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D M Jacobs, W-Y Leung, D Essi, W Park, A Shaver, J Claus, C Ruh, G G Rao
Outpatient parenteral antimicrobial therapy (OPAT) programmes facilitate hospital discharge, but patients remain at risk of complications and consequent healthcare utilisation (HCU). Here we elucidated the incidence of and risk factors associated with HCU in OPAT patients. This was a retrospective, single-centre, case-control study of adult patients discharged on OPAT. Cases (n = 63) and controls (n = 126) were patients that did or did not utilise the healthcare system within 60 days. Characteristics associated with HCU in bivariate analysis (P ≤ 0...
March 14, 2018: Epidemiology and Infection
Tomas Majtan, Erez M Bublil, Insun Park, Erland Arning, Teodoro Bottiglieri, Frank Glavin, Jan P Kraus
AIMS: PEGylated human truncated cystathionine beta-synthase, lacking the C-terminal regulatory domain (PEG-CBS), is a promising preclinical candidate for enzyme replacement therapy in homocystinuria (HCU). It was designed to function as a metabolic sink to decrease the severely elevated plasma and tissue homocysteine concentrations. Here we evaluated pharmacokinetics (PK), pharmacodynamics (PD) and sub-chronic toxicity of PEG-CBS in homocystinuric mice and wild type rats and monkeys to estimate the minimum human efficacious dose for clinical trials...
March 8, 2018: Life Sciences
Paul Hüsing, Bernd Löwe, Katharina Piontek, Meike Shedden-Mora
RATIONALE, AIMS, AND OBJECTIVES: Patients with somatoform disorders are frequent attenders in primary and secondary care. While co-morbid mental disorders, especially depression and anxiety, are frequently present, there is controversy on whether mental co-morbidity leads to higher health care utilization (HCU). The present paper investigates the influence of co-morbid depressive and anxiety disorders on primary, specialized somatic and mental HCU in primary care patients with somatoform disorders...
March 2, 2018: Journal of Evaluation in Clinical Practice
Catherine Hayes, Dervla Kelly, Cristina Taut, Elizabeth Nixon, Lina Zgaga, James Williams, Thomas O'Dowd, Udo Reulbach
Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU) is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1), 8,568 9-year-olds, and their carers. Being bullied was assessed by a self-reported questionnaire completed by children at home...
February 25, 2018: Healthcare (Basel, Switzerland)
Johanna Katharina Hohls, Hans-Helmut König, Yulia I Raynik, André Hajek
THEORETICAL BACKGROUND: In older people, anxiety disorders are among the most prevalent mental disorders and a high proportion suffers from clinically relevant anxiety symptoms. Despite studies suggesting an association of anxiety with health care utilization (HCU) and a resulting economic burden to the health care system, we found no review systematically analyzing evidence on this association in older people. OBJECTIVE: To analyze and synthesize evidence on the association of anxiety disorders and symptoms with HCU and costs in people aged 65 years and over in a systematic review...
February 15, 2018: Journal of Affective Disorders
Dominik Mertz, Jennifer Macri, Susy Hota, Kanchana Amaratunga, Ian Davis, Lynn Johnston, Bonita Lee, Linda Pelude, Michelle Science, Stephanie Smith, Alice Wong
Canadian hospitals were made aware of the risk of Mycobacterium chimaera infection associated with heater-cooler units (HCUs) through alerts issued by the US food and Drug Administration (FDA) and the US Centers for Disease Control and Prevention (CDC). In response, most hospitals conducted retrospective reviews for infections, informed exposed patients, and initiated a requirement for informed consent with HCU use. Infect Control Hosp Epidemiol 2018;1-4.
February 28, 2018: Infection Control and Hospital Epidemiology
Dennis Nurjadi, Klaus Heeg, Alexander N R Weber, Philipp Zanger
OBJECTIVES: Toll-like receptor (TLR) -9 could have importance in human S. aureus immunity, but population level evidence for this hypothesis is missing. METHODS: We phenotyped 603 volunteers for S. aureus nasal carriage using four consecutive swabs, genotyped TLR9 promotor variants in 106 persistent carriers and 219 non-carriers, measured TLR9-mRNA expression in whole blood after stimulation with viable S. aureus, and studied mutual associations of carriage, transcriptional activity, and single nucleotide polymorphisms while accounting for sex and hormonal contraceptive use (HCU+/- )...
February 16, 2018: Clinical Microbiology and Infection
Tomas Majtan, Wendell Jones, Jakub Krijt, Insun Park, Warren D Kruger, Viktor Kožich, Steven Bassnett, Erez M Bublil, Jan P Kraus
Classical homocystinuria (HCU) is the most common inherited disorder of sulfur amino acid metabolism caused by deficiency in cystathionine beta-synthase (CBS) activity and characterized by severe elevation of homocysteine in blood and tissues. Treatment with dietary methionine restriction is not optimal, and poor compliance leads to serious complications. We developed an enzyme replacement therapy (ERT) and studied its efficacy in a severe form of HCU in mouse (the I278T model). Treatment was initiated before or after the onset of clinical symptoms in an effort to prevent or reverse the phenotype...
