Physical Therapy Assistant

Physical Therapy Assistant. Physical Therapy Assistant.

Instructions: Using the LIRN database, research and review 1 scholarly article related to a Physical Therapy based topic, for example; can be related to lifelong learning. For the review portion of the assignment, in a few paragraphs or less, briefly explain what the article is about and provide your point of view, IN YOUR OWN WORDS. The article must be included with your assignment and the review must be typed. Format should resemble the following:
A. Introduction
B. Body
a. Describe the Study
b. State study hypothesis & explain
c. Point of view
C. Conclusion
a. Summarize methods and resultsP(5.u)

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Physical Therapy Assistant

Physical Therapy Assistant

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biosignal with clinical relevance

biosignal with clinical relevance. biosignal with clinical relevance. Instructions: Pick a biosignal with clinical relevance. Explain what it is used for clinically. What are the characteristics of the signal—amplitude, frequency if periodic, type of signal (e.g., electrical voltage, current, resistance, temperature, displacement, concentration, photons, etc.) and units (Volts, Ohms, Amperes, degrees Celsius, mm, femtoMolar, light intensity, etc.). What disease(s) or pathology/pathologies does the biosignal indicate? What ranges of the biosignal are normal vs. abnormal? Using the libraries portal into pubmed or web of science, find out about the disease state fundamentals from a review article. List as many interesting and relevant facts as you can about the disease state, and cite the review article. Then, find 3 articles that describe different ways to measure the biosignal. An alternative option to a peer-reviewed article is a commercial product with a specification sheet and/or instructions manual. List the top 5 design requirements for a new instrument that would measure the biosignal, based on the clinical need. For each instrument, explain how the signal is sensed, filtered, conditioned, amplified, digitized, and displayed. Cite the 3 peer-reviewed articles for each of these explanations. Come up with a new design of an instrument to detect the biosignal. Make a block diagram or schematic that traces the signal through the sensor, and all processing steps through to the display. Come up with a preliminary parts list where you list the part number and manufacturer. How are the parts linked together (circuit board, cables, wiring, etc.). Finally, explain why your new design fulfills the design requirements. What are potential sources of error, or potential design flaws?
Grading Rubric:
Biosignal

6 pts
Characteristics (2), units (2), uses (2).
Disease state fundamentals

15 pts
Fifteen cited facts (1 pt each).
Pathology-signal relation
4 pts

Normal range (2 pts), abnormal range (2 pts).
3 research articles/commercial instruments
6 pts
2 pts each. All must be relevant to the biosignal and disease/pathology.
5 design requirements
5 pts
1 pt each. These must be clearly important functionalities that can be addressed by instrumentation choices: for example, cost, sensitivity, accuracy, ease of use.
Signal flow and processing
12 pts
For each of the 3 designs: explain features of the signal (1), conditioning (1), digitization (1), and display (1).
New design—block diagram
6 pts
Flow from signal detection to display is fully explained (6 pts), all steps labeled correctly and in an order that makes sense. Insert picture from a powerpoint slide.
Parts list
6 pts
Parts with numbers and manufacturer (3), explanation how linked (3).
Design requirements fulfilled
10 pts
Good explanation for new instrument fulfilling each design requirement (2 pts each).
Sources of error/flaws
5 pts
Complete explanations
TOTAL
75 pts

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biosignal with clinical relevance

biosignal with clinical relevance

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Post-marketing drug monitoring, surveillance, and research

Post-marketing drug monitoring, surveillance, and research. Post-marketing drug monitoring, surveillance, and research. Greetings all, for the last forum of our course, I would like for us to look at the current network for monitoring the safety and effectiveness of our nation’s drug supply. Understanding these processes and their limitations should help us to better understand the challenges that we face today and in the future. Despite the FDA’s vigilant premarket review of all new drugs, the active "post-marketing surveillance" (post-FDA approval) of a given drug’s adverse events (A/E’s) are also essential. One must keep in mind that all possible side effects or toxicities of a drug can’t be anticipated based on pre-approval studies involving only several hundred to several thousand patients. The FDA maintains a system of post-marketing surveillance and risk assessment programs to identify adverse events that did not appear during the drug approval process or appeared at a different frequency or severity. The FDA then uses this information (database) to update drug labeling, and on rare occasions, to reevaluate the drug approval or marketing decision. The FDA Adverse Event Reporting System (FAERS) is a computerized information database designed to support the FDA’s post-marketing safety surveillance program for all approved drugs and therapeutic biologic products. The ultimate goal of FAERS is to improve the public health by providing the best available tools for storing and analyzing safety reports. The reports in FAERS are evaluated by a multidisciplinary staff safety evaluators, epidemiologists and other scientists in the Center for Drug Evaluation and Research’s (CDER) Office of Surveillance and Epidemiology to detect safety signals and to monitor drug safety. As a result, the FDA may take regulatory actions to improve product safety and protect the public health, such as updating a product’s labeling information, sending out a "Dear Health Care Professional" letter, or re-evaluating an approval decision.

