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Search Results: 1 - 10 of 36 matches for " Raymund Dantes "
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Impact of Isoniazid Resistance-Conferring Mutations on the Clinical Presentation of Isoniazid Monoresistant Tuberculosis
Raymund Dantes, John Metcalfe, Elizabeth Kim, Midori Kato-Maeda, Philip C. Hopewell, Masae Kawamura, Payam Nahid, Adithya Cattamanchi
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0037956
Abstract: Background Specific isoniazid (INH) resistance conferring mutations have been shown to impact the likelihood of tuberculosis (TB) transmission. However, their role in the clinical presentation and outcomes of TB has not been evaluated. Methods We included all cases of culture-confirmed, INH monoresistant tuberculosis reported to the San Francisco Department of Public Health Tuberculosis Control Section from October 1992 through October 2005. For cases with stored culture isolates, we used polymerase chain reaction (PCR) testing and gene sequencing to identify INH resistance-conferring mutations, and compared genotypic and phenotypic characteristics. Results Among 101 consecutive cases of INH monoresistant TB in San Francisco 19 (19%) had isolates with a katG mutation other than S315T; 38 (38%) had isolates with the katG S315T mutation, 29 (29%) had isolates with a inhA-15;c-t promoter mutation, and 15 (15%) had isolates with other mutations. The katG S315T mutation was independently associated with high-level INH resistance (risk ratio [RR] 1.56, 95% confidence interval [CI] 1.07–2.27), and the inhA-15;c-t promoter mutation was inversely associated with high-level INH resistance (RR 0.43, 95% CI 0.21–0.89). However, specific INH resistance-conferring mutations were not associated with the clinical severity or outcomes of INH monoresistant TB cases. Conclusion These data suggest that INH resistance-conferring mutations do not impact the clinical presentation of TB.
Predictors of Spontaneous Bacterial Peritonitis (SBP) in Liver Cirrhosis: Current Knowledge and Future Frontiers  [PDF]
Helen Ngo, Raymund Gantioque
Open Journal of Gastroenterology (OJGas) , 2017, DOI: 10.4236/ojgas.2017.712031
Abstract: Spontaneous bacterial peritonitis (SBP) in patients with cirrhotic liver disease is a serious complication that contributes to the high morbidity and mortality rate seen in this population. Currently, there is a lack of consensus amongst the research community on the clinical predictors of SBP as well as the risks and benefits of prophylactic antibiotic therapy in these patients. Pharmacological gastric acid suppression (namely with PPIs and H2RAs) are frequently prescribed for these patients, many times without a clear indication, and may contribute to gut bacterial overflow and SBP development. However, this remains controversial as there are conflicting findings in SBP prevalence between PPI/H2RA-users and non-users. In addition, studies show recent antibiotic use, whether for SBP prophylaxis or for another infectious process, appear to be associated with higher rates of SBP and drug-resistant organisms. Other researchers have also explored the link between zinc, platelet indices (MPV), and macrophage inflammatory protein-1 β (MIP-1β) levels in liver cirrhosis, all of which appear to be promising markers for classifying SBP risk and diagnosis. This literature review was limited by the number and quality of studies available as most are retrospective in nature. Thus, more ongoing, prospective studies and trials are needed to judge the true value of the findings in the studies reviewed in hopes that they can guide appropriate prevention, diagnosis, and management of SBP.
Diagnosis and Treatment Options for Pulmonary Embolism (PE) in the Acute Care Setting  [PDF]
Simona Campa, Raymund Gantioque
World Journal of Cardiovascular Diseases (WJCD) , 2018, DOI: 10.4236/wjcd.2018.82015
Abstract: Thromboembolic diseases continue to be one of the most prevalent medical problems today and can lead to life-threatening conditions, such as pulmonary embolism (PE). Currently, PE diagnosis and treatment are a challenge because of acute onset right ventricular strain with right-sided heart failure, sudden death, pulmonary infarction, and cardiogenic shock, which limit the time for therapeutic success.The aim of this study was to evaluate our perception, knowledge, and concerns regarding PE, discuss the importance of promptly diagnosing PE to provide appropriate treatment options for this life-threatening condition, list the most common clinical manifestations present when PE is suspected, and review the clinical approach to patients with suspected PE in an inpatient setting.In addition, this study reviews the risk stratification of patients with PE and treatment options beyond anticoagulation, compares new treatment options for patients presenting with acute symptomatic PE, and compares aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter (Vascular Solutions, Minneapolis, MN)) and ultrasound-assisted catheter-directed thrombolysis (USAT) versus systemic thrombolysis.This literature review was limited by the quality and number of studies available regarding new treatment options for patients presenting with acute symptomatic PE. Thus, more studies are needed to prove the validity of newer treatment options being trialed, such as aspiration catheters (10 F Pronto .035” and 14 F XL extraction catheter) and USAT, with the hope that further studies will guide patient management and increase our understanding of next generation aspiration catheters, which may provide novel insights on treating acute symptomatic PE.
Differentiating between SIADH and CSW Using Fractional Excretion of Uric Acid and Phosphate: A Narrative Review  [PDF]
Alexandria Rudolph, Raymund Gantioque
Neuroscience & Medicine (NM) , 2018, DOI: 10.4236/nm.2018.92007
Abstract: Background: Sodium imbalances are among the most common electrolyte abnormalities encountered in the acute care setting. The syndrome of inappropriate anti-diuretic hormone (SIADH) and cerebral salt wasting (CSW) are characterized by hyponatremia and can be difficult to differentiate. Failure to accurately diagnose these conditions and implement the correct treatment results in an increased mortality risk, a longer length of stay in the hospital, and an increase in the cost of hospitalization. Objective: The purpose of this review is to summarize the key diagnostic findings in each disorder and to review the use of the fractional excretion of uric acid (FeUA) and the fractional excretion of phosphate as additional diagnostic measures to differentiate between SIADH and CSW. Observation: Publications from MEDLINE, CINAHL, and Google Scholar from 2009 through 2017 were reviewed. Articles were included if original data was presented and diagnosed either SIADH or CSW. Articles were excluded if they did not discuss diagnostic measures or were review articles. Results: Thirteen out of 51 publications met the inclusion criteria; four (31%) were clinica trials, seven (54%) were case reports, one (7.5%) was a prospective study and one (7.5%) was a retrospective-observational study. The populations studied, the etiologies causing hyponatremia, and diagnostic criteria used to distinguish between SIADH and CSW varied. Conclusion and Relevance: There is a need for consistent diagnostic criteria for SIADH and CSW. Based on current evidence, the use of FeUA and the fractional excretion of phosphate have consistently and accurately differentiated between SIADH and CSW.
Internet @ Europe: Overcoming institutional fragmentation and policy failure
Raymund Werle
European Integration Online Papers , 2001,
Abstract: For more than a decade the Internet was confronted with ignorance and resistance in many European countries. National and European technology policies were unfavorable to not invented here technologies and committed to open networks of a different kind. The incumbent network operators in telecommunications, most of them enjoying a monopoly status for a long time, declined tolerating deviant modes of data communication and service provision, which might trigger competition and uncontrollable use of their networks. This situation was not simply a matter of attitudes and beliefs of the managerial and political élite. It was rather an expression of constraints of a traditional institutional setting which had produced industry structures and industrial policy strategies that were not compatible with the Internet. Only recently can we observe changes. Telecoms liberalization in the European Union and the emergence of market competition in this industry coincide with a new Internet policy that recognizes the infrastructural significance of this network for a European information society and the need to involve Internet users in order to exploit the potential of this network.
Internet @ Europe: Overcoming institutional fragmentation and policy failure
Raymund Werle
European Integration Online Papers , 2001,
Abstract: For more than a decade the Internet was confronted with ignorance and resistance in many European countries. National and European technology policies were unfavorable to not invented here technologies and committed to open networks of a different kind. The incumbent network operators in telecommunications, most of them enjoying a monopoly status for a long time, declined tolerating deviant modes of data communication and service provision, which might trigger competition and uncontrollable use of their networks. This situation was not simply a matter of attitudes and beliefs of the managerial and political élite. It was rather an expression of constraints of a traditional institutional setting which had produced industry structures and industrial policy strategies that were not compatible with the Internet. Only recently can we observe changes. Telecoms liberalization in the European Union and the emergence of market competition in this industry coincide with a new Internet policy that recognizes the infrastructural significance of this network for a European information society and the need to involve Internet users in order to exploit the potential of this network.
Palliative Care in Emergency Medicine. What Are We Missing?  [PDF]
Lauren Nigolian, Raymund Gantioque, Joshua Dexheimer
Open Journal of Emergency Medicine (OJEM) , 2019, DOI: 10.4236/ojem.2019.71002
Abstract: Patients present to the emergency department with critical and complex medical conditions that require a broad scope of medicine to achieve patient outcomes. Emergency medicine physicians are recognizing the importance and positive outcomes that arise when palliative care teams are consulted in the emergency room. Today, medical schools, residency programs, and emergency departments are requiring palliative care curriculum apart of their education. However, there continues to be a gap in early initiation of palliative care in emergency medicine. Nurse practitioners are becoming pivotal in the emergency department, and patients are considering them key providers in their medical journey. The role of an advanced practice nurse in an emergency room may be optimal for the early onset of palliative care consultation. This manuscript examines current knowledge that explores the background of palliative care, the current practice in the emergency department, the positive outcomes and gaps that still exist today, and the increasing role of an advanced practice nurse in the emergency room and their impact on palliative care initiation.
Huntington's disease: a clinical review
Raymund AC Roos
Orphanet Journal of Rare Diseases , 2010, DOI: 10.1186/1750-1172-5-40
Abstract: The first description by Waters, of a patient with what we now call Huntington's chorea, dates from 1842. But it was not until 1872, after the lecture and description of the disease by George Huntington, that it became known as Huntington's chorea. It is a neurodegenerative disorder passing within families from generation to generation with onset in middle age and characterized by unwanted choreatic movements, behavioral and psychiatric disturbances and dementia [1] For many decades its name remained unchanged, until the nineteen-eighties when, fully aware of the extensive non-motor symptoms and signs, the name was changed to Huntington's disease (HD). In 1983, a linkage on chromosome 4 was established and in 1993 the gene for HD was found [2]. That period marked a tremendous increase in interest in HD and neurogenetic disorders. For the first time, actual premanifest diagnoses could be made and as more diseases involving trinucleotide repeats of CAG were found, HD served as a model for many studies in medicine. CAG (cytosine (C), adenine (A), and guanine (G)), is a trinucleotide, the building stone of DNA. CAG is the codon for the amino acid glutamic. Finding the gene opened new research lines, new models and for the first time a real rationale on the way to treat this devastating disease. Many symptomatic treatments are now available, but there is a need for better, modifying drugs.Huntington's disease is a rare neuropsychiatric disorder with a prevalence of 5-10 per 100,000 in the Caucasian population. In Japan, a much lower prevalence of about one-tenth of prevalence of the Caucasion population is described [3]. Recently, several phenocopies have been described, all of which have an even lower prevalence (see paragraph on differential diagnosis).The nuclear symptoms and signs of Huntington's disease (HD) consist of motor, cognitive and psychiatric disturbances. Other less well-known, but prevalent and often debilitating features of HD include unintended weight l
Waltzing with the Army: From Marcos to Arroyo
Raymund Jose G. Quilop
Kasarinlan : Philippine Journal of Third World Studies , 2001,
Abstract: The relationship between civilian political leadership and the military has changed in character from the Marcos dictatorship to the Macapagal-Arroyo presidency. The military, ideally a professional and depoliticized institution, found itself in conflicting roles in governance. President Ferdinand Marcos used the military to pursue personal interests. After the first EDSA revolt, the principle of civilian superiority was restored but sections in the AFP responded with a series a coup d'etats against the I govemment of President Corazon Aquino. President Fidel Ramos, a former general, found difficulty in limiting the role of the military in government and appointed retired officers in key positions. His government eventually emphasized the role of the armed forces in national development and pushed for the modernization of the AFP, a program sidelined by the previous administration. President Joseph Estrada was more supportive of the military campaign in Mindanao but eventually lost the, support of the AFP in EDSA II. So far the administration of President Gloria Macapagal-Arroyo appears to have a better understanding of the military.The president, a consistent visitor of the military camps, increased the benefits of military personnel and appointed the outgoing AFP Chief of Staff, General AngeloReyes, as Secretary of National Defense. When pro-Estrada supporters clamored, for the latter's return in the so-called EDSA III, the military stood by President Macapagal-Arroyo Civilian political leadership played a great role in shaping the mindset of and their relationship with military officers. They must be knowledgeable and sensitive to the military culture and psyche. The ability to govern effectively and cultivate the culture within the armed forces that subscribes to civilian authority is necessary for harmonious civil-military relations, particularly for democratic societies like the Philippines.
Information and Security: Arguments for a Regional Information Network
Raymund Jose G. Quilop
Kasarinlan : Philippine Journal of Third World Studies , 1995,
Abstract: In the information age, the ability to gather, process and disseminate information plays vital part in the enhancement of regional security. Information being the strategic resource in the 21st century, ASEAN member-states must recognize the indispensability of information-sharing and strive to install a regional information network by interlinking their respective national information systems. Despite potential drawbacks, the establishment if a regional information network will give ASEAN states a sense of community and certainty thereby inducing greater cooperation, transparency and interdependence among them.
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