with a walking cast. 
Is it perhaps a little too aggressive to address a recent sprain with a rubber band and ROM exercises especially inversion given the nature of the injury?   It doesn't seem like a magic bullet to me. 
Gradual weight bearing given an appropriate healing time is logical.  I remember a presentation  in Dallas which had some relevance regarding treating an MCL strain with progressive weights to accelerate healing.  Similar approach but that too puts a patient at risk to further injury. 
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please share your practical experiences.
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My late grandmother in law use to suffer from this condition terribly. I know she used a herbal treatment but I can't recall the name as she passed away many years ago, but what she used she said was effective but that is only one person's experience, I have no idea of the evidence and as I said I can't recall what she said she took, just that she said it worked and it was herbal or a natural remedy.
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A patient 45 years of age presented with a broken down MOD Amalgam restoration in tooth # 16 with poor proximal contacts.
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Low self esteem is core in most psychopathology but there are rare guidelines, manuals, and protocols to help therapists to cover this condition.
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Hi Miriam
LSE isn't disorder based on any classification, but It is transdiagnostic phenomena that can be share in many disordres such as dysthymia. In CBT approach, there are protocols that focus this part of psychopathology particularly.
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Vanadium carbonyl is obtained along with the carbide as the impurities, which is neither removed by acid treatment nor by heating. Can you suggest any treatment to remove it from the product?
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Hello,
The original prep in JACS, year 1960, v82, p2966 used an extraction. You might be able to use that same approach.
Dr. Grice
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Does the bactofugation improve the shelf life of the Ultra High Treatment milk product?
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Hi,
I think that this bactofugation process was initially meant to improve the shelf-life of pasteurised milk, i.e. milk that is treated at relatively low temperatures (60-70 °C) to kill pathogenic bacteria, with little effect on thermophilic bacteria and no effect at all on spores.
In the case of UHT (Ultra High Temperature) treatment, milk is actually sterilized applying much higher temperatures (130-150 °C) in a way that both bacteria and spores are inactivated, not only the pathogenic ones. In this case, the shelf-life, is already much longer than pasteurized milk (months instead of days). Usually spoilage in UHT milk is due to heat resistant proteases or to the destabilisation of milk constituents, rather than to vegetative forms of bacteria.
For such reasons, I think that pre-processing milk with bactofugation before the UHT treatment could only give a slight (if any) improvement of its shelf-life.
However, no need to say, the raw material is always important. I don't know what could be the interest for a hardly contaminated raw milk. But there again, I tend to think that a milk that is heavily contaminated with bacteria may have other problems that could not be solved with bactofugation, such as possible polluting toxins and modification of pH, proteolysis, lipolysis etc...
This is my opinion, at least, I'd be curious to read others' view on this subject.
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I read something about using animals in treatments. How it works?
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There is an interesting book named "Handbook on Animal-Assisted Therapy"  by Aubrey H. Fine, which describes the theoretical Foundations of this treatment. I think this one can be helpful and you can read some abstract online.
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The situation: Consider an experimental design with 10 patients. For each patient, imagine you have ~ 100 cells of interest in the left hand and ~ 100 cells of interest in the right hand. Then, you submit the left hand to treatment A and the right hand to treatment B. Finally, you count the number of cells who survive for each patient and each treatment (i.e. in each hand).
To analyze such data, we can imagine these 2 models :
Model 1: First, we compute the percentage of cells who survive for each patient and each treatment. The outcome of the model is a percentage (i.e a continuous variable). You can therefore compute a linear mixed effect model with a random patient effect and a fixed treatment effect. With this first solution, your dataset include 20 lines.
Model 2: You keep one line for each cell. The outcome will be binary (0=cell death, 1=cell survive). You can build a logistic linear model with a random patient effect and a fixed treatment effect. With this second solution, your dataset includes ~2000 lines (because you have ~100 cells for each patient and each treatment).
The question: the p-value is highly impacted by the sample size. Consequently, you will often obtain a highly significant p-value with solution 2 even when the p-value is not significant with solution 1 because of a small effect size. When should I consider solution 1 or solution 2 to analyze such data? In other word, what is the statistical unit: the patient (n=20) or the cell (n~2000)
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There are other options. When modeling proportions (or percentages), it is often useful to use a logistic regression. With a linear regression predicted values may be outside of the range [0,1]. Still, your second model may be better if you have variables at the cell level, and if within the patient you can treat these as iid Bernoulli. Your treatment variable is still only varied by patient, so it is still that sample size that effects the precision of the treatment effect estimate.
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Hi. 
I am looking for latest progress of E-Beam Flue Gas Treatment ? Technology provider? results,... 
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Dear Ms.Kohzadi,
We have recently tested process at pilot plant built in Aramco refinery in Jeddah. It works well. Greetings from Warsaw, I visited Teheran several times. We implemented some thechnologies through IAEA in your country.
Best regards.
Andrzej G. Chmielewski
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tb 
treatment compliance
poverty 
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Dear Bethanie,
this is a very interesting topic! I've worked with homeless people for 18 years, "the poorest of the poor", and in West Germany homeless people belong to a social group with a high rate of TB-Patients. So from my perspective as social worker, it's an important and practice-focused question.
Have a try with following reports and articles:
Keshavjee, S., I. Gelmanova, A. Pasechnikov, S. Mushustin, Y. Andreev, J. Furin, J.S. Mukherjee, M. Rich, E. Nardell, P.E. Farmer, J.Y. Kim, S.S. Shin (2008): Treating Multi-Drug Resistant Tuberculosis in Tomsk, Russia. Developing Programs that Address the Linkage Between Poverty and Disease. In: Annals of the New York Academy of Sciences 1136:1-11.
