American Journal of Medicine and Pharmacology

Diagnosis of Gestational Diabetes Mellitus: It Is Time for International Consensus

2022-06-09T09:02:40-07:00

Gestational diabetes mellitus (GDM)2 has been defined as any degree of glucose intolerance with an onset or first recognition during pregnancy. Fetal complications of GDM include macrosomia (large baby, which leads to birth injuries), shoulder dystocia, and neonatal hypoglycemia, and adverse outcomes for the mother are an increased risk of cesarean delivery, pre-eclampsia, and hypertension during pregnancy, as well as a significantly higher risk of subsequent type 2 diabetes. Treating women with GDM reduces at least some of the adverse outcomes

ASIA Outbreak of West Nile Virus Infection

2022-06-09T08:49:42-07:00

From July 25 to October 1, 1999, 826 patients were admitted to Volgograd Region, Russia, hospitals with acute aseptic meningoencephalitis, meningitis, or fever consistent with arboviral infection. Of 84 cases of meningoencephalitis, 40 were fatal. Fourteen brain specimens were positive in reverse transcriptase-polymerase chain reaction assays, confirming the presence of West Nile/Kunjin virus. West Nile (WN) virus is a member of the Japanese encephalitis (JE) antigenic complex of the genus Flavivirus, family Flaviviridae. Mosquito-borne WN virus fever is endemic in Africa, the Middle East, and Southwest Asia. The antigenically and genetically related Kunjin virus is a WN virus counterpart in Australia and Southeast Asia and has recently been taxonomically classified as a subtype of WN virus. Until recently, WN virus infection in humans was considered a relatively mild, influenzalike disease with full recovery, although occasionally

Patient’s Clinical Management With The Observation Of COVID-19

2022-06-09T09:07:14-07:00

Three leading infectious disease experts in China were invited to share their bedside observations in the management of COVID-19 patients. Professor Taisheng Li was sent to Wuhan to provide frontline medical care. He depicts the clinical course of SARS-CoV-2 infection. Furthermore, he observes the significant abnormality of coagulation function and proposes that the early intravenous immunoglobulin and low molecular weight heparin anticoagulation therapy are very important. Professor Hongzhou Lu, a leader in China to try various anti-viral drugs, expresses concern on the quality of the ongoing clinical trials as most trials are small in scale and repetitive in nature, and emphasizes the importance of the quick publication of clinical trial results. Regarding traditional Chinese medicine, Professor Lu suggests developing a creative evaluation system because of the complicated chemical compositions. Professor Wenhong Zhang is responsible for Shanghai’s overall clinical management of the COVID-19 cases. He introduces the team approach to managing COVID-19 patients. For severe or critically ill patients, in addition to the respiratory supportive treatment, timely multiorgan evaluation and treatment is very crucial. The medical decisions and interventions are carefully tailored to the unique characteristics of each patient.

Implementing Cognitive Services in Community Pharmacy: A Review of Facilitators Used in Practice Change

2022-06-09T08:55:32-07:00

To investigate facilitators of change in community pharmacy and their use in the implementation of cognitive pharmaceutical services (CPS). Method Relevant literature published in English was identified through searches of online databases (no date limits), texts, conference proceedings, and bibliographies of identified literature. Literature that involved a discussion of facilitators of community pharmacy practice change in relation to the implementation and/or delivery of CPS was selected for review. Some of the identified studies were conceptual in nature, and although they were selected in the same way as the empirical research papers, were not able to be critically reviewed in an equivalent manner. A narrative, rather than systematic review, was considered more appropriate. Key findings The identified facilitators exist at two levels: the individual (e.g. knowledge) and the organisation (e.g. pharmacy layout). Few studies identified or measured facilitators drawn from experience, with many based on the views of researchers or participants in the studies, in reaction to identified barriers to CPS implementation. Purposive sampling was common in the reviewed studies, limiting the generalisability of the findings. Conclusion Although a number of facilitators have been identified in the literature, it appears that little consideration has been given to how they can best be used in practice to accelerate CPS implementation. Identifying facilitators at both individual and organisational levels is important, and future research should focus not only on their identification in representative populations, but on how they should be incorporated into programmes for CPS delivery.

Medical Transcription Rules

2022-04-05T09:03:10-07:00

Regulation of gene expression is a crucial step in the maintenance of cellular homeostasis. The control of gene expression can occur in multiple steps. The overwhelming majority of regulatory events occur at the level of transcription. To initiate transcription eukaryotic polymerase RNA II requires the close collaboration of a battery of proteins collectively termed transcription factors. Transcription factors are generally divided into two groups: (Sauer & Tjian, 1997) the basal transcription factors which are ubiquitous and recruit the RNA polymerase II multi-protein complex to the minimal promoter; (Maniatis, Goodbourn, & Fischer, 1987) gene-specific transcription factors that activate or repress basal transcription. These proteins bind to regulatory sequences organized in a series of regulatory modules along with the DNA. Thus, the molecular basis for transcriptional regulation of gene expression is the binding of trans-acting proteins (transcription factors) to sequences (binding sites). A growing list of human diseases is due to genetic defects in transcription factors. In most cases, mutations in transcription factors lead to pleiotropic effects. Clinical observations can be explained at the molecular level by the fact that these trans-acting factors control the expression of many genes, usually in combination with one or more further activators. In addition, many events that lead to the process of tumorigenesis in leukemias and in solid tumors implicate overexpression or mutations of transcription factors. This review describes human diseases attributable to mutations in the genes coding for transcription factors or mutations in their cognate binding sites.