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https://www.readbyqxmd.com/read/29223678/protein-sparing-therapies-in-acute-illness-and-obesity-a-review-of-george-blackburn-s-contributions-to-nutrition-science
#1
REVIEW
Dylan D Thomas, Nawfal W Istfan, Bruce R Bistrian, Caroline M Apovian
Protein sparing therapies were developed to mitigate the harms associated with protein-calorie malnutrition and nitrogen losses induced by either acute illness or hypocaloric diets in patients with obesity. We review the development of protein sparing therapies in illness and obesity with a focus on the pioneering contributions of George Blackburn, MD, PhD. He recognized that protein-calorie malnutrition is a common and serious clinical condition and developed new approaches to its treatment in hospitalized patients...
December 7, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#2
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29215962/personal-exposure-to-fine-particulate-matter-concentrations-in-central-business-district-of-a-tropical-coastal-city
#3
Jyothi S Menon, S M Shiva Nagendra
In the present study, personal exposure to fine particulate matter (PM2.5) concentrations in an urban hotspot (CBD: central business district) was investigated. The PM monitoring campaigns were carried out at an urban hotspot from June to October 2015. The personal exposure monitoring was performed during three different time periods, i.e. morning (8AM -9AM), afternoon (12.30PM-1.30PM) and evening (4PM-5PM), to cover both the peak and lean hour activities of the CBD. The median PM2.5 concentrations were 38...
December 7, 2017: Journal of the Air & Waste Management Association
https://www.readbyqxmd.com/read/29204469/high-frequency-electrical-stimulation-hfes-data-lean-and-obese-zucker-rat-soleus-muscle-regulation-of-p70s6kinase-associated-proteins
#4
Kevin M Rice, Anjaiah Katta, Nandini D P K Manne, Ravikumar Arvapalli, Gautam K Ginjupalli, Miaozong Wu, Shinichi Asano, Eric R Blough
Anaerobic exercise has been advocated as a prescribed treatment for the management of diabetes: however, alterations in exercise-induced signaling remain largely unexplored in the diabetic muscle. Here, we compare the basal and the in situ contraction-induced phosphorylation of the AKT, GSK3beta, mTor, p70s6K, Pten, and Shp2 proteins in the lean and obese (fa/fa) Zucker rat soleus muscle following a single bout of contractile stimuli. This article represents data associated with prior publications from our lab (Katta et al...
February 2018: Data in Brief
https://www.readbyqxmd.com/read/29199408/beneficial-effects-of-aerobic-exercise-training-combined-with-rosiglitazone-on-glucose-metabolism-in-otsuka-long-evans-tokushima-fatty-rats
#5
Shan Ji Piao, So Hun Kim, Young Ju Suh, Seong Bin Hong, Seong Hee Ahn, Da Hae Seo, In Sun Park, Moonsuk Nam
BACKGROUND: Regular aerobic exercise is essential for the prevention and management of type 2 diabetes mellitus and may be particularly beneficial for those treated with thiazolidinediones, since it may prevent associated weight gain. This study aimed to evaluate the effect of combined exercise and rosiglitazone treatment on body composition and glucose metabolism in obese diabetes-prone animals. METHODS: We analyzed metabolic parameters, body composition, and islet profiles in Otsuka Long Evans Tokushima Fatty rats after 28 weeks of aerobic exercise, rosiglitazone treatment, and combined exercise and rosiglitazone treatment...
November 15, 2017: Diabetes & Metabolism Journal
https://www.readbyqxmd.com/read/29190380/relationship-centered-health-care-as-a-lean-intervention
#6
Jennifer Dunsford, Laura E Reimer
Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of processes and sub processes required to deliver value within a bureaucratic environment, while maintaining some level of compassionate and personalized care. There is inherent tension between what is required to be efficient and what is required to be caring and this conflict presses against Lean practice at the level of delivery...