Keshavjee, S., I.Y. Gelmanova, J.Y. Kim, S.P. Mishustin, A.K. Strelis, Y.G. Andreev, J.S. Mukherjee, A.D. Psechnikov, S. Atwood, M.L. Rich, J.J. Furin, E.A. Nardell, P.E. Farmer, S.S. Shin (2008): Extensively Drug-Resistant Tuberculosis: Lessons from MDR-TB Treatment Scale-Up in Tomsk, Russia. In: Lancet 372(9639):1403-9.
Shin, S.S., A.D. Pasechnikov, I.Y. Gelmanova, G.G. Peremitin, A.K. Strelis, Y.G. Andreev, V.T. Golubchikova, T.P. Tonkel, G.V. Yanova, M. Nikiforov, A. Yedilbayev, J.S. Mukherjee, J.J. Fuin, D.J. Barry, P.E. Farmer, M.L. Rich, S. Keshavjee (2006): Treatment Outcomes in an Integrated Civilian and Prison Multi Drug-Resistant Tuberculosis Treatment Program in Russia. In: International Journal of Tuberculosis Lung Disease 10(4):402-8.
Keshavjee S, Seung K, Satti H, Furin J, Farmer P, Kim JY, Becerra M. (2008): Building capacity for multidrug-resistant tuberculosis treatment. Health systems strengthening in Lesotho. In: Innovations. 2008; 2(4):87-106.
Jakubowiak, W. M., Bogorodskaya, E. M., Borisov, S. E., Danilova, I. D., and
Kourbatova, E. V. (2007a): Risk factors associated with default among new pulmonary
TB patients and social support in six Russian regions. (2007a); In: Int. J. Tuberc. Lung Dis., 11: 46-53.
Jakubowiak, W. M., Bogorodskaya, E. M., Borisov, S. E., Danilova, I. D., and
Kourbatova, E. V. (2007b): Treatment default among new smear-positive pulmonary
TB patients in Russian regions. (2007b); Int. J. Tuberc. Lung Dis., 11: 353-354.
Woith, W. M. and Larson, J. L. (2008): Delay in seeking treatment and adherence to tuberculosis medications in Russia: a survey of patients from two clinics. In: Int. J. Nurs. Stud., 45: 1163-1174.
Good luck and kind regards
Detlef
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See above
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Hi,
It is likely that MW irradiation will simply heat biofuel. I don't see another possible non-thermal effect that could change the properties of biofuel.
If you know the specific absorption rate (SAR) of the biofuel and the MW irradiance level, you can certainly have an idea of the temperature change.  
You can compare a sample of biofuel heated by MW irradiation and a similar sample heated in a conventional climatic chamber. They should behave identically ! If not, there is something to investigate...
Christophe
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There are several papers on miRNA prediction.
Why don't we predict an miRNA against pathogen causing diseases?
How could it help to improve therapies of those diseases?
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Can we imagine one therapy for all diseases. I guess not
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I want to do a study on the difference between triage with nurses only and triage with doctors and nurses.
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Dear colleague:
         I have designed a Psychiatric Triage Instrument and tested its validity and reliability at a Mexican Psychiatric Emergency Department.
           Testing validity or reliability of an emergency tool is not easy as it is necessary to assess on actual emergency presentations. So, our point of view is that the best place to test a triage scale is a real emergency department, and the subjects of the study should be real users of patients of this service.
          We found that the best form of tes reliability of a triage instrument  or scale in an emergency service is first implementing and standardizing it as an usual procedure al Emergency Department. After this standardization, you can assess simultaneous triage assessment with the professional staff you want. After that you have to correlate each other outcomes in order to have certain correlations or coefficients of validity and reliability.
            As an example, a doctor can assess the "usual" triage, and simultaneously a researcher (Doctor, nurse or administrative staff) can assess the same test to the same user at the same time. Outcomes must be blind to each other staff.
            Of course, you have first to reach local Director's approval to standardize the tool, and the research must be approved by a local ethics research board. And the patient/subject must approve a verbal or written informed consent to be included in the validation study.
             Have a nice day :)
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The use of dextrose gel has been shown to be an effective treatment for hypoglycemia. I'm curious how many nurseries actually use it?  
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I also am interested but don't know of any units using it.
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Hi sir
I don't think that there is ONE antibiotic used to treat all cases cause different microorganisms with different species
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A neat and smooth way of life, avoiding the acquisition of inadequate health habits, as well as certain foodstuffs, and the sensitivity which can be a cause of neurological disease, including MS, may also be cure for the disease
Such a macrobiotic diet, and low radioactive water (cca 6 Becquerel / Bq) lower temperatures (18-20° C), swimming pool and professionally indicated and controlled use of corticosteroids, symptomatic therapy and immunomodulatory drugs in different phases of the disease, proved to be very useful in many cases the form of RR MS, as evidenced by reports of many research papers, observations, the patients themselves and their medical practitioners.
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According to a personal belief, the answer lies largely in already given an introductory explanation to a question. Adding that according “Randomized clinical trials have demonstrated the efficacy of disease - modifying drug (DMDs)- interferon beta-1a, interferon beta-1b, and glatiramer acetate – in relapsing-onset MS … to estimates of disease – modifying drug (DMD) relative treatment effect size, in the context of ‘real-world’ clinical practice, are similar to DMD treatment efficacy estimate in pivotal, though findings attained statistical significance. DMDs are effective in delaying Expanded Disability Status Scale progression in patients with relapsing-onset definite MS (90%), although effectiveness is much better for RRMS than for secondary progressive MS” (Neurology 2007; 69: 1498-1507).