The MedWatch program is for health professionals and the public to voluntarily report serious reactions and problems with medical products, such as drugs and medical devices. It also ensures that new safety information is rapidly communicated to the medical community thereby improving patient care. All data contained on the MedWatch form will be entered into the AERS database. The MedWatch page includes sections on how to report an adverse event, safety information, and publications. For more information on how to report adverse events, see Reporting Problems to FDA. The Division of Drug Marketing, Advertising and Communications page also contains other useful drug advertising and surveillance information. After a drug is approved and marketed, the FDA uses different mechanisms to assure that firms 1) adhere to the terms and conditions of approval described in the application and 2) that the drug is manufactured in a consistent and controlled manner. This is done by periodic, unannounced inspections of the drug’s production and control facilities by FDA’s field investigators and analysts.

Manufacturers of prescription medical products are required by regulation to submit adverse event reports to the FDA. The MedWatch site provides information on mandatory reporting by manufacturers. In addition, drug manufacturers must submit either error and accident reports or drug quality reports when deviation from current good manufacturing practice regulations occur.

The FDA receives medication error reports on marketed human drugs (including prescription drugs, generic drugs, and over-the-counter drugs) and non-vaccine biological products and devices. The National Coordinating Council for Medication Error Reporting and Prevention defines a medication error as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use." CDER medication errors program staff review medication error reports sent to the USP-ISMP Medication Errors Reporting Program and MedWatch, evaluate causality, and analyze the data to provide feedback to others at FDA.

In addition, it is the FDA’s policy to attempt to prevent or alleviate shortages of medically necessary products. Drug shortages may arise from varying causes, such as the unavailability of raw materials or packaging components, marketing decisions, and enforcement issues.of drug products that fail to work in patients because the product simply has no effect or is toxic. These problems are usually attributed to switching brands of drugs. As a result, on September 14, 1988, the FDA created in CDER the Therapeutic Inequivalence Action Coordinating Committee (TIACC) to identify and evaluate reports of therapeutic failures and toxicity that could indicate that one product is not equivalent to another similar product. Post-marketing evaluations can be lauched by the FDA or voluntarily by the pharmaceutical company.

1) Does the use of a randomized controlled trial (RCT) guarantee that the information obtained will be generalizable to the population at-large?

2) What is a "black-box" label warning? Are they effective?

3) What strategies may be used to reach those individuals with limited access to information technologies that routinely provide drug safety information such as the Internet? Are the elderly and the poor at a serious disadvantage that cannot be corrected?

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Post-marketing drug monitoring, surveillance, and research

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musculoskeletal

musculoskeletal. musculoskeletal. Your first patient has a musculoskeletal complaint. Using musculoskeletal medical word elements construct 10 medical terms that would reasonably be involved in a complaint dealing with the muscles and/or bones. For example, you could say that your patient had a herniated disk (rupture of a vertebral disk’s center that puts pressure on the spinal cord), perhaps due to lifting heavy weights, as part of her complaint. Each term should include its meaning in parentheses. Then list 3 tests or procedures that would reasonably be involved in evaluating a patient like this.

Your second patient has a gastrointestinal complaint. Using digestive medical word elements construct 10 medical terms that would reasonably be involved in a complaint dealing with the digestive tract. For example, you could say that your patient had glossitis (inflammation of the tongue), perhaps due to overindulging in jalapeno peppers, as part of his complaint. Each term should include its meaning in parentheses. Then list 3 tests or procedures that would reasonably be involved in evaluating a patient like this.

Your final patient has a respiratory problem, so something having to do with her breathing or lungs needs to be described. Again, use at least 10 terms especially using the respiratory medical word elements . Also, you need to include 3 tests or procedures that will help you to discover what the problem with your patient is.

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musculoskeletal

musculoskeletal

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Medicines Information reply letter

Medicines Information reply letter. Medicines Information reply letter. write no more than 2 pages reply to a letter written by a local prescriber (General Practitioner (GP) or hospital doctor). Their letter details a query about a specific patient.
The paper need to reply to is in the attachment named medicine information letter. Also, there is another paper as a sample.
References cited in the text should follow the Vancouver convention.

