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The California Budget Crisis and How It Is Affecting The Emergency Care Funds
Lotfipour, Shahram
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2002,
Legislative Update: Is There a "Perfect Storm" in the California Horizon?
Lotfipour, Shahram
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2003,
The Dilemma of Increasing Media Scrutiny on Older-Adult Driving Fitness
Grotsky, Thomas,Lotfipour, Shahram
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2006,
Abstract: As several highly publicized traffic collisions occurred in 2003 and 2004, the nation began to give more attention to the issue of older drivers. After several older-driver collisions, California, Minnesota, Wisconsin, and Massachusetts examined their license renewal and driver testing policies for both the young and old. We describe these major traffic incidents and discuss their impact on the political, medical, and social forums.
Advantages of a Three-Year Residency
Langdorf, Mark,Lotfipour, Shahram
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2004,
Evaluation of the effect of CaCl2 and alginate concentrations and hardening time on the characteristics of Lactobacillus acidophilus loaded alginate beads using response surface analysis
Farzaneh Lotfipour,Shahla Mirzaeei,Maryam Maghsoodi
Advanced Pharmaceutical Bulletin , 2012,
Abstract: Purpose: This article describes preparation and characterization of beads of alginate containing probiotic bacteria of Lactobacillus acidophilus DMSZ20079. Methods: Fourteen formulations using different alginate (ALG) and CaCl2 concentrations as well as hardening times were prepared using extrusion technique. The prepared beads were characterized in terms of size, morphology, encapsulation efficiency and bacterial viabilities in acid (pH 1.8, 2 hours) condition. Results: The results showed that spherical beads with narrow size distribution ranging from 1.32±0.04 to 1.70±0.07 mm were achieved with encapsulation efficiency higher than 98%. Surface response analysis revealed that alginate concentration was the important factor for the size, shape and encapsulation efficiency of prepared beads. Furthermore, survived bacteria after acid exposure in all prepared beads (63-83%) were significantly higher than those of untreated cells (39%) and enhanced by increasing alginate concentration. Surface response analysis revealed that the effect of all three factors of alginate and CaCl2 concentrations as well as hardening times were significant in acid viability, however alginate concentration played the most important role according to its regression coefficient. Conclusion: Among alginate and CaCl2 concentrations as well as hardening times, alginate concentration was the most variable in the characteristics of Alginate beads.
Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse
Bharath Chakravarthy,Shyam Shah,Shahram Lotfipour
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2012,
Abstract: The Center for Disease Control and Prevention (CDC) has published significant data and trendsrelated to opioid prescription pain relievers (OPR). In 2008, 20,044 deaths were attributedto prescription drug overdose of which 14,800 (73.8%) were due to OPR, an amount greaterthan the number of overdose deaths from heroin and cocaine combined. The majority of thesedeaths were unintentional. Between 1999-2008, overdose deaths from OPR increased almostfour-fold. Correspondingly, sales of OPR were four times greater in 2010 than in 1999. Mostsignificant to emergency physicians is the estimate that 39% of all opioids prescribed, administeredor continued come from the emergency department (ED). We present findings from theCDC’s Morbidity and Mortality Weekly Report (MMWR) with commentary on current recommendationsand policies for curtailing the OPR epidemic.1
Pedestrian Injuries: Emergency Care Considerations
Chakravarthy, Bharath,Lotfipour, Shahram,Vaca, Federico E
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2007,
Abstract: Traffic-related pedestrian injuries are a growing public health threat worldwide. The global economic burden of motor vehicle collisions and pedestrian injuries totals $500 billion. In 2004, there were 4,641 pedestrian deaths and over 70,000 injuries in the United States. Injury patterns vary depending on the age, gender and socioeconomic status of the individual. Children, older adults, and those of lower socioeconomic status are most affected. The burden of injury upon the individual, families and society is frequently overwhelming. Although pedestrian injuries and deaths are relatively on the decline in the United States, this is not universally true throughout the world. It requires particular attention by emergency medicine physicians, public health experts and policy makers.
