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Focused Ga ion beam can deposit various materials with high-resolution assisted by elaborately selected precursor gases. During the deposition process, the secondary effect arises due to the generation of secondary particles by primary ions. Prominent morphological changes are caused by the secondary effect between adjacent, densely arranged structures. This study analyzes the morphological changes and structural characterizations from the perspective of secondary particles, including scattered ions, sputtered atoms, and re-emitted precursor molecules, with the assistance of continuous cellular automata. C14H10 and W(CO)6 were utilized as the precursor gas in the experiments under the same parameters as the numerical model. The experimental and simulation results demonstrated that the deposit morphology on the adjacent structure, and the enhanced growth rate of the processing structure, could be precisely predicted, with a good estimation of secondary particles contribution. Furthermore, the deposition efficiency on the adjacent structure was improved, and the higher metal content in the deposits was validated by Energy Dispersive X-Ray Spectroscopy (EDS). This work, therefore, lays foundation for avoiding the secondary effect when fabricating nanostructure arrays, and utilizing it for coatings, chiral structure construction, and tuning material properties.

Abstract Background Polypharmacy increases the risk of pharmacological interactions, prevalence of secondary effects and with this the lack of adherence to treatment. It is estimated that between 10 and 40% of patients hospitalized in psychiatric institutions are prescribed more than one antipsychotic. The objective of the present study was to identify the prevalence of polypharmacy, evaluate adverse effects associated to the use of psych drugs and to estimate the risk in specific groups. Methods We carried out a longitudinal, retrospective study that included the analysis of all discharged patients (n = 140) in the first trimester of the year in a psychiatric hospital in Mexico. The information was classified into 7 sections: sociodemographic, diagnosis, clinical follow-up information, prescribed drugs, adverse reactions, substance abuse, laboratory and complementary results. Risk estimation was obtained with Odds Ratios, to correlate continuous variables Pearson’s correlation was used. Student’s T and Mann Whitney’s U were used to compare 2 independent samples; multiple and linear regressions were carried out. Results The mean number of drugs used during hospitalization was 7.8 drugs per patient. The mean prescribed psych drugs was 4.07. The mean antipsychotic dose was the risperidone equivalent of 5.08 mg. 29.2% of patients had at least one secondary effect associated to the use of drugs, 17.8% presented extrapyramidal symptoms. 81.4% of patients were prescribed 6 or more drugs (polypharmacy) and were 5 times more likely to suffer a secondary effects (OR 6.24). 14.2% had polypharmacy while receiving antipsychotics and had more than twice the risk of presenting extrapyramidal symptoms (OR 3.05). For each added psych drug, hospital stay increased by 6.56 days. Conclusions Despite international guideline recommendations where reasoned and conciliatory prescription of psych drugs is advised, there is still a high prevalence of polypharmacy in patients hospitalized in psychiatric institutions. In the present study 4 out of 5 patients received polypharmacy decreasing tolerability, treatment adherence and increasing the risk and costs secondary to an increased hospital stay.

Introduction We present the case of a man who, after receiving treatment for Covid-19 pneumonia, suffers a manic episode induced by medication. Objectives This case is chosen to present as an example of a psychiatric illness derived from Covid-19, in this case secondary to its treatment. Methods We present a manic episode induced by covid medication. Results Complementary examinations are carried out in which organic pathology is ruled out, being diagnosed of a manifest episode in probable relation to the treatments used and hospital admission is decided due to the impossibility of home management. Neuroleptic and anxiolytic treatment was started at low doses with a good response, and he was discharged with complete recovery and critiqued of the episode. Conclusions It is estimated that between 20-40% of patients with COVID infection have presented neuropsychiatric symptoms. Mania secondary to treatment was reported in 13 (0 · 7%) of 1744 patients with coranavirus included in a study (1). The Spanish Pharmacivigilance System of Medicines for Human Use (SEFV-H) closely monitors the suspected adverse reactions reported with drugs considered potential therapeutic strategies for SARS-CoV-2 infection. 327 cases of adverse reactions have been reported, of which 18 cases include 28 thermal cases of suspected psychiatric adverse reactions. The interest of this case lies in the fact that it illustrates a psychiatric disorder derived from Covid-19, in this case secondary to the treatment used, which causes a manifest episode with a typical evolution in this type of case with rapid improvement at low doses of antipsychotics.

Using Ti-6Al-4V alloy as the target substrate and rigid balls as the incident particles, we studied the anti-erosion behavior of the substrate with varying surface patterns collided by multiple particles with finite element method. The overlapping impact and secondary impact were considered in the model. The results reveal that the patterned surfaces may increase or decrease the mass loss, which is attributed to the combined effects of effective impact angle, overlapping impact and secondary impact. In particular, on curved surfaces, the impact coverage becomes highly non-uniform, leading to significant overlapping impact at certain areas, and secondary impact is also prone to occur. For overlapping impact, the accumulative mass loss arises from impacts at the lips caused by former impacts. The results also show that when the secondary impact lands at the damage zone caused by the primary impact, the material failure will be considerably worse. Unlabelled Image • A finite element model simulates particle erosion on planar and corrugated substrates. • The overlap and secondary impact are pronounced on the erosion of patterned surface. • The overlap impact on the lips causes greater erosion than that on the indention. • The secondary impact occurring on the damage regions greatly increase mass loss of material. • The patterned target of cylindrical form with a quarter circle achieves highest anti-erosion performance. [ABSTRACT FROM AUTHOR]