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Medicines Information reply letter

Medicines Information reply letter

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Toxicology of ibuprofen

Toxicology of ibuprofen. Ibuprofen is made up of 75.69% carbon, 15.51% oxygen, and 8.80% hydrogen. Toxicology is defined as the branch of science that deals with nature, impact and the identification of toxins. The toxicological studies are carried out to detect the mode of actions of toxic chemicals, to evaluate the degree to which the drug substances are toxic for the animals and to develop new or improved tests for specific types of chemically induced effects. Reproductive toxicology studies, developmental toxicology studies, carcinogenicity studies and genotoxicity studies are conducted to assess the toxicity of the drugs. The aim of the report is to investigate ibuprofen toxicology in animal models before releasing the drug into the market.

 

Gastrointestinal ulcer is the major toxic effect that occur due to the use of ibuprofen in rats, rabbits and dogs. In one pre-clinical study, a single dose toxicity test of ibuprofen was carried out in rats and mice. These animals were given ibuprofen in different doses and different routes of administration. The result showed that the LD50 values for ibuprofen were 800 mg/kg orally and 320 mg/kg intraperitoneally in the mouse and 1600 mg/kg orally and 1300 mg/kg subcutaneously in the rat. Moreover, clinical signs of gastric ulcers were seen in both animals which concluded that ibuprofen in lethal dose was ulcerogenic in both rat and mouse.This occurred due to the inhibition of COX-1 enzyme and the loss of GI protective mechanism. There are widely drugs that can be used to treat or minimize this side effect.

 

Types of species Routes of administration LD50 values

 

mice Orally 800 mg/kg
Mice Intraperitoneally 320 mg/kg
Rats Orally 1600 mg/kg
rats Subcutaneously 1300 mg/kg

Based on another pre-clinical study, ibuprofen was given to dogs in different doses (25,125, > 175, >400, >600) mg/kg to establish the toxicity issues of ibuprofen. It was found that ibuprofen in a dose above 400mg/kg can have an impact on the central nervous system causing coma, depression & seizures.  High incidence of developing acute renal failure was observed in dogs taking ibuprofen in a dose above 175mg/kg. This occur due to the ability of ibuprofen to block the vasodilatory prostaglandin which in turn result in reduction of renal blood flow that lead to acute renal failure and other renal diseases. These side effects are more common only when ibuprofen is overdosed.

 

Ibuprofen dose (mg/kg) Toxicity issues
25-125 Nausea, vomiting, diarrhea
>175 Nausea, vomiting, diarrhea, acute renal failure, polyuria or polydipsia
>400 All the above + coma, depression and seizures
>600 Death

 

 

Reproductive toxicology studies are concerned within the influence of the drug substance on different aspects of reproductive capacity. Ibuprofen was given to female and male rats in a dose of 20mg/kg/ day to investigate the reproductive performance of the drug. It was proven that ibuprofen doesn’t cause any effect on male or female rat’s fertility or reproductive function. However, ovulation was inhibited in rabbits by the use of ibuprofen.

 

In terms of developmental toxicology studies, no evidence of teratogenicity of ibuprofen was seen in any animal studies. In one rat study, ibuprofen showed the ability to inhibit fetal implantation. Another study revealed that ibuprofen has low degree in affecting parturition in female rats. However, the previous conditions are minor and not common while using ibuprofen. In addition to that, no alteration was observed in the duration of gestation in rats. Some laboratory animal studies showed that ibuprofen can increase the incidence of developing cognitional malformation specifically during the period of heart growth in rats and rabbits causing the selective COX-2 inhibitor to increase the risk of having heart anomalies. In another study, ibuprofen was administrated to female rats in a total daily dose of 25.5, 255 & 600 mg/kg/day respectively) to establish the toxicity of ibuprofen. Miscarriage was only observed in one of the cases that was given ibuprofen in a dose of 255mg/kg/day. Furthermore, at does 600mg/kg/day intrauterine growth retardation was noted. Therefore, ibuprofen should be avoided during pregnancy.

 

To evaluate the carcinogenicity of ibuprofen, rats and mice were given ibuprofen for up to two years. The majority of studies showed that ibuprofen didn’t affect the natural incidence of tumors that spontaneously develop in mice or rats. As a result, no effect of carcinogenicity was detected

 

The mutagenicity of ibuprofen was tested in Ames mutagenicity and in vivo genotoxicity was tested by sister chromatid exchange (SCE) in bone marrow cells of mice. The study concluded that ibuprofen was shown to be non-mutagenic in the Ames test specifically in Salmonella strains. Moreover, sister chromatid exchange (SCE) results showed weak genotoxic effect in mice. Another study showed that ibuprofen has no mutagenic effect in mammals cells.

 

To conclude, Ibuprofen has a relatively low toxicity. The major toxic effect of ibuprofen that was proven is the formation of gastric ulcers among different species. This toxic issue can be controlled by the use of other drugs that can treat or minimize this condition. Ibuprofen should be avoided during pregnancy

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Toxicology of ibuprofen

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