Antimicrobial Photodynamic Therapy

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Nanostructures for Antimicrobial Therapy

Author : Anton Ficai
Publisher : Elsevier
ISBN 13 : 0323461514
Total Pages : 724 pages
Book Rating : 4.3/5 (234 download)

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Book Synopsis Nanostructures for Antimicrobial Therapy by : Anton Ficai

Download or read book Nanostructures for Antimicrobial Therapy written by Anton Ficai and published by Elsevier. This book was released on 2017-05-29 with total page 724 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nanostructures for Antimicrobial Therapy discusses the pros and cons of the use of nanostructured materials in the prevention and eradication of infections, highlighting the efficient microbicidal effect of nanoparticles against antibiotic-resistant pathogens and biofilms. Conventional antibiotics are becoming ineffective towards microorganisms due to their widespread and often inappropriate use. As a result, the development of antibiotic resistance in microorganisms is increasingly being reported. New approaches are needed to confront the rising issues related to infectious diseases. The merging of biomaterials, such as chitosan, carrageenan, gelatin, poly (lactic-co-glycolic acid) with nanotechnology provides a promising platform for antimicrobial therapy as it provides a controlled way to target cells and induce the desired response without the adverse effects common to many traditional treatments. Nanoparticles represent one of the most promising therapeutic treatments to the problem caused by infectious micro-organisms resistant to traditional therapies. This volume discusses this promise in detail, and also discusses what challenges the greater use of nanoparticles might pose to medical professionals. The unique physiochemical properties of nanoparticles, combined with their growth inhibitory capacity against microbes has led to the upsurge in the research on nanoparticles as antimicrobials. The importance of bactericidal nanobiomaterials study will likely increase as development of resistant strains of bacteria against most potent antibiotics continues. Shows how nanoantibiotics can be used to more effectively treat disease Discusses the advantages and issues of a variety of different nanoantibiotics, enabling medics to select which best meets their needs Provides a cogent summary of recent developments in this field, allowing readers to quickly familiarize themselves with this topic area

Antimicrobial Photodynamic Therapy

Author : Siddhardha Busi
Publisher : CRC Press
ISBN 13 : 100092534X
Total Pages : 377 pages
Book Rating : 4.0/5 (9 download)

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Book Synopsis Antimicrobial Photodynamic Therapy by : Siddhardha Busi

Download or read book Antimicrobial Photodynamic Therapy written by Siddhardha Busi and published by CRC Press. This book was released on 2023-08-22 with total page 377 pages. Available in PDF, EPUB and Kindle. Book excerpt: Antimicrobial Photodynamic Therapy: Concepts and Applications explores the novel antimicrobial therapeutic technique. As the world searches for new, efficient modalities for fighting microorganisms, this book offers a complete understanding of the concept, and knowledge about the emerging technique ‘antimicrobial photodynamic therapy’ (aPDT) for the scientific communities and budding researchers. The book aligns concepts, significance, and applications of the technique systematically. Chapters in the book cover microorganisms, pathogenesis, conventional treatment methods, and significance of new treatment approaches to the concept of antimicrobial photodynamic therapy. The authors describe the mechanism behind it, with applications and examples from research studies. The book discusses photosensitisers in detail, with one chapter emphasising natural photosensitisers. Use of nanostructures in the antimicrobial photodynamic therapy is elaborated on, and we conclude with a well-explored application of the therapeutic technique in dentistry. Features: Efficiently covers the topic in detail with scientifically proven examples. Applications of the therapeutic approach are well discussed, and readers can learn about the research gaps, challenges, and future of the technique. Starts from basics, enabling readers to understand why the approach is relevant and important for study. Simplistic elucidated concepts and applications make it accessible at all levels.

