oalib

Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99

Submit

Any time

2019 ( 156 )

2018 ( 886 )

2017 ( 805 )

2016 ( 1163 )

Custom range...

Search Results: 1 - 10 of 480310 matches for " Paul A Gurbel "
All listed articles are free for downloading (OA Articles)
Page 1 /480310
Display every page Item
Interaction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases
Paul A Gurbel, Udaya S Tantry, Dean J Kereiakes
Drug, Healthcare and Patient Safety , 2010, DOI: http://dx.doi.org/10.2147/DHPS.S7297
Abstract: teraction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases Review (3676) Total Article Views Authors: Paul A Gurbel, Udaya S Tantry, Dean J Kereiakes Published Date November 2010 Volume 2010:2 Pages 233 - 240 DOI: http://dx.doi.org/10.2147/DHPS.S7297 Paul A Gurbel1, Udaya S Tantry1, Dean J Kereiakes2 1Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, USA; 2The Christ Hospital Heart and Vascular Center/The Lindner Research Center at The Christ Hospital, Cincinnati, OH, USA Abstract: Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin has been successful in reducing ischemic events in a wide range of patients with cardiovascular diseases. However, the anti-ischemic effects of DAPT may also be associated with gastrointestinal (GI) complications including ulceration and bleeding particularly in ‘high risk’ and elderly patients. Current guidelines recommend the use of proton-pump inhibitors (PPIs) to reduce the risk of GI bleeding in patients treated with DAPT. However, pharmacodynamic studies suggest an effect of PPIs on clopidogrel metabolism with a resultant reduction in platelet inhibitory effects. Similarly, several observational studies have demonstrated reduced clopidogrel benefit in patients who coadministered PPIs. Although recent US Food and Drug Administration and European Medicines Agency statements discourage PPI (particularly omeprazole) and clopidogrel coadministration, the 2009 AHA/ACC/SCAI PCI guidelines do not support a change in current practice in the absence of adequately powered prospective randomized clinical trial data. The data regarding pharmacologic and clinical interactions between PPI and clopidogrel therapies are herein examined and treatment strategies are provided.
Interaction between clopidogrel and proton-pump inhibitors and management strategies in patients with cardiovascular diseases
Paul A Gurbel,Udaya S Tantry,Dean J Kereiakes
Drug, Healthcare and Patient Safety , 2010,
Abstract: Paul A Gurbel1, Udaya S Tantry1, Dean J Kereiakes21Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, USA; 2The Christ Hospital Heart and Vascular Center/The Lindner Research Center at The Christ Hospital, Cincinnati, OH, USAAbstract: Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin has been successful in reducing ischemic events in a wide range of patients with cardiovascular diseases. However, the anti-ischemic effects of DAPT may also be associated with gastrointestinal (GI) complications including ulceration and bleeding particularly in ‘high risk’ and elderly patients. Current guidelines recommend the use of proton-pump inhibitors (PPIs) to reduce the risk of GI bleeding in patients treated with DAPT. However, pharmacodynamic studies suggest an effect of PPIs on clopidogrel metabolism with a resultant reduction in platelet inhibitory effects. Similarly, several observational studies have demonstrated reduced clopidogrel benefit in patients who coadministered PPIs. Although recent US Food and Drug Administration and European Medicines Agency statements discourage PPI (particularly omeprazole) and clopidogrel coadministration, the 2009 AHA/ACC/SCAI PCI guidelines do not support a change in current practice in the absence of adequately powered prospective randomized clinical trial data. The data regarding pharmacologic and clinical interactions between PPI and clopidogrel therapies are herein examined and treatment strategies are provided.Keywords: cardiovascular disease, gastrointestinal, proton-pump inhibitor, antiplatelet therapy
Impact of clopidogrel treatment on platelet function and thrombogenecity in diabetic patients undergoing elective coronary stenting  [PDF]
Anand Singla, Kevin P. Bliden, Young-Hoon Jeong, Joseph DiChiara, Mark J. Antonino, Denny P. Mathew, William C. Muse, Katrina Abadilla, Tania Gesheff, Udaya S. Tantry, Paul A. Gurbel
Journal of Diabetes Mellitus (JDM) , 2012, DOI: 10.4236/jdm.2012.22025
Abstract: High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in Type II diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to examine the effect of clopidogrel on platelet reactivity, and thrombogenecity between DM and non-DM PCI-treated patients (n = 138). Patients were categorized according to clopidogrel treatment and DM status. Patients received a maintenance-dose clopidogrel of 75 mg/d (C75 group, n = 72) or a 600 mg clopidogrel loading-dose in clopidogrel na?ve patients (C600 group, n = 66). Platelet function was assessed by thrombelastography, flow cytometry, VerifyNowTM aspirin assay and light transmittance aggregometry (LTA). Aspirin response was similar between treatments and DM status. In the C75 group, DM patients had higher 5 and 20 μM ADP-, 2 μg/ml collagen-induced LTA; and p-selectin expression compared to non-DM patients (p ≤ 0.05 for all). DM patients in the C600 group had higher 5 and 20 μM ADP-induced LTA post dosing (p < 0.04) and higher maximum induced platelet-fibrin clot strength at baseline and post dosing timepoints (p < 0.05 for all). The present study provides further evidence that DM patients on DAPT are characterized by persistently higher platelet reactivity and thrombogenecity, making them potential candidates for more potent P2Y12 receptor antagonists.
