Homing

PURPOSE: Home sleep testing devices are being widely used in diagnosis/screening for obstructive sleep apnea (OSA). We examined differences in OSA metrics obtained from two devices with divergent home monitoring strategies, the Apnea Risk Evaluation System (ARES™, multiple signals plus forehead reflectance oximetry) and the Nonin WristOx2™ (single channel finger transmission pulse oximeter), compared to differences from night-night variability of OSA. METHODS: One hundred fifty-two male/26 female subjects (BMI = 30...

BACKGROUND: The introduction of 'smoke-free laws' has reduced the population's exposure to second-hand smoke (SHS), although SHS is still an issue in homes and other public places. Children are vulnerable to its health effects, and their greatest exposure occurs at home. OBJECTIVES: To assess airborne nicotine concentration of the living room and children's bedroom of homes with children under 13 years of age, and to analyse factors associated with these levels...

AIMS: To study the capacity of the SEGAm instrument to predict loss of independence among elderly community-dwelling subjects. METHODS: The study was performed in four French departments (Ardennes, Marne, Meurthe-et-Moselle, Meuse). Subjects aged 65 years or more, living at home, who could read and understand French, with a degree of autonomy corresponding to groups 5 or 6 in the AGGIR autonomy evaluation scale were included. Assessment included demographic characteristics, comprehensive geriatric assessment, and the SEGAm instrument at baseline...

BACKGROUND: High blood pressure (BP) is the most common modifiable cause of death from cardiovascular disease. Lowering BP with medication improves patient outcomes, but even in populations with normal upper arm (brachial) BP there remains considerable residual risk for cardiovascular disease and this may be due to persistently elevated central BP. There has never been a trial to determine the value of targeted central BP lowering among patients with hypertension, and this was the aim of this study...

Activated leukocyte cell adhesion molecule (ALCAM) is expressed on various cell types, including leukocytes, endothelial cells and certain tumor cells. While ALCAM expression on tumor cells has been linked with tumor invasion and metastatic spread, the contribution of ALCAM expressed in cells forming the tumor stroma to cancer progression has not been investigated. In this study, we made use of ALCAM-deficient (ALCAM(-/-)) mice to evaluate the role of ALCAM in lung tumor growth and metastasis. ALCAM(-/-) mice displayed an altered blood vascular network in the lung and the diaphragm, indicative of an angiogenesis defect...

Inpatient management is necessary in many situations, but medical and allied-health treatments are increasingly being used on an outpatient basis to allow patients who would traditionally have been admitted to hospital to remain at home. Home-based clinical management has many potential benefits, including reduced hospital-acquired infections, cost savings, and patient and family satisfaction. Studies in adults provide evidence for the benefits of home-based versus hospital-based intravenous antibiotics, but few studies inform practice in home-based intravenous antibiotic therapy for children...

BACKGROUND: Pubic symphysis rupture significant enough to cause serious complications or require surgical intervention is exceedingly rare. Here we review the literature and examine the details of a unique presentation. CASE: A 27-year-old woman presented in labour at 34+6 weeks gestation after an uncomplicated monochorionic-diamniotic twin pregnancy. After vaginal delivery, she developed a substantial labial hematoma. Hours later, she became hemodynamically unstable...

Objective: In order to explore the effects of human umbilical cord mesenchymal stem cells (UCMSC) transplantation on the treatment of two noncontinuous segments spinal cord compression injury and to investigate whether repeated intravenous injection UCMSC was more beneficial for the recovery of spinal cord function. Methods: A total of 30 adult rabbits were randomly divided into three groups: control group (received PBS), single injection group, repeated injection group with 3 days intervals. A noncontinuous two segments SCI model was established by using the 2F Fogarty balloon catheter...

Objective: To study the phenotype of memory CD4(+) T cells in peripheral blood of asthmatics and its relationship with asthma severity. Methods: From Dec 2014 to Aug 2015, thirty-three asthmatics, twenty-six chronic obstructive pulmonary disease (COPD) patients and twenty-two healthy volunteers were enrolled in Respiratory Clinics of Zhongshan Hospital, Fudan University. Peripheral blood mononuclear cells (PBMCs) were isolated from peripheral blood. Cell surface markers (CD45RO, CRTH2, CD62L, and CCR7) and intracellular protein[interleukin (IL)-5, IL-17, interferon (IFN)-γ]staining was performed using flow-cytometric techniques...