November 28, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29189702/nurse-training-in-self-management-of-patients-with-cardiovascular-diseases-a-multicentre-observational-study
#7
Rachele La Sala, Rita Bruna Dicembrino, Simona Dall'Argine, Monica Baiguera, Lorena Gazzotti, Elena Gubin, Alessia Rondini, Ilaria Mamei
BACKGROUND AND AIM: The therapeutic education and self-management carried out by nurses, are winning elements in cardiovascular secondary prevention, but because they are complex matters, they require special training by the professionals. The target of the study has been to assess the effects in clinical practice of a training program for nurses in the management of patients with cardiovascular diseases, leaning towards a self-oriented patient management and therapeutic patient education...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29188339/clinical-and-metabolic-features-of-the-randomised-controlled-diabetes-remission-clinical-trial-direct-cohort
#8
Roy Taylor, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Naveed Sattar, Paul Welsh, Carl Peters, Sviatlana Zhyzhneuskaya, Kieren G Hollingsworth, Ahmad Al-Mrabeh, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Sharon Kean, Ian Ford, Alex McConnachie, Michael E J Lean
AIMS/HYPOTHESIS: Substantial weight loss in type 2 diabetes can achieve a return to non-diabetic biochemical status, without the need for medication. The Diabetes Remission Clinical Trial (DiRECT), a cluster-randomised controlled trial, is testing a structured intervention designed to achieve and sustain this over 2 years in a primary care setting to determine practicability for routine clinical practice. This paper reports the characteristics of the baseline cohort. METHODS: People with type 2 diabetes for <6 years with a BMI of 27-45 kg/m2 were recruited in 49 UK primary care practices, randomised to either best-practice diabetes care alone or with an additional evidence-based weight management programme (Counterweight-Plus)...
November 30, 2017: Diabetologia
https://www.readbyqxmd.com/read/29187082/lean-leadership-attributes-a-systematic-review-of-the-literature
#9
Kjeld Harald Aij, Maurits Teunissen
Purpose Emphasis on quality and reducing costs has led many health-care organizations to reconfigure their management, process, and quality control infrastructures. Many are lean, a management philosophy with roots in manufacturing industries that emphasizes elimination of waste. Successful lean implementation requires systemic change and strong leadership. Despite the importance of leadership to successful lean implementation, few researchers have probed the question of ideal leadership attributes to achieve lean thinking in health care...
October 9, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29186013/improving-the-accessibility-and-efficiency-of-point-of-care-diagnostics-services-in-low-and-middle-income-countries-lean-and-agile-supply-chain-management
#10
REVIEW
Desmond Kuupiel, Vitalis Bawontuo, Tivani P Mashamba-Thompson
Access to point-of-care (POC) diagnostics services is essential for ensuring rapid disease diagnosis, management, control, and surveillance. POC testing services can improve access to healthcare especially where healthcare infrastructure is weak and access to quality and timely medical care is a challenge. Improving the accessibility and efficiency of POC diagnostics services, particularly in resource-limited settings, may be a promising route to improving healthcare outcomes. In this review, the accessibility of POC testing is defined as the distance/proximity to the nearest healthcare facility for POC diagnostics service...
November 29, 2017: Diagnostics
https://www.readbyqxmd.com/read/29166409/post-weaning-high-fat-diet-results-in-growth-cartilage-lesions-in-young-male-rats
#11
Samuel S Haysom, Mark H Vickers, Lennex H Yu, Clare M Reynolds, Elwyn C Firth, Sue R McGlashan
To determine if a high-fat diet (HF) from weaning would result in a pro-inflammatory state and affect joint cartilage, we fed male rats either HF or Chow diet post-weaning, and voluntary wheel exercise (EX) or cage only activity (SED) after 9 weeks of age. At 17 weeks body composition, plasma biomarkers and histomorphology scores of femoro-tibial cartilages of HF-SED, HF-EX, Chow-SED and Chow-EX groups were compared. Food intake and activity were not significantly different between groups. HF diet resulted in significantly higher weight gain, %fat, fat:lean ratio, and plasma leptin, insulin and TNFα concentrations, with significant interactions between diet and exercise...