December 19, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
Amandine Bertrand, Bertrand Favier, Yves Devaux, Florence Goy, Anna Marcault-Derouard, Véronique Veyet, Marie Cervos, Matthias Schell
INTRODUCTION: Our home care unit (HCU) developed the administration of IV chemotherapy at home for some pediatric oncologic patients. METHODS: We conducted a retrospective monocentric analysis, leading to identify patients with at least one sequence of chemotherapy at home in 2015. RESULTS: Two hundred and forty four sequences of home chemotherapy have been administered in 2015. We identified two situations for home IV chemotherapy. Pediatric oncologist of day hospital prescribes the sequence...
January 29, 2018: Bulletin du Cancer
Soraia Poloni, Fernanda Sperb-Ludwig, Taciane Borsatto, Giovana Weber Hoss, Maria Juliana R Doriqui, Emília K Embiruçu, Ney Boa-Sorte, Charles Marques, Chong A Kim, Carolina Fischinger Moura de Souza, Helio Rocha, Marcia Ribeiro, Carlos E Steiner, Carolina A Moreno, Pricila Bernardi, Eugenia Valadares, Osvaldo Artigalas, Gerson Carvalho, Hector Y C Wanderley, Johanna Kugele, Melanie Walter, Lorena Gallego-Villar, Henk J Blom, Ida Vanessa D Schwartz
BACKGROUND: Classical homocystinuria (HCU) is a monogenic disease caused by the deficient activity of cystathionine β-synthase (CβS). The objective of this study was to identify the CBS mutations in Brazilian patients with HCU. METHODS: gDNA samples were obtained for 35 patients (30 families) with biochemically confirmed diagnosis of HCU. All exons and exon-intron boundaries of CBS gene were sequenced. Gene expression analysis by qRT-PCR was performed in six patients...
January 20, 2018: Molecular Genetics & Genomic Medicine
Sara Romano-Bertrand, Marine Evrevin, Chloé Dupont, Jean-Marc Frapier, Jean-Claude Sinquet, Elodie Bousquet, Bernard Albat, Estelle Jumas-Bilak
Recently, surgical site infections due to non-tuberculous Mycobacterium (NTM) have been linked to heater-cooler units (HCUs) contamination. ECDC and manufacturers now recommend the use of hydrogen peroxide in filtered water to fill HCU tanks. After implementation of these measures in our hospital, HCUs became heavily contaminated by opportunistic waterborne pathogens such as Pseudomonas aeruginosa and Stenotrophomonas maltophilia. No NTM were detected but fast-growing resistant bacteria could impair their detection...
January 10, 2018: Journal of Hospital Infection
Sergei Muratov, Justin Lee, Anne Holbrook, J Michael Paterson, Jason Robert Guertin, Lawrence Mbuagbaw, Tara Gomes, Wayne Khuu, Priscila Pequeno, Andrew P Costa, Jean-Eric Tarride
INTRODUCTION: Senior high-cost users (HCUs) are estimated to represent 60% of all HCUs in Ontario, Canada's most populous province. To improve our understanding of individual and health system characteristics related to senior HCUs, we will examine incident senior HCUs to determine their incremental healthcare utilisation and costs, characteristics of index hospitalisation episodes, mortality and their regional variation across Ontario. METHODS AND ANALYSIS: A retrospective, population-based cohort study using administrative healthcare records will be used...
December 26, 2017: BMJ Open
Ruth Roberts, Eamon McCrory, Helene Joffe, Nicole De Lima, Essi Viding
Parenting children with conduct problems (CP) is challenging, yet very little is known about the impact of the child's behaviour on family functioning or how parents of children with CP perceive their child. The aim of this research was to examine whether families with children with CP and high vs. low levels of callous-unemotional traits (HCU vs. LCU) experience differences in family functioning and parental perceptions. One hundred and one parents/caregivers of boys aged 11-16 [Typically developing (TD) n = 31; CP/HCU n = 35; CP/LCU n = 35] completed the McMaster Family Assessment Device, measuring multiple domains of family functioning...
December 4, 2017: European Child & Adolescent Psychiatry
Sarah Gebauer, Joanne Salas, Jeffrey F Scherrer
BACKGROUND: Although treatment for new back pain is heavily guideline driven, deviations occur frequently. Neighborhood socioeconomic status (nSES) may contribute to these deviations. OBJECTIVE: Determine whether nSES is associated with type of treatment provided for patients seeking treatment for new back pain in primary care clinics. METHODS: This retrospective cohort was conducted in academic internal and family medicine practices. Data were examined from the Primary Care Patient Data Registry...
