Obiettivo: esaminare l’uso di antibiotici in pazienti che si avvicinano alla fine della vita, in termini di frequenza di prescrizione, scopo del trattamento, effetti benefici e avversi e contributo allo sviluppo della resistenza antimicrobica.
Progetto: revisione dell’ambito FONTI DEI DATI: Uno scienziato dell’informazione ha cercato Ovid MEDLINE, Ovid EMBASE, The Cochrane library, PubMed Clinical Queries, NHS Evidence, Epistemonikos, SIGN, NICE, Google Scholar dall’inizio fino a febbraio 2019 per qualsiasi progetto di studio incluso, ma non limitato a, studi clinici randomizzati, studi prospettici interventistici o osservazionali, studi retrospettivi e studi qualitativi. La ricerca di Ovid MEDLINE è stata aggiornata il 10 giugno 2020.
Selezione degli studi: studi che riportano l’uso di antibiotici in pazienti che si avvicinano alla fine della vita in qualsiasi ambiente e atteggiamenti e comportamenti dei medici in relazione alla prescrizione di antibiotici in questa popolazione
ESTRAZIONE DEI DATI: due revisori hanno selezionato studi per l’idoneità; due revisori hanno estratto i dati dagli studi inclusi. I dati sono stati analizzati per descrivere i modelli di prescrizione di antibiotici in diverse popolazioni di pazienti, i benefici e gli effetti avversi (per i singoli pazienti e la società in generale), il razionale per il processo decisionale e i comportamenti e gli atteggiamenti dei medici nei confronti del trattamento con antibiotici in questo gruppo di pazienti.
Risultati: sono stati inclusi ottantotto studi. La definizione di fine vita è molto variabile, così come l’uso di antibiotici nei pazienti che si avvicinano alla fine della vita. Le decisioni sulla prescrizione sono influenzate dall’età del paziente, dalla diagnosi primaria, dall’impostazione dell’assistenza e dagli obiettivi della terapia, sebbene le preferenze dei pazienti non siano sempre documentate o rispettate. Le infezioni delle vie urinarie e delle basse vie respiratorie sono le indicazioni più comunemente riportate con esiti in termini di controllo dei sintomi e sopravvivenza riportati in modo variabile. Un piccolo numero di studi ha riportato eventi avversi e resistenza agli antimicrobici. I medici a volte si sentono a disagio nel discutere il trattamento antibiotico alla fine della vita e trarrebbero beneficio dalle linee guida per l’assistenza diretta.
Conclusioni: l’uso di antibiotici nei pazienti che si avvicinano alla fine della vita è comune sebbene ci siano variazioni significative nella pratica. Ci sono una miriade di questioni biologiche, etiche, sociali, medico-legali e cliniche intrecciate associate all’argomento.
Malformazione venosa intraepatica gigante con coagulopatia intravascolare localizzata. Follow-up e trattamento durante la gravidanza
Le lesioni intraepatiche negli adulti, comunemente chiamate emangioma epatico, dovrebbero essere chiamate malformazioni venose intraepatiche (IHVM) o malformazioni venose intraepatiche giganti (GIHVM) quando più grandi di 10 cm secondo la classificazione ISSVA (gruppo di studio della società internazionale per le anomalie vascolari). I disturbi localizzati della coagulazione (LIC) nei pazienti con malformazioni venose sono abbastanza comunemente associati a malformazioni venose, provocano una diminuzione del fibrinogeno (<2g / l) e un aumento dei d-dimeri (> 1500 ng / ml) e potrebbero essere responsabili di trombosi intralesionale, episodi di dolore o sanguinamento Riportiamo un caso clinico di un paziente di 41 anni che ha presentato episodi di dolore dell’ipocondrio destro scoprendo un GIHVM sconosciuto all’ecografia con una storia precedente di episodi di sanguinamento uterino e aborti multipli.
una coagulazione intravascolare localizzata (LIC) associata con il GIHVM. Poiché il desiderio della paziente di rimanere incinta era importante, la nostra clinica multidisciplinare ha consentito una gravidanza con un attento monitoraggio clinico, biologico e di imaging e follow-up. L’inizio precoce dell’eparina a basso peso molecolare (EBPM) ha consentito con successo una gravidanza a termine e un parto senza complicazioni. È stata raggiunta la stabilità della lesione intraepatica e si è prevenuta la progressione da LIC a disturbo diffuso della coagulazione intravascolare (DIC).
