The structures of new compounds were determined by extensive spectroscopic analyses. Structurally, compounds 1 and 3 are tremulane-type sesquiterpenoids with an unusual perhydroazulene carbon skeleton.”
“Objective. Pain concerns are one of the leading causes of visits to primary care. However, practicing physicians find managing pain frustrating and complex. There is little information about how undergraduate medical students approach pain and its management. This study aimed to explore
first-year medical selleck chemicals students’ perceptions of pain-related patient encounters in the primary care setting.
Design. Qualitative analysis was used to explore first-year students’ reflective journals written during an early clinical experience in primary care. Using iterative process for text analysis, entries referencing pain-related encounters were coded by two independent researchers with 94% inter-rater
reliability. Themes and categories were sought by immersion crystallization.
Results. Three themes emerged from the students’ journals: positive, negative, and neutral perceptions of pain-related encounters. With further analysis of the journals, acute, chronic, end-of-life, iatrogenic, and emotional pain categories also emerged. Most journal entries were negative, and chronic pain generated the most negativity.
Conclusions. First-year medical students identified pain as a major concern in their early clinical experience. Students’ selleck screening library perceptions of pain-related encounters can inform curriculum design and may ultimately benefit both physicians and the patients.”
“Two new drimane sesquiterpenoids, 11,12-dihydroxy-15-drimeneoic acid (1) and 3,11,15-trihydroxydrimene (2), were isolated from cultures of the basidiomycete Agaricus arvensis, together with one known compound 3,11,12-trihydroxydrimene (3). Their structures were established by means of spectroscopic analysis.”
“Objective. Methylnaltrexone, a selective peripherally acting mu-opioid
receptor antagonist, effectively treats opioid-induced constipation (OIC) in patients with advanced illness and shows efficacy in patients with chronic nonmalignant pain. The objective was to identify patients who achieved maximal treatment effect based on response to initial four methylnaltrexone Cl-amidine in vivo doses.
Design. A post hoc analysis of a randomized, double-blind, placebo-controlled study evaluating patients with OIC and chronic nonmalignant pain who received 12 mg subcutaneous methylnaltrexone daily for 4 weeks was performed to determine if response to the first four methylnaltrexone doses predicted overall response during the study. Patients receiving >= 8 doses were included.
Outcome Measures. Patients having >= 3 rescue-free bowel movements (RFBMs)/week; change from baseline in RFBMs/week; percentage of doses with RFBMs within 4 hours after dosing.
Results.