DATING THE LOST ARC OF ALASKA: CONSTRAINING THE TIMING OF INITIATION OF THE WRANGELL ARC WITH A NEW 40AR/39AR GEOCHRONOLOGY APPROACH ON MODERN RIVER DETRITAL LITHIC GRAINS

2017 ◽  
Author(s):  
Kailyn N. Davis ◽  
◽  
Jeff Benowitz ◽  
Paul W. Layer ◽  
Jeffrey Trop ◽  
...  
Keyword(s):  
Timing Of Initiation

scholarly journals Timing of Bisphosphonate Initiation After Fracture: What Does the Data Really Say?

2020 ◽  
Vol 11 ◽  
pp. 215145932098036
Author(s):  
David W. Barton ◽  
C. Taylor Smith ◽  
Amit S. Piple ◽  
Sterling A. Moskal ◽  
Jonathan J. Carmouche
Keyword(s):  
Fracture Healing ◽  
Clinical Studies ◽  
Osteoporosis Treatment ◽  
The Body ◽  
Non Union ◽  
Increased Risk ◽  
Level I ◽  
Timing Of Initiation ◽  
The Impact ◽  
Published Research

Introduction: Osteoporosis is often not clinically recognized until after a fracture occurs. Individuals who have 1 fracture are at increased risk of future fractures. Prompt initiation of osteoporosis treatment following fracture is critical to reducing the rate of future fractures. Antiresorptives are the most widely used class of medications for the prevention and treatment of osteoporosis. Many providers are hesitant to initiate antiresorptives in the acute post-fracture period. Concerns include interference with bone remodeling necessary for successful fracture healing, which would cause increased rates of non-union, malunion, and refracture. While such concerns should not extend to anabolic medications, physicians may also hesitate to initiate anabolic osteoporosis therapies due to high cost and/or lack of familiarity. This article aims to briefly review the available data and present a digestible narrative summary to familiarize practicing orthopaedic surgeons with the essential details of the published research on this topic. Results: The results of 20 clinical studies and key pre-clinical studies related to the effect of anti-resorptive medications for osteoporosis on fracture healing are summarized in the body of this narrative review. Discussion & Conclusions: While few level I studies have examined the impact of timing of initiation of osteoporosis medications in the acute post-fracture period, the few that have been published do not support these concerns. Specifically, data from level I clinical trials indicate that initiating bisphosphonates as early as 2 weeks post-fracture does not increase rates of non-union or malunion. By reviewing the available data, we hope to give clinicians the confidence to initiate osteoporosis treatment promptly post-fracture.

Implementation of a Leeches + Antimicrobial Prophylaxis Order Panel to Optimize Medicinal Leech Use at a Tertiary Care Academic Medical Center

2021 ◽  
pp. 089719002199368
Author(s):  
Nicole M. Palm ◽  
Jill C. Wesolowski ◽  
Janet Y. Wu ◽  
Pavithra Srinivas
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Medicinal Leech ◽  
Aeromonas Species ◽  
Leech Therapy ◽  
Before And After ◽  
Timing Of Initiation ◽  
Medicinal Leeches

Medicinal leech therapy promotes vascular flow and can be used to salvage grafts. Medicinal leeches have a symbiotic relationship with Aeromonas species and can therefore present a risk of bacterial transmission to patients. Antimicrobial prophylaxis is warranted for the duration of leech therapy, however, an institutional evaluation of 40 patients receiving medicinal leech therapy demonstrated poor adherence with recommendations. An electronic medical record order panel for antimicrobial prophylaxis with medicinal leech therapy was implemented, leading to a subsequent improvement in adherence to prophylaxis use, including significant increases in the ordering of antibiotics and the appropriate timing of initiation in the subsequent 10 patients receiving medicinal leech therapy after panel implementation. Aeromonas infections were rare before and after panel implementation, and developed only in the patient subset with non-optimized prophylaxis.

scholarly journals Early High-dose Caffeine Improves Respiratory Outcomes in Preterm Infants

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 501
Author(s):  
Vineet Lamba ◽  
Oscar Winners ◽  
Prem Fort
Keyword(s):  
Mechanical Ventilation ◽  
Preterm Infants ◽  
Regression Models ◽  
High Dose ◽  
Long Term Outcomes ◽  
Logistic Regression Models ◽  
Caffeine Citrate ◽  
Timing Of Initiation ◽  
Respiratory Outcomes

The objective of the study is to determine if early high-dose caffeine (HD) therapy is associated with shorter duration of mechanical ventilation, bronchopulmonary dysplasia (BPD), or decreased need for mechanical ventilation. We conducted a single center, retrospective cohort study of 273 infants less than 32 weeks gestational age (GA). Infants receiving early HD (10 mg/kg/day maintenance) caffeine citrate started within 24 h of life were compared with those receiving LD (6 mg/kg/day) with variable timing of initiation using linear and logistic regression models. The infants in the early HD group had 91.4 (95% confidence interval (CI): −166.6, −16.1; p = 0.018) less hours of mechanical ventilation up to 36 weeks PMA or discharge as compared with the LD group. Moreover, infants in the HD group had 0.37 (95% CI: 0.14, 0.97; p = 0.042) times lower odds of developing moderate/severe BPD compared with the LD group. Infants receiving early HD caffeine had improved respiratory outcomes with no increase in measured comorbidities. Large prospective studies are needed to determine the long-term outcomes of using high-dose caffeine prophylaxis for preterm infants.

scholarly journals Timing of Initiation of Maintenance Dialysis

2016 ◽  
Vol 176 (2) ◽  
pp. 228 ◽  
Author(s):  
Susan P. Y. Wong ◽  
Elizabeth K. Vig ◽  
Janelle S. Taylor ◽  
Nilka R. Burrows ◽  
Chuan-Fen Liu ◽  
...  
Keyword(s):  
Maintenance Dialysis ◽  
Timing Of Initiation

Race Differences in Changing Family Demographics in the 1980s

1994 ◽  
Vol 15 (2) ◽  
pp. 290-308 ◽  
Author(s):  
TIM B. HEATON ◽  
CARDELL K. JACOBSON
Keyword(s):  
Living Arrangements ◽  
Family Formation ◽  
White Family ◽  
Mean Values ◽  
Independent Variables ◽  
Black And White ◽  
First Marriage ◽  
Small Set ◽  
Timing Of Initiation ◽  
Mother's Educational Level

Traditional demarcators of family formation and dissolution have changed dramatically over the past few decades and Black-White differences have become pronounced. In this article, we explore the degree to which a relatively small set of variables can account for racial difference in timing of initiation of sexual activity, first marriage, first birth, and divorce. The independent variables included in the model are adolescent living arrangements (single-parent vs. two-parent), mother's educational level, religion, region of the country, area of residency (urban, suburban, rural), birth cohort, and year of the survey. Based on hazard models for the rate of occurrence of each event, we estimate how Blacks would differ if they had mean values on covariates equal to White observed means. Although the results differ for the four dependent variables, this particular set of independent variables does not provide a satisfactory explanation of the differences between Black and White family formation and dissolution. Blacks and Whites may be responding to different structural and cultural constraints not easily captured by basic demographic variables.

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