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https://www.readbyqxmd.com/read/29224257/models-of-care-for-non-invasive-ventilation-in-the-acute-copd-comparison-of-three-tertiary-hospitals-act3-study
#1
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29224205/healthcare-acquired-infections-prevention-strategies
#2
Shelanah A Fernando, Timothy J Gray, Thomas Gottlieb
Healthcare-acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health-care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi-resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence-based antimicrobial use; infection prevention strategies, to control MRO - particularly methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp...
December 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29224092/sex-differences-in-leptin-control-of-cardiovascular-function-in-health-and-metabolic-diseases
#3
Eric J Belin de Chantemèle
Leptin, the adipocyte-derived hormone identified in 1994 for its major role in the control of satiety and body weight regulation, is an adipokine secreted in a sex-specific manner. Although it has clearly been established that females secrete three to four times more leptin than males and that this sexual dimorphism in leptin secretion is exacerbated with overweight and obesity, the origin and the physiological consequences of this sexual dimorphism remain ill-defined. The adipose tissue is the major site of leptin secretion; however, leptin receptors are ubiquitously expressed, conferring to leptin, and indirectly to the adipose tissue, a potential role in the control of numerous physiological functions...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29223674/prediction-of-need-for-intervention-in-posterior-urethral-valves-use-of-urine-osmolality
#4
Anna E Wright, Ruth Wragg, Joana Lopes, Andrew Robb, Liam McCarthy
AIM: Renal tubular dysfunction (RTD) causing obligate production of hypoosmolar urine in boys with posterior urethral valves (PUVs) has been described. It is not known how clinically significant this is. We hypothesize that a feedback loop is present in many PUV boys who suffer deterioration of their lower urinary tract (LUT). RTD results in hypoosmolar urine, obligate polyuria, and bladder stretch-injury. The increasing back-pressure worsens RTD, thus exacerbating the injury. Coexisting renal dysplasia and acquired renal scarring exacerbate this...
November 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29222949/a-switch-from-gaba-inhibition-to-excitation-of-vasopressin-neurons-exacerbates-the-development-angiotensin-ii-dependent-hypertension
#5
Aaron K Korpal, Su Young Han, Daryl O Schwenke, Colin H Brown
Hypothalamic magnocellular neurons secrete vasopressin into the systemic circulation to maintain blood pressure by increasing renal water reabsorption and by vasoconstriction. When blood pressure rises, baroreflex activation normally inhibits vasopressin neurons via activation of GABAergic inputs. However, plasma vasopressin levels are paradoxically elevated in several models of hypertension and in some patients with essential hypertension, despite increased blood pressure. We have previously shown that vasopressin neuron activity is increased early in the development of moderate angiotensin II-dependent hypertension via blunted baroreflex inhibition of vasopressin neurons...
December 9, 2017: Journal of Neuroendocrinology
https://www.readbyqxmd.com/read/29222744/activation-of-intestinal-gr-fxr-and-ppar%C3%AE-ugt-signaling-exacerbates-ibuprofen-induced-enteropathy-in-mice
#6
Zhiqiang Lu, Yuanfu Lu, Xue Wang, Fangyu Wang, Youcai Zhang
Nonsteroidal anti-inflammatory drugs (NSAIDs)-induced small intestinal injury (enteropathy) occurs in about two-thirds of regular NSAID users. To date, there is no proven-effective treatment for NSAID enteropathy, and its underlying mechanism remains obscure. The present study showed that glucocorticoids are an important determinant of NSAID enteropathy. High dose dexamethasone (DEX, 75 mg/kg) markedly exacerbated the acute toxicity of ibuprofen (IBU, 200 mg/kg) in the small intestine of mice, which was not due to the pregnane-X-receptor pathway...
December 8, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/29222667/drug-burden-and-its-association-with-falls-among-older-adults-in-new-zealand-a-national-population-cross-sectional-study
#7
Hamish A Jamieson, Prasad S Nishtala, Richard Scrase, Joanne M Deely, Rebecca Abey-Nesbit, Martin J Connolly, Sarah N Hilmer, Darrell R Abernethy, Philip J Schluter
BACKGROUND: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy. OBJECTIVES: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders. METHODS: We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over...
December 8, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29222479/gdf15-deficiency-exacerbates-chronic-alcohol-and-carbon-tetrachloride-induced-liver-injury
#8
Hyo Kyun Chung, Jung Tae Kim, Hyeon-Woo Kim, Minjoo Kwon, So Yeon Kim, Minho Shong, Koon Soon Kim, Hyon-Seung Yi
Growth differentiation factor 15 (GDF15) has recently been shown to have an important role in the regulation of mitochondrial function and in the pathogenesis of complex human diseases. Nevertheless, the role of GDF15 in alcohol-induced or fibrotic liver diseases has yet to be determined. In this study, we demonstrate that alcohol- or carbon tetrachloride (CCl4)-mediated hepatic GDF15 production ameliorates liver inflammation and fibrosis. Alcohol directly enhanced GDF15 expression in primary hepatocytes, which led to increased oxygen consumption...
