Wilkes University

About: Wilkes University is a education organization based out in Wilkes-Barre, Pennsylvania, United States. It is known for research contribution in the topics: Population & Pharmacy. The organization has 616 authors who have published 1032 publications receiving 21050 citations. The organization is also known as: Wilkes & Wilkes College.

Rosuvastatin for the treatment of hypercholesterolemia

Abstract: Rosuvastatin, a new hydrophilic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin), is approved as an adjunct to diet in patients with primary hypercholesterolemia, mixed dyslipidemia, or Fredrickson type IV hypercholesterolemia. Because of its increased affinity for the reductase, rosuvastatin reduces the low-density lipoprotein cholesterol (LDL) level more than atorvastatin, simvastatin, and pravastatin do, without additional adverse effects. In addition, cytochrome P450 isoenzymes do not extensively metabolize rosuvastatin, and inhibitors of these isoenzymes do not substantially affect it. Rosuvastatin could be a first-line option for patients requiring a reduction of 50% or more to reach the LDL goal of the National Cholesterol Education Program Adult Treatment Panel III. Rosuvastatin monotherapy may allow patients to achieve this LDL goal earlier, and it may help them avoid combination therapy or potential adverse effects of high-dose statin therapy. However, because cardiovascular disease morbidity and mortality data are lacking for rosuvastatin (but available for all other marketed statins) and because its postmarketing data are limited, rosuvastatin should be reserved for patients requiring an LDL reduction of 50% or less who cannot reach the recommended goal with other statins because of adverse effects, drug interactions, or cost.

Prolonged infusions of dexmedetomidine in critically ill patients

Abstract: Purpose The efficacy and safety of dexmedetomidine when used longer than the manufacturer-recommended 24 hours were evaluated Summary Dexmedetomidine is the newest agent available for use in the critical care setting to induce and maintain sedation and analgesia. However, concerns over efficacy and safety during prolonged administration are a limiting factor for use in this patient population. A literature review was conducted to assess the clinical evidence regarding the efficacy and safety of dexmedetomidine for longer than 24 hours. A total of 11 studies were identified. Of these trials, 6 included adult patients and 5 included pediatric patients. Of the 6 adult trials, 3 comparative trials demonstrated a similar efficacy with benzodiazepines (i.e., midazolam and lorazepam) or propofol, with a reduction in the incidence of delirium and coma associated with dexmedetomidine. In noncomparative trials, dexmedetomidine was efficacious in achieving sedation goals with only mild adverse effects. In the 5 pediatric trials evaluated, efficacy to achieve a target sedation scale score could not be assessed, as most studies did not use validated sedation scales to measure goal sedation. Alternatively, the safety of dexmedetomidine has been demonstrated throughout an extended duration of use. In all of the studies evaluated, dexmedetomidine was associated with bradycardia; however, there were no reports of withdrawal effects, including rebound tachycardia and hypertension, upon discontinuation of dexmedetomidine infusion. Conclusion Dexmedetomidine is an alternative to traditional sedatives and analgesics in critically ill patients. The safety and efficacy of dexmedetomidine in adults likely persist beyond 24 hours, without the emergence of rebound effects after discontinuation.

The Effect of Approval Balloting on Strategic Voting under Alternative Decision Rules

Abstract: Voting systems combine balloting methods with decision rules or procedures. Most analyses of approval voting (a balloting method) assume it will be combined with plurality rule but advocates often urge its use with more complex procedures. Because much of the case for approval balloting hinges on its encouragement of sincere voting, we ask whether it retains this advantage when combined with multistage procedures. After distinguishing five forms of sincere and insincere approval voting, we find that certain elements of multistage procedures promote departures from purely sincere strategies, including, in some instances, strictly insincere voting. However, most strategic approval voting involves truncating the approved list, including bullet-voting, which is especially likely under certain threshold rules. Coalitions also increase members' incentive to truncate. We conclude that approval balloting with plurality rule remains preferable to conventional single-vote plurality, but we urge caution and further research regarding combining approval balloting with multistage rules.

Predation behaviour of land planarians

Abstract: Predatory behaviour of land planarians is seldom observed or reported. Aspects reported are (1) finding prey; (2) attack behaviour; (3) capture using adhesive mucus, pharyngeal action, poisonous secretions, physical embrace; (4) feeding by extension of pharynx, releasing copious digestive fluid. The species Bipalium kewense, B. adventitium and B. pennsylvanicum attack earthworms, immobilizing them by physical holding, digesting by pharyngeal secretions and then ingesting the treated tissue. Group attacks on giant African land snails involving chemotactic tracking, occur in Platydemus manokwari and Endeavouria septemlineata. Specialized capture methods are used by some species; Rhynchodemus sylvaticus uses an expanded cephalic hood to capture small insects and in Africa, termites are captured by the elongated anterior of Microplana termitophaga as planarians wait within the colony air shaft openings to ensnare the workers in sticky mucus. The result of extensive predation by land planarians may seriously reduce the prey, e.g., providing effective population control of giant land snails by introduced Platydemus manokwari, or causing serious depletion of desirable earthworm populations by the exotic Artioposthia triangulata in North Ireland.