Uso di antimicrobici a fine vita: una revisione dell’ambito
Resilienza psicologica: un aggiornamento sulle definizioni, una valutazione critica e raccomandazioni di ricerca
Background: la capacità di resistere a esiti avversi o di dimostrare resilienza dopo l’esposizione a un trauma è un fiorente campo di studio. Eppure il dibattito in corso persiste riguardo alle definizioni di resilienza, generalizzabilità della letteratura esistente, correlati neurobiologici e un programma di ricerca di consenso. Obiettivi: per rispondere a queste pressanti domande, Drs. Christy Denckla e Karestan Koenen (co-presidenti) hanno convocato un pannello multidisciplinare che includeva i dottori. Dante Cicchetti, Laura Kubzansky, Soraya Seedat, Martin Teicher e David Williams all’incontro annuale 2019 della International Society for Traumatic Stress Studies (ISTSS). Le domande includevano (1) come si sono evolute le definizioni di resilienza, (2) quali sono i migliori approcci per catturare la complessità dei processi di resilienza e (3) quali sono le aree più importanti per la ricerca futura?
Metodi: Gli atti di questo panel sono riassunti in questo rapporto e temi importanti sono sintetizzati e integrati.
Risultati: sebbene siano emerse definizioni diverse, tutte condividevano un focus sulla concettualizzazione della resilienza a più livelli, dal livello biologico a quello strutturale sociale, un focus sulla natura dinamica della resilienza e un allontanamento dalla concettualizzazione della resilienza come solo un tratto individuale. Le aree critiche per la ricerca futura includevano 1) sforzi mirati per migliorare la valutazione che ha validità internazionale e interculturale, 2) sviluppare progetti all’interno dello studio che impiegano strategie di fenotipizzazione più intense, 3) esaminare i risultati su più livelli e domini e 4) integrare concettualizzazioni di resilienza dal livello individuale al contesto sociale più ampio a livello di salute della popolazione.
Description: Our Ras Activation Assays use visible agarose beads to selectively precipitate the active form of specific Ras protein of interest. The precipitated small GTPase is then detected by Western blot using a target-specific antibody included in the kit. Assays are available to detect specific isoforms H-Ras, K-Ras, and N-Ras, as well as a Pan-Ras assay that detects all three isoforms.
Description: Our Ras Activation Assays use visible agarose beads to selectively precipitate the active form of specific Ras protein of interest. The precipitated small GTPase is then detected by Western blot using a target-specific antibody included in the kit. Assays are available to detect specific isoforms H-Ras, K-Ras, and N-Ras, as well as a Pan-Ras assay that detects all three isoforms.
Description: Our Ras Activation Assays use visible agarose beads to selectively precipitate the active form of specific Ras protein of interest. The precipitated small GTPase is then detected by Western blot using a target-specific antibody included in the kit. Assays are available to detect specific isoforms H-Ras, K-Ras, and N-Ras, as well as a Pan-Ras assay that detects all three isoforms.
Description: Our Ras Activation Assays use visible agarose beads to selectively precipitate the active form of specific Ras protein of interest. The precipitated small GTPase is then detected by Western blot using a target-specific antibody included in the kit. Assays are available to detect specific isoforms H-Ras, K-Ras, and N-Ras, as well as a Pan-Ras assay that detects all three isoforms.
Description: Our Ral Activation Assay uses visible agarose beads to selectively precipitate the active form of Ral protein. The precipitated small GTPase is then detected by Western blot using a Ral-specific antibody included in the kit.