Photodynamic Inactivation of Microbial Pathogens

Author : Michael R Hamblin
Publisher : Royal Society of Chemistry
ISBN 13 : 1849733082
Total Pages : 451 pages
Book Rating : 4.8/5 (497 download)

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Book Synopsis Photodynamic Inactivation of Microbial Pathogens by : Michael R Hamblin

Download or read book Photodynamic Inactivation of Microbial Pathogens written by Michael R Hamblin and published by Royal Society of Chemistry. This book was released on 2011-06-06 with total page 451 pages. Available in PDF, EPUB and Kindle. Book excerpt: Photodynamic therapy (PDT) was discovered over one hundred years ago after observing the death of microorganisms upon exposure to dyes and light. It is the combination of non-toxic dyes and harmless visible light that, in the presence of oxygen, produce highly toxic reactive species. The principal medical application during the last century was in cancer therapy but, in these days of rising antibiotic resistance, PDT shows increasing promise as an alternative approach to treating infections. PDT has also been used in blood product sterilization, peridontology, acne reduction, and the treatment of viral lesions such as those caused by human papilloma virus. It may also have potential as an environmentally friendly pesticide. This is the first and only book to comprehensively cover the use of light and photosensitising agents for controlling microbial pathogens. It provides a comprehensive and up-to-date coverage of an emerging field. There are several chapters on the design of antimicrobial photosensitizers, their use to kill pathogenic organisms and their success in treating infections in animal models. It has long been known that gram-positive bacteria are highly susceptible to photoinactivation but the book also discusses means of widening the range of microorganisms that can be tackled by PDT. Edited by two pioneers in the application of PDT to medical and environmental issues, this book covers the basic science, translational research in animals, and the clinical applications in various medical specialities. It represents an indispensable resource for microbiologists and infectious disease doctors as well as dentists, dermatologists, gastroenterologists and transfusion specialists.

Photodynamic Medicine

Author : Herwig Kostron
Publisher : Royal Society of Chemistry
ISBN 13 : 1782624511
Total Pages : 680 pages
Book Rating : 4.7/5 (826 download)

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Book Synopsis Photodynamic Medicine by : Herwig Kostron

Download or read book Photodynamic Medicine written by Herwig Kostron and published by Royal Society of Chemistry. This book was released on 2016 with total page 680 pages. Available in PDF, EPUB and Kindle. Book excerpt: Comprehensive Series in Photochemical and Photobiological Sciences. Photodynamic therapy (PDT) is increasingly being used amongst health practitioners in combating a variety of disease. This book reviews the current state of development of PDT, and also presents the foreseeable advancements of the field in the next decade. Practitioners in biological sciences, biotechnology and medicinal and pharmaceutical chemistry will find this book an invaluable source of information. Chapters are drawn from research discusses at the 10th International Symposium on Photodynamic Therapy and Photodiagnosis in Clinical Practice in Brixen and are written and edited by leaders in the field. Mirroring the philosophy of that meeting, this book contains an informative balance of the basic sciences and clinical applications of PDT. Following an introduction to PDT, its history, and how techniques have developed, chapter serve as a practical guide for practitioners, covering topics such as sensitizer dosage and light dosage, and examples of relevant studies. The text goes further tp explore areas outside the medical field, such as the impact of PDT on society and the environment, and the economics of therapies. This book is dedicated to the memory of Professor Giulio Jori, and expert in this field, who sadly passed away on the 23rd December 2014.

Handbook on Nanobiomaterials for Therapeutics and Diagnostic Applications

Author : Krishnan Anand
Publisher : Elsevier
ISBN 13 : 0128210133
Total Pages : 610 pages
Book Rating : 4.1/5 (282 download)

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Book Synopsis Handbook on Nanobiomaterials for Therapeutics and Diagnostic Applications by : Krishnan Anand

