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Karen M Detering, Kimberly Buck, Rasa Ruseckaite, Helana Kelly, Marcus Sellars, Craig Sinclair, Josephine M Clayton, Linda Nolte
OBJECTIVES: It is important that the outcomes of advance care planning (ACP) conversations are documented and available at the point of care. Advance care directives (ACDs) are a subset of ACP documentation and refer to structured documents that are completed and signed by competent adults. Other ACP documentation includes informal documentation by the person or on behalf of the person by someone else (eg, clinician, family). The primary objectives were to describe the prevalence and correlates of ACDs among Australians aged 65 and over accessing health and residential aged care services...
January 15, 2019: BMJ Open
James W T Toh, Kevin Phan, Kerry Hitos, Nimalan Pathma-Nathan, Toufic El-Khoury, Arthur J Richardson, Gary Morgan, Alexander Engel, Grahame Ctercteko
Importance: There has been a resurgence of interest in the use of mechanical bowel preparation (MBP) and oral antibiotics (OAB) before elective colorectal surgery. Until now, clinical trials and meta-analyses have not compared all 4 approaches (MBP with OAB, OAB only, MBP only, or no preparation) simultaneously. Objective: To perform a network meta-analysis to clarify which approach in colorectal surgery is associated with the lowest rate of surgical site infection (SSI)...
October 5, 2018: JAMA network open
Gabriela Carreno, Jessica K R Boult, John R Apps, Jose Mario Gonzalez-Meljem, Scott Haston, Romain Guiho, Christina Stache, Laura S Danielson, Alexander Koers, Laura S Smith, Alex Virasami, Leonidas Panousopoulos, Michael Buchfelder, Thomas S Jacques, Louis Chesler, Simon Robinson, Juan Pedro Martinez-Barbera
Pharmacological inhibition of the sonic hedgehog (SHH) pathway can be beneficial against certain cancers but detrimental in others. Adamantinomatous craniopharyngioma (ACP) is a relevant pituitary tumour, affecting children and adults, that is associated with high morbidity and increased mortality in long-term follow up. We have previously demonstrated overactivation of the SHH pathway in both human and mouse ACP. Here, we show that this activation is ligand dependent and induced by the expression of SHH protein in a small proportion of tumour cells...
January 1, 2019: Endocrine-related Cancer
Fadi M Alkhateeb, Steve Arkle, Sharon L K McDonough, David A Latif
Objective. To compare the different philosophies, emphases and processes of national and international accreditation paths available to pharmacy programs in Gulf Cooperation Council (GCC) countries. To identify engagement of GCC pharmacy programs with International Pharmacy Accreditation or Certification (IPAC) and the outcome advantages of IPAC compared to other national accreditation standards. Findings. National quality standards across the GCC countries are similarly structured but in different stages of development...
December 2018: American Journal of Pharmaceutical Education
Amy Waller, Heidi Turon, Jamie Bryant, Alison Zucca, Tiffany-Jane Evans, Rob Sanson-Fisher
BACKGROUND: Medical oncology outpatients are a group for whom advance care planning (ACP) activities are particularly relevant. Patient views can help prioritise areas for improving end of life communication. The study aimed to determine in a sample of medical oncology outpatients: (1) the perceived importance of participating in ACP activities; (2) the proportion of patients who have ever participated in ACP activities; and (3) the proportion of patients who had not yet participated in ACP activities who were willing to do so in next month...
January 14, 2019: BMC Cancer
Reham Al-Dhelaan, Paul S Russo, Sean E Padden, Anthony Amaya, Debbie W Dong, Young-Ok You
Non-elongating modules with condensation-incompetent ketosynthase (KS0 ) are frequently found in many trans-acyltransferase polyketide synthases ( trans-AT PKS). KS0 catalyzes translocation of carbon chain without decarboxylative condensation. Unlike typical elongating modules where malonylation of acyl carrier protein (ACP) precedes elongation, the malonylation of ACP downstream of KS0 is assumed to be prevented. In this study, the regulation mechanism(s) of ACP malonylation in a non-elongating module of difficidin biosynthase was investigated...
January 14, 2019: ACS Chemical Biology
Antonello Nicolini, Matteo Ferrando, Paolo Solidoro, Fabiano Di Marco, Fabrizio Facchini, Fulvio Braido
INTRODUCTION: Non-invasive ventilation (NIV) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades compared to prior decades. There are particular groups of patients that are more likely to benefit from NIV. One of these groups is patients with obesity hypoventilation syndrome (OHS). The aim of this review is to evalue the effectiveness of NIV in acute ARF. EVIDENCE ACQUISITION: MEDLINE, EMBASE, CINHAIL, Cochrane Central Register of Controlled Trials, DARE, the Cochrane Database of Systematic Reviews, and the ACP Journal Club database were searched from January 2001 to December 2017...