Description: Our Ran Activation Assay uses visible agarose beads to selectively precipitate the active form of Ran protein. The precipitated small GTPase is then detected by Western blot using a Ran-specific antibody included in the kit.
Description: Our Rac Activation Assays use visible agarose beads to selectively precipitate the active form of Rac1 or Rac2. The precipitated small GTPase is then detected by Western blot using a Rac1- or Rac2-specific antibody included in the kit.
Description: Our Rac Activation Assays use visible agarose beads to selectively precipitate the active form of Rac1 or Rac2. The precipitated small GTPase is then detected by Western blot using a Rac1- or Rac2-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Arf Activation Assays use visible agarose beads to selectively precipitate the active form of Arf1 or Arf 6. The precipitated small GTPase is then detected by Western blot using an Arf1- or Arf6-specific antibody included in the kit.
Description: Our Arf Activation Assays use visible agarose beads to selectively precipitate the active form of Arf1 or Arf 6. The precipitated small GTPase is then detected by Western blot using an Arf1- or Arf6-specific antibody included in the kit.
Description: Our Cdc42 Activation Assays use visible agarose beads to selectively precipitate the active form of Cdc42 protein. The precipitated small GTPase is then detected by Western blot using a Cdc42-specific antibody included in the kit.
Description: Our Rap Activation Assays use visible agarose beads to selectively precipitate the active form of Rap1 or Rap2. The precipitated small GTPase is then detected by Western blot using a Rap1- or Rap2-specific antibody included in the kit.
Description: Our Rap Activation Assays use visible agarose beads to selectively precipitate the active form of Rap1 or Rap2. The precipitated small GTPase is then detected by Western blot using a Rap1- or Rap2-specific antibody included in the kit.
Description: Our Ral Activation Assay uses visible agarose beads to selectively precipitate the active form of Ral protein. The precipitated small GTPase is then detected by Western blot using a Ral-specific antibody included in the kit.
Description: Our Ran Activation Assay uses visible agarose beads to selectively precipitate the active form of Ran protein. The precipitated small GTPase is then detected by Western blot using a Ran-specific antibody included in the kit.
Description: Our Rac Activation Assays use visible agarose beads to selectively precipitate the active form of Rac1 or Rac2. The precipitated small GTPase is then detected by Western blot using a Rac1- or Rac2-specific antibody included in the kit.
Description: Our Rac Activation Assays use visible agarose beads to selectively precipitate the active form of Rac1 or Rac2. The precipitated small GTPase is then detected by Western blot using a Rac1- or Rac2-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Rho Activation Assays use visible agarose beads to selectively precipitate the active form of RhoA, RhoB or RhoC. The precipitated small GTPase is then detected by Western blot using a RhoA-, RhoB- or RhoC-specific antibody included in the kit.
Description: Our Rap Activation Assays use visible agarose beads to selectively precipitate the active form of Rap1 or Rap2. The precipitated small GTPase is then detected by Western blot using a Rap1- or Rap2-specific antibody included in the kit.
Description: Our Rap Activation Assays use visible agarose beads to selectively precipitate the active form of Rap1 or Rap2. The precipitated small GTPase is then detected by Western blot using a Rap1- or Rap2-specific antibody included in the kit.
Description: Our Arf Activation Assays use visible agarose beads to selectively precipitate the active form of Arf1 or Arf 6. The precipitated small GTPase is then detected by Western blot using an Arf1- or Arf6-specific antibody included in the kit.
Description: Our Arf Activation Assays use visible agarose beads to selectively precipitate the active form of Arf1 or Arf 6. The precipitated small GTPase is then detected by Western blot using an Arf1- or Arf6-specific antibody included in the kit.
Description: Our Cdc42 Activation Assays use visible agarose beads to selectively precipitate the active form of Cdc42 protein. The precipitated small GTPase is then detected by Western blot using a Cdc42-specific antibody included in the kit.
Description: Our Rac1/Cdc42 Activation Assays use visible agarose beads to selectively precipitate the active form of the small GTPase. The precipitated small GTPase is then detected by Western blot using a specific antibody included in the kit.