Download or read book Handbook on Nanobiomaterials for Therapeutics and Diagnostic Applications written by Krishnan Anand and published by Elsevier. This book was released on 2021-03-19 with total page 610 pages. Available in PDF, EPUB and Kindle. Book excerpt: Handbook of Nano-biomaterials for Therapeutics and Diagnostic Applications covers in-depth topics on nano-biomaterials and nano drug delivery systems (biosensors and bioimaging) involving polymer nanocomposites, metal nanocomposites, and other carbon family fibers and proteins. The book covers the current application of tiny machines or nanodevices and their use as early detection systems for life threatening diseases, giving detailed literature on the development of nanodevices, their use as diagnostic tools, and their present trend in the industry and market. In addition, their synthesis, potential applications and future of smart nanodevices in diagnosis of diseases and their use as smart clinical devices is covered. Users will find sections on recent advances in interdisciplinary research on the processing, morphology, structure and properties of nanostructured materials and their applications in drug delivery for various diseases such as cancer, tuberculosis, Alzheimer disease, ophthalmic diseases, and more. Offers a comprehensive coverage of the therapeutics and smart nanodevices as diagnostic tools and their potential clinical applications in biosensing and bioimaging Includes a glimpse into the nano-biomaterials that are essential components in nanomedicines Describes nanodevices in the early diagnosis of the diseases Explains the nano-drug delivery system for the treatment of various diseases, including cancer, tuberculosis, Alzheimer disease, and ophthalmic diseases Encompasses all information, starting from the design of nano-biomaterials to their applications in theranostics

Antimicrobial Photodynamic Therapy - what We Know and what We Don't

Author : Fabian Alfred Aloi Cieplik
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (135 download)

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Book Synopsis Antimicrobial Photodynamic Therapy - what We Know and what We Don't by : Fabian Alfred Aloi Cieplik

Download or read book Antimicrobial Photodynamic Therapy - what We Know and what We Don't written by Fabian Alfred Aloi Cieplik and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract: Considering increasing number of pathogens resistant towards commonly used antibiotics as well as antiseptics, there is a pressing need for antimicrobial approaches that are capable of inactivating pathogens efficiently without the risk of inducing resistances. In this regard, an alternative approach is the antimicrobial photodynamic therapy (aPDT). The antimicrobial effect of aPDT is based on the principle that visible light activates a per se non-toxic molecule, the so-called photosensitizer (PS), resulting in generation of reactive oxygen species that kill bacteria unselectively via an oxidative burst. During the last 10-20 years, there has been extensive in vitro research on novel PS as well as light sources, which is now to be translated into clinics. In this review, we aim to provide an overview about the history of aPDT, its fundamental photochemical and photophysical mechanisms as well as photosensitizers and light sources that are currently applied for aPDT in vitro. Furthermore, the potential of resistances towards aPDT is extensively discussed and implications for proper comparison of in vitro studies regarding aPDT as well as for potential application fields in clinical practice are given. Overall, this review shall provide an outlook on future research directions needed for successful translation of promising in vitro results in aPDT towards clinical practice

Antimicrobial Photodynamic Inactivation and Antitumor Photodynamic Therapy with Fullerenes

Author : L F de Freitas
Publisher : Myprint
ISBN 13 : 9781681747392
Total Pages : 88 pages
Book Rating : 4.7/5 (473 download)

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Book Synopsis Antimicrobial Photodynamic Inactivation and Antitumor Photodynamic Therapy with Fullerenes by : L F de Freitas

Download or read book Antimicrobial Photodynamic Inactivation and Antitumor Photodynamic Therapy with Fullerenes written by L F de Freitas and published by Myprint. This book was released on 2016-04-14 with total page 88 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Symposium-in-print on Antimicrobial Photodynamic Therapy and Photoinactivation

Author : Jean Cadet
Publisher :
ISBN 13 :
Total Pages : 2 pages
Book Rating : 4.:/5 (839 download)

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Book Synopsis Symposium-in-print on Antimicrobial Photodynamic Therapy and Photoinactivation by : Jean Cadet

Download or read book Symposium-in-print on Antimicrobial Photodynamic Therapy and Photoinactivation written by Jean Cadet and published by . This book was released on 2012 with total page 2 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Nanostructures for Antimicrobial and Antibiofilm Applications

Author : Ram Prasad
Publisher : Springer Nature
ISBN 13 : 3030403378
Total Pages : 461 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Nanostructures for Antimicrobial and Antibiofilm Applications by : Ram Prasad