December 2018: Minerva Medica
Lois Snyder Sulmasy, Thomas A Bledsoe
Medicine, law, and social values are not static. Reexamining the ethical tenets of medicine and their application in new circumstances is a necessary exercise. The seventh edition of the American College of Physicians (ACP) Ethics Manual covers emerging issues in medical ethics and revisits older ones that are still very pertinent. It reflects on many of the ethical tensions in medicine and attempts to shed light on how existing principles extend to emerging concerns. In addition, by reiterating ethical principles that have provided guidance in resolving past ethical problems, the Manual may help physicians avert future problems...
January 15, 2019: Annals of Internal Medicine
Xiaoying Lou, Edward P Chen
Cerebral protection strategies in aortic surgery have undergone significant evolution over the years, but its tenets remain rooted in maintenance of hypothermia and cerebral perfusion to limit adverse neurologic outcomes. While deep hypothermic circulatory arrest (DHCA) alone remains a viable approach in many instances, the need for prolonged duration of circulatory arrest and increasing case complexity have driven the utilization of adjunctive cerebral perfusion strategies. In this review, we present the most recent studies published on this topic over the last few years investigating the efficacy of DHCA, retrograde cerebral perfusion (RCP), and unilateral and bilateral antegrade cerebral perfusion (ACP), as well as the emerging trend towards mild and moderate HCA temperatures...
January 8, 2019: Seminars in Thoracic and Cardiovascular Surgery
Eun-Kyung Moon, Hyun-Seo Choi, So-Min Park, Hyun-Hee Kong, Fu-Shi Quan
Pathogenic Acanthamoeba spp. cause granulomatous amoebic encephalitis and keratitis. Acanthamoeba keratitis (AK) is a rare but serious ocular infection that can result in permanent visual impairment or blindness. However, pathogenic factors of AK remain unclear and treatment for AK is arduous. Expression levels of proteins secreted into extracellular space were compared between A. castellanii pathogenic (ACP) and non-pathogenic strains. Two-dimensional polyacrylamide gel electrophoresis revealed 123 differentially expressed proteins, including 34 increased proteins , 7 qualitative increased proteins, 65 decreased proteins, and 17 qualitative decreased proteins in ACP strain...
December 2018: Korean Journal of Parasitology
Qianqian Zhai, Jian Li
The effects of oral administration of enrofloxacin (ENR) and San-Huang-San (SHS), singly or in combination, on the survival performance, disease resistance, and immunity of Litopenaeus vannamei were investigated. After challenge with an AHPND-causing strain of Vibrio parahaemolyticus (VPAHPND ), shrimp were immediately fed a drug-free diet, diets containing only ENR (20 mg kg-1 ) or SHS (500 mg kg-1 ) or diets containing low-dose (10 mg kg-1 ENR + 250 mg kg-1 SHS), medium-dose (20 mg kg-1 ENR + 500 mg kg-1 SHS), and high-dose (40 mg kg-1 ENR + 1000 mg kg-1 SHS) drug combinations for 5 days...
January 7, 2019: Fish & Shellfish Immunology
Michele Riccio, Andrea Marchesini, Letizia Senesi, Edlira Skrami, Rosaria Gesuita, Francesco De Francesco
BACKGROUND: Pathological scars are unattractive and may significantly impair the patient's quality of life. Current treatments provide inconsistent results, and none may be regarded as definitive. Recently, an auto-cross-linked hyaluronic acid (HA) formulation, IAL-SYSTEM ACP, featuring a long residence time and an enhanced safety profile, has been successfully used to prevent surgical adhesions, treat tendon lesions and rejuvenate the face and the décolletage. This study aims to preliminarily investigate whether IAL-SYSTEM ACP may also be effective in treating pathological scars resulting from burns, trauma or iatrogenic causes...
January 9, 2019: Aesthetic Plastic Surgery
Paul H Caldron
This case study was extracted from an administrative report generated for Project Salud y Paz (SYP), a non-governmental organization (NGO) that supports short term global health clinical experiences (STGHCE) in Guatemala. As a basis to generate criticisms and offer recommendations, the analysis used the shared themes of two sets of standards recently published by Globalization and Health (GH) and the American College of Physicians (ACP). These standards respectively address the ethical responsibilities of organizations and of physicians in the conduct of STGHCE...
