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Multidisciplinary approach

Jifeng Liu, Tengfei Ma, Yilin Liu, Jian Zou, Mingzhong Gao, Ru Zhang, Jiang Wu, Shixi Liu, Heping Xie
The world is entering a new era of exploring and exploiting the deep-underground space. With humans poised to reach historical depths in the use of the deep Earth, it is essential to understand the effect of the deep-underground environment on the health of humans and other living organisms. This article outlines the history and development of biological research conducted in deep-underground laboratories and provides insight into future areas of investigation. Many deep-underground laboratories have investigated the effects of reduced cosmic ray muons flux, searching for rare events such as proton decay, dark matter particles, or neutrino interactions, but few have focused on the influence of the environmental factors in the deep-underground on living organisms...
August 8, 2018: Environment International
Liron Sinvani, Jessy Warner-Cohen, Andrew Strunk, Travis Halbert, Ruchika Harisingani, Colm Mulvany, Michael Qiu, Andrzej Kozikowski, Vidhi Patel, Tara Liberman, Maria Carney, Renee Pekmezaris, Gisele Wolf-Klein, Corey Karlin-Zysman
OBJECTIVES: To determine whether a multicomponent intervention improves care in hospitalized older adults with cognitive impairment. DESIGN: One-year retrospective chart review with propensity score matching on critical demographic and clinical variables was used to compare individauls with cognitive impairmenet on intervention and nonintervention units. SETTING: Large tertiary medical center. PARTICIPANTS: All hospitalized individuals age 65 and older with cognitive impairment admitted to medicine who required constant or enhanced observation for behavioral and psychological symptoms...
August 11, 2018: Journal of the American Geriatrics Society
Donna M Zulman, Colin W O'Brien, Cindie Slightam, Jessica Y Breland, David Krauth, Andrea L Nevedal
BACKGROUND: Intensive outpatient programs address the complex medical, social, and behavioral needs of individuals who account for disproportionate healthcare costs. Despite their promise, the impact of these programs is often diminished due to patient engagement challenges (i.e., low rates of patient participation and partnership in care). OBJECTIVE: The objective of this study was to identify intensive outpatient program features and strategies that increase high-need patient engagement in these programs...
August 10, 2018: Journal of General Internal Medicine
Cora Janzen, Josh Marko, Michael Schwandt
BACKGROUND: Population health approaches are visible among multidisciplinary methods used in urban design and planning, but attention to health equity is not always an explicit focus. Population and Public Health-Saskatoon Health Region recognized the need for frameworks to prioritize, integrate and measure health equity within local built environments. SETTING: A cross-department healthy built environment (HBE) initiative coordinated activities involving Health Promotion, Environmental Public Health, Public Health Observatory, and Medical Health Officers engaged with municipal, academic and community partners in Saskatoon, Saskatchewan...
August 10, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
Patrick Fitzgerald, Fred Kusumoto
AV conduction abnormalities are observed in 15-30% of patients with hypertrophic cardiomyopathy but are usually not severe enough to require permanent pacemaker implant. Both septal myectomy and alcohol septal ablation are effective options to relieve symptoms due to left ventricular outflow tract gradient in patients with hypertrophic cardiomyopathy but have procedure-specific effects on AV conduction and the His Purkinje system. Septal myectomy is associated with the development of LBBB in 50-100% of patients, while alcohol septal ablation is associated with RBBB in 37-70% of patients...
August 10, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Nicola Imperatore, Giancarlo Micheletto, Gianpiero Manes, Davide Giuseppe Redaelli, Elisa Reitano, Germana de Nucci
BACKGROUND: Hepatic hematoma (HH) is a rare but severe adverse event following endoscopic retrograde cholangiopancreatography (ERCP). AIMS: To perform a systematic literature review and describe two additional cases, one of which presenting multiple subcapsular/intrahepatic hematomas after ERCP. METHODS: The literature review was performed in PubMed/MEDLINE, EMBASE, and SCOPUS to identify all cases reporting on HH after ERCP. RESULTS: A total of 48 cases (females 63%, mean age 58...
July 20, 2018: Digestive and Liver Disease
Jesús Morón-López, Lucía Nieto-Reyes, Jorge Senán-Salinas, Serena Molina, Rehab El-Shehawy
Increased harmful cyanobacterial blooms and drought are some negative impacts of global warming. To deal with cyanotoxin release during water treatment, and to manage the massive quantities of end-of-life membrane waste generated by desalination processes, we propose an innovative biological system developed from recycled reverse osmosis (RO) membranes to remove microcystins (MC). Our system, named the Recycled-Membrane Biofilm Reactor (R-MBfR), effectively removes microcystins, while reducing the pollution impact of RO membrane waste by prolonging their life span at the same time...