On the clinical question: What is the best current DMDs for RRMS? By info: Neuropsychiatric Disease and Treatment 2010:6 365–373, the research results were: "The evidence shows that the most effective DMD for delaying short- to medium-term disability progression, prevention of relapses, reducing the area and activity of lesions on magnetic resonance imaging, with the least side effects, is high-dose, high-frequency subcutaneous interferon-β1a 44 µg three times per week".
Future research directions on MS treatments include investigations of MS pathogenesis and heterogeneity; research of more effective, convenient, or tolerable new treatments for RRMS; creation of therapies for the progressive subtypes; neuroprotection strategies; and the search for effective symptomatic treatments. Many treatments already in clinical trials involve drugs that are used in other diseases or medications that have not been designed specifically for MS. There are also trials involving the combination of drugs that are already in use for MS. Finally, there are also many basic investigations that try to understand better the disease and in the future may help to find new treatments.
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In cases of poisoning what are the test/ bedside test done to diagnose it?
Are they routinely done in your hospital set-up?
Are there any quick test to diagnose/ confirm a known poison?
Are there any test like urine pregnancy test kits to diagnose poisoning cases?
Is it really helpful to diagnose poisoning cases by such test?
Can this be of some importance to medical or medicolegal purpose?
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* Firstly, "poisoning" and "poisons" are the broadest of terms. Many poison determinations utilize a very wide variety of methodologies that I could not discuss without some specificity.
Secondly, bed side testing, also called "point of care" testing, for toxicology related situations is an untapped area. Mostly because the current types of testing require involved sample prepping and the use of sizable instruments to analyze the products.
In cases of poisoning what are the test/ bedside test done to diagnose it?
* There are very few tests that can be used at bedside. There are numerous drugs of abuse testing that can be run on a card and a little urine, other poisons, not so much.
Are they routinely done in your hospital set-up?
* point of care testing-- no. However our laboratory screens for many drugs using a mass spectrometer. As to other poisons, there is literature that descrbes many techniques for quick testing of other poisons like heavy metals, cyanide etc..
Are there any quick test to diagnose/ confirm a known poison?
* By "quick tests" you may be referring to what we call "spot tests". Spot test can be very general or very specific for a particular compound or classes of compounds. Again literature can be helpful here. A word of caution, spot tests should not be used soley for the determination of a poison or compound. It is strongly suggested that confirmatory (using another methodology) testing be performed before acting on a presumptive spot test.
Are there any test like urine pregnancy test kits to diagnose poisoning cases?
* Yes mostly pertaining to drug use.
Is it really helpful to diagnose poisoning cases by such test?
* In cases involving drugs of abuse, yes. Again, confirmatory testing should be followed up.
Can this be of some importance to medical or medicolegal purpose?
* Testing of newborn urine to determine drug abuse by pregnant mothers is an example of a medicolegal purpose.
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Psychosis is more common in people with intellectual disability than general population. Can you share your experience of diagnosing and treating psychosis in this population. Have you across any issues which are unique to this population.
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Kind regards,
Jerome
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We are looking for new literature (after 2010) on the above topics. Previous researchers are among others Bion, Winnicott, Ulla Beck, Steen Visholm, Paula Jacobsen.
Where should we look? We are examining the psychological unconscious processes in organisations that treat children with emotional disorders based on a psychodynamic approach.
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Perhaps the references in these papers leeds you a step forward:
Inpatient Weight Loss as a Precursor to Bariatric Surgery for Adolescents With Extreme Obesity: Optimizing Bariatric Surgery CLIN PEDIATR 2013; 52:7 608-611
Empirical Evaluation of Age Groups and Age-Subgroup Analyses in Pediatric Randomized Trials and Pediatric Meta-analyses Pediatrics 2012; 129:Supplement_3 S161-S184
Intensive in-patient treatment for children with severe traumatization in infancy by Karl Heinz Brisch, Ulrike Paesler, Kathrin Zeber, Anne Budke, Ludwig Ebeling, Julia Quehenberger. Dept. of Paediatric Psychosomatic Medicine and Psychotherapy. Dr. von Hauner Childrens’ Hospital, Ludwig-Maximilians University of Munich
Astrid.Lampe@uki.at is also in this field.
Cochrane Database Syst Rev. 2014 Jun 18;6:CD003148. Psychological interventions for individuals with cystic fibrosis and their families.
Goldbeck L, Fidika A, Herle M, Quittner AL.
Indian Pediatr. 2004 Jul;41(7):673-9.
Pseudoseizures.
Bhatia MS.
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Antibiotics are given to safe guard against secondary bacterial infections due to reduced immunity during viral infections.
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Cold viruses, including influenza, are difficult to treat because they are constantly mutating. There are over 300 viruses that cause "colds". Influenza, in particular, is one of the most challenging to treat because it's genome consists of multiple RNA strands that are prone to mutating.
The influenza virus exists in avian and swine species. Unfortunately, the influenza virus is one of those viruses that can cross species barriers. As a result of the virus jumping from one species to another, the RNA strands have the opportunity to mutate and become more virulent.