January 9, 2019: Globalization and Health
Shohei Hayashi, Yasuharu Satoh, Yasushi Ogasawara, Chitose Maruyama, Yoshimitsu Hamano, Tetsuro Ujihara, Tohru Dairi
Polyunsaturated fatty acids (PUFAs) such as docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA) are essential fatty acids for humans. Some microorganisms biosynthesize these PUFAs through PUFA synthases composed of four subunits with multiple catalytic domains. These PUFA synthases each create a specific PUFA without undesirable byproducts even though the multiple catalytic domains in each huge subunit are very similar. However, the detailed biosynthetic pathways and mechanisms for controlling final product profiles are still obscure...
January 8, 2019: Angewandte Chemie
K Phan, H R Kahlaee, S H Kim, J W T Toh
BACKGROUND: The usage of robotic surgery in rectal cancer is increasing, but there is an ongoing debate as to whether it provides any benefit. The aim of the present study was to determine if robotic surgery results in less conversion to an open operation than laparoscopic rectal cancer surgery. METHODS: A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using Ovid Medline, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ACP Journal Club and Database of Abstracts of Review of Effectiveness...
January 8, 2019: Techniques in Coloproctology
Kamonchanock Eungrasamee, Rui Miao, Aran Incharoensakdi, Peter Lindblad, Saowarath Jantaro
Background: Cyanobacteria are potential sources for third generation biofuels. Their capacity for biofuel production has been widely improved using metabolically engineered strains. In this study, we employed metabolic engineering design with target genes involved in selected processes including the fatty acid synthesis (a cassette of accD , accA , accC and accB encoding acetyl-CoA carboxylase, ACC), phospholipid hydrolysis ( lipA encoding lipase A), alkane synthesis ( aar encoding acyl-ACP reductase, AAR), and recycling of free fatty acid (FFA) ( aas encoding acyl-acyl carrier protein synthetase, AAS) in the unicellular cyanobacterium Synechocystis sp...
2019: Biotechnology for Biofuels
Adnan Özdemir, Nuray Bayar Muluk, Neşe Asal, Mehmet Hamdi Şahan, Mikail Inal
OBJECTIVES: We investigated the relationship between Onodi cells and optic canal by paranasal sinus computed tomography (PNSCT). METHODS: In this retrospective study, 508 PNSCT (265 males and 243 females) was examined. Onodi cell presence, pneumatization types, optic canal types; and also sphenoid sinusitis and anterior clinoid process pneumatization were evaluated. RESULTS: The prevalence of Onodi cells was 21.2% of the patients. Onodi cells were observed 40...
January 7, 2019: European Archives of Oto-rhino-laryngology
Xi Chen, Yusheng Tong, Zhifeng Shi, Hong Chen, Zhong Yang, Yuanyuan Wang, Liang Chen, Jinhua Yu
BACKGROUND: Frequent somatic mutations of BRAF and CTNNB1 were identified in both histological subtypes of craniopharyngioma (adamantinomatous and papillary) which shed light on target therapy to cure this oncogenic disease. The aim of this study was to investigate the noninvasive MRI-based radiomics diagnosis to detect BRAF and CTNNB1 mutations in craniopharyngioma patients. METHODS: Forty-four patients pathologically diagnosed as adamantinomatous craniopharyngioma (ACP) or papillary craniopharyngioma (PCP) were retrospectively studied...
January 7, 2019: BMC Neurology
Ling Zhang, Wenting Wang, Chaoyang Wang, Mingxing Li, Zhe Wang, Zhiwei Su, Baiping Fu
OBJECTIVES: The study investigated the solid reactants of amorphous calcium phosphate (ACP) nanoparticles with 10-methacryloyloxydecyl dihydrogen phosphate (MDP) in ethanol-aqueous solution, and the effect of ACP-MDP suspension as a novel primer on dentin micro-tesnisl bond strengths (MTBS) prior to application of self-etch adhesives. MATERIALS AND METHODS: The ACP nanoparticles were synthesized. The solid reactants of ACP nanoparticles with MDP ethanol-aqueous solution were analyzed by TEM, SEM, XRD and AFM...
December 18, 2018: Journal of the Mechanical Behavior of Biomedical Materials
Anouk Overbeek, Ida J Korfage, Bernard J Hammes, Agnes van der Heide, Judith A C Rietjens
Background: Advance Care Planning (ACP) may prepare relatives of frail older patients for future decision-making. Objective: to investigate (1) how bereaved relatives of frail older patients experience ACP conversations and (2) whether ACP has an effect on relatives' preparation for decision-making and on their levels of anxiety and depression. Design: cluster randomised controlled trial. Setting: residential care homes in the Netherlands and community setting...
January 7, 2019: Age and Ageing
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