Download or read book Nanostructures for Antimicrobial and Antibiofilm Applications written by Ram Prasad and published by Springer Nature. This book was released on 2020-05-12 with total page 461 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the pursuit of technological advancement in the field of biotechnology and pharmaceutical industries to counteract health issues, bacterial infections remain a major cause of morbidity and mortality. The ability of bacterial pathogens to form biofilms further agglomerates the situation by showing resistance to conventional antibiotics. To overcome this serious issue, bioactive metabolites and other natural products were exploited to combat bacterial infections and biofilm-related health consequences. Natural products exhibited promising results in vitro, however; their efficacy in in vivo conditions remain obscured due to their low-solubility, bioavailability, and biocompatibility issues. In this scenario, nanotechnological interventions provide a multifaceted platform for targeted delivery of bioactive compounds by slow and sustained release of drug-like compounds. The unique physico-chemical properties, biocompatibility and eco-friendly nature of bioinspired nanostructures has revolutionized the field of biology to eradicate microbial infections and biofilm-related complications. The green-nanotechnology based metal and metal oxide nanoparticles and polymeric nanoparticles have been regularly employed for antimicrobial and antibiofilm applications without causing damage to host tissues. The implications of these nanoparticles toward achieving sustainability in agriculture by providing systemic resistance against a variety of phytopathogens therefore plays crucial role in growth and crop productivity. Also the advent of smart and hybrid nanomaterials such as metal-based polymer nanocomposites, lipid-based nanomaterials and liposomes have the inherent potential to eradicate bacterial biofilm-related infections in an efficient manner. The recent development of carbon-based nanomaterials such as carbon nanotubes (CNTs) and silica based nanomaterials such as mesoporous silica nanoparticles (MSNs) also exploit a target of dreadful healthcare conditions such as cancer, immunomodulatory diseases, and microbial infections, as well as biofilm-related issues owing to their stability profile, biocompatibility, and unique physio-chemical properties. Recently novel physical approaches such as photothermal therapy (PTT) and antimicrobial photodynamic therapy (aPDT) also revolutionized conventional strategies and are engaged in eradicating microbial biofilm-related infections and related health consequences. These promising advancements in the development of novel strategies to treat microbial infections and biofilm-related multidrug resistance (MDR) phenomenon may provide new avenues and aid to conventional antimicrobial therapeutics.

Adjunctive Antimicrobial Photodynamic Therapy in the Non-surgical Treatment of Periodontitis

Author : 陳悦安
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (125 download)

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Book Synopsis Adjunctive Antimicrobial Photodynamic Therapy in the Non-surgical Treatment of Periodontitis by : 陳悦安

Download or read book Adjunctive Antimicrobial Photodynamic Therapy in the Non-surgical Treatment of Periodontitis written by 陳悦安 and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Antimicrobial Photodynamic Therapy as an Adjunct to Non‐Surgical Treatment of Aggressive Periodontitis: A Split‐Mouth Randomized Controlled Trial

Download Antimicrobial Photodynamic Therapy as an Adjunct to Non‐Surgical Treatment of Aggressive Periodontitis: A Split‐Mouth Randomized Controlled Trial PDF Online Free

Author :
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (15 download)

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Book Synopsis Antimicrobial Photodynamic Therapy as an Adjunct to Non‐Surgical Treatment of Aggressive Periodontitis: A Split‐Mouth Randomized Controlled Trial by :

Download or read book Antimicrobial Photodynamic Therapy as an Adjunct to Non‐Surgical Treatment of Aggressive Periodontitis: A Split‐Mouth Randomized Controlled Trial written by and published by . This book was released on 2015 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Oral Biofilms

Author : S. Eick
Publisher : Karger Medical and Scientific Publishers
ISBN 13 : 3318068527
Total Pages : 247 pages
Book Rating : 4.3/5 (18 download)

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Book Synopsis Oral Biofilms by : S. Eick