August 1, 2018: Science of the Total Environment
Sabrina Santarsia, Ana Sofia Grosso, Filipa Trovão, Jesús Jiménez-Barbero, Ana Luísa Carvalho, Cristina Nativi, Filipa Marcelo
Overexpression of the Thomsen-Friedenreich (TF) antigen in cell membrane proteins occurs in 90% of adenocarcinomas. Additionally, the binding of the TF-antigen to human galectin-3 (Gal-3), also frequently overexpressed in malignancy, promotes cancer progression and metastasis. In this context, structures that interfere with this specific interaction display the potential to prevent cancer metastasis. Herein, a multidisciplinary approach, combining the optimized synthesis of a TF-antigen mimetic with NMR, X-ray crystallography methods and isothermal titration calorimetry assays has been employed to unravel the molecular structural details that govern the Gal-3/TF-mimetic interaction...
August 9, 2018: ChemMedChem
Anna Patrikidou, Pierre Maroun, Jean-Jacques Patard, Hervé Baumert, Laurence Albiges, Christophe Massard, Yohann Loriot, Bernard Escudier, Mario Di Palma, Julia Arfi-Rouche, Laurence Rocher, Zahira Merabet, Alberto Bossi, Karim Fizazi, Pierre Blanchard
Objectives: The initial treatment decision for newly diagnosed non-metastatic prostate cancer is complex. Multiple valid approaches exist, without a clear and absolute consensus for every clinical scenario, and therefore specialist opinions may vary. Multidisciplinary consultations focusing on shared decision-making aim to provide an apposite tool for the initial treatment decision. We have evaluated the first two years of activity of the Gustave Roussy Prostate Cancer Multidisciplinary Clinic (PCMC), dedicated to the initial decision-making for non-metastatic prostate cancer...
August 2018: Clinical and Translational Radiation Oncology
Tita Alissa Bach, Lars-Martin Berglund, Eva Turk
Objective: To provide an overview of documented studies and initiatives that demonstrate efforts to manage and improve alarm systems for quality in healthcare by human, organisational and technical factors. Methods: A literature review, a grey literature review, interviews and a review of alarm-related standards (IEC 60601-1-8, IEC 62366-1:2015 and ANSI/Advancement of Medical Instrumentation HE 75:2009/2013) were conducted. Qualitative analysis was conducted to identify common themes of improvement elements in the literature and grey literature reviews, interviews and the review of alarm-related standards...
2018: BMJ Open Quality
Matthew P M Graham-Brown, Cristina Vasilica, Tom Oates, Ben Light, Christian Clausner, Apostolos Antonacoloulos, Lydia Y J Chen, Paula Ormandy, Jonathan Barratt
Background: IgA nephropathy is the most common cause of glomerulonephritis in the Western world and predominantly affects young adults. Demographically these patients are the biggest users of social media. With increasing numbers of patients turning to social media to seek information and support in dealing with their disease, analysis of social media streams is an attractive modern strategy for understanding and responding to unmet patient need. Methods: To identify unmet patient need in this population, a framework analysis will be undertaken of prospectively acquired social media posts from patients with IgA nephropathy, acquired from a range of different social media platforms...
August 2018: Clinical Kidney Journal
Ioan Lancrajan, Ioan Lisencu, Laurentiu Ignat, Rares Trisca, Madalina Coman, Floarea Mocean
Background: The quality of medical care, as well as the application of effective treatments in the management of patients with gynecologic neoplasm, is of great importance. Finding new and efficient ways of communication between the doctors involved in the multidisciplinary team for the management of the disease, from the diagnosis to the reintegration into society, would help improve the quality of comprehensive patient care. Objective: The objective of the study was to assess the collaboration of family physicians with specialists treating patients suffering from gynecologic cancer, in order to improve the relationship between them via electronic communication...
July 2018: Clujul Medical (1957)
Dr Ee-Yuee Chan, Ms Leting Isabella Hong, Ms Ying-Hua Grace Tan, Wei-Ling Chua
Maximizing the functional ability of older patients through participation in physical activities during hospitalization could prevent functional decline. This study describes nurses' perceptions of facilitators and barriers to hospitalized older patients' physical activity participation in an acute Asian setting. An exploratory qualitative study employing thematic analysis was used. Semi-structured, audio recorded, focus group interviews on 30 nurses from a hospital in Singapore, were conducted until data saturation...
