Early Deep Anterior Lamellar Keratoplasty (DALK) for Acanthamoeba Keratitis Poorly Responsive to Medical Treatment.

OBJECTIVE
To evaluate the success (eradication of infection) or failure (recurrence of infection in the cornea or sclera, or endophthalmitis) of the initial therapy anterior lamellar keratoplasty (DALK) for active Acanthamoeba keratitis (AK) is less responsive to medical treatment.


METHOD
Retrospective, noncomparative case series of 11 patients (11 eyes) affected by the active AK less responsive to treatment who underwent DALK start of therapy. Surgery was performed in all cases within 30 to 60 days of onset of symptoms. corneal ulcer depth is less than 300 m in all cases. 3-drug combination (chlorhexidine gluconate, isethionate propamidine and neomycin sulfate) is antiamoebic protocol used preoperatively and postoperatively. Cannula large bubbles and “layer by layer” do the dissection technique. Eradication of infection, rejection episodes, postoperative endothelial cell density, and the best spectacle-corrected visual acuity were evaluated. Histological examination of surgical margins is done, and the margin permission rated. Average follow-up was approximately 2 years.


RESULTS
Four DALK descemetic and 7 DALK predescemetic do. One small Descemet membrane rupture occurs. peripheral surgical margins free of infection in all cases. deep surgical margins are not free of the infection was found in 2 cases. However, there is no recurrence of infection episodes was observed. The average postoperative best spectacle-corrected visual acuity was 0.8 (range, 0.6 to 1.0). No cases of refusal was recorded.


CONCLUSION
DALK initial therapy can be considered as a new approach to combat an active infection in the case of AK less responsive to treatment, with significant ulcer in the optical zone. Further studies are needed to validate this new indication for DALK.

Early Deep Anterior Lamellar Keratoplasty (DALK) for Acanthamoeba Keratitis Poorly Responsive to Medical Treatment.
Early Deep Anterior Lamellar Keratoplasty (DALK) for Acanthamoeba Keratitis Poorly Responsive to Medical Treatment.

Culture responsive integrated health care: Key issues for medical education.

Primary care providers increasingly responsible for providing mental health care in the United States. For patients who received specialized mental health services, primary care providers function as the major entry point into the mental health system.

Given the persistent racial and ethnic health disparities in the United States, it is not surprising that the mental health gap also presents a difficult challenge for both the US healthcare system and front line practitioners. Doctors-in-training need psychiatric evaluation tool for fast that will quickly identify the cluster of symptoms is concerned and distinguish between major psychological disorders.

It is the obligation of residency faculty to teach medical residents how to provide culturally responsive mental health assessment and intervention / referral knowledge and skills towards the elimination of this gap and toward patient-centered care. This article begins with an overview of health inequalities and barriers to health and access to mental health care, followed by a discussion of cultural responsive care, including examples of educational programs responsive culture in the United States that directly target the problem of access within a geographic area.

p38
MBS8533658-01mLAF635 0.1mL(AF635)
EUR 565

P38 mAb
MBS435304-005mL 0.05mL
EUR 415

P38 mAb
MBS435304-01mL 0.1mL
EUR 660

P38 mAb
MBS435304-5x01mL 5x0.1mL
EUR 2655

p38 MAPK
E8ET1702-65 100ul
EUR 275
Description: Available in various conjugation types.

Mxi2, p38
MBS603655-01mg 0.1mg
EUR 820

Mxi2, p38
MBS603655-5x01mg 5x0.1mg
EUR 3530

p38 MAPK
MBS8534372-01mL 0.1mL
EUR 345

p38 MAPK
MBS8534372-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 MAPK
MBS8534372-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 MAPK
MBS8534372-01mLAF610 0.1mL(AF610)
EUR 565

p38 MAPK
MBS8534372-01mLAF635 0.1mL(AF635)
EUR 565

p38 protein
E20-80078 20ug
EUR 275
Description: N/A

p38 protein
E20-80079 20ug
EUR 275
Description: N/A

p38 protein
MBS8526800-002mg 0.02mg
EUR 345

p38 protein
MBS8526800-5x002mg 5x0.02mg
EUR 1410

p38 protein
MBS8526801-002mg 0.02mg
EUR 345

p38 protein
MBS8526801-5x002mg 5x0.02mg
EUR 1410

p38 Antibody
35478 100ul
EUR 479

p38 Antibody
35478-100ul 100ul
EUR 468

p38 Antibody
48644 100ul
EUR 499

p38 Antibody
48644-100ul 100ul
EUR 399.6

p38 Antibody
48644-50ul 50ul
EUR 286.8

p38 antibody
70R-51505 100 ul
EUR 242
Description: Purified Polyclonal p38 antibody