Abstract: Three common false‐negative scenarios have been encountered with amendment addition in whole‐sediment toxicity identification evaluations (TIEs): dilution of toxicity by amendment addition (i.e., not toxic enough), not enough amendment present to reduce toxicity (i.e., too toxic), and the amendment itself elicits a toxic response (i.e., secondary amendment effect). One such amendment in which all 3 types of false‐negatives have been observed is with the nonpolar organic amendment (activated carbon or powdered coconut charcoal). The objective of the present study was to reduce the likelihood of encountering false‐negatives with this amendment and to increase the value of the whole‐sediment TIE bioassay. To do this, the present study evaluated the effects of various activated carbon additions to survival, growth, emergence, and mean development rate of Chironomus tepperi. Using this information, an alternative method for this amendment was developed which utilized a combination of multiple amendment addition ratios based on wet weight (1%, lower likelihood of the secondary amendment effect; 5%, higher reduction of contaminant) and nonconventional endpoints (emergence, mean development rate). This alternative method was then validated in the laboratory (using spiked sediments) and with contaminated field sediments. Using these multiple activated carbon ratios in combination with additional endpoints (namely, emergence) reduced the likelihood of all 3 types of false‐negatives and provided a more sensitive evaluation of risk. Environ Toxicol Chem 2018;37:1219–1230. © 2017 SETAC [ABSTRACT FROM AUTHOR]

This study proposes an easy-to-implement approximation for primary and secondary effects in the study of inequality of educational opportunity by discretizing the measure of academic performance. Relative to the widely-used Erikson-Jonsson model, our method is not subject to the potential limitations that are associated with the parametric configurations of the normal distribution of academic performance and the model form restriction for predicting educational choice. Besides, the proposed discretization method can be used to reveal the heterogeneous effect of academic performance on the likelihood of educational transition across the spectrum of performance. Using Monte Carlo simulation and survey data collected in China, we show that our method recovers the results based on the Erikson-Jonsson approach. With another simulation, we illustrate that the Erikson-Jonsson model might produce misleading results if academic performance is not normally distributed. The discretization approach, in contrast, does not suffer from this problem. [ABSTRACT FROM AUTHOR]

Com a introdução da soja resistente ao glifosato, ocorreu mudança no manejo da cultura, principalmente com relação ao manejo das plantas invasoras. Este trabalho foi desenvolvido com o objetivo de avaliar os efeitos da aplicação de diferentes manejos de herbicidas e fungicidas sobre o rendimento de grãos e os componentes do rendimento da soja. O experimento foi conduzido no ano agrícola 2006/2007, na área experimental do Departamento de Fitotecnia da Universidade Federal de Santa Maria. Foram utilizadas quatro cultivares de soja Roundup ReadyTM ('NK Mireya 4.2 RR', 'Fundacep 55 RR', 'NK Mágica 7.3 RR' e 'A 8100 RG'), dois manejos de herbicida (Clethodim + Bentazon e outro com glifosato), dois manejos de doenças constituídos com a aplicação de fungicida (Tebuconazole + Tiofanato Metílico) e sem o tratamento. O delineamento experimental utilizado foi o de blocos ao acaso com parcela subsubdivididas, com quatro repetições. Foram avaliados o rendimento de grãos e os componentes do rendimento. As cultivares responderam diferentemente ao manejo de herbicidas e fungicidas para produção de grãos; as cultivares que foram afetadas pelo manejo de herbicida obtiveram maior produtividade com a aplicação de glifosato, efeito que também foi observado com a aplicação de fungicida. As cultivares mais e menos produtivas apresentaram o maior e o menor peso de grãos, respectivamente. A aplicação de fungicida aumentou o índice de colheita.With the introduction of the resistant soybeans to the glyphosate changed the management of the culture, mainly for management of the weed. This work was developed with the objective of evaluate the effect of the different management systems of herbicides and fungicides in grain yield and yield components of the soybean. The experiment was carried in the agricultural year of 2006/2007, at the Experimental Area of Department of Phytotecny of the Santa Maria Federal University. It was used, four soybean cultivars Roundup ReadyTM ('NK Mireya 4.2 RR', 'Fundacep 55 RR', 'NK Mágica 7.3 RR' and 'A 8100 RG'), two herbicide management (Clethodim + Bentazon and with glyphosate) and two fungicides management with application (Tebuconazole + Tiofanato Metílico) and without treatment. The experiment design was randomized blocks with splitsplitplot plot, with four replications. It was evaluated the grain yield and components of yield. The cultivars showed different responses to the management of herbicide and fungicides, for grain yield, cultivars that were affected by the herbicide management showed higher productivity with the application of glyphosate. The effect also was observed with the application of fungicide. The cultivars more and less productive presented the highest and lowest grain weight respectively. Fungicide application increased the harvest index.