November 2017: Journal of the American Board of Family Medicine: JABFM
Benjamin D Hallowell, Douglas M Puricelli Perin, Eduardo J Simoes, Diana C Paez, Diana C Parra, Ross C Brownson, Mona Saraiya
In 2004 the Brazilian National Cancer Institute (INCA) established breast cancer screening guidelines for women in Brazil: annual clinical breast exam for women age 40-49 and biennial mammogram for women age 50-69. Healthcare provider's adherence to these guidelines is currently unknown. The objective of this study is to describe the perceptions and practices related to breast cancer screening among physicians, nurses, and health unit coordinators working in the network of primary healthcare units (HCUs) in Brazil...
January 2018: Preventive Medicine
Tomas Majtan, Angel L Pey, Paula Gimenez-Mascarell, Luis Alfonso Martínez-Cruz, Csaba Szabo, Viktor Kožich, Jan P Kraus
Classical homocystinuria (HCU) is the most common loss-of-function inborn error of sulfur amino acid metabolism. HCU is caused by a deficiency in enzymatic degradation of homocysteine, a toxic intermediate of methionine transformation to cysteine, chiefly due to missense mutations in the cystathionine beta-synthase (CBS) gene. As with many other inherited disorders, the pathogenic mutations do not target key catalytic residues, but rather introduce structural perturbations leading to an enhanced tendency of the mutant CBS to misfold and either to form nonfunctional aggregates or to undergo proteasome-dependent degradation...
November 10, 2017: Handbook of Experimental Pharmacology
Thomas A Barker, Uday Dandekar, Nina Fraser, Lincoln Dawkin, Paul Sweeney, Fraser Heron, Jacqui Simmons, Jitendra Parmar
INTRODUCTION: Mycobacterium chimaera ( M. chimaera) is a recently characterised bacterium that can cause life-threatening infections in small numbers of patients who undergo cardiopulmonary bypass during cardiac surgery. The likely mode of transmission is thought to occur through aerosolisation from contaminated water reservoirs. The airborne bacteria then contaminate the surgical field, leading to an infection months or even years later. The preferred practical solution to disrupt the transmission of these airborne bacteria to the patient is to remove the heater-cooler units (HCUs) from the operating room (OR)...
November 1, 2017: Perfusion
Kenneth N Maclean, Hua Jiang, Stefanos Aivazidis, Eugene Kim, Colin T Shearn, Peter S Harris, Dennis R Petersen, Robert H Allen, Sally P Stabler, James R Roede
Cystathionine β-synthase-deficient homocystinuria (HCU) is a poorly understood, life-threatening inborn error of sulfur metabolism. Analysis of hepatic glutathione (GSH) metabolism in a mouse model of HCU demonstrated significant depletion of cysteine, GSH, and GSH disulfide independent of the block in trans-sulfuration compared with wild-type controls. HCU induced the expression of the catalytic and regulatory subunits of γ-glutamyl ligase, GSH synthase (GS), γ-glutamyl transpeptidase 1, 5-oxoprolinase (OPLAH), and the GSH-dependent methylglyoxal detoxification enzyme, glyoxalase-1...
November 3, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Karine Moschetti, Véra Zabrodina, Pierre Stadelmann, Tenzin Wangmo, Alberto Holly, Jean-Blaise Wasserfallen, Bernice S Elger, Bruno Gravier
Prison healthcare is an important public health concern given the increasing healthcare needs of a growing and aging prison population, which accumulates vulnerability factors and suffers from higher disease prevalence than the general population. This study identifies the key factors associated with outpatient general practitioner (GP), nursing or psychiatric healthcare utilization (HCU) within prisons. Cross-sectional data systematically collected by the prison medical staff were obtained for a sample of 1664 adult prisoners of the Canton of Vaud, Switzerland, for the year 2011...
2017: PloS One
Tomas Majtan, Insun Park, Erez M Bublil, Jan P Kraus
Skeletal and connective tissue defects are the most striking symptoms in patients suffering from classical homocystinuria (HCU). Here, we determined body composition and bone mass in three mouse models of HCU and assessed whether a long-term administration of enzyme replacement therapy (ERT) corrected the phenotype. The mouse models of HCU were analyzed using dual-energy X-ray absorptiometry and the data were complemented by plasma biochemical profiles. Both the mouse model lacking CBS (KO) and the one expressing human CBS mutant transgene on a mouse CBS null background (I278T) showed marked bone loss and decreased weight mostly due to a lower fat content compared with negative controls...
October 16, 2017: Human Mutation
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