Download or read book Oral Biofilms written by S. Eick and published by Karger Medical and Scientific Publishers. This book was released on 2020-12-21 with total page 247 pages. Available in PDF, EPUB and Kindle. Book excerpt: Biofilms are highly organized polymicrobial communities that are embedded in an extracellular matrix and formed on natural and artificial surfaces. In the oral cavity, biofilms are formed not only on natural teeth, but also on restorative materials, prosthetic constructions, and dental implants. Oral diseases like caries, gingivitis, periodontitis, and also pulp inflammation are associated with biofilms. This publication is an up-to-date overview on oral biofilms from different clinically relevant perspectives. Experts comprising basic researchers and clinicians report on recent research relating to biofilms - from general summaries to recommendations for daily clinical work. This book covers all aspects of oral biofilms, including models used in the laboratory, biofilms in dental water unit lines, periodontal and peri-implant biofilms, caries-related biofilms, halitosis, endodontic biofilms, and Candida infections, as well as biofilms on dental materials and on orthodontic appliances. Several chapters deal with anti-biofilm therapy, from the efficacy of mechanical methods and the use of antimicrobials, to alternative concepts. This publication is particularly recommended to dental medicine students, practitioners, other oral healthcare professionals, and scientists with an interest in translational research on biofilms.

Imaging in Photodynamic Therapy

Author : Michael R. Hamblin
Publisher : CRC Press
ISBN 13 : 1315278162
Total Pages : 502 pages
Book Rating : 4.3/5 (152 download)

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Book Synopsis Imaging in Photodynamic Therapy by : Michael R. Hamblin

Download or read book Imaging in Photodynamic Therapy written by Michael R. Hamblin and published by CRC Press. This book was released on 2017-02-03 with total page 502 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers the broad field of cellular, molecular, preclinical, and clinical imaging either associated with or combined with photodynamic therapy (PDT). It showcases how this approach is used clinically for cancer, infections, and diseases characterized by unwanted tissue such as atherosclerosis or blindness. Because the photosensitizers are also fluorescent, the book also addresses various imaging systems such as confocal microscopy and small animal imaging systems, and highlights how they have been used to follow and optimize treatment, and to answer important mechanistic questions. Chapters also discuss how imaging has made important contributions to clinical outcomes in skin, bladder, and brain cancers, as well as in the development of theranostic agents for detection and treatment of disease. This book provides a resource for physicians and research scientists in cell biology, microscopy, optics, molecular imaging, oncology, and drug discovery.

Lasers in Dentistry

Author : Patricia M. Freitas
Publisher : John Wiley & Sons
ISBN 13 : 1118275020
Total Pages : 372 pages
Book Rating : 4.1/5 (182 download)

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Book Synopsis Lasers in Dentistry by : Patricia M. Freitas

Download or read book Lasers in Dentistry written by Patricia M. Freitas and published by John Wiley & Sons. This book was released on 2015-04-27 with total page 372 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lasers have become an increasingly useful tool in conventional dental practice. Their precision and less invasive quality make them an attractive technology in esthetic and pediatric dentistry, oral medicine, and a range of other dental procedures. Lasers in Dentistry: Guide for Clinical Practice is a comprehensive, yet concise and easy-to-use guide to integrating lasers into conventional clinical practice. The book begins by providing the reader a thorough understanding of how lasers work and their varied effects on oral tissues. Subsequent chapters are organized by procedure type, illustrating common clinical techniques with step-by-step illustrations and case examples. In addition, each chapter provides an overview of the latest research for use in clinical practice. More comprehensive than at atlas yet practical and clinically oriented in its approach, Lasers in Dentistry is an essential tool for practitioners and students looking to broader their skill set in laser dentistry.

Ultrasound in Food Processing

Author : Mar Villamiel
Publisher : John Wiley & Sons
ISBN 13 : 1118964160
Total Pages : 764 pages
Book Rating : 4.1/5 (189 download)

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Book Synopsis Ultrasound in Food Processing by : Mar Villamiel