O trabalho tem como objetivo verificar a influência de diferentes densidades e épocas de semeadura em genótipos convencionais e Roundup ReadyTM (RR), nas características morfológicas de plantas de soja. O experimento foi conduzido em Jari, Rio Grande do Sul (RS). A primeira semeadura foi realizada dentro da época indicada para a cultura (novembro), e a segunda, após a época indicada (janeiro), com as cultivares 'CEP/CD 41', 'CD 201', 'Fundacep 39',' Fundacep 44', 'CD 205', 'BRS 133', 'Fundacep 45', 'A 6001 RG', 'Mágica', 'AL72' e 'A 8100 RG', nas densidades de 250, 400 e 550 mil sementes aptas ha-1, na safra 2005/2006. O delineamento experimental utilizado foi blocos ao acaso, com parcelas subsubdivididas e quatro repetições. Foram avaliados o ciclo das cultivares, a altura de plantas, a altura de inserção do primeiro legume, o número de ramos planta-1 e de ramos m-2, o número de nós na haste principal planta-1 e na haste principal m-2, o rendimento biológico (RB) e o índice de colheita (IC). A semeadura em janeiro ocasiona redução no ciclo da cultura, na altura de plantas, na altura de inserção do primeiro legume, no número de nós planta-1 e de RB e no atraso da semeadura. O aumento da densidade de sementes não proporcionou aumento na estatura de plantas e altura de inserção do primeiro legume, nas cultivares RR. O período do ciclo que é mais afetado com atraso da semeadura é o vegetativo. O IC foi menor na semeadura em novembro; no entanto, o RB foi maior.This paper has the objective to evaluate the influence of seed densities and sowing season in conventional soybean genotype and Roundup ReadyTM (RR), in the morphological characteristic of soybean plant. The experiments were conducted in Jari-RS, Brazil. The first seeding was done within the time prescribed for the crop(November), and the second, after the time indicated (January), with the cultivars 'CEP/CD 41', 'CD 201', 'Fundacep 39', 'Fundacep 44', 'CD 205', 'BRS 133', 'Fundacep 45', 'A 6001 RG', 'Mágica, AL72' and A '8100 RG', at densities of 250, 400 and 550 thousand seed seeds suitable ha-1 in the 2005/2006 harvest. The experiment design was randomized blocks with split plots, with four replications. The cultivars cycle, plant height, height of first pod insertion, number of branches plant-1, branches m-2, nodes' number of the main stem plant-1, nodes main stem m-2, biological yield (RB) and harvest index (IC). Sowing in January causes reduction in the crop cycle, plant height, height of first pod insertion, number of nodes plant-1 and RB and the increase in seed density not increased the height of first pod insertion in RR cultivars. The period cycle that is most affected by the delayed sowing is the vegetative. The IC sowing in November was lower, but the RB was larger.

Purpose: Orbital decompression is mainly performed in thyroid eye disease to reduce proptosis and retrobulbar pressure, to improve venous congestion, and to relieve optic nerve compression. Secondary effects of orbital decompression are also occasionally encountered. The aim of this study was to review the secondary effects of orbital decompression., Methods: This is a comprehensive literature review that summarizes the secondary effects of orbital decompression., Results: Decreased intraocular pressure, inter-pupillary distance, and eyelid pressure, and improvement of eyelid retraction, lateral flare, orbital discomfort, and psychosocial condition after orbital decompression are favorable changes for patients. In contrast, refractive changes in some patients and decreased Bell's phenomenon and nasal function worsen patients' condition., Conclusion: These favorable changes may reduce the patients' burden for treatment of thyroid eye disease. In contrast, as some of the adverse effects significantly worsen the patients' disease condition, we should carefully monitor these changes.

Background: Secondary myeloid neoplasms comprise a group of diseases arising after chemotherapy, radiation, immunosuppressive therapy or from aplastic anemia. Few studies have addressed prognostic factors in these neoplasms. Method: Forty-two patients diagnosed from 1987 to 2008 with secondary myeloid neoplasms were retrospectively evaluated concerning clinical, biochemical, peripheral blood, bone marrow aspirate, biopsy, and immunohistochemistry and cytogenetic features at diagnosis as prognostic factors. The International Prognostic Scoring System was applied. Statistical analysis employed the Kaplan--Meier method, log-rank and Fisher's exact test. Results: Twenty-three patients (54.8%) were male and the median age was 53.5 years (range: 4--88 years) at diagnosis of secondary myeloid neoplasms. Previous diseases included hematologic malignancies, solid tumors, aplastic anemia, autoimmune diseases and conditions requiring solid organ transplantations. One third of patients (33%) were submitted to chemotherapy alone, 2% to radiotherapy, 26% to both modalities and 28% to immunosuppressive agents. Five patients (11.9%) had undergone autologous hematopoietic stem cell transplantation. The median latency between the primary disease and secondary myeloid neoplasms was 85 months (range: 23--221 months). Eight patients were submitted to allogeneic hematopoietic stem cell transplantation to treat secondary myeloid neoplasms. Important changes in bone marrow were detected mainly by biopsy, immunohistochemistry and cytogenetics. The presence of clusters of CD117+ cells and p53+ cells were associated with low survival. p53 was associated to a higher risk according to the International Prognostic Scoring System. High prevalence of clonal abnormalities (84.3%) and thrombocytopenia (78.6%) were independent factors for poor survival. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Secondary effects and drug reactions relative to collagenase Clostridium histolyticum treatment for Dupuytren's contracture are frequent. In only a few cases these secondary effects are considered serious. The mechanism that produces these effects of production is not well understood. CLINICAL REPORT: We present the case report of a woman with fifth finger interphalangeal joint treatment with generalized skin rash as a complication of collagenase Clostridium histolyticum treatment. DISCUSSION: We discuss treatment, causes and mechanisms of this rare complication from this treatment and review the bibliography about mechanisms for the different types of immunological reactions that may occur after treatment with collagenase Clostridium histolyticum and the possibility of crossed reactions with Clostridiopeptidase A used to treat skin lacerations. [ABSTRACT FROM AUTHOR]