Description: Our RhoA/Rac1/Cdc42 Activation Assays use visible agarose beads to selectively precipitate the active form of the small GTPase. The precipitated small GTPase is then detected by Western blot using a specific antibody included in the kit.
Description: Our 96-Well Ras Activation ELISA Kit uses the Raf1 RBD (Rho binding domain) bound to a 96-well plate to selectively pull down the active form of Ras from purified or endogenous samples. The captured GTP-Ras is then detected by a pan-Ras antibody and HRP-conjugated secondary antibody.
Description: Our 96-Well Ras Activation ELISA Kit uses the Raf1 RBD (Rho binding domain) bound to a 96-well plate to selectively pull down the active form of Ras from purified or endogenous samples. The captured GTP-Ras is then detected by a pan-Ras antibody and HRP-conjugated secondary antibody.
CORNING® BIOCOAT™ T-CELL ACTIVATION CONTROL 96 WELL FLAT BOTTOM ASSAY PLATE, INDIVIDUALLY WRAPPED, 5/CASE
Description: NF-?B Activation Inhibitor III is a NF-?B inhibitor.NF-?B (nuclear factor kappa-light-chain-enhancer of activated B cells) is a protein complex controling transcription of DNA, cytokine production as well as cell survival.
Description: NF-?B Activation Inhibitor III is a NF-?B inhibitor.NF-?B (nuclear factor kappa-light-chain-enhancer of activated B cells) is a protein complex controling transcription of DNA, cytokine production as well as cell survival.
Description: A competitive ELISA for quantitative measurement of Rat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A polyclonal antibody for detection of GAL4 Activation Domain from Human. This GAL4 Activation Domain antibody is for WB. It is affinity-purified from rabbit antiserum by affinity-chromatography using epitope-specific immunogenand is unconjugated. The antibody is produced in rabbit by using as an immunogen recombinant protein
Description: A polyclonal antibody for detection of GAL4 Activation Domain from Human. This GAL4 Activation Domain antibody is for WB. It is affinity-purified from rabbit antiserum by affinity-chromatography using epitope-specific immunogenand is unconjugated. The antibody is produced in rabbit by using as an immunogen recombinant protein
Description: A polyclonal antibody for detection of GAL4 Activation Domain from Human. This GAL4 Activation Domain antibody is for WB. It is affinity-purified from rabbit antiserum by affinity-chromatography using epitope-specific immunogenand is unconjugated. The antibody is produced in rabbit by using as an immunogen recombinant protein
Description: Fibroblast activation protein alpha is a homodimeric 170 kDa melanoma membrane-bound gelatinase, protein that in humans is encoded by the FAP gene. The protein encoded by this gene is a homodimeric integral membrane gelatinase belonging to the serine protease family. It is selectively expressed in reactive stromal fibroblasts of epithelial cancers, granulation tissue of healing wounds, and malignant cells of bone and soft tissue sarcomas. This protein is thought to be involved in the control of fibroblast growth or epithelial-mesenchymal interactions during development, tissue repair, and epithelial carcinogenesis. Alternatively spliced transcript variants encoding different isoforms have been found for this gene.
Description: A competitive ELISA for quantitative measurement of Goat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Goat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Goat B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Human B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Human B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Human B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Mouse B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Mouse B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Mouse B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rabbit B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rabbit B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rabbit B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Monkey B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Monkey B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Monkey B Cell Activation Factor in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Porcine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rat Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rat Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Rat Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Description: A competitive ELISA for quantitative measurement of Canine Trypsinogen activation peptide in samples from blood, plasma, serum, cell culture supernatant and other biological fluids. This is a high quality ELISA kit developped for optimal performance with samples from the particular species.
Conclusione: quadri concettuali sempre più sofisticati e sfumati, insieme alla ricerca che fa leva sui progressi della genetica, della biologia molecolare, una maggiore capacità computazionale e set di dati più ampi e diversificati suggeriscono che il prossimo decennio di ricerca potrebbe portare a scoperte significative.
