Granulation of Poorly Water-Soluble Drugs
Dilip M. Parikh in Handbook of Pharmaceutical Granulation Technology, 2021
Once the optimal CD and appropriate stoichiometry for the investigated drug have been established, a complex of the drug and this CD can be made using different methods. The classical method for preparing cyclodextrin complexes is in the liquid phase, usually by heating an aqueous solution of a CD, adding the drug in the suitable stoichiometric proportion [43,44], and then stirring the solution for several hours. The duration of the stirring is to be determined empirically. The solution is then cooled down slowly in a controlled way to obtain the complex in a crystalline form. The crystals are separated, rinsed, and dried. In a similar way, the drug is dissolved in an organic solvent mixture and added gradually to an aqueous solution of a CD, and the mixture is stirred for a certain time and resulting crystals are separated. This is feasible if the CD used is crystalline, like the native CDs. Such a method requires reactors for the preparation of a large quantity of the complex. This usually is not available in classical pharmaceutical production facilities. It is also important to note here that the used solvent should not disrupt the formation of the complex by competition [45].
Small Bowel Crohn’s Disease
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Recurrence is common in CD. In general, the recurrence tends to mimic the original presentation of the disease. If the original presentation was fibrostenotic, then the recurrence tends to be fibrostenotic. The same holds true for a penetrating (inflammatory) presentation. One major shift in the clinical management of CD following surgery is the prophylactic treatment by newer and more powerful anti-TNFs, biologics and monoclonal antibody medications. This is fully reviewed in Chapter 57 of this Section. The diagnosis of recurrence is either by endoscopy or other forms of imaging. Endoscopic recurrence at one year post-op is predictive of clinical recurrence at five years after a previous resection.56 The question as to when and what medication should be used to treat recurrence is still a matter of debate.
Promoting Good Practice in Telehealth
Marjorie Gott in Telematics for Health, 2018
‘One CD-ROM can hold more than 600 megabytes of text, graphics, music, maps, moving video, computer programs and other digital data, so there’s almost no limit to what can be served up on a silver platter. And since it costs less than £1 (UK) to press a CD, huge quantities of material could be distributed at a very low price.’ (Schofield, 1993)
Feasibility and acceptability of collaborative documentation tool for implementing medication-assisted treatment in substance use disorder counseling
Published in Journal of Social Work Practice in the Addictions, 2023
V. B Lushin, E Matthews, V Stanhope, R Rivera, J Rzewinski, R Stewart, J Rees, S Marcus
The eleven counselors, who have received training on the CD MAT Tool, and a booster coaching session, used the CD MAT Tool in sessions with their patients diagnosed with OUD. The Clinical Director helped select such patients from the participating counselors’ rosters who were either: (a) newly identified as MAT candidates, or (b) have been prescribed MAT before, but were struggling with adherence to the MAT regimens. All the sessions were conducted during June and July 2020 and used a telehealth approach, due to COVID-19. During sessions, counselors were encouraged to type session notes, following the template in the CD MAT Tool. Because most sessions were delivered via cell phone, the collaboration with the patient on writing session notes was conducted by reading the session note to the patient by phone, as opposed to in-person screen sharing that would occur in the office setting. The CD MAT Tool (a) provided a session support structure for collaborative dialogue about MAT tailored to each client’s needs, and (b) provided a template to create the session note during the session, and to discuss this emerging document with the patient in-vivo.
Effects of music therapy on occupational stress and burn-out risk of operating room staff
Published in Libyan Journal of Medicine, 2020
I. Kacem, M. Kahloul, S. El Arem, S. Ayachi, M. Hafsia, M. Maoua, M. Ben Othmane, O. El Maalel, W. Hmida, O. Bouallague, K. Ben Abdessalem, W. Naija, N. Mrizek
The second phase consisted of a one-month intervention (from January 9th to February 9th). Three sessions of music therapy of 30 minutes each were provided daily to the operating room staff during working days. These sessions had the same hours during the whole study period (from 8:00 am to 8:30 am, from 10:00 am to 10:30 am and from 12:00 pm to 12:30 pm) unless a patient-related incident occurred during a session. In this case, the current session was shifted. The same type of generic brand CD player was used in all operating rooms. The musical repertoire used was varied to satisfy all the participants’ preferences. Indeed several types of music have been used namely oriental, occidental and Tunisian music. In order to avoid noise pollution, music volumes were set below 60 dB using a mobile application (Sound meter, Smart tools Co) [13,16].
Unintended hysterotomy extension during caesarean delivery: risk factors and maternal morbidity
Published in Journal of Obstetrics and Gynaecology, 2018
Lauren E. Giugale, Sara Sakamoto, Jonathan Yabes, Shannon L. Dunn, Elizabeth E. Krans
Our final sample consisted of 2707 low transverse CDs performed via a Pfannenstiel skin incision and 392 (14.5%) had documentation of an unintended hysterotomy extension (Table 1). The mean age of the patients in our sample was 30 years. The majority of the patients were Caucasian, had private insurance, and had their CD performed by a private attending. The mean BMI of our cohort was 33.3 kg/m2. Approximately 17% had either chronic or gestational HTN, 11% had either pre-gestational or gestational DM and 4% of patients had a diagnosis of chorioamnionitis. The most common indication for a CD was an elective repeat CD. Over half of the CDs were performed after the onset of labour. Approximately 6% of the CDs had an EBL >1200 ml and 5% had a postoperative drop in haemoglobin of ≥3.7 g/dL. 2.4% required an intraoperative evaluation for LUT injury [a backfilling of the bladder (n = 77), an intraoperative cystoscopy (n = 24), or a cystotomy requiring repair (n = 11)], and less than 1% required a blood transfusion. The mean duration of a CD operative time was approximately 51 minutes.
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