The aims of this research were to evaluate the efficacy of copper oxychloride (CuCl2.3Cu(OH)2), copper hydroxide (Cu(OH)2) and diquat (1.1′-ethylene-2.2′-bipyridyldiylium dibromide), isolated and in association with 0.1% of both copper sources, in the control of the unicellular algaeAnkistrodesmus gracilisand the filamentous algaePithophora kewesis, and to determine the acute toxicity of the tested chemicals inHyphressobrycon eques, Pomacea canaliculata, Lemna minorandAzolla caroliniana.The efficacy was estimated by the methods of chlorophyllaand pheophytinareadings, changed into growth inhibition percentage. Both algae were exposed to the following concentrations: 0.2; 0.4; 0.8; 1.2 mg L−1of diquat and its association with the copper sources; and 0.1; 0.3; 0.5; 0.7; 1.0 and 1.5 mg L−1in the isolated applications of copper hydroxide and copper oxychloride. An untreated control was kept. The acute toxicity was estimatedby 50% lethal concentration (LC50). The copper sources were effective forA. graciliscontrol, at rates as high as 0.1 mg L−1(>95% efficacy). Isolated diquat and its association with copper hydroxide were both effective at rates as high as 0.4 mg L−1, with 95 and 88% control efficacy, respectively. The copper oxychloride was effective at 0.2 mg L−1, with 93% efficacy. None of the tested chemicals and associations was effective onP. kewesiscontrol. The most sensitive non target organism to the tested chemicals wasL. minor; the less sensitive wasH. eques. [ABSTRACT FROM PUBLISHER]

Este estudo objetivou monitorar e avaliar a ocorrência e grau de intensidade da náusea, vômito e diarréia em pacientes com neoplasia de cólon, submetidos à quimioterapia ambulatorial, que receberam informações de enfermagem para o manejo desses sintomas. Fizeram parte do estudo 17 pacientes tratados com 5-Fluorouracil e baixas doses de ácido folínico, no Ambulatório de Quimioterapia de Adultos do Hospital São Paulo/Universidade Federal de São Paulo. Foram elaborados instrumentos para o registro da ocorrência e grau de intensidade desses sintomas e folhetos com informações sobre o seu manejo. As informações e o seguimento foram realizados pela enfermeira do setor, durante as consultas de enfermagem. Os resultados evidenciaram que a maioria dos pacientes (82,4%) apresentou pelo menos um dos sinais e sintomas estudados, entre o primeiro e o 21º dias do ciclo de tratamento. A náusea foi o sintoma mais freqüente (76,5%), com pico no 4º e 5º dias do ciclo, seguida da diarréia (70,5%), com pico no 7º dia e, por último o vômito (53,0%), com pico no 5º dia. Quanto ao grau de intensidade desses sintomas, a maioria dos pacientes situou-se no grau 1, estabelecido como aceitável para o estudo, indicando que as orientações de enfermagem e o acompanhamento contínuo contribuíram para a maior efetividade do manejo desses sintomas por parte dos pacientes.Este estudio tuvo como objetivo monitorear y evaluar la frecuencia y el grado de intensidad de la náusea, vómito y diarrea en pacientes con neoplasia de colon sometidos a quimioterapia ambulatoria que recibieron información de enfermería para el manejo de esos síntomas. Participaron del estudio 17 pacientes tratados con 5-Fluorouracil y bajas dosis de ácido folínico, en el Ambulatorio de Quimioterapia de Adultos del Hospital São Paulo / Universidad Federal de São Paulo, Brasil. Para el registro de la frecuencia e intensidad de esos síntomas fueron elaborados instrumentos y guías con informaciones de cómo manejarlos. Las informaciones y seguimiento de los pacientes fueron realizados por la enfermera del sector durante la consulta de enfermería. Los resultados evidenciaron que la mayoría de los pacientes (82,4%) presentó por lo menos uno de los síntomas estudiados, entre el primero y 21º día del ciclo de tratamiento. La náusea fue el síntoma más frecuente (76,5%), presentando pico en el 4º y 5º días del ciclo. Enseguida la diarrea (70,5%) con pico en el 7º día y, por ultimo, el vómito (53,0%) con pico en el 5º día. Cuanto al grado de intensidad de los síntomas, la mayoría de los pacientes se situó en el grado 1, establecido como aceptable para este estudio, indicando que las orientaciones de enfermería y el seguimiento continuo contribuyeron para la mayor efectividad del manejo de esos síntomas por parte de los pacientes.This study aimed to monitor and evaluate the occurrence and intensity level of nausea, vomiting and diarrhea in patients with colon cancer, submitted to outpatient chemotherapy, who received nursing information for handling these symptoms. Study participants were 17 patients, who were treated with 5-Fluorouracil and low doses of folinic acid, at the Adult Outpatient Chemotherapy Clinic of the Hospital São Paulo/Federal University of São Paulo, Brazil. Instruments were elaborated for registering these symptoms' occurrence and intensity level and a patient guide for handling them. The information and patient monitoring were carried out by the nurse during the consultations. The results showed that most of the patients (82.4%) displayed at least one of the signs and symptoms under study between the first and the 21st day of the treatment cycle. Nausea was the most frequent symptom (76.5%), with a peak on the 4th and 5th day of the cycle, followed by diarrhea (70.5%), with a peak on the 7th day, and vomiting (53.0%), with a peak on the 5th day. Regarding the intensity of these symptoms, most patients were classified as level 1, which was established as acceptable for this study. These results indicate that the nursing instructions and the continuous monitoring contributed to the effectiveness of the patient's symptom management.