Recently, it has been shown that Tamiflu (an antiviral medication for those afflicted by flu) is absolutely useless. The only thing that countries can do to protect it's citizens is to offer vaccinations when anticipating the new flu season but even vaccinations are no guarantee of attenuating influenza...
Physicians need to educate patients and make them understand that antibiotics are to counter bacteria and not viruses. With plasmids that are resistant to antibiotics, we are already experiencing a crisis of antibiotic resistant bacteria such as those responsible for nosocomial infections (eg. VRE,MRSA,Clostridium difficile). If physicians aren't judicious in the prescription of antibiotics, microbes will rule this world one day.
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There are some questions on RG about EBM (e.g. Rachel E Patzer: What proportion of medicine is evidence-based). In a lot of such discussions one can find critics. My motivation is to develop a distinguished picture of advantages and disadvantages, limitations and perspectives.
To trigger the discussion here are some possible arguments: Is it possible to use EBM in the same way in every medical or therapeutic discipline, or are there crucial differences? Does the institutionalization of EBM lead to a conservative attitude? What are the limits of research methods preferred by EBM (e.g. randomized controlled studies, meta-analysis)? How is the relation of expertise to evidence? Is verification the right way or should research strategies of EBM better be based on falsificationism? Are evidence informed practice or empirical supported treatments better concepts / terms to enhance the interaction of research and treatment?
If we are able to figure out the problems, we are perhaps able to optimize the situation.
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Dear colleagues
let me try to add a systematic overview:
1. Problems of the EBM idea
• It is a really complex challenge to unite clinician’s expertise with best available evidence. For example it is epistemologically not easy to combine first person (clinician) perspective with third person perspective (research results).
• Clinicians have to be both perfect experienced clinicians and researchers that understand the methods, methodology and limits of EBM research.
• First naturalistic fallacy: Even knowing everything would not imply a question to the answer ‘what should be done’.
2. Problems of EBM research methods
• There are a lot of possible bias’ associated with RCTs (e.g. representativity of datasets, control group problems).
• There are a lot of possible bias’ associated with meta-analysis (e.g. garbage-in-garbage-out, apples-and-oranges, abstraction).
• There is a reductionism-problem associated with group research methods.
• The applicability of the currently preferred methods in different clinical fields, is an unsolved problem (e.g. what works in pharmacotherapy does not necessarily work in psychiatry).
3. Methodological / epistemological problems
• There is a allegiance- or stake-holder-problem that leads to a tendency to produce positive results.
• To produce meta-analyses needs time that leads to an up-to-date problem.
• Additionally there is a conservative drift (old intervention methods of which meta-analyses exist are preferred).
What do you think? Do you have ideas to complete? Do you have alternative statements ? I do not want to deprecate EBM. The idea is to improve it or develop alternative approaches.
Regards Thomas
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Preeclampsia is still being debated as a “disease of theories” as we enter the second half of the second decade of the 21st century. Is there evidence for the dogmatic two stage theory? If we are to find a cure for this elusive disorder in the first quarter of this century do we need new tactics and will we have to abandon old ones?
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Preeclampsia does not happen where there is adequate micro and macro nutrients.
In addition, eating a bulb (not one piece, but the whole bulb or perhaps 2 bulbs) of fresh garlic daily, will lower blood pressure significantly and prevent eclamptic seizures
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I think that multiple therapy targeting different pathways and highly personalized to each patient and degree of evolution of the disease is one option.
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I start : I think that multiple therapy targeting different pathways and highly personalized to each patient and degree of evolution of the disease is one option.
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I am writing an article on this topic and I am looking for opinions.
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Hi Alisa,
Maybe you want to have a look at this paper of my group:
"iPSC-derived neurons from GBA1-associated Parkinson's disease patients show autophagic defects and impaired calcium homeostasis"
PMID: 24905578
So for me there is evidence that gene therapy/correction could be a helpfull tool.
Best Lukas
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Trying to compare and analyse both treatment types
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HI,
Phage therapy involves the targeted application of bacteriophages that, upon encounter with specific pathogenic bacteria, can infect and kill them. As typically practiced, phages then lyse those bacteria, releasing virion progeny that can continue the cycle, including migrating to other sites of infection anywhere in the body. The actual phage-mediated bacterial killing, however, occurs well prior to the lysis step—e.g., such as in the first minutes of infection for a phage such as phage T4 1—as the phage converts the cell into a factory for making new phages. Phages are unique among antibacterial agents in their ability to increase their numbers when in the presence of bacterial targets. Of similar importance, phages only minimally impact non-target bacteria or body tissues. A more complete list of advantages associated with phage therapy, relative particularly to chemical antibacterials, is presented in this issue2 and elsewhere.3 Here we review the potential for phages to treat bacterial infections afflicting humans. Other therapeutic applications, such as in veterinary medicine, have been reviewed in reference 4, and will be also covered in future issues of this journal. Other reviews focusing on various aspects of human phage therapy are also available.3,5–11.
The viruses of bacteria were discovered in 1915 by Frederick Twort.12 The “bacteriophage” era, however, did not begin until the seminal publication demonstrating “un bact.
This time of excessive expectations was followed by a period of declining enthusiasm for phage therapy in much of the western world, subsequent displacement of its use after World War II by antibiotics, and a shift in focus to using phages as model genetic systems. This second stage started with the quite critical 1934 Eaton-Bayne-Jones report14–16 reviewing the available literature on phage therapy3 and continued through the late 1940s. At the same time, development of phage therapy and its active application continued to increase within the Soviet Union and eastern Europe, where it was well supported until the fall of the Soviet Union. In the West, the golden age of phage-based development of molecular biology involved intense work with just a few phages infecting one avirulent lab host (E. coli B) rather than broad exploration of phages targeting a range of key pathogens.