December 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29222430/fisheries-independent-surveys-identify-critical-habitats-for-young-scalloped-hammerhead-sharks-sphyrna-lewini-in-the-rewa-delta-fiji
#9
Amandine D Marie, Cara Miller, Celso Cawich, Susanna Piovano, Ciro Rico
Sharp declines in numerous shark populations around the world have generated considerable interest in better understanding and characterising their biology, ecology and critical habitats. The scalloped hammerhead shark (SHS, Sphyrna lewini) is subject to a multitude of natural and anthropogenic threats that are often exacerbated within the coastal embayments and estuaries used during SHS early life stages. In this study, we describe the temporal and spatial distribution, age class composition, and reproductive biology of SHS in the Rewa Delta (RD), Fiji...
December 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29222404/lack-of-parkin-anticipates-the-phenotype-and-affects-mitochondrial-morphology-and-mtdna-levels-in-a-mouse-model-of-parkinson-s-disease
#10
Milena Pinto, Nadee Nissanka, Carlos T Moraes
PARK2 is the most common gene mutated in monogenic recessive familial cases of Parkinson's disease (PD). Pathogenic mutations cause a loss of function of the encoded protein Parkin. ParkinKO mice, however, poorly represent human PD symptoms as they only exhibit mild motor phenotypes, minor dopamine metabolism abnormalities, and no signs of dopaminergic neurodegeneration. Parkin has been shown to participate in mitochondrial turnover, by targeting damaged mitochondria, with low membrane potential, to mitophagy...
December 8, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#11
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222091/waste-management-informal-recycling-environmental-pollution-and-public-health
#12
Hong Yang, Mingguo Ma, Julian R Thompson, Roger J Flower
With rapid population growth, especially in low-income and middle-income countries, the generation of waste is increasing at an unprecedented rate. For example, annual global waste arising from waste electrical and electronic equipment alone will have increased from 33.8 to 49.8 million tonnes between 2010 and 2018. Despite incineration and other waste treatment techniques, landfill still dominates waste disposal in low-income and middle-income countries. There is usually insufficient funding for adequate waste management in these countries and uptake of more advanced waste treatment technologies is poor...
December 8, 2017: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29222078/texting-condolences-adapting-mhealth-programs-after-unexpected-pregnancy-and-infant-outcomes
#13
Jennifer A Unger, John Kinuthia, Grace John-Stewart
Mobile health (mHealth) short message system (SMS) interventions for maternal and child health (MCH) are being implemented globally. In many low- and middle-income settings in which these mHealth interventions are being rolled out, stillbirths and neonatal and infant deaths are common. It is important that mHealth solutions do not exacerbate emotional stress and pain by continuing with routine messaging for pregnancy or infant care when someone has experienced loss. In this brief viewpoint paper, we argue that SMS programs for maternal and child health need to adapt and make available messaging for miscarriage, stillbirth, and infant loss...
December 8, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29222055/autophagy-plays-a-protective-role-in-mn-induced-toxicity-in-pc12-cells
#14
Qian Zhou, Xiaolong Fu, Xueting Wang, Qin Wu, Yuanfu Lu, Jingshan Shi, James E Klaunig, Shaoyu Zhou
Excessive environmental or occupational exposure to manganese (Mn) is associated with increased risk of neuron degenerative disorders. Oxidative stress and mitochondrial dysfunction are the main mechanisms of Mn mediated neurotoxicity. Selective removal of damaged mitochondria by autophagy has been proposed as a protective mechanism against neuronal toxicant-induced neurotoxicity. Whether autophagic flux plays a role in Mn-induced cytotoxicity remains to be fully elucidated. The present study was designed to investigate the effect of Mn exposure on autophagy, and how modulation of autophagic flux alters the sensitivities of cells to Mn-elicited cytotoxicity...
December 6, 2017: Toxicology
https://www.readbyqxmd.com/read/29221752/chronic-nicotine-exposure-impairs-uncertainty-modulation-on-reinforcement-learning-in-anterior-cingulate-cortex-and-serotonin-system
#15
Zhengde Wei, Long Han, Xiuying Zhong, Ying Liu, Rujing Zha, Ying Wang, Li-Zhuang Yang, Junjie Bu, Hongwen Song, Wenjuan Wang, Yifeng Zhou, Ping Gao, Xiaochu Zhang
Deficits in the computational processes of reinforcement learning have been suggested to underlie addiction. Additionally, environmental uncertainty, which is encoded in the anterior cingulate cortex (ACC), modulates reward prediction errors (RPEs) during reinforcement learning and exacerbates addiction. The present study tested whether and how the ACC would have an essential role in drug addiction by failing to use uncertainty to modulate the RPEs during reinforcement learning. In Experiment I, we found that the ACC/medial prefrontal cortex (MPFC) did not modulate RPE learning according to uncertainty in smokers...