Using the empirical or phenomenological research method by observing the effects of drugs in the human physiology, Samuel Hahnemann proposed the homeopathic treatment. He synthesized modern pharmacodynamic in the 'primary action' of the drugs and in the consequent and opposite 'secondary action' or 'vital reaction' of the organism. Noting that drugs with 'contrary' primary action to the symptoms of the diseases caused worsening of the symptoms after its withdrawal, as a result of secondary action of the organism, Hahnemann proposed using this vital reaction (secondary action) in a curative way, administering to sick individuals the drugs that caused 'similar' symptoms in healthy individuals (therapeutic use of the similitude principle). According to the clinical and experimental pharmacology, this secondary action (vital reaction) of the organism is observed in the 'rebound effect' or 'paradoxical reaction' of several classes of drugs, which is the scientific basis of the 'homeopathic pharmacology'. In the last decade, exponents of modern pharmacology have suggested the therapeutic use of the paradoxical reaction ('paradoxical pharmacology'), proposing the use of drugs that cause an exacerbation of the disease in the short term to treat these same diseases in the long-term. In this review, we compare the various aspects between the 'homeopathic pharmacology' and the 'paradoxical pharmacology', reinforcing the validity of homeopathic assumptions and expanding the knowledge to optimize both proposals. [ABSTRACT FROM AUTHOR]

Abstract: N-methyl-d-aspartate (NMDA) receptors can be inhibited by inhalational anesthetics in vitro at clinically relevant concentrations. Here, to clarify the role of NMDA receptors in anesthetic-induced unconsciousness, we examined the hypnotic properties of isoflurane, sevoflurane and nitrous oxide in NMDA receptor GluN2A subunit knockout mice. The hypnotic properties of inhalational anesthetics were evaluated in mice in the loss of righting reflex (LORR) assay by measuring the 50% concentration for LORR (LORR ED50). Knockout mice displayed isoflurane and sevoflurane LORR ED50 values similar to wild-type controls, indicating no significant contribution of these receptors to the hypnotic action of halogenated anesthetics. However, compared with wild-type controls, mutant mice displayed larger isoflurane LORR ED50 values in the presence of nitrous oxide, indicating a resistance to this gaseous anesthetic. Knockout mice have enhanced brain monoaminergic activity which occurs secondary to NMDA receptor dysfunction, and the observed resistance to the isoflurane LORR ED50-sparing effect of nitrous oxide could be abolished by pretreatment with the dopamine D2 receptor antagonist droperidol or with the serotonin 5-HT2A receptor antagonist ketanserin. Thus, resistance to nitrous oxide in knockout mice appears to be a secondary phenomenon of monoaminergic origin and not a direct result of impaired NMDA receptor function. Our results indicate that NMDA receptors are not critically involved in the hypnotic action of conventionally-used inhalational anesthetics. Also, they suggest that increased brain monoaminergic tone can diminish the effects of general anesthesia. Finally, they provide further evidence that changes secondary to genetic manipulation can explain the results obtained in global knockouts. [Copyright &y& Elsevier]

Background: Homeopathy is based on treatment by similitude (‘like cures like’) administering to sick individuals substances that cause similar symptoms in healthy individuals, employing the secondary and paradoxical action of the organism as therapeutic response. This vital or homeostatic reaction of the organism can be scientifically explained by the rebound effect of drugs, resulting in worsening of symptoms after suspension of treatment. Bisphosphonates (BPs) reduce ‘typical’ fractures in patients with osteoporosis, but recent studies report ‘atypical’ fractures of the femur after stopping the BPs, a rebound effect may be the causal mechanism. Method: Review of the literature concerning the relationship between atypical femoral fractures and antiresorptive drugs (bisphosphonates), identifying the pathogenesis of this adverse event. Results: Several studies have described multiple cases of ‘atypical’ low-impact subtrochanteric stress fractures or complete fractures of the femur. These fractures are often bilateral, preceded by pain in the affected thigh, may have a typical X-ray appearance, and may delayed healing. Rebound of osteoclastic activity after suspension of antiresorptive drugs is a plausible mechanism to explain this phenomenon. Conclusion: As for other classes of drugs, the rebound effect of antiresorptive drugs supports Hahnemann''s similitude principle (primary action of the drugs followed by secondary and opposite action of the organism), and clarifies this ‘unresolved’ issue. Unfortunately, the rebound effect is little discussed among health professionals, depriving them of important knowledge ensure safe management of drugs. [Copyright &y& Elsevier]