Download or read book Ultrasound in Food Processing written by Mar Villamiel and published by John Wiley & Sons. This book was released on 2017-04-25 with total page 764 pages. Available in PDF, EPUB and Kindle. Book excerpt: Part I: Fundamentals of ultrasound This part will cover the main basic principles of ultrasound generation and propagation and those phenomena related to low and high intensity ultrasound applications. The mechanisms involved in food analysis and process monitoring and in food process intensification will be shown. Part II: Low intensity ultrasound applications Low intensity ultrasound applications have been used for non-destructive food analysis as well as for process monitoring. Ultrasonic techniques, based on velocity, attenuation or frequency spectrum analysis, may be considered as rapid, simple, portable and suitable for on-line measurements. Although industrial applications of low-intensity ultrasound, such as meat carcass evaluation, have been used in the food industry for decades, this section will cover the most novel applications, which could be considered as highly relevant for future application in the food industry. Chapters addressing this issue will be divided into three subsections: (1) food control, (2) process monitoring, (3) new trends. Part III: High intensity ultrasound applications High intensity ultrasound application constitutes a way to intensify many food processes. However, the efficient generation and application of ultrasound is essential to achieving a successful effect. This part of the book will begin with a chapter dealing with the importance of the design of efficient ultrasonic application systems. The medium is essential to achieve efficient transmission, and for that reason the particular challenges of applying ultrasound in different media will be addressed. The next part of this section constitutes an up-to-date vision of the use of high intensity ultrasound in food processes. The chapters will be divided into four sections, according to the medium in which the ultrasound vibration is transmitted from the transducers to the product being treated. Thus, solid, liquid, supercritical and gas media have been used for ultrasound propagation. Previous books addressing ultrasonic applications in food processing have been based on the process itself, so chapters have been divided in mass and heat transport, microbial inactivation, etc. This new book will propose a revolutionary overview of ultrasonic applications based on (in the authors’ opinion) the most relevant factor affecting the efficiency of ultrasound applications: the medium in which ultrasound is propagated. Depending on the medium, ultrasonic phenomena can be completely different, but it also affects the complexity of the ultrasonic generation, propagation and application. In addition, the effect of high intensity ultrasound on major components of food, such as proteins, carbohydrates and lipids will be also covered, since this type of information has not been deeply studied in previous books. Other aspects related to the challenges of food industry to incorporate ultrasound devices will be also considered. This point is also very important since, in the last few years, researchers have made huge efforts to integrate fully automated and efficient ultrasound systems to the food production lines but, in some cases, it was not satisfactory. In this sense, it is necessary to identify and review the main related problems to efficiently produce and transmit ultrasound, scale-up, reduce cost, save energy and guarantee the production of safe, healthy and high added value foods.

Photodynamic Therapy

Author : Natalia Mayumi Inada
Publisher : BoD – Books on Demand
ISBN 13 : 1839680601
Total Pages : 243 pages
Book Rating : 4.8/5 (396 download)

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Book Synopsis Photodynamic Therapy by : Natalia Mayumi Inada

Download or read book Photodynamic Therapy written by Natalia Mayumi Inada and published by BoD – Books on Demand. This book was released on 2021-05-05 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: Today, in the face of resistant microorganisms, aggressive cancers unresponsive to conventional treatments, and the COVID-19 pandemic, the need for advanced and innovative protocols for combating and treating disease is paramount. This book presents basic concepts of photodynamic therapy along with data from clinical research on its use in treating oncologic and other diseases. It also presents innovative strategies in photodynamic therapy, including information on polymer nanoparticles. This book was prepared with great care and by many valuable hands so that we can expand the dissemination of Photodynamic Therapy, as well as motivate for new research.

Infection Prevention

Author : Gonzalo Bearman
Publisher : Springer
ISBN 13 : 3319609807
Total Pages : 311 pages
Book Rating : 4.3/5 (196 download)

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Book Synopsis Infection Prevention by : Gonzalo Bearman

Download or read book Infection Prevention written by Gonzalo Bearman and published by Springer. This book was released on 2017-09-07 with total page 311 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book reviews evolving areas in infection prevention on topics including contact precautions, technology implementation, specific infections, and care in various settings. The book summarizes the current data oninfection prevention, presents controversies on the various topics, and includes recommendations for patient safety. Addressing hot topics such as MRSA, C. difficile vaccination, mandatory flu vaccines, and CLABSI, this is the only text to include prevention and control overviews across a range of infection issues. Written by experts in thefield, this book contains 32 chapters that educates and presents the most cutting-edge models of care on emerging and evolving topics in infectious diseases. Infection Prevention: New Perspectives and Controversies is a valuable resource for infection prevention professionals, healthcare quality and safety professionals, caring for patients in in- and outpatient settings.