p38 antibody
70R-51506 100 ul
EUR 286
Description: Purified Polyclonal p38 antibody

p38 Antibody
20-abx007541
  • Ask for price
  • Ask for price
  • Ask for price
  • 30 ul
  • 100 ul
  • 200 ul

p38 Antibody
20-abx133223
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  • Ask for price
  • Ask for price
  • 30 ul
  • 100 ul
  • 200 ul

p38 Antibody
20-abx141038
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  • Ask for price
  • Ask for price
  • 30 ul
  • 100 ul
  • 200 ul

p38 Antibody
B7178-100ul 100μl
EUR 217
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
B7178-50ul 50μl
EUR 143.5
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
B0798-100ul 100μl
EUR 217
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
B0798-50ul 50μl
EUR 143.5
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
B0799-100ul 100μl
EUR 217
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
B0799-50ul 50μl
EUR 143.5
Description: p38 Rabbit Polyclonal Antibody

p38 Antibody
abx236076-100g 100 µg
EUR 350

p38 Antibody
abx236076-100ug 100 ug
EUR 577.2

p38 Antibody
E38PA4721 100ul
EUR 225
Description: Available in various conjugation types.

p38 Antibody
E38PA5060 100ul
EUR 225
Description: Available in various conjugation types.

p38 Antibody
E38PA5094 100ul
EUR 225
Description: Available in various conjugation types.

p38 Antibody
E38PA7126 100ul
EUR 225
Description: Available in various conjugation types.

p38 Antibody
E38PA3186 100ul
EUR 225
Description: Available in various conjugation types.