The homeopathic model applies the secondary action or vital reaction of the organism as a therapeutic method and thus prescribes treatment by similitude, which consists in administering to ill individuals substances that cause similar symptoms in healthy individuals. The vital, homeostatic or paradoxical reaction of the organism might be explained scientifically by means of the rebound effect of modern drugs, which might cause fatal iatrogenic events after discontinuation of antipathic (a term used in alternative medicine for palliative treatment, also known as enantiopathic) treatment. Although the rebound effect is studied by modern pharmacology, it is poorly communicated to and discussed among healthcare professionals, who are thus deprived of information needed for the safe management of modern drugs. This article presents an up-to-date review on the rebound effect of modern drugs that grounds the homeopathic principle of healing and calls the attention of doctors to this type of adverse effect that is usually unnoticed. The rebound effect of modern palliative drugs, which was pointed out by Hahnemann more than two centuries ago, might cause fatal adverse events and is illustrated by the examples of acetylsalicylic acid, anti-inflammatory agents, bronchodilators, antidepressants, statins, proton-pump inhibitors, etc. Although the rebound effect is expressed by a small fraction of (susceptible) individuals and might be avoided by gradual tapering of antipathic drugs, it exhibits epidemiologic importance as a function of the massive use of such palliative drugs and the lack of knowledge in its regard. [ABSTRACT FROM AUTHOR]

When Samuel Hahnemann systematized homeopathy and the effects of drugs on the state of human health, he described the primary action of drugs and the following secondary and opposite reaction of the organism. Seeking to apply this secondary action or vital reaction of the organism as therapeutic method, he postulated the principle of similitude, i.e. the prescription to ill individuals of drugs that cause similar symptoms in the healthy (similia similibus curentur). In modern pharmacology, secondary action (vital reaction) of drugs is known as rebound effect or paradoxical reaction of the organism. It has been observed after discontinuation of several classes of palliative (enantiopathic) drugs, namely those that act according to the principle of contraries (contraria contrariis curentur). Although in this case it is associated with severe and fatal iatrogenic events, rebound effect might awaken a healing reaction when the very same drug is employed according to the principle of similitude. The validity of the principle of similitude is proved by scientific evidence on rebound effect, whereas conventional drugs primary (therapeutic, adverse and side) effects might be equated to pathogenetic manifestations and thus be homeopathically applied. For this purpose a homeopathic materia medica and repertory comprising 1,251 modern drugs was elaborated using the monographs described in The United States Pharmacopeia Dispensing Information as source (www.newhomeopathicmedicines.com). Thus, the therapeutic range of homeopathy is broadened through the addition of hundreds of new medicines that might be employed in every kind of disease including countless modern clinical syndromes. [ABSTRACT FROM AUTHOR]

Background: The homeopathic method is based on the application of the principle of therapeutic similitude (similia similibus curentur), using medicines that cause effects similar to the symptoms of disease in order to stimulate the reaction of the organism against disturbances. Such vital, homeostatic or paradoxical reaction of the organism can be scientifically explained on the basis of the rebound effect of modern drugs. Aims: This article presents the conclusion of a study aiming at a method to use modern drugs with homeopathic criteria. Methods: Adverse effects as catalogued in United States Pharmacopoeia Dispensing Information Drug monographs were collected. Results: A homeopathic materia medica and repertory comprising 1251 modern drugs to be employed according to the principle of therapeutic similitude was developed. Conclusion: Besides supplying a basis for homeopathy as a medical rationale related to scientific pharmacology, this study makes available a method that may broaden the scope of intervention of homeopathy in present day diseases. [Copyright &y& Elsevier]

Background: Homeopathy is based on the principle of similitude (similia similibus curentur) using medicines that cause effects similar to the symptoms of disease in order to stimulate the reaction of the organism. Such vital, homeostatic or paradoxical reaction of the organism is closely related to rebound effect of drugs. Method: Review of the literature concerning the rebound effects of drugs used to suppress gastric acidity, particularly proton pump inhibitors (PPIs). Results: The mechanism of action of these effects is discussed. Rebound in terms of clinical symptoms and physiological effects occur in about 40% of people taking PPIs, their timing depends on the half-life of the drug and the adaptation period of the physiological mechanisms involved. The wide use of PPIs may be linked to the rising incidence of carcinoid tumours. Conclusions: These findings support Hahnemann’s concept of secondary action of drugs. We are developing a homeopathic materia medica and repertory of modern drugs on the basis of reported rebound effects. [Copyright &y& Elsevier]

Hahnemann considered the secondary action of medicines to be a law of nature and reviewed the conditions under which it occurs. It is closely related to the rebound effects observed with many modern drugs. I review the evidence of the rebound effect of statins that support the similitude principle. In view of their indications in primary and secondary prevention of cardiovascular diseases, statins are widely prescribed. Besides reducing cholesterol biosynthesis, they provide vasculoprotective effects (pleiotropic effects), including improvement of endothelial function, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory and thrombogenic responses, stabilisation of atherosclerotic plaques, and others. Recent studies suggest that suspension of statin treatment leads to a rebound imparing of vascular function, and increasing morbidity and mortality in patients with vascular diseases. Similarly to other classes of modern palliative drugs, this rebound effect is the same as a secondary action or vital reaction described by Samuel Hahnemann, and used in homeopathy in a therapeutic sense. [Copyright &y& Elsevier]

This article claims that an analysis of secondary effects of technology is essential for sustainable development. It then proposes the idea of chain effects defined as the creation of a series of solutions subsequent to the initial impacts of an infrastructure. It depicts the mechanism of how a series of solutions forms orders of decision-making processes in accordance with interests of particular groups of stakeholders. The analysis employs an eclectic approach consisting of the concept of ‘what governs’ and ‘who governs’. From the viewpoint of ‘what governs’, it indicates at least three patterns of chain. The analysis of the chain, from the viewpoint of ‘who governs’, suggests an interesting characteristic of stakeholders' decisions. Two case studies are taken for the discussion to develop propositions associated with the political aspects of infrastructure development. They include successive advantage-taking behaviors by particular groups of stakeholders, and embedded values along the process of chain. Sustainable development of infrastructure is unlikely to be achieved without consideration of chain effects. Copyright © 2008 John Wiley & Sons, Ltd and ERP Environment. [ABSTRACT FROM AUTHOR]