Self-evaluated health of married people in Jamaica  [PDF]
Paul A. Bourne
Health (Health) , 2009, DOI: 10.4236/health.2009.14055
Abstract: Background: In the Caribbean in particular Ja-maica, no study has been done to examine married respondents in order to understand reasons for their greater health status. The ob-jectives of the current study are: 1) examine the sociodemographic characteristics of married people in Jamaica; 2) evaluate self-rated health status of married people in Jamaica; 3) deter-mine factors that account for good health status of married people and 4) provide public health practitioners with empirical studies that can be used to formulate policies for men in particular non-married men in Jamaica. Materials and me- thods: Stratified random sampling technique was used to select 6,783 respondents. It was a nationally representative sample. Logistic re-gression analysis was used to ascertain the correlates of health status. Results: The mean age for women in marriage in Jamaica was 6 years lower than that of men. The correlates of good health status (including moderate health) of respondents in descending order were self- reported illness (OR = 0.12, 95%CI = 0.01- 0.17); age (OR = 0.94, 95%CI = 0.93-0.96); income (OR = 1.32, 95%CI = 1.05-1.66) and sex of respon-dents (Or = 1.14-2.32)—χ2(df = 4) = 383.2, P < 0.05. The four variables accounted for 44.4% of the explanatory power of the model; with self-reported illness accounting for 32.5% of the explanatory power. Conclusion: Marriage pro-vides greater access to more socioeconomic resources for its participants as well as increase men’s unwillingness to visit medical care prac-titioners.
Births, economic growth, mortality and murder in a developing country  [PDF]
Paul A. Bourne
Health (Health) , 2012, DOI: 10.4236/health.2012.42009
Abstract: Background: In 1960, total fertility rate in Jamaica was 5.6 children per woman which declined by 57.5% in 2008. The reduction in fertility is primarily attributable to contraceptive measures; but murder and other selected macroeconomic variables have never been included in the literature. Objectives: This study examines murder, mortality, and selected macroeconomic variables are factors of births, using data for Jamaica from 1989-2009. Methods: The study is a secondary data analysis of statistics on Jamaica from 1989 - 2009 but also includes data on births from 1900s. Find- ings: In the decade of the 1950s, births increased by 79.9% over the decade of 1900s, grew by 22.4% in the 1960s over the previous decade and declined by 17.6% in 2000s compared with the 1990s. Four emerged as statistically significant predictors of lnbirth—inflation, GDP per capita growth, mortality and murder, with an explanatory power of 90.6%—F = 19.291, P < 0.0001. With there being a strong statistical correlation between annual exchange rate and murder (rs = 0.962), when murder was excluded and replaced by annual exchange rate, the factors influencing lnbirth was exchange rate, inflation, unemployment, GDP per capita growth and mortality—all factors account for 92.2% of the variability in lnbirth—F = 30.572, P < 0.0001. Conclusion: Murder is more that a crime it is a cause of birth decline, suggesting that public health practitioners as well as epidemiologists must take this factor into account as it is a birth determinant.
The Dragon vs. the Eagle & Serpent: The Economic Impact of China in Mexico  [PDF]
Paul A. Escajadillo
Open Journal of Political Science (OJPS) , 2014, DOI: 10.4236/ojps.2014.44024
Abstract: Although China has become, over the past three decades, an unprecedented case of economic growth accompanied by a voracious appetite for natural resources, China has been increasingly engaging with Latin America. However, as Sino-Latin American relationships have improved Latin American countries’ economies through their supply of primary products and through the region’s growing importance to China as a market, Mexico has not benefited from this increased engagement. This paper will show that as the balance of trade of selected Latin American countries has grown with China and benefited their economies, it has not been the case with Mexico in particular.
Negotiating the Moral Education of Medical Students in the Age of Multiculturalism  [PDF]
Paul A. Komesaroff
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.64047