There continued to be regular literature reports on phage therapy in France until at least 1979 (cf. Henri de Montclos spent the majority of his career at the Pasteur Institute of Lyon where he was Chief of Clinical Microbiology for 10 years and he and his research team produced antistaphyloccal vaccines and therapeutic phages until the early 1990s. In his 2002 review,51 he described how several European laboratories maintained an individualized, essentially artisan-like production of phages by classical methods until the 1980s. He stated that phages appear to be safe for human cells though potentially there could be problems associated with modes of preparation. Among his recommendations is purification from pyrogen released by the lysing of bacteria, for example by cesium chloride gradient centrifugation. He also recommended against propagation on media produced from animal tissues. Successful treatment was typically achieved in a few weeks and there was a general impression of a real service rendered, although this individualized approach did not lend itself to double-blind study establishing proof. After the AIDS crisis in the blood supply, regulations within the public health system became less conducive to continued production of pharmaceuticals, including phages, in this individualized manner.
A few French physicians have continued to use phages therapeutically even after the Pasteur Institute stopped making therapeutic cocktails in the mid 1990's, now generally obtaining their phages from Russia or Georgia.47 Staphylococcus infections seem to be the most common target of these more-recent efforts. Dublanchet and colleagues have recently reported successful phage therapy of two patients from France and one from Australia who had failed other therapies, including all available antibiotics.52.
Mikeladze53 described the treatment of 21 patients with typhoid fever with per os bacteriophage, using 10 mL of lysate for three to five consecutive days. Compared to 64 controls treated by the usual methods, they noted a reduction in mortality from 15.6% to 4.8% and a reduction in complications from 56.2% to 13%. There was a doubling of the recurrence rate from 4.5% to 9.5%, however, when phage treatment was delayed until between the tenth and fifteenth day of illness. The duration of illness was essentially the same, though. Subsequently, they used intravenous phages for patients whose blood cultures yielded the typhoid bacillus, infusing one mL of phages daily for three consecutive days. The duration of illness was decreased, but “violent reactions” were seen after the injection.
Mikeladze53 also described the treatment of “acute colitis” due to Shigella or Salmonella in Georgia. One ampoule (5 mL) of bacti-intesti-phage diluted in boiled and cooled water was administered orally every 2 hours. The patients ingested a total of 8–10 ampoules while taking a liquid diet. In general, they noted that phages caused a decrease in temperature and an improvement in the patient's feeble and rapid pulse, intestinal pain and tenesmus. In unfavorable cases, treated late in infection, the improvement was still considerable, although the colitis tended to persist. They found that a second series of ampoules, given after a day of rest, always yielded good results. In 47 cases of dysentery, 3 died (6.4%), which is half the usual mortality. Of 43 patients with colitis, all were cured.
Gougerot and Peyre55 described the treatment of skin infections using phages, with particular emphasis on recurrent furunculosis. Local treatment was best, but each pustule needed to be opened with a phage-containing syringe. Then a pad moistened with phage was rubbed over the area and a compress dampened with phage was used as the dressing. The next day they observed that each pustule had increased in size and was surrounded by an indurated, red zone of inflammation. But after 48 hours, the lesions would dry up and disappear. They repeated this every two days for new or overlooked pustules, with improvement in nearly all cases. After eight or ten applications, most of the patients were cured. In cases of bacterial infection of the dermis and epidermis, such as impetigo, they recommended unroofing the lesions, removing the crusts, opening bullous lesions and rubbing a bit roughly in order to introduce the phages into the skin, then applying a large compress moistened with the same bacteriophages. As with abscesses, it was helpful to advise the patient to expect a worsening of inflammation in the first 24 hours, prior to improvement.
Michon57 described the treatment of urinary tract infections. He stated that it was necessary to first alkalinize the urine. After evacuation of the bladder, they infused phage for three consecutive days. Twenty mL were instilled into the bladder on the first and second days and 10 mL on the third day. The patient continued urinary antiseptic treatments for the entire period, including three to four days following the infusion of phage. In cases of uretero-prostatitis, they instilled the phage to the area of the posterior urethra. For pyelonephritis, he recommended alkalinization of the urine, renal lavage with 20 to 30 mL of phages followed by urethral lavage, and then phage instillation into the bladder. They noted much less relapse than they had seen with silver nitrate treatment.
Halphen58 described the use of phage therapy in otolaryngology. He noted the treatment of furunculosis of external otitis, but noted that general anesthesia or great bravery on the part of the patient was necessary for the injection of phage into the already-inflamed cartilage. A second treatment was often needed two days later, but they concluded that if these first two treatments were not effective, then the phages used were not effectively lysing the bacterial strain. They had also used phages in dressings applied to the nasal furuncles with success. They treated furuncles of the upper lip (known in the pre-antibiotic era as the danger triangle) with several mL of lysate without anesthesia. “Immediately the lip swells greatly and very painfully, but after 5–6 hours, the drainage from the incision becomes serous (i.e., yellow, transparent and benign), and within 24 hours, the patient is cured.”.