2017: PloS One
https://www.readbyqxmd.com/read/29154418/measuring-non-polyaminated-lipocalin-2-for-cardiometabolic-risk-assessment
#12
Kangmin Yang, Han-Bing Deng, Andy W C Man, Erfei Song, Jialiang Zhang, Cuiting Luo, Bernard M Y Cheung, Kwok-Yung Yuen, Pia Søndergaard Jensen, Akhmadjon Irmukhamedov, Atlanta G I M Elie, Paul M Vanhoutte, Aimin Xu, Jo G R De Mey, Yu Wang
AIMS: Lipocalin-2 is a pro-inflammatory molecule characterized by a highly diversified pattern of expression and structure-functional relationships. In vivo, this molecule exists as multiple variants due to post-translational modifications and/or protein-protein interactions. Lipocalin-2 is modified by polyamination, which enhances the clearance of this protein from the circulation and prevents its excessive accumulation in tissues. On the other hand, animal studies suggest that non-polyaminated lipocalin-2 (npLcn2) plays a causal role in the pathogenesis of obesity-associated medical complications...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29147169/uncomplicated-acute-type-b-aortic-dissection-selection-guidelines-for-tevar
#13
Emilia Krol, Jean M Panneton
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#14
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29142442/debates-regarding-lean-patients-with-polycystic-ovary-syndrome-a-narrative-review
#15
REVIEW
Manu Goyal, Ayman S Dawood
Polycystic ovary syndrome (PCOS) is a complex syndrome showing the clinical features of an endocrine/metabolic disorder, including hyperinsulinemia and hyperandrogenism. Two phenotypes are present, either lean or obese, with different biochemical, hormonal, and metabolic profiles. Evidence suggests many treatment modalities that can be applied. However, many of these modalities were found to be not suitable for the lean phenotype of PCOS. Much contradictory research was found regarding lean patients with PCOS...
July 2017: Journal of Human Reproductive Sciences
https://www.readbyqxmd.com/read/29141973/energy-metabolism-profile-in-individuals-with-prader-willi-syndrome-and-implications-for-clinical-management-a-systematic-review
#16
REVIEW
Maha Alsaif, Sarah A Elliot, Michelle L MacKenzie, Carla M Prado, Catherine J Field, Andrea M Haqq
Prader-Willi syndrome (PWS) is a rare genetic disorder associated with excessive weight gain. Hyperphagia associated with PWS may result in higher energy intake, but alterations in energy expenditure may also contribute to energy imbalance. The purpose of this critical literature review is to determine the presence of alterations in energy expenditure in individuals with PWS. Ten studies that measured total energy expenditure (TEE), resting energy expenditure (REE), sleep energy expenditure (SEE), activity energy expenditure (AEE), and diet induced thermogenesis (DIT) were included in this review...
November 2017: Advances in Nutrition
https://www.readbyqxmd.com/read/29136532/spatial-and-temporal-distribution-of-rainfall-and-drought-characteristics-across-the-pearl-river-basin
#17
Shulin Deng, Tan Chen, Ni Yang, Lean Qu, Manchun Li, Dong Chen
Understanding rainfall trends as well as drought characteristics plays a key role in watershed development and management. In this study, the spatial and temporal characteristics of rainfall and drought based on temperature and precipitation data observed in 48 meteorological stations from 1959 to 2012 across the Pearl River Basin in China were analyzed. The possible influence of El Nino-Southern Oscillation (ENSO) and El Nino Modoki (ENSO_M) events on seasonal drought based on the Standardized Precipitation-evapotranspiration Index (SPEI) were also investigated...
November 11, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29136150/using-value-stream-mapping-to-improve-quality-of-care-in-low-resource-facility-settings
#18
Rohit Ramaswamy, Claire Rothschild, Funmi Alabi, Eric Wachira, Faith Muigai, Nick Pearson
Quality problem or issue: Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi. Initial assessment: JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency. Choice of solution: Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care...
November 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29121006/origin-and-clinical-relevance-of-chromosomal-aberrations-other-than-the-common-trisomies-detected-by-genome-wide-nips-results-of-the-trident-study
#19
Diane Van Opstal, Merel C van Maarle, Klaske Lichtenbelt, Marjan M Weiss, Heleen Schuring-Blom, Shama L Bhola, Mariette J V Hoffer, Karin Huijsdens-van Amsterdam, Merryn V Macville, Angelique J A Kooper, Brigitte H W Faas, Lutgarde Govaerts, Gita M Tan-Sindhunata, Nicolette den Hollander, Ilse Feenstra, Robert-Jan H Galjaard, Dick Oepkes, Stijn Ghesquiere, Rutger W W Brouwer, Lean Beulen, Sander Bollen, Martin G Elferink, Roy Straver, Lidewij Henneman, Godelieve C Page-Christiaens, Erik A Sistermans
PurposeNoninvasive prenatal screening (NIPS) using cell-free DNA in maternal blood is highly sensitive for detecting fetal trisomies 21, 18, and 13. Using a genome-wide approach, other chromosome anomalies can also be detected. We report on the origin, frequency, and clinical significance of these other chromosome aberrations found in pregnancies at risk for trisomy 21, 18, or 13.MethodsWhole-genome shallow massively parallel sequencing was used and all autosomes were analyzed.ResultsIn 78 of 2,527 cases (3...
October 2, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#20
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
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