Abstract: Formal teaching of ethics in medical courses has failed, providing little more than a vehicle for recapitulating conventional theories and reinforcing social prejudices. Courses are most typically based on out-dated and partial hyper-rationalistic theories that bear little relevance to the tasks of decision making in actual clinical life and on outmoded educational theories. A more adequate approach must recognise two paradoxes. First, the educational process in medicine has to be both limiting and enabling: it must control behaviours, characters and interpersonal styles, and it must achieve exactly the opposite, by establishing the possibility of responding to novel situations and inventing original solutions to ethical uncertainties. Second, despite the extreme complexity of ethical encounters and cultures, communication among contending discourses is always possible; indeed, the more profound the gulf is, the richer and more fecund the play of differences that constitute the dialogue can become. The multiple, diverse tasks of ethics are linked to contrasting technologies and pedagogies. In recognition of this, this article highlights the need for educational approaches in medicine that do not only reproduce the moral assumptions and prejudices of the mainstream culture but also are faithful to the actual practices of clinical decision making, thereby contributing to the cultivation of multidimensional competencies covering many levels of personal and social experience.
Modelling social determinants of self-evaluated health of poor older people in a middle-income developing nation  [PDF]
Paul A. Bourne
Journal of Biomedical Science and Engineering (JBiSE) , 2010, DOI: 10.4236/jbise.2010.37094
Abstract: Over the last 2 decades (1988-2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting more health conditions in a 4-week period (15.5% in 2007) and at the same time this corresponds to a decline in the percentage of people seeking medical care. Older people’s health status is of increasing concern, given the high rates of prostate cancer, genitourinary disorders, hypertension, diabetes mellitus and the presence of risk factors such as smoking. Yet, there is a dearth of studies on the health status of older people in the two poor quintiles. This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status. A sample of 1,149 elderly respondents, with an average age of 72.6 years (SD = 8.7 years) were extracted from a total survey of 25,018 Jamaicans. The initial survey sample was selected from a stratified probability sampling frame of Jamaicans. An administered questionnaire was used to collect the data. Descriptive statistics were used to examine background information on the sample, and stepwise logistic regression was used to ascertain the factors which are associated with health status. The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90; 95% CI: 7.98-24.19), age of respondents (OR = 7.98; 95% CI: 1.02-1.06), and secondary level education (OR=1.82; 95% CI: 1.35-2.45). Males are less likely to report good health status than females (OR = 0.56; 95% CI: 0.42-0.75). Older people in Jamaica do not purchase health insurance coverage as a preventative measure but as a curative measure. Health insurance coverage in this study does not indicate good health but is a proxy of poor health status. The demand of the health services in Jamaica in the future must be geared towards a particular age cohort and certain health conditions, and not only to the general population, as the social determinants which give rise to inequities are not the same, even among the same age cohort.
Is Use of Radiation Hormesis the Missing Link to a Better Cancer Treatment?  [PDF]
Paul A. Oakley
Journal of Cancer Therapy (JCT) , 2015, DOI: 10.4236/jct.2015.67065
Abstract: Radiation hormesis is a concept that pervades radiobiological exposures; low doses enhance immune response, while higher doses inhibit immune response. Low-dose Total-Body Irradiation (TBI) therapy offers radiation treatment to cancer patients using the concepts of radiation hormesis and show very good success rates. This phenomenon has been reported elsewhere as the “abscopal effect” and considering the marginal success rates of other treatment agents, like the immunotherapy drug Ipilimumab, TBI therapy may prove to be the missing link to a better cancer treatment.
Paired, Total, and Connected Domination on the Queen’s Graph Revisited  [PDF]
Paul A. Burchett
Open Journal of Discrete Mathematics (OJDM) , 2016, DOI: 10.4236/ojdm.2016.61001
Abstract: The question associated with total domination on the queen’s graph has a long and rich history, first having been posed by Ahrens in 1910 [1]. The question is this: What is the minimum number of queens needed so that every square of an n × n board is attacked? Beginning in 2005 with Amirabadi, Burchett, and Hedetniemi [2] [3], work on this problem, and two other related problems, has seen progress. Bounds have been given for the values of all three domination parameters on the queen’s graph. In this paper, formations of queens are given that provide new bounds for the values of total, paired, and connected domination on the queen’s graph, denoted \"\", \"\", and \"\" respectively. For any n × n board size, the new bound of \"\" is arrived at, along with the separate bounds of \"\" , for \"\" with \"\" , and \"\" , for \"\" with \"\".
Page 1 /480310
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.