Background: Samuel Hahnemann noticed that palliative treatments for the symptoms of chronic diseases, after an initial improvement, provoked symptoms similar but stronger symptoms to those initially suppressed. He regarded this as a consequence of the vital reaction of the organism: an automatic and instinctive capacity to return to the initial health condition altered by medicines. Using this homeostatic conception of the organism as a treatment rationale, Hahnemann proposed the therapy of similarity, administering to the patients medicines capable of causing, in healthy individuals, similar symptoms to the natural disease. Based on experimental observations, he proposed that the primary action of the drug was followed by the secondary and opposite action of the organism, inaugurating homeopathic pharmacology, and alerting to the harmful consequences of palliative medicines in susceptible individuals. Such iatrogenic events can be observed in contemporary medicine, after the withdrawal of modern enantiopathic medicines, according to the study of the rebound effect or paradoxical reaction of the organism. Method:This study reviews the recent studies which describe suicidality after the suspension or discontinuation of second generation antidepressants according to the hypothesis of the paradoxical reaction of the organism. Conclusions: Rebound and withdrawal effects, including suicidality occur with antidepressant drugs. They are relatively rare but more intense than the primary action of the drug. The probability of such effects is influenced by patient factors including age and diagnosis, and drug factors including half-life. [Copyright &y& Elsevier]

Abstract: To adequately help children with cancer, care providers need to understand the complexity of symptoms and problems associated with the illness that children are experiencing, which can enable them to better tailor patient care individually to each child. In this integrative literature review, we identified the types of symptoms and problems that children with cancer can experience during treatment and rehabilitation; the terms/expressions they use to describe their symptoms and problems; how children''s symptoms and problems vary during the course of their illness; and how they vary and co-vary with age, gender or race. Of the 1175 titles identified, 110 articles met the inclusion criteria and were included in the review. Seventy-eight were research-based. A total of 219 distinct symptoms or problems were identified in the literature either as the main problem or a symptom of the main problem. There is significant evidence that children and adolescents experience numerous and complex symptoms, and problems during and after treatment for cancer. Children use many different expressions to talk about their symptom experiences. However, few articles looked at how children''s symptoms and problems varied during the course of their illness or the variations in symptom severity and degree of bother, or examined the relationship between children''s symptom experience and age, gender, or race. Most instruments that were used to measure symptoms were interviewer-administered questionnaires, often adaptations from adult versions, and in younger children, symptoms were often obtained from adult informants. The insights gained from this review can be helpful to researchers and clinicians who wish to better understand how symptoms and problems are experienced from the children''s own perspective. However, more research is needed: to better understand differences in symptom experiences among different age groups; to identify differences among children from distinct cultural, ethnic, or socio-economic backgrounds; to clarify how symptoms and problems interfere with daily life; and to refine assessment methods that allow even younger children to communicate their symptom experiences in an age-adjusted manner. [Copyright &y& Elsevier]

Frugivorous animals disperse the seeds of the majority of rainforest plant species and hence play a key role in the trajectory of rainforest regeneration. This study investigated whether changes in the species composition of the frugivore community in fragmented rainforest in subtropical Australia is likely to impact the dispersal of native plant species. The potential of frugivorous bird and bat species to disperse the seeds of plant species in fragmented rainforest was assessed using published dietary information together with field surveys of frugivore abundance within intact forest, forest fragments and patches of regrowth. Frugivore species with reduced abundance in fragmented rainforest were the only known dispersers of 27 of the 221 native plant species in the data set (12% of species). These frugivore species were also major dispersers of plant species producing fruits wider than 10mm and species from the families Rubiaceae, Lauraceae, Myrtaceae, Meliaceae, Lamiaceae and Vitaceae. Except for Rubiaceae, these plant taxa are also potentially dispersed by two of the frugivore species that were widespread in fragmented rainforest, Lopholaimus antarcticus and Ptilonorhynchus violaceus, although dispersal rates are likely to be lower in fragmented than in extensive rainforest. Consistent with other regions, large-seeded plants are susceptible to reduced dispersal in fragmented rainforest in subtropical Australia. However, we predict a smaller deficit in seed dispersal in fragmented forests than has been reported from other regions, due to factors such as functional overlap among frugivore species, the ability of many Australian rainforest vertebrates to persist in fragmented rainforest, and a lack of hunting in these forests. Nevertheless, rainforest fragmentation has reduced the abundance of a suite of frugivorous rainforest fauna, which in turn is likely to reduce the dispersal of a certain plant taxa and may alter patterns of plant regeneration in subtropical Australian rainforest fragments. [Copyright &y& Elsevier]