December 5, 2017: NeuroImage
https://www.readbyqxmd.com/read/29221643/respiratory-and-cardiovascular-responses-to-walking-down-a-traffic-polluted-road-compared-with-walking-in-a-traffic-free-area-in-participants-aged-60-years-and-older-with-chronic-lung-or-heart-disease-and-age-matched-healthy-controls-a-randomised-crossover
#16
Rudy Sinharay, Jicheng Gong, Benjamin Barratt, Pamela Ohman-Strickland, Sabine Ernst, Frank Kelly, Junfeng Jim Zhang, Peter Collins, Paul Cullinan, Kian Fan Chung
BACKGROUND: Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults...
December 5, 2017: Lancet
https://www.readbyqxmd.com/read/29221627/alkaline-diet-and-metabolic-acidosis-practical-approaches-to-the-nutritional-management-of-chronic-kidney-disease
#17
Larissa Rodrigues Neto Angéloco, Gabriela Cristina Arces de Souza, Elen Almeida Romão, Paula Garcia Chiarello
The kidneys play an extremely important role in maintaining the body acid-base balance by excreting nonvolatile acids and regenerating and reabsorbing bicarbonate in the kidney tubules. As the individual loses their kidney function, renal excretion of nonvolatile acid produced by metabolism of the diet is impaired, resulting in low-grade metabolic acidosis. With this in mind, it is relevant to better understand the dietary aspects related to the acid-base balance in chronic kidney disease metabolic acidosis and try to provide possible strategies for the nutritional management of these cases...
December 5, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29221624/international-medical-graduates-in-nephrology-roles-rules-and-future-risks
#18
Jeffrey S Berns, Muriel Ghosn, Rodolfo R Altamirano
International medical graduates (IMGs) have become an increasingly essential part of many residency and fellowship programs in the United States. IMGs, who may be of either US or non-US citizenship, contribute significantly to the physician workforce across this country, particularly in underserved areas, as well as in their home countries on their return after training. Approximately 65% of nephrology fellows are IMGs, with most of these being non-US citizens. Non-US IMG applications for nephrology fellowship have been declining, exacerbating an ongoing shortage of nephrology trainees...
December 5, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29221581/biomarkers-for-severe-eosinophilic-asthma
#19
REVIEW
Steven W Yancey, Oliver N Keene, Frank C Albers, Hector Ortega, Stewart Bates, Eugene R Bleecker, Ian Pavord
The last decade has seen the approval of several new biologics for the treatment of severe asthma-targeting specific endotypes and phenotypes. This review will examine how evidence generated from the mepolizumab clinical development program showed that blood eosinophil counts, rather than sputum or tissue eosinophil counts, evolved as a pharmacodynamic and predictive biomarker for the efficacy of treatment with mepolizumab in patients with severe eosinophilic asthma. Based on the available evidence and combined with clinical judgement, a baseline blood eosinophil threshold of 150 cells/μL or greater or a historical blood eosinophil threshold of 300 cells/μL or greater will allow selection of patients with severe eosinophilic asthma who are most likely to achieve clinically significant reductions in the rate of exacerbations with mepolizumab treatment...
December 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29221328/uncontrolled-and-under-diagnosed-asthma-in-a-damascus-shelter-during-the-syrian-crisis
#20
Yousser Mohammad, Shaaban Rafea, Youssef Latifeh, Ali Khaddam, Bisher Sawaf, Mhd Ismael Zakaria, Mohammad Sadek Al Masalmeh, Yaser Fawaz, Abdoulraouf Allaham, Imad Almani, Hiba El-Tarcheh, Ayham Ghazal, Ali Zaher, Hala Rifai, Hamed Joumah, S Dresden Glockler-Lauf, Teresa To
Background: Studies have shown that poor shelter or dwelling conditions may lead to deteriorations in health. Those with asthma may be more susceptible to compromised living conditions and stress leading to a higher risk of asthma exacerbations. To describe the asthma control and quality of life of individuals with diagnosed asthma living in a shelter in Damascus, Syria and estimate the prevalence of respiratory symptoms in shelter dwellers without diagnosed asthma. Methods: In this cross-sectional study, all individuals 5 years and older living in Al-Herjalleh shelter with diagnosed asthma were recruited to complete a questionnaire, which included items related to their respiratory symptoms, asthma exacerbations, exposure to asthma triggers, medication use, and health-related quality of life before and since entering the shelter...
September 2017: Journal of Thoracic Disease
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