p38 Antibody
MBS5316121-01mL 0.1mL
EUR 460

p38 Antibody
MBS5316121-5x01mL 5x0.1mL
EUR 1920

p38 Antibody
MBS5316122-01mL 0.1mL
EUR 535

p38 Antibody
MBS5316122-5x01mL 5x0.1mL
EUR 2270

p38 Antibody
MBS805089-01mL 0.1mL
EUR 425

p38 Antibody
MBS805089-5x01mL 5x0.1mL
EUR 1350

p38 Antibody
MBS806203-0025mL 0.025mL
EUR 320

p38 Antibody
MBS8002013-0025mL 0.025mL
EUR 315

p38 Antibody
MBS8002013-5x0025mL 5x0.025mL
EUR 890

p38 Antibody
MBS8584173-01mL 0.1mL
EUR 305

p38 Antibody
MBS8584173-01mLAF405L 0.1mL(AF405L)
EUR 465

p38 Antibody
MBS8584173-01mLAF405S 0.1mL(AF405S)
EUR 465

p38 Antibody
MBS8584173-01mLAF610 0.1mL(AF610)
EUR 465

p38 Antibody
MBS8584173-01mLAF635 0.1mL(AF635)
EUR 465

p38 Antibody
MBS8582665-01mL 0.1mL
EUR 305

p38 Antibody
MBS8582665-01mLAF405L 0.1mL(AF405L)
EUR 465

p38 Antibody
MBS8582665-01mLAF405S 0.1mL(AF405S)
EUR 465

p38 Antibody
MBS8582665-01mLAF610 0.1mL(AF610)
EUR 465

p38 Antibody
MBS8582665-01mLAF635 0.1mL(AF635)
EUR 465

p38 Antibody
MBS8582905-01mL 0.1mL
EUR 305

p38 Antibody
MBS8582905-01mLAF405L 0.1mL(AF405L)
EUR 465

p38 Antibody
MBS8582905-01mLAF405S 0.1mL(AF405S)
EUR 465

p38 Antibody
MBS8582905-01mLAF610 0.1mL(AF610)
EUR 465

p38 Antibody
MBS8582905-01mLAF635 0.1mL(AF635)
EUR 465

p38 Antibody
MBS8582923-01mL 0.1mL
EUR 305

p38 Antibody
MBS8582923-01mLAF405L 0.1mL(AF405L)
EUR 465

p38 Antibody
MBS8582923-01mLAF405S 0.1mL(AF405S)
EUR 465

p38 Antibody
MBS8582923-01mLAF610 0.1mL(AF610)
EUR 465

p38 Antibody
MBS8582923-01mLAF635 0.1mL(AF635)
EUR 465

p38 Antibody
MBS8581787-01mL 0.1mL
EUR 305

p38 Antibody
MBS8581787-01mLAF405L 0.1mL(AF405L)
EUR 465

p38 Antibody
MBS8581787-01mLAF405S 0.1mL(AF405S)
EUR 465

p38 Antibody
MBS8581787-01mLAF610 0.1mL(AF610)
EUR 465

p38 Antibody
MBS8581787-01mLAF635 0.1mL(AF635)
EUR 465

p38 Antibody
MBS9508977-005mL 0.05mL
EUR 285

p38 Antibody
MBS9508977-01mL 0.1mL
EUR 385

p38 Antibody
MBS9508977-5x01mL 5x0.1mL
EUR 1590

p38 Antibody
MBS9435492-005mL 0.05mL
EUR 325

p38 Antibody
MBS9435492-01mL 0.1mL
EUR 435

p38 Antibody
MBS9435492-5x01mL 5x0.1mL
EUR 1810

p38 Antibody
MBS9409774-01mL 0.1mL
EUR 420

p38 Antibody
MBS9409774-5x01mL 5x0.1mL
EUR 1740

p38 Antibody
SPC-172D 0.1ml
EUR 161
Description: Rabbit Anti-Human p38 Polyclonal

p38 Antibody
SPC-172S 0.012ml Ask for price
Description: Rabbit Anti-Human p38 Polyclonal

p38 Substrate
MBS517838-1mg 1mg
EUR 205

p38 Substrate
MBS517838-5x1mg 5x1mg
EUR 675

MAP Kinase p38, Control Cell Extracts (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS657552-10Blots 10Blots
EUR 430

MAP Kinase p38, Control Cell Extracts (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS657552-5x10Blots 5x10Blots
EUR 1785

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS633592-01mL 0.1mL
EUR 695

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS633592-5x01mL 5x0.1mL
EUR 2985

MAP Kinase p38, phosphorylated (Thr180, Tyr182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS630803-02mL 0.2mL
EUR 650

MAP Kinase p38, phosphorylated (Thr180, Tyr182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS630803-06mL 0.6mL
EUR 1175

MAP Kinase p38, phosphorylated (Thr180, Tyr182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS630803-5x06mL 5x0.6mL
EUR 5140

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS632290-02mL 0.2mL
EUR 660

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS632290-5x02mL 5x0.2mL
EUR 2810

MAP Kinase p38, phosphorylated (Thr180, Tyr182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS627818-10Blots 10Blots
EUR 875

MAP Kinase p38, phosphorylated (Thr180, Tyr182) (Mitogen Activated Protein Kinase p38, MAPK p38)
MBS627818-5x10Blots 5x10Blots
EUR 3785

SB-203580 p38 MAPK(p38 MAP kinase) Inhibitor
E1B1863 1mg
EUR 85

SB-203580 p38 MAPK (p38 MAP kinase) Inhibitor
MBS8579825-1mg 1mg
EUR 180

SB-203580 p38 MAPK (p38 MAP kinase) Inhibitor
MBS8579825-5x1mg 5x1mg
EUR 660

p38 (411-425) M.leprae
MBS8246858-10mg 10mg
EUR 675

p38 (411-425) M.leprae
MBS8246858-1mg 1mg
EUR 255

p38 (411-425) M.leprae
MBS8246858-5mg 5mg
EUR 480

p38 (411-425) M.leprae
MBS8246858-5x10mg 5x10mg
EUR 2955

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38) (Agarose)
MBS631660-04mL 0.4mL
EUR 670

MAP Kinase p38, phosphorylated (Thr180, Ty182) (Mitogen Activated Protein Kinase p38, MAPK p38) (Agarose)
MBS631660-5x04mL 5x0.4mL
EUR 2870