Often these were treatments of last resort for chronic bacterial infections that had not responded to standard antibiotic treatment. Such infections are among the most difficult to successfully treat. Indeed, as noted on p. 582 of the same publication, “Unfavorable treatment results may be accounted, to a great extent, to too late initiation of the treatment and also great cachexy of patients with long course of disease.” In this vein, however carefully phages were chosen and whatever the nature of the problem, the fundamental health of the patient was also a key factor in the effectiveness of phage therapy, implying utility to not excessively delaying phage application. Thus, for example, Slopek et al.68 report 84.2% positive results given “severe” disease versus 92.8% for “medium-severe” and 96.9% for “generally good”.
A successful physician-initiated FDA-approved phase I safety trial of phage therapy against skin ulcerations and other wounds was completed in 2008 at the Wound Care Center in Lubbock, Texas, following a series of positive results with Pyophage brought from the Eliava Institute over a period of several years under “compassionate use” provisions. For the phase I trial102 a special formulation of fully sequenced phages prepared by the company Intralytix, containing only two phages active against S. aureus, five against P. aeruginosa and one against E. coli, was applied to chronic infections without observation of significant side effects. Phage phase I safety trials have also been administered by the companies Exponential Biotherapies11 and Biocontrol, though only the latter is published.132 See also in reference 133 for an additional phage safety trial and reference 11 for review and discussion of these trials.
Generally, treatment of infections close to the surface of the body involves a number of steps. The first is cleaning the wound quite radically, including removal of necrotic tissue (debridement), which is crucial in an ongoing fashion with all wounds. Often, the typical procedure of incision and drainage is done, so that the wound is open and still-living tissue is highly accessible. The next step is to assure adequate drainage of exudate from the wound. As usual, premature closure of the wound before the infection is adequately treated such that the wound has been rendered sterile can lead to many complications. Georgian surgeons find that use of a Pyophage cocktail—including as infusions and in the form of PhagoBioDerm, etc.—during early wound treatment facilitates far earlier wound closure and faster healing.
M D Vaidya (BrainBridge)
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Does anybody know of recent or current comparison studies between the effects of bacteriophage therapy and that with antibiotics?
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This is excellent! Thank you so much for your help... no doubt I will be contacting you with more questions within the next few months! Steph
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Because I am not a clinician, I want to know the real case. They have a fact to often cause a problem action, in society. And they can not keep good relationship with others. For these patients, I think that person centered approach, PCA,(counseling) is effective. Also treatment is difficult in my country, and almost they depends to medication prescription.
I want to hear the real case and the the good idea of the treatment for your BPD patient.
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Person-centred working is important with people with Borderline Personality Disorder. Therapists need to be genuine, consistent and accepting within clear boundaries. However, some of the behaviours exhibited by people with BPD can be problematic for patient and for others, and some other kinds of therapy, including problem management/CBT for self-harm, for example, will probably need to be integrated into a person-centred framework, to establish the safety, stabilization and security necessary to address the underlying trauma. Definitely not a project for the trainee counsellor!
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Used in clinic coercive treatment.
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I'm pretty sure this question is still open because it's not clear.
Gudrun, could you please rephrase it clearly? Thanks.
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Acute and chronic sinusitis are common and often have over diagnosis.
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Amoxicillin 40-50 mg/kg and or 80-90 mg/kg for 2-3weeks and 4-6 weeks respectively in child and adult.
Current best treatments for bladder cancer?
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Cancer
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Holistic treatment brings comprehensive improvement in the patient which is difficult to document by laboratory tests. Is there a simple evaluation method, that can be completed by patient or attendees?
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After several months of understanding, the following may be considered;
1. There shall be no progress in the disease
2. There shall be improvement in Food eating, sleeping and energy levels
3. Blood picture should improve / constant / no deterioration
4. With chemo: Previously seen ADR - reduced
5. Reduced levels / Reversals of signs & symptoms of disease
6. Extension of Life without compromising the quality of life
This is what I have observed in majority of patients which doesn't require any money.
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Will these insights change your practical approach to diagnosi and treatment of premature ejaculation?
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I believe it is. Drugs able to reduce sympathetic overtone might play a crucial role in lifelong premature ejaculation.
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I am continuing ongoing research related the the therapeutic use of role-playing games in various forms, and for different populations as detailed on rpgresearch.com.
As part of the research, always trying to find those that have actually tried using RPG's as a treatment approach.
Psychotherapeutic role-playing,  gestalt therapy's chair work, and Psychodrama are somewhat well known, but do not have the same distinctive levels of structure (defined rules, "character sheet", character "advancement", etc.) as RPG, a key difference. The definition of clearly established rules, and usually a more significant form of abstraction between the participant and the participant's "character", create a bit more of a "buffer" between self and other.
So with that in mind, how many of you have used, or are aware of someone using, some form of tabletop, live-action (LARP), or computer-based RPG as a treatment intervention modality?
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In France, Brigitte Baron are using another type of projectve role play called Scenodramma . There are many tecnique used in Sysemi Therapy. But I think we can consider also waht games pastients usually play as possible underground to develop psychotherapy. As Edelman noticed, computer are changing the way we experience the world, in a bad or good manner. CBT used computer simulation to treat eating disorders. It depends also yor theoretical background. I always used the tools of the patients....the only door throught I have to go to help them.
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It's a correlational study where I have three groups of cancer patient's preferences about treatment decision making, and I want to search for associations between demographic factors and these preferences, but I am not sure what kind of sample size formula I should use.
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 The G* power data analysis can help you with this. The software is free to download here-  http://www.psycho.uni-duesseldorf.de/abteilungen/aap/gpower3/
You can also read materials to help you with how to go about it on this website.