Despite knowledge about the profound effects of child abuse and neglect, we know little about how best to assess whether maltreated children should return home. The effectiveness of the New Orleans Intervention Model (NIM) is being tested in a randomized controlled trial where the comparison is social work 'services as usual.' The future trial results will tell us which approach produces the best outcomes for children; meanwhile qualitative process evaluation is generating intriguing findings about the perceived impact of NIM on decision-making about childrens' futures...

BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...

The purpose of this study was to investigate health care for patients with rheumatoid arthritis (RA) before and after admission to nursing homes. Data of a German health insurance fund from persons with diagnostic codes of RA, aged ≥65 years, admitted to a nursing home between 2010 and 2014 and continuously insured 1 year before and after admission were used. The proportion of patients with ≥1 rheumatologist visit and ≥1 prescription of biologic or conventional synthetic disease-modifying antirheumatic drugs (bDMARDs or csDMARDs), glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) in the year before and after admission were calculated...

OBJECTIVE: To evaluate 'days at home up to 30 days after surgery' (DAH30) as a patient-centred outcome measure. DESIGN: Prospective cohort study. DATA SOURCE: Using clinical trial data (seven trials, 2109 patients) we calculated DAH30 from length of stay, readmission, discharge destination and death up to 30 days after surgery. MAIN OUTCOME: The association between DAH30 and serious complications after surgery. RESULTS: One or more complications occurred in 263 of 1846 (14...

BACKGROUND: Little is known about how the proportions of dependency states have changed between generational cohorts of older people. We aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care. METHODS: In this population-based study, we compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of older people (aged ≥65 years) who were permanently registered with a general practice in three defined geographical areas (Cambridgeshire, Newcastle, and Nottingham; UK)...

Early detection of asymptomatic atrial fibrillation (AF) provides an opportunity to treat patients to reduce their risk of stroke. Long-term residents of skilled nursing facilities frequently have multiple risk factors for strokes due to AF and may benefit from screening for AF. Patients in a skilled nursing facility 65 years and older, without a history of AF and without a pacemaker or defibrillator, were evaluated using a Microlife WatchBP Home A automatic blood pressure monitor that can detect AF when set to a triple reading mode...

BACKGROUND: Continuous-flow ventricular assist devices (CF VADs) designed for adults are increasingly used in pediatric patients. However, there is greater risk of device inflow obstruction as a result of size and anatomy. METHODS: We reviewed all cases of systemic atrioventricular valve (AVV) excision with HeartWare HVAD (HeartWare, Framingham, MA) implantation in the systemic ventricle performed at our institution from November 2015 to May 2016. RESULTS: AVV excision with CF VAD implantation was undertaken in 3 patients...

The first years of life are the most dynamic period for childhood growth. There are limited data available on growth patterns of infants and children living in rural Latin America. The aim of this study was to describe the growth patterns from birth to 5years in children living in a rural District of tropical coastal Ecuador using data from a birth cohort of 2404 neonates. We hypothesize that there would be growth differences according to ethnicity and sex. Evaluations were conducted at birth or until 2weeks of age and at 7, 13, 24, 36 and 60months during clinic and home visits...

BACKGROUND: The Adult Social Care Outcomes Toolkit (ASCOT-SCT4) is a multi-attribute utility index designed for the evaluation of long-term social care services. The measure comprises eight attributes that capture aspects of social care-related quality of life. The instrument has previously been validated with a sample of older adults who used home care services in England. This paper aims to demonstrate the instrument's test-retest reliability and provide evidence for its validity in a diverse sample of adults who use publicly-funded, community-based social care in England...

BACKGROUND: Following esophagectomy, esophageal cancer patients experience a clinically relevant deterioration of health-related quality of life, both on the short- and long-term. With the currently growing number of esophageal cancer survivors, the burden of disease- and treatment-related complaints and symptoms becomes more relevant. This emphasizes the need for interventions aimed at improving quality of life. Beneficial effects of post-operative physical exercise have been reported in several cancer types, but so far comparable evidence in esophageal cancer patients is lacking...

Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics...