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Bilder G.E.,Gwynedd-Mercy University
Side Effects of Drugs Annual | Year: 2014

The Side Effects of Drugs Annuals forms a series of volumes in which the adverse effects of drugs and adverse reactions to them are surveyed. The series supplements the contents of Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions. This review of the January 2012 to June 2013 publications on adverse reactions to thyroid hormones, iodine and antithyroid drugs (ATDs) covers levothyroxine, the thyroid hormone analogue eprotirome, iodine and radioactive iodine and thionamide ATDs. Until recently, liver transplantation was the only therapy available to suppress the main source of the transthyretin amyloidogenic mutant. However, several drug treatments are emerging, including transthyretin tetramer stabilisers, small molecules that bind to the native form of transthyretin, preventing its dissociation and subsequent aggregation and deposition. One of these compounds, tafamidis, has been approved by the European Medicines Agency for the treatment of transthyretin familial amyloid polyneuropathy. Other drug candidates are being evaluated. © 2014 Elsevier B.V.

Roberts N.,Gwynedd-Mercy University
Nursing in critical care | Year: 2011

Ventilator-associated pneumonia (VAP) is a common complication of mechanical ventilation after endotracheal intubation. The role of chlorhexidine and tooth-brushing has been considered as a clinical intervention to reduce infection rates, however, evidence to inform this needs appraising. This paper presents a critical review on the effect of chlorhexidine gluconate (CHX) and tooth-brushing in decreasing rates of VAP in mechanically ventilated adult patients cared for in intensive care settings. A literature search was conducted using a number of bibliographic databases (n = 6). A number of parameters were used to exclude irrelevant papers. A total n = 17 papers were located and accessed, which were directly related to the field. Eight studies that met the criteria and addressed the study aims were reviewed. CHX was successful in reducing the rate of VAP and using a combination of CHX and colistine resulted in better oropharyngeal decontamination which reduced and delayed VAP. Chlorhexidine was also effective in reducing dental plaque in patients cared for in intensive care and had the potential to reduce nosocomial infections. Results of studies investigating the use of tooth-brushing in reducing VAP incidence proved inconsistent, although all recommend tooth-brushing as important in maintaining good oral hygiene. The use of chlorhexidine has been proven to be of some value in reducing VAP, although may be more effective when used with a solution which targets gram-negative bacteria. Tooth-brushing is recommended in providing a higher standard of oral care to mechanically ventilated patients and reducing VAP when used with chlorhexidine. However, limitations in study design and inconsistency in results suggest that further research is required into the effects of tooth-brushing. © 2011 The Authors. Nursing in Critical Care © 2011 British Association of Critical Care Nurses.

Rollins-Smith L.A.,Vanderbilt University | Fites J.S.,Vanderbilt University | Fites J.S.,University of Wisconsin - Madison | Reinert L.K.,Vanderbilt University | And 3 more authors.
Infection and Immunity | Year: 2015

Batrachochytrium dendrobatidis is a fungal pathogen in the phylum Chytridiomycota that causes the skin disease chytridiomycosis. Chytridiomycosis is considered an emerging infectious disease linked to worldwide amphibian declines and extinctions. Although amphibians have well-developed immune defenses, clearance of this pathogen from the skin is often impaired. Previously, we showed that the adaptive immune system is involved in the control of the pathogen, but B. dendrobatidis releases factors that inhibit in vitro and in vivo lymphocyte responses and induce lymphocyte apoptosis. Little is known about the nature of the inhibitory factors released by this fungus. Here, we describe the isolation and characterization of three fungal metabolites produced by B. dendrobatidis but not by the closely related nonpathogenic chytrid Homolaphlyctis polyrhiza. These metabolites are methylthioadenosine (MTA), tryptophan, and an oxidized product of tryptophan, kynurenine (Kyn). Independently, both MTA and Kyn inhibit the survival and proliferation of amphibian lymphocytes and the Jurkat human T cell leukemia cell line. However, working together, they become effective at much lower concentrations. We hypothesize that B. dendrobatidis can adapt its metabolism to release products that alter the local environment in the skin to inhibit immunity and enhance the survival of the pathogen. © 2015, American Society for Microbiology.

Griffin J.,Temple University | Pirmann T.,Springfield Township High School | Pirmann T.,Gwynedd-Mercy University | Gray B.,George Washington Carver High
SIGCSE 2016 - Proceedings of the 47th ACM Technical Symposium on Computing Science Education | Year: 2016

This paper reports on an investigative, qualitative case study of the teaching practices of two public high school Computer Science teachers as they teach courses that are fully or partially aligned with the CS Principles framework. One teaches at an urban, high minority STEM school, the other at a middle class suburban school. Ethnographic methods were used to collect data via classroom observations and teacher interviews. Within-case and across-case analyses are presented which characterize the teachers' practices regarding pedagogy, curricula, creative activities, problem-solving activities, and management of social interactions. The findings provide detailed insights regarding the challenges these teachers face and the strategies they use, which may be useful to teachers in a variety of settings at both the high school and college/university levels. © 2016 ACM.

Bond A.,University of Cardiff | Ahmed W.,Gwynedd-Mercy University
BMJ Case Reports | Year: 2016

Gastrointestinal (GI) angiodysplasia is an important and challenging cause of acute GI haemorrhage, particularly in the elderly. We present the case of an 83-year-old woman admitted with acute upper GI bleeding that was refractory to both endoscopic ablation with argon plasma coagulation and gastroduodenal artery embolisation. Administration of thalidomide 100 mg daily after failure of the above therapeutic procedures resulted in cessation of bleeding and avoided the need for further blood transfusion at 6-month follow-up. Copyright 2016 BMJ Publishing Group. All rights reserved.

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