Best wishes 
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I am analyzing of expression of a few genes in WT and transgenic plant under normal growth conditions and the NaCl treated plants. I am using Ubiquitin as a reference gene In non treated sample in WT and transgenic the expression level of Ubiquitin is almost similar but in treated plant there is a significant difference in the Cvalue of ubiquitin. So what could be the reason it is because of difference in cDNA concentration or It the expression of ubiquitin which is changing due to the transgene under stress condition because in two independent transgenic lines under NaCl treatment Ubiquitin expression is same but in treated WT it is different.....
  • Another problem is in presenting the expression data, in few article i found that they have presented the expression of target gene separately one set is before treatment and other is after treatment. And each set contain the target gene expression in WT and transgenic. And they have mentioned that they have used 2-deltadeltaCt  method for data analysis. But as far i understood if we are presenting the treated and untreated set of sample separately and giving the difference of target gene expression with reference gene expression which will be only delta Ct. So i got this doubt how it can be deltadelta Ct......I am attaching one paper for the reference......please help me how should i make the calculation in this case.........because i am unable to understand the calculation of this paper.......
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1)
If Ubiquitin expression is changed in the transgenes upon NaCl treatment, then is is no valid reference gene. Use a panel of possible reference gens. Their expression should NOT change in response to your treatment. You can see this when the differences between their ct-values are (more or less) constant.
2)
The paper is not good withe respective to the presentation of real-time PCR (method and results). They state that Actin or Ubiquitin were used as reference genes. Why "or"? why not both? Unclear. They also apply some stress (dehydration) where I would also expect that Ubiquitin reacts and should therefore not be used as reference gene.
It is not shown how the "relative expression values" were calculated, The authors call ist the "delta-delta Ct method of the system". It is not stated what system they mean or have! So one can only speculate. The delta-delta Ct method (as it is conventionally called) was introduced by Livak, but he's not cited. In this publication, no "relative expression values" are calculated. One may refer to the delta-Ct values as measures for relative expression (including an unknown proportionality factor and representing a log of an unknown base). Some people feel better when they can present these measures on a linear scale (rather than a logarithmic) so they unlog the values, often with base 2 (because it's the optimum efficiency - but it does not matter because there is still the unknown prop.factor).
Livak calculated the delta-Ct as ct[target gene] - ct[reference gene], what actually gives the expression of the reference gene normalized to the expression of the target gene (so the inverse of what one would actually want or expect to have). This must be considered and clearly documented if one presents "relative expression" values following the "delta-delta ct method". Since the authors did not write how they calculated it, it remains unclear if they really show the correct results or their inverse transformations (well, I hope they did it correctly).
The presentation of the results is inappropriate. The use barcharts to present relative measures (-> laws of perception! Apart from this it's a bad information-to-ink ratio). Further standard errors (SE) are shown. It is not clear how these are calculated. One can calculate them for the delta-cts, but it is not clear how the authort propagated them to the scale of the "relative expression values". Even if this was done correctly (here I start loosing my hope), it would have a different meaning than the SE of the delta-cts, and the visualization on the same diagram (as error bars) is misleading (if not completely nonsense). Showing error bars of similar lengths at both sides of the means is another indication that the authors are not aware of the meaning or interpretation and just show somethig (usually because many others also show similar things...).
It would have been far better simply to show the delta-ct values. Neither the transformation nor that strange normalization would not have been required.
So there is not much to understand in this paper (regarding qPCR!). Thsi is not your fault. It is simply missing and unclear in the paper. Usually I would now suggest to contact the authors directly, but sseing the presentation of these results I am afraid that they won't be able to answer your questions.
 
PS: I do not want to insult the authors. The presentation is "typical", one can find it in many papers of many authors. Sometimes reviewers or even editors request this kind of suboptimal (re-)presentation. I do not know the authors and it is understood that my comments are prejusdices based on this single paper. And I do not refer to any scientific content (which I do not understand, and I haven't even read the whole paper carefully!).
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I am writing an article on this topic and I am looking for opinions.
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Is gene therapy for Alzheimer's disease a promising treatment?
Possibly, but not so far.
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Someone have experience in Nellix EndoVascular Aneurysm Sealing (EVAS) for the treatment of infrarenal abdominal aortic aneurysm (AAA).
In our center we performed 40 case and all with good results.
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Yes. We have used it in Manchester. Early results good but 1 case of rupture before 3 months with no endoleak on follow up CT. So interested to see mid term results for proof of principle
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Proton pump inhibitors are among the most prescribed group of drugs. Question is in concern to a) condition/indication and b) treatment duration
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Characteristics of relapse following adolescent substance abuse treatment. 
Addictive Behavior 1989; 14:291-300  by Brown, SA and Vik PW, Creanerm, VA
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The wiring and rewiring to MV and SB are a vital step for the treatment of coronary bifurcation lesion. However it is still a question to resolve that, how to solve difficult side branch access.
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thank you for your answer and  paper. In the paper, coronary bifurcation stent are recommended, which I am interesting in. however, coronary bifurcation stent are stil applied in china. In the department of cardiology of Harbin Medical University, some techniques such as modeling of guidewire tip, antegrade wire technique,retrograde wire technique, the ballon you mentioned, and so on are often utilized.
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Dear Colleagues
I am trying to estimate Difference in Differences Treatment Effects model on stata but I don't have the dofile. Any help?
Thank you in advance.
Eman
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What is the most effective method for the treatment of flint glass substrates for subsequent vacuum deposition of gold on them without preheating of the substrate? Require achieve the highest possible adhesion.
