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"Clowes, Martin"
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The basics of organic chemistry
\"Students see chemistry in action in this thorough but accessible informational text is aligned to science core curriculum, includes crosscutting concepts, and covers carbon bonding, chains, and rings, alcohol and acids, other organic compounds such as esters, aldehydes, ketones, ethers, amines, and halides, and polymers. Fact boxes about key terms, events, people, discoveries, and technologies, along with sidebars that give everyday examples of chemical applications help make the subject fun for readers.\"-- Provided by publisher.
Book
Ocular hypotensive efficacy and safety of brinzolamide ophthalmic suspension 1% added to travoprost ophthalmic solution 0.004% therapy in patients with open-angle glaucoma or ocular hypertension
ABSTRACT
Objective: The primary objective of this study was to determine if combined travoprost ophthalmic solution 0.004% and brinzolamide ophthalmic suspension 1% therapy is superior in lowering intraocular pressure (IOP) compared to travoprost monotherapy for patients with open angle glaucoma or ocular hypertension. The secondary objective was to measure the percentage of patients achieving IOP levels of 18 mmHg or less.
Study design and methods: Single arm, open-label. Participants: eighty-two patients with inadequate IOP control with travoprost monotherapy. Intervention: the addition of brinzolamide ophthalmic suspension 1% twice daily.
Main outcome measures: The primary endpoint was mean IOP reduction from baseline at 4 and 12 weeks. The percentage of patients who achieved IOP values ≤ 18 mmHg was also measured.
Results: The mean age of the patients was 67 years. Ethnic origin was 92.7% Caucasian, 3.7% Black, 2.4% Asian and 1.2% other. The mean duration of travoprost treatment before the trial started was 30 weeks. Compared to the baseline data (IOP = 22.5 mmHg) with travoprost ophthalmic solution 0.004% monotherapy, IOP was decreased after 4 (n = 78) and 12 (n = 71) weeks of combined travoprost and brinzolamide therapy by an average of 3.9 mmHg (17.4%) and 4.2 mmHg(18.4%), respectively. At baseline 6.3% of patients had an IOP of 18 mmHg or less whereas at 4 and 12 weeks, 53.8% and 60.6% of patients respectively had an IOP of 18 mmHg or less. Common adverse events were mild and included ocular hyperaemia, dysgeusia and eye irritation. Study limitations: this study had a small sample size and was open-label.
Conclusion: Patients receiving combined travoprost ophthalmic solution 0.004% and brinzolamide ophthalmic suspension 1% therapy had lower IOP values compared to those on travoprost monotherapy ( p < 0.0001). Combined therapy resulted in a significantly greater percentage of patients achieving IOPs of 18 mmHg or less ( p < 0.0001).
Journal Article
Atoms and molecules : investigating the building blocks of matter
A look at various theories about atoms throughout history.
Book
Loeys-Dietz syndrome: life threatening aortic dissection diagnosed on routine family screening
A 52-year-old man was found to have a severely dilated aortic root and a Stanford type A dissection on familial screening echocardiography, following diagnosis of a dilated aorta in his son. The dissection required urgent surgical repair. Clinical examination suggested features of Loeys-Dietz syndrome type II, and subsequent demonstration of a mutation in the TGFBR1 gene in the patient and his son confirmed the diagnosis. This article highlights the high prevalence of inherited conditions in dilated aortic root presentations and the importance of family screening and surveillance to allow early surgical intervention.
Journal Article
Attitudes of people in the UK with HIV who Are Antiretroviral (ART) Naïve to starting ART at high CD4 counts for potential health benefit or to prevent HIV transmission
To assess if a strategy of early ART to prevent HIV transmission is acceptable to ART naïve people with HIV with high CD4 counts.
ASTRA is a UK multicentre, cross sectional study of 3258 HIV outpatients in 2011/12. A self-completed questionnaire collected sociodemographic, behavioral and health data, and attitudes to ART; CD4 count was recorded from clinical records.
ART naïve participants with CD4 ≥350 cells/µL (n = 281) were asked to agree/disagree/undecided with the statements (i) I would want to start treatment now if this would slightly reduce my risk of getting a serious illness, and (ii) I would want to start treatment now if this would make me less infectious to a sexual partner, even if there was no benefit to my own health.
Participants were 85% MSM, 76% white, 11% women. Of 281 participants, 49.5% and 45.2% agreed they would start ART for reasons (i) and (ii) respectively; 62.6% agreed with either (i) or (ii); 12.5% agreed with neither; 24.9% were uncertain. Factors independently associated (p<0.1) with agreement to (i) were: lower CD4, more recent HIV diagnosis, physical symptoms, not being depressed, greater financial hardship, and with agreement to (ii) were: being heterosexual, more recent HIV diagnosis, being sexually active.
A strategy of starting ART at high CD4 counts is likely to be acceptable to the majority of HIV-diagnosed individuals. Almost half with CD4 >350 would start ART to reduce infectiousness, even if treatment did not benefit their own health. However a significant minority would not like to start ART either for modest health benefit or to reduce infectivity. Any change in approach to ART initiation must take account of individual preferences. Transmission models of potential benefit of early ART should consider that ART uptake may be lower than that seen with low CD4 counts.
Journal Article
Health Security as a Global Public Good in the Conditions of the Revolution 4.0
Objectives: Although the concept of health security is becoming accepted in public-health-related literature and practice, there is no full agreement on the scope and content. The aim of this paper is to draw attention to the definition of health security and its role within the Revolution 4.0. Research Design & Methods: This is a theoretical article and as such addresses a problematic situation concerning missing standards in health security and the Revolution 4.0. Findings: The WHO (2018) has stated unequivocally that 'functioning health systems are the bedrock of health security'. The authors attempt to prove that health security in the conditions of the Revolution 4.0 needs to be defined more precisely and has to be implemented as a global public good nationwide with accepted minimal standards. Implications / Recommendations: Health security belongs to the sphere equally important to that of the Revolution 4.0. A concept of Health Security that is not widely accepted and implemented creates a problematic mélange for employees as well as for industrial development. These features will be considered. Contribution / Value Added: This paper tries to underline the relative shortage of common agreements on health within the Revolution 4.0.
Journal Article
Loeys-Dietz syndrome: life threatening aortic dissection diagnosed on routine family screening
A 52-year-old man was found to have a severely dilated aortic root and a Stanford type A dissection on familial screening echocardiography, following diagnosis of a dilated aorta in his son. The dissection required urgent surgical repair. Clinical examination suggested features of Loeys-Dietz syndrome type II, and subsequent demonstration of a mutation in the TGFBR1 gene in the patient and his son confirmed the diagnosis. This article highlights the high prevalence of inherited conditions in dilated aortic root presentations and the importance of family screening and surveillance to allow early surgical intervention.
Report