This study investigates a control strategy for torque vectoring (TV) and active rear wheel steering (RWS) using feedforward and feedback control schemes for different circumstances. A comprehensive vehicle and combined slip tire model are used to determine the secondary effect and to generate desired yaw acceleration and side slip angle rate. A model-based feedforward controller is designed to improve handling but not to track an ideal response. A feedback controller based on close loop observation is used to ensure its cornering stability. The fusion of two controllers is used to stabilize a vehicle's lateral motion. To increase lateral performance, an optimization-based control allocation distributes the wheel torques according to the remaining tire force potential. The simulation results show that a vehicle with the proposed controller exhibits more responsive lateral dynamic behavior and greater maximum lateral acceleration. The cornering safety is also demonstrated using a standard stability test. The driving performance and stability are improved simultaneously by the proposed control strategy and the optimal control allocation scheme. [ABSTRACT FROM AUTHOR]

Background: Percutaneous renal biopsy (PRB) is invasive, and bleeding-related complications are a concern. Desmopressin (DDAVP) is a selective type 2 vasopressin receptor-agonist also used for haemostasis., Aim: To evaluate the side effects of intravenous (IV) weight-adjusted desmopressin preceding PRB., Methods: This was a retrospective study of renal biopsies performed by nephrologists from 2013 to 2017 in patients who received single-dose DDAVP pre-PRB., Results: Of 482 PRBs, 65 (13.5%) received DDAVP (0.3 µg/kg); 55.4% of the PRBs were native kidneys. Desmopressin indications were altered platelet function analyser (PFA)-100 results (75.3% of the patients), urea >24.9 mmol/L (15.5%), antiplatelet drugs (6.1%) and thrombocytopaenia (3%). Of the 65 patients, 30.7% had minor asymptomatic complications, and 3 patients had major complications. Pre-PRB haemoglobin (Hb) <100 g/L was a risk factor for Hb decrease >10 g/L, and altered collagen-epinephrine (Col-Epi) time was a significant risk factor for overall complications. Mean sodium decrease was 0.6 ± 3 mmol/L. Hyponatraemia without neurological symptoms was diagnosed in two patients; no cardiovascular events occurred., Conclusion: Hyponatraemia after single-dose DDAVP is rare. A single IV dose of desmopressin adjusted to the patient's weight is safe as pre-PRB bleeding prophylaxis.

Introduction: We present the case of a man who, after receiving treatment for Covid-19 pneumonia, suffers a manic episode induced by medication. Objectives: This case is chosen to present as an example of a psychiatric illness derived from Covid-19, in this case secondary to its treatment. Methods: We present a manic episode induced by covid medication. Results: Complementary examinations are carried out in which organic pathology is ruled out, being diagnosed of a manifest episode in probable relation to the treatments used and hospital admission is decided due to the impossibility of home management. Neuroleptic and anxiolytic treatment was started at low doses with a good response, and he was discharged with complete recovery and critiqued of the episode. Conclusions: It is estimated that between 20-40% of patients with COVID infection have presented neuropsychiatric symptoms. Mania secondary to treatment was reported in 13 (0 ± 7%) of 1744 patients with coranavirus included in a study (1). The Spanish Pharmacivigilance System of Medicines for Human Use (SEFV-H) closely monitors the suspected adverse reactions reported with drugs considered potential therapeutic strategies for SARS-CoV-2 infection. 327 cases of adverse reactions have been reported, of which 18 cases include 28 thermal cases of suspected psychiatric adverse reactions. The interest of this case lies in the fact that it illustrates a psychiatric disorder derived from Covid-19, in this case secondary to the treatment used, which causes a manifest episode with a typical evolution in this type of case with rapid improvement at low doses of antipsychotics. [ABSTRACT FROM AUTHOR]

Background: Polypharmacy increases the risk of pharmacological interactions, prevalence of secondary effects and with this the lack of adherence to treatment. It is estimated that between 10 and 40% of patients hospitalized in psychiatric institutions are prescribed more than one antipsychotic. The objective of the present study was to identify the prevalence of polypharmacy, evaluate adverse effects associated to the use of psych drugs and to estimate the risk in specific groups. Methods: We carried out a longitudinal, retrospective study that included the analysis of all discharged patients (n = 140) in the first trimester of the year in a psychiatric hospital in Mexico. The information was classified into 7 sections: sociodemographic, diagnosis, clinical follow-up information, prescribed drugs, adverse reactions, substance abuse, laboratory and complementary results. Risk estimation was obtained with Odds Ratios, to correlate continuous variables Pearson's correlation was used. Student's T and Mann Whitney's U were used to compare 2 independent samples; multiple and linear regressions were carried out. Results: The mean number of drugs used during hospitalization was 7.8 drugs per patient. The mean prescribed psych drugs was 4.07. The mean antipsychotic dose was the risperidone equivalent of 5.08 mg. 29.2% of patients had at least one secondary effect associated to the use of drugs, 17.8% presented extrapyramidal symptoms. 81.4% of patients were prescribed 6 or more drugs (polypharmacy) and were 5 times more likely to suffer a secondary effects (OR 6.24). 14.2% had polypharmacy while receiving antipsychotics and had more than twice the risk of presenting extrapyramidal symptoms (OR 3.05). For each added psych drug, hospital stay increased by 6.56 days. Conclusions: Despite international guideline recommendations where reasoned and conciliatory prescription of psych drugs is advised, there is still a high prevalence of polypharmacy in patients hospitalized in psychiatric institutions. In the present study 4 out of 5 patients received polypharmacy decreasing tolerability, treatment adherence and increasing the risk and costs secondary to an increased hospital stay. [ABSTRACT FROM AUTHOR]