August 6, 2018: Geriatric Nursing
Lisa Kumar, Amanda H Kumar, Stuart A Grant, Jeff Gadsden
Enhanced recovery after surgery (ERAS) programs for orthopedics involve a multidisciplinary approach to accelerating return to function, reducing pain, improving patient comfort and satisfaction, reducing complications from the surgical procedure, reducing hospital length of stay, and reducing costs. ERAS pathways for patients receiving total knee arthroplasty are different from those having intracavitary surgery; they are less focused on fluid homeostasis and gut motility than they are with optimizing systemic and local analgesics and providing a balance between the highest quality pain control and accelerated return to ambulation...
September 2018: Anesthesiology Clinics
Rebecca O'Hara, Heather Rowe, Louise Roufeil, Jane Fisher
Objective The aim of this study was to determine whether endometriosis meets the definition for chronic disease in Australian policy documents. Methods A qualitative case study approach was used to thematically analyse the definitions contained in Australian chronic disease policy documents and technical reports. The key themes were then compared with descriptions of endometriosis in peer-reviewed literature, clinical practice guidelines and expert consensus statements. Results The search yielded 18 chronic disease documents that provided a definition or characteristics of chronic disease...
August 10, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Jaume Flexas, Jorge Gago
Plant Ecophysiology is the study on how Plant Physiology is modulated by the environment. This discipline could have benefited greatly from the development of the different 'omic' technologies (from genomics to metabolomics). Instead, the overall impression is that ecophysiology and 'omics' have developed mostly independent each other. Here we provide a literature analysis over the past twenty years which fully confirms this view. Then, we review a few examples of studies in which ecophysiology and 'omics' studies have combined to different extents to illustrate the potential benefits from their mutualistic interaction...
August 9, 2018: Plant Journal: for Cell and Molecular Biology
Peiman Habibollahi, Stephen Hunt, Therese Bitterman, Terence P Gade, Michael C Soulen, Gregory Nadolski
PURPOSE: Since the change in the United Network for Organ Sharing (UNOS) policy excluding patients with very early stage hepatocellular carcinoma (veHCC, single tumor nodule <2 cm) from receiving Model for End-stage Liver Disease (MELD) exception points, patients eligible to receive liver transplantation (LT) who fall in this category are commonly treated with locoregional therapy (LRT) after progression to UNOS T2 stage (1 nodule of 2-5 cm or up to 3 nodules, none above 3 cm). The aim of the current study is to compare the outcomes of patients treated with bridging LRT and LT with wait-and-not-treat approach with patients treated with definitive LRT...
July 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Jose L Sanmillan, Pablo Lopez-Ojeda, Isabel Fernández-Conejero, Alejandro Fernández-Coello, Gerard Plans, Yara Ali-Ciurana, Andreu Gabarrós
BACKGROUND: Eloquent area surgery has become safer with the development of intraoperative neurophysiological monitoring and brain mapping techniques. However, the usefulness of intraoperative electric brain stimulation techniques applied to the management and surgical treatment of cavernous malformations in supratentorial eloquent areas is still not proven. With this study, we aim to describe our experience with the use of a tailored functional approach to treat cavernous malformations in supratentorial eloquent areas...
August 8, 2018: Acta Neurochirurgica
Zahra Enshaei, Maede Ghasemi
The management of traumatic dental injuries as well as crown-root fractures is always challenging in everyday general dental practice. A number of treatment modalities are available for crown-root fractures, depending on the position, extent and severity of the fracture. The aim of this case report was to describe a clinical case of rehabilitation of a complicated crown-root fracture of the maxillary left central incisor, successfully treated by a multidisciplinary approach including orthodontic extrusion. The final result was esthetically pleasant and periodontally sound in the follow ups...
May 2018: Journal of Dentistry of Tehran University of Medical Sciences
Amir Kazory, Peter A McCullough, Janani Rangaswami, Claudio Ronco
The field of cardiorenal medicine is vast, rapidly expanding, and complex. Conventional nephrology training programs provide the fellows with the necessary core knowledge to provide general care for patients with renal and cardiovascular diseases. However, there is a need for focused training of interested physicians to master the specialized aspects of these exceedingly common clinical scenarios and optimize the care of such patients. A cardionephrology-focused training can add value to the nephrology subspecialty and potentially increase its attractiveness for a significant subset of trainees...
August 8, 2018: Cardiorenal Medicine
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