Guidelines for Field Triage of Injuried Patients
Chakravarthy, Bharath,McCoy, Christopher Eric,Lotfipour, Shahram
Western Journal of Emergency Medicine : Integrating Emergency Care with Population Health , 2013,
Abstract: The Centers for Disease Control and Prevention (CDC) has published significant data and trends related to the national public health burden associated with trauma and injury. In the United States (U.S.), injury is the leading cause of death for persons aged 1-44 years. In 2008, approximately 30 million injuries resulted in an emergency department (ED) evaluation; 5.4 million (18%) of these patients were transported by Emergency Medical Services (EMS).1 EMS providers determine the severity of injury and begin initial management at the scene. The decisions to transport injured patients to the appropriate hospital are made through a process known as “field triage.” Since 1986, the American College of Surgeons Committee on Trauma (ACS-COT) has provided guidance for the field triage process though its “Field Triage Decision Scheme.” In 2005, the CDC, with financial support from the National Highway Traffic Safety Administration (NHTSA), collaborated with ASC-COT to convene the initial meeting of the National Expert Panel on Field Triage (the Panel) to revise the decision scheme. This revised version was published in 2006 by ASC-COT, and in 2009 the CDC published a detailed description of the scientific rational for revising the field triage criteria entitled, “Guidelines for FieldTriage of Injured Patients.”2-3 In 2011, the CDC reconvened the Panel to review the 2006 Guidelines and recommend any needed changes. We present the methodology, findings and updated guidelines from the Morbidity & Mortality Weekly Report (MMWR) from the 2011 Panel along with commentary on the burden of injury in the U.S., and the role emergency physicians have in impacting morbidity and mortality at the population level. [West J Emerg Med. 2013;14(1):69-76.]
Effect of Taurine on the antimicrobial efficiency of Gentamicin
Islambulchilar Mina,Sattari Mohammad Reza,Sardashti Mohammad,Lotfipour Farzaneh
Advanced Pharmaceutical Bulletin , 2011,
Abstract: Context: Gentamicin is mainly used in severe infections caused by gram-negatives. However toxicity including nephrotoxicity and ototoxicity is one of the most important complications of its treatment. The production of free radicals seems to be involved in gentamicin toxicity mechanism. Taurine, a major intracellular free β-amino acid, is known to be an endogenous antioxidant. So potentially the co-therapy of taurine and gentamicin would reduce the adverse effects of the antibiotic. Objectives: In this study, we wished to know the effect of taurine on the antibiotic capacity of gentamicin. methods: strains of P. aeruginosa, E. coli, S. aureus and S. epidermidis were used as test organisms. Minimum inhibitory concentrations of gentamicin in the presence and absence of taurine at quantities from 40 to 2 mg/L were determined using macro-dilution method. Results: MICs were determined in the various concentrations of taurine for bacterial indicators. The MIC values of gentamicin for P. aeruginosa, S. aureus and E. coli remained unchanged in the values of 2.5, 5 and 20 μg/ml respectively in the absence and presences of different concentrations of taurine. The bactericidal activity of gentamicin against S. epidermidis was increased by addition of taurine in the concentrations higher than 6 mg/L. Conclusion: According to our study the antibacterial activity of gentamicin against the indicator microorganisms were not interfere with taurine at selected concentrations. Further in vivo studies are needed to establish if a combination of gentamicin and taurine would have the same effect.
Determination of comparative minimum inhibitory concentration (MIC) of bacteriocins produced by enterococci for selected isolates of multi-antibiotic resistant Enterococcus spp.
Maryam Hassan,Yousef Javadzadeh,Farzaneh Lotfipour,Rajabali Badomchi
Advanced Pharmaceutical Bulletin , 2011,
Abstract: Introduction: The occurrence of multi-antibiotic resistance among enterococci is a prevalent clinical problem worldwide and continues to get serious due to the lack of efficient therapeutic options by the time. In this regards, prokaryotic antimicrobial peptides with bactericidal or bacteriostatic activity which are directed against bacterial strains closely related to producer strains looks one of the promising alternative to conventional antibiotics. Methods: The antibiotic susceptibility pattern of 20 clinical isolates of enterococci was evaluated and subsequently the isolates were screened for antibacterial activity against three different indicator strains. The efficacy of potential bacteriocinogenic isolates were assayed against multi-antibiotic resistant Enterococcus spp. by comparative minimum inhibitory concentration (MIC). Results: Antibiotic resistant pattern of enterococcal isolates demonstrated that multi-antibiotic resistant to conventional antibiotics were significantly high and the prevalent pattern of resistance was combination of gentamicin, streptomycin, chloramphenicol and vancomycin. In addition, the data from comparative MIC showed the noticeable activity of selected potential bacteriocinogenic strains against pathogenic enterococci. Conclusion: The present survey may address the potential applicability of antimicrobial peptides in alleviating the problems of antibiotic resistance.
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