Anti - p38-a
MBS684252-002mL 0.02mL
EUR 270

Anti - p38-a
MBS684252-005mL 0.05mL
EUR 485

Anti - p38-a
MBS684252-01mL 0.1mL
EUR 720

Anti - p38-a
MBS684252-5x01mL 5x0.1mL
EUR 2925

Anti - p38-b
MBS684253-002mL 0.02mL
EUR 270

Anti - p38-b
MBS684253-005mL 0.05mL
EUR 485

Anti - p38-b
MBS684253-01mL 0.1mL
EUR 720

Anti - p38-b
MBS684253-5x01mL 5x0.1mL
EUR 2925

Anti - p38-g
MBS684254-002mL 0.02mL
EUR 270

Anti - p38-g
MBS684254-005mL 0.05mL
EUR 485

Anti - p38-g
MBS684254-01mL 0.1mL
EUR 720

Anti - p38-g
MBS684254-5x01mL 5x0.1mL
EUR 2925

Anti - p38-d
MBS684255-002mL 0.02mL
EUR 270

Anti - p38-d
MBS684255-005mL 0.05mL
EUR 485

Anti - p38-d
MBS684255-01mL 0.1mL
EUR 720

Anti - p38-d
MBS684255-5x01mL 5x0.1mL
EUR 2925

p38 Mouse mAb
E2222580 100ul
EUR 255
Description: Biotin-Conjugated, FITC-Conjugated , AF350 Conjugated , AF405M-Conjugated ,AF488-Conjugated, AF514-Conjugated ,AF532-Conjugated, AF555-Conjugated ,AF568-Conjugated , HRP-Conjugated, AF405S-Conjugated, AF405L-Conjugated , AF546-Conjugated, AF594-Conjugated , AF610-Conjugated, AF635-Conjugated , AF647-Conjugated , AF680-Conjugated , AF700-Conjugated , AF750-Conjugated , AF790-Conjugated , APC-Conjugated , PE-Conjugated , Cy3-Conjugated , Cy5-Conjugated , Cy5.5-Conjugated , Cy7-Conjugated Antibody

p38 Mouse mAb
E2220879 100ul
EUR 225
Description: Available in various conjugation types.

p38 Mouse mAb
MBS8539086-01mL 0.1mL
EUR 305

p38 Mouse mAb
MBS8539086-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Mouse mAb
MBS8539086-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Mouse mAb
MBS8539086-01mLAF610 0.1mL(AF610)
EUR 565

p38 Mouse mAb
MBS8539086-01mLAF635 0.1mL(AF635)
EUR 565

p38 Rabbit pAb
E2340697 100ul
EUR 225
Description: Available in various conjugation types.

p38 Rabbit pAb
E2380881 100ul
EUR 225
Description: Available in various conjugation types.

p38 Rabbit pAb
E2381051 100ul
EUR 225
Description: Available in various conjugation types.

p38 Rabbit mAb
E38A4061 100ug/100ul
EUR 255

p38 Rabbit mAb
E2R25239 100μl
EUR 225
Description: Available in various conjugation types.

p38 Rabbit pAb
E2251338 100ul
EUR 225
Description: Available in various conjugation types.

p38 Rabbit pAb
E2251719 100ul
EUR 225
Description: Available in various conjugation types.

p38 Rabbit mAb
E2R27123 100μl
EUR 225
Description: Available in various conjugation types.

p38 Rabbit mAb
MBS4752931-01mL 0.1mL
EUR 450

p38 Rabbit mAb
MBS4752931-5x01mL 5x0.1mL
EUR 1540

p38 Rabbit mAb
MBS4754198-01mL 0.1mL
EUR 450

p38 Rabbit mAb
MBS4754198-5x01mL 5x0.1mL
EUR 1540

p38 Rabbit pAb
MBS8542346-01mL 0.1mL
EUR 305

p38 Rabbit pAb
MBS8542346-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Rabbit pAb
MBS8542346-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Rabbit pAb
MBS8542346-01mLAF610 0.1mL(AF610)
EUR 565

p38 Rabbit pAb
MBS8542346-01mLAF635 0.1mL(AF635)
EUR 565

p38 Rabbit pAb
MBS8542516-01mL 0.1mL
EUR 305

p38 Rabbit pAb
MBS8542516-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Rabbit pAb
MBS8542516-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Rabbit pAb
MBS8542516-01mLAF610 0.1mL(AF610)
EUR 565

