Platelet-rich plasma (PRP) is a common therapy for acceleration of maxillofacial and spinal fusion bone-graft healing. This study analyzes the therapeutic role of PRP during long-bone fracture healing evaluated Lewis rats. Following creation of unilateral open femur fractures, either 500 microL thrombin-activated PRP (PRP treated group) or 500 microL saline (control group) were applied once to the fracture site. Fracture healing was analyzed after 1 and 4 weeks. Following 4 weeks of fracture healing, radiographic analysis demonstrated higher callus to cortex width ratio (P < 0.05) in the PRP group (PRP: 1.65 +/- 0.06; control: 1.48 +/- 0.05). Three-point load bearing showed increased bone strength following PRP treatment (PRP: 60.85 +/- 6.06 Newton, control: 47.66 +/- 5.49 Newton). Fracture histology showed enhanced bone formation in the PRP group. Immunohistochemistry and Western-blotting demonstrated healing-associated changes in transforming growth factor (TGF)-beta1 and bone morphogenetic protein (BMP)-2. Our results suggest that PRP accelerates bone fracture healing of rat femurs via modulation of TGF-beta1 and BMP-2 growth factor expression.

Compared with participants without borderline personality symptoms, those participants with such symptoms in this study evidenced lower general health care compliance.

Given the current state of the art of the measurement of adherence, we elected to rely on a carefully designed self-report assessment instrument in the MOS. Collateral reports were rejected because of the difficulty of identifying a knowledgeable informant, especially among older patients. Objective measures were not relied on because none were available that were comprehensive enough to capture the wide range of behaviors we were interested in studying.However, many of the patients in the study were given independent health examinations (at baseline and exit) and adherence-related data was gathered at that time (e.g., blood pressure, foot check, lung exam, cholesterol level, glucose, weight and height).Both a general and a specific measure were developed for assessing the adherence of patients with heart disease (congestive heart failure or recent myocardial infarction), diabetes, and hypertension. The generic or general measure of adherence summarizes a patient's tendency to adhere to medical recommendations using the five items presented in Table 1 below. The five general adherence items were well distributed, although there was a tendency for patients to report complying with treatment (see Table 2). The internal consistency reliability of the scale was acceptable (alpha = 0.81). To score general adherence, we averaged together the responses to the five general adherence items after reversing the scoring of items 1 and 3. Tables 3 and 4 supply information about adherence to particular treatment recommendations. Specific adherence measures necessarily vary with the kind of medical condition examined. Our specific adherence measure was developed to be appropriate to patients with the MOS tracer conditions and comprises two parallel lists, one of specific

Patients with histories of childhood trauma demonstrate some deficits with health care compliance in comparison to those without childhood trauma. One interpretation is that the mistreated appear to believe that they are fairly compliant with health care treatment, but objective variables appear to suggest otherwise.

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Background 25% of all breast cancer patients have HER-2 overexpression. Breast Cancer patients with HER-2 overexpression are typically treated with HER-2 inhibitors such as Trastuzumab. Trastuzumab is known to cause a decrease in left ventricular ejection fraction. The aim of this study is to create a cardiac risk prediction tool among women with Her-2 positive breast cancer to predict cardiotoxicity. Method Using a split sample design, we created a risk prediction tool using patient level data from electronic medical records. The study included women 18 years of age and older diagnosed with HER-2 positive breast cancer who received Trastuzumab. Outcome measure was defined as a drop in LVEF by more than 10% to less than 53% at any time in the 1-year study period. Logistic regression was used to test predictors. Results The cumulative incidence of cardiac dysfunction in our study was 9.4%. The sensitivity and specificity of the model are 46% and 84%, respectively. Given a cumulative incidence of cardiotoxicity of 9%, the negative predictive value of the test was 94%. This suggests that in a low-risk population, the interval of screening for cardiotoxicity may be performed less frequently. Conclusion Cardiac risk prediction tool can be used to identify Her-2 positive breast cancer patients at risk of developing cardiac dysfunction. Also, test characteristics in addition to disease prevalence may inform a rational strategy in performing cardiac ultrasound in Her-2 breast cancer patients. We have developed a cardiac risk prediction model with high NPV in a low-risk population which has an appealing cost-effectiveness profile.

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