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The purpose of this study was to evaluate the time to medication administration, clinical effect, and safety of a recent Pharmacy and Therapeutics Committee-approved change in the administration of levetiracetam from intravenous piggyback (IVPB) over 15min to undiluted intravenous push (IVP) over 2-5min at a large academic medical center.

The primary outcome was the time from order verification to the administration of IVP levetiracetam versus IVPB levetiracetam. The secondary outcome was any benzodiazepine administered in the time between levetiracetam order verification and administration in both groups. Amcenestrant manufacturer Adult patients admitted to the neuro-spine intensive care unit in the 6months prior to and after the policy change, and who received at least one dose of 1000mg or higher of IVP or IVPB levetiracetam for active seizures, were included in this retrospective, observational, institutional review board-approved study. Data were analyzed using descriptive statistics, χ

, and the Mann-Whitney U-test as appro administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use.

Administration of levetiracetam doses up to 2000 mg via IVP is a safe method of administration that results in a reduction of time to medication administration and a reduction of benzodiazepine use.

Potential effects of chromium supplementation on blood pressure (BP) have been examined in several interventional studies. Nevertheless, findings in this context are controversial.

Therefore, the current systematic review and meta-analysis aimed to comprehensively assess the impact of chromium supplementation on BP.

Five online databases including Web of Science, Scopus, Embase, Google Scholar, and PubMed were systematically searched from inception to March 2020. We included all randomized clinical trials (RCTs) evaluating the effects of chromium supplementation on systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) in humans.

The random-effects meta-analysis of 11 eligible RCTs with 637 participants demonstrated the significant decline in both SBP (WMD – 2.51 mmHg; 95% CI – 4.97 to – 0.05, p = 0.04) and DBP (WMD – 1.04 mmHg; 95% CI – 1.96 to – 0.12, p = 0.026) following supplementation with chromium. In subgroup analysis, studies that were administered chromium yeast and brewer’s yeast, showed greater decrease in SBP. Also, in stratification based on participants’ health status, significant reduction in SBP only was seen in diabetic patients with chronic heart disease (CHD). Nonlinear dose-response analysis revealed a significant influence of chromium dosage on SBP changes.

The current meta-analysis, indicated that supplementation with chromium significantly decrease SBP and DBP. In subgroup analysis, administration of chromium yeast and brewer’s yeast resulted in greater reduction in SBP. Further large-scale RCTs with better design are needed to confirm these findings.

The current meta-analysis, indicated that supplementation with chromium significantly decrease SBP and DBP. In subgroup analysis, administration of chromium yeast and brewer’s yeast resulted in greater reduction in SBP. Further large-scale RCTs with better design are needed to confirm these findings.UFL1 is an ufmylation (a novel post-translational modification) E3 ligase, mainly located in the endoplasmic reticulum (ER), that has emerged as a significant regulator of several physiological and pathological processes. Yet its physiological function in milk synthesis in bovine mammary epithelial cells (BMECs) remains unknown. In this study, we investigated the effects of UFL1 in milk protein and fat synthesis-related gene expression, with a particular emphasis on the role of UFL1 in LPS-treated BMECs. Results showed that UFL1 depletion significantly reduced the expression of milk protein and fat synthesis-related gene and mTOR phosphorylation in both normal and LPS-treated BMECs. Overexpression of UFL1 enhanced the activation of the mTOR and milk protein and fat synthesis-related gene expression. Collectively, these above results strongly demonstrate that UFL1 could regulate milk protein and fat synthesis-related gene expression of BMECs probably via the mTOR signaling pathway.

Stage IV rectal cancer with resectable disease presents challenging issues, as the radical treatment of the whole disease is difficult. Surgery and chemotherapy (CT) play an unquestionable role, but the contribution of pelvic radiotherapy (RT) is not very clear.

In 2009, we established a prospective treatment protocol that included CT, short-course preoperative radiotherapy (SCRT) with surgery of the primary tumour and all metastatic locations.

Forty patients were included. Eight (20%) patients did not receive CT due to significant comorbidities. Radical surgery treatment was possible in 22 (55%) patients. The mean follow-up was 42.81months (3.63-105.97). Overall survival at 24 and 36months was 71.4% and 58.2%, respectively. There was good local control of the disease, as 97.2% of pelvic surgeries were R0 and there were no local recurrences.

In stage IV with resectable metastatic disease, the proposed therapeutic regimen seems very appropriate in well selected patients able to tolerate the treatment. We bet on the role of pelvic RT, due to the good local control of the disease in our series.

In stage IV with resectable metastatic disease, the proposed therapeutic regimen seems very appropriate in well selected patients able to tolerate the treatment. We bet on the role of pelvic RT, due to the good local control of the disease in our series.To compare the outcomes of patients undergoing right hemicolectomy using laparoscopic or robotic approaches and perform a cost analysis. Retrospective review of all patients undergoing elective laparoscopic and robotic right hemicolectomies at a public and private hospital in NSW/QLD from January 2015 to June 2018. Cost analysis was calculated using actual and estimated costs by the local health district. A total of 101 patients were identified. 59 (58%) had Robotic resection, of which 44 (75%) had an intra-corporeal anastomosis. There were no demographic or oncological differences between the two groups. The robotic group had a significantly earlier time to bowels opening (2 vs 4 days, p  less then  0.001) and shorter length of stay (3 vs 5 days, p  less then  0.001). The robotic group had a lower rate of ileus (2% vs 14%, p = 0.02) and complications (5% vs 33%, p = 0.006). The mean lymph node harvest was higher in the robotic group (18 vs 14, p = 0.001). The operative time was longer in the robotic group (110 vs 97 min, p = 0.