p38 Rabbit pAb
MBS8542516-01mLAF635 0.1mL(AF635)
EUR 565

p38 Rabbit pAb
MBS8540327-01mL 0.1mL
EUR 305

p38 Rabbit pAb
MBS8540327-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Rabbit pAb
MBS8540327-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Rabbit pAb
MBS8540327-01mLAF610 0.1mL(AF610)
EUR 565

p38 Rabbit pAb
MBS8540327-01mLAF635 0.1mL(AF635)
EUR 565

p38 Rabbit pAb
MBS8541727-01mL 0.1mL
EUR 305

p38 Rabbit pAb
MBS8541727-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Rabbit pAb
MBS8541727-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Rabbit pAb
MBS8541727-01mLAF610 0.1mL(AF610)
EUR 565

p38 Rabbit pAb
MBS8541727-01mLAF635 0.1mL(AF635)
EUR 565

p38 Rabbit pAb
MBS8539985-01mL 0.1mL
EUR 305

p38 Rabbit pAb
MBS8539985-01mLAF405L 0.1mL(AF405L)
EUR 565

p38 Rabbit pAb
MBS8539985-01mLAF405S 0.1mL(AF405S)
EUR 565

p38 Rabbit pAb
MBS8539985-01mLAF610 0.1mL(AF610)
EUR 565

p38 Rabbit pAb
MBS8539985-01mLAF635 0.1mL(AF635)
EUR 565

p38 HOG Kinase
MBS395428-025mg 0.25mg
EUR 425

p38 HOG Kinase
MBS395428-5x025mg 5x0.25mg
EUR 1760

anti-Crk p38
YF-PA11088 50 ul
EUR 435.6
Description: Mouse polyclonal to Crk p38

anti-Crk p38
YF-PA11089 50 ug
EUR 435.6
Description: Mouse polyclonal to Crk p38

anti-Crk p38
YF-PA11090 100 ug
EUR 483.6
Description: Rabbit polyclonal to Crk p38

anti-Crk p38
YF-PA23509 50 ul
EUR 400.8
Description: Mouse polyclonal to Crk p38

p38 beta, Active
7763-100 each
EUR 5214

p38 beta, Active
7763-5 each
EUR 444

p38 beta protein
30R-2875 5 ug
EUR 425
Description: Purified recombinant Human p38 beta protein

Crk p38 Antibody
AF6323 200ul
EUR 420

Crk p38 Antibody
AF6323-100ul 100ul
EUR 168
Description: WB,IHC,IF/ICC,ELISA(peptide)

Crk p38 Antibody
AF6323-200ul 200ul
EUR 210
Description: WB,IHC,IF/ICC,ELISA(peptide)

p38 (C20) Antibody
MBS440021-02mg 0.2mg
EUR 285

p38 (C20) Antibody
MBS440021-5x02mg 5x0.2mg
EUR 1185

p38 Antibody: HRP
MBS805179-01mL 0.1mL
EUR 455

p38 Antibody: HRP
MBS805179-5x01mL 5x0.1mL
EUR 1505

p38 Antibody: RPE
MBS805299-01mL 0.1mL
EUR 465

p38 Antibody: RPE
MBS805299-5x01mL 5x0.1mL
EUR 1535

p38 Hog Antibody
P9809 100ug
EUR 259

p38 Antibody: APC
SPC-172D-APC 0.1ml
EUR 197.4
Description: Rabbit Anti-Human p38 Polyclonal

p38 Antibody: HRP
SPC-172D-HRP 0.1ml
EUR 189
Description: Rabbit Anti-Human p38 Polyclonal

p38 Antibody: RPE
SPC-172D-RPE 0.1ml
EUR 195.3
Description: Rabbit Anti-Human p38 Polyclonal

anti-AIMP2/p38
YF-PA15507 50 ug
EUR 435.6
Description: Mouse polyclonal to AIMP2/p38

p38 MAPK Antibody
49379 100ul
EUR 499

It concludes with a review of educational strategies to improve mental health services responsive behavior and culture by doctors in training.
This review was organized by organ system, each section includes a brief discussion with reference to more in-depth discussion in other sources. A number of algorithms including to determine the approach to the evaluation of common clinical presentation that can help doctors treat this population in the setting of acute or subacute.