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Hi,
we have some good experience with medium frequency plasma etching of normal glass substrates using a good amount of oxygen (or even air) together with the Ar prior to the deposition of gold layers by DC magnetron sputtering. Adhesion was good except when applying shear forces
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I still want to find out if anyone knows whether Surgery is the best approach for treatment of Adenotonsillar hypertrophy in Infants
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I am doing reserch on functional treatment of class II .. my problem is that i don't have control group and i don't have retrospective data
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Khalid, what do you mean by "functional treatment of class II"? It is difficult to answer your question because it is not clear. Thanks.
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Is surgery the best approach for the treatment and management of Adenotonsillar Hypertrophy in Infants
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Is there any special treatment.
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The thicknes of the nitrocarburised layer maybe too small, and the process need long time. It is not good in mass production.
The local heat treatment by laser is better. 
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treatment of pulmonary hypertension in patients with cystic fibrosis medically 
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In a small group of CF patients, oxygen supplementation was demonstrated to decrease mean PAP and pulmonary vascular resistance ,, as well as improve RV performance .
Diuretics have a place in the treatment of pulmonary hypertension in the setting of hypervolemia and elevated PAOP. In advanced cases, care should be exercised to avoid a rapid reduction in the intravascular volume that may decrease the filling of the RV and hence impair cardiac output . Digoxin does not seem to be beneficial in improving symptoms or survival in CF patients with right heart failure . Anticoagulation is indicated in some patients with group I pulmonary hypertension (PAH) but not in pulmonary hypertension due to CF because of the lack of evidence to support its use and the possibility of increasing the risk of bleeding .
Pulmonary hypertension-specific therapies have not been well studied in CF patients with pulmonary hypertension. Phosphodiestearase- inhibitors like sildenafil may be useful in these patients; however, this treatment continues to be controversial in pulmonary hypertension due to parenchymal lung diseases such as COPD and interstitial lung disease –.
Inhaled prostacyclin analogues may theoretically increase the pulmonary artery vascular flow in well ventilated areas of the lung, potentially improving the match between ventilation and perfusion. Promising results have also been observed with the use of inhaled prostacyclin analogues in patients with pulmonary hypertension due to other lung diseases
Source [ Pulmonary hypertension survival effects and treatment options in cystic fibrosis Tonelli, Adriano R.]
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27 yo healthy male neg CT/MRI modest BHCG/AFP elevation that is declining post right I/O
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The question is vascular invasion is present or not. After the tm markers are normalized. If vascular invasion present, embrional ca component higher than 50 % or proliferation rate greater than 70%, the terapy should be two cure BEP. If not, active survilance is proper terapy.
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Young lady 25 years old.
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5% Dapsone gel may be tried.
The use of Daposone in treatment of Acne vulgaris was suggested as early as 1961 by Dr. C M Ross.
Dapsone has bacteostatic action on selected bacteria.
It has complex actions on functions of neutrophils, antigen-antobody reaction etc.
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treatment
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Hi,  researchers, Scientists,
I am planning to do a study in TB in south India, Which is the relevant study in TB? Two options, Default in Treatment or relapse in Tb treatment? Which area should I focus? Please do help me?
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Hi, Good Afternoon
Area: Pulmonary Tuberculosis.  This is the common one in India.  So many persons were affected by this disease.  So, you would get more sample to this study.
Study variables: 
Socio economic variables like:  Household income, household possessions, people per room, cooking fuel (wood, kerocine, gas), separate kitchen or not, occupation and BMI of the participants.
Smoking and Alcohol
Kindly see the following links:
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Lacrimal trephine, Mini Monoka stent
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For distal and common canalicular obstructions, Lacrimal trephination with Sisler's lacrimal trephine has provided around 80% success rate. This has to be combined with mono canalicular intubation.
I am still in doubt about the management of proximal obstructions #
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Other than Allopathic approach for treatment of various diseases, Homeopathic treatment, as one of the naturopathic treatment schedule is now taking ahead the job to cure many diseases that are almost failed by Allopathic or any other treatment schedule. Perhaps a surgery free approach and good result with much and much lesser costly medicines, Homeopathic Science is growing very widely and may for the above reasons in countries such as Germany, England and India, it is widely accepted by patients. Unfortunately, very less research on the influence or action of Homeopathic drugs on any revealed biochemical or molecular pathways are studied. So, should research on this particular Science be accelerated with a world wide approach. 
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Treatment with zolpidem for catatony
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Dear, I have downloaded the TCGA data from AML. I would like to process the data (preferrable without using R) in order to obtain the expression levels from mRNA and I would like to know the corresponding patients data: e.g. treatment... among others. Thank you!!!
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Long term pain management after burn injury
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depends on the depth. most of the third degree burns will have pain due to faulty renervation. exposed nerve endings due to axon damage. or myelin sheath damage.
gabapentin may be helpful or if it is local or if  due to nerve entrapment secondary to  scars.then surgical interference may be helpful. even then pain is troublesome.
TENS may reduce some pain.
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Like to revisit the management of gouty arthritis
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AstraZeneca’s lesinurad (formerly known as RDEA-594), a selective oral Uric Acid Transporter URAT1 inhibitor, was just approved.  
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for example in a inflammation condition, to capture the cell condition before and after inflamed and after exposed with treatment. Is it valid for TEM and SEM
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Dear Amiedul
First, what do you want to show?. Do you have control pictures? Is the sample good quality?
Showing SEM or TEM is valid but you have to have a good answers for the questions above