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https://www.readbyqxmd.com/read/29350771/recombinant-relaxin-protects-liver-transplants-from-ischemia-damage-via-hepatocyte-glucocorticoid-receptor-from-bench-to-bedside
#1
Shoichi Kageyama, Kojiro Nakamura, Takehiro Fujii, Bibo Ke, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI) represents a major risk factor of early graft dysfunction and acute/chronic rejection as well as a key obstacle to expanding the donor pool in orthotopic liver transplantation (OLT). Although glucocorticoid receptor (GR) signaling may enhance cytoprotective programs, clinical use of glucocorticoid is limited due to adverse effects, while clinical relevance of GR-facilitated cytoprotection in OLT remains unknown. We aimed to evaluate the significance of hepatic GR in clinical OLT and verify the impact of recombinant human relaxin (rhRLX), which may function as GR agonist in tissue/disease-specific manner...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29301343/the-neonatal-intensive-care-unit-environmental-stressors-and-supports
#2
Kristen G Williams, Kayla T Patel, Julie M Stausmire, Christy Bridges, Mary W Mathis, Jennifer L Barkin
The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six (n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically...
January 3, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29276214/new-perspective-on-the-treatment-of-intractable-gastrointestinal-cancers-role-of-combination-therapies
#3
Dan G Duda
Unresectable gastrointestinal cancers, such as gastric, hepatocellular, biliary tract or pancreatic carcinomas, are often resistant to anti-cancer systemic therapies, and often recur locally or even after aggressive local therapies leading to dismal survival rates. Recent developments in oncology, have offered renewed hoped for the development of more efficacious therapies. For example, our understanding of the oncogenic drivers in carcinogenesis has increased exponentially, and may potentially allow personalization of therapy...
2017: Keio Journal of Medicine
https://www.readbyqxmd.com/read/29261516/neonatal-neuroprotection-bringing-best-practice-to-the-bedside-in-the-nicu
#4
Terrie Lockridge
Preterm birth interrupts the precise process of fetal maturation, forcing critical neurologic growth to continue within the Neonatal Intensive Care Unit (NICU). Concern for the impact of the NICU experience on the developing brain led to a unit-based Quality Improvement (QI) project to promote best outcomes for our graduates. The objective was to implement a standard of care for neonatal neuroprotection in a large urban tertiary center. A multidisciplinary committee researched and developed the Neonatal Neuroprotective Best Practice Guidelines to identify optimal interventions, as well as provide physiologic rationales to reinforce importance of these practices...
December 19, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/29210766/tele-icu-and-patient-safety-considerations
#5
Erkan Hassan
The tele-ICU is designed to leverage, not replace, the need for bedside clinical expertise in the diagnosis, treatment, and assessment of various critical illnesses. Tele-ICUs are primarily decentralized or centralized models with differing advantages and disadvantages. The centralized model has sufficiently powered published data to be associated with improved mortality and ICU length of stay in a cost-effective manner. Factors associated with improved clinical outcomes include improved compliance with best practices; providing off-hours implementation of the bedside physician's care plan; and identification of and rapid response to physiological instability (initial clinical review within 1 hour) and rapid response to alerts, alarms, or direct notification by bedside clinicians...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29172797/infertility-providers-and-patients-views-and-experiences-concerning-doctor-shopping-in-the-usa
#6
Robert Klitzman
Many questions arise concerning how infertility patients decide whether, how much and why or why not to consult more than one doctor and change physicians. To explore this issue, a total of 37 US in vitro fertilization (IVF) providers and patients were interviewed in-depth. Many infertility patients feel disappointed with infertility providers, especially after treatment failure, and then struggle to evaluate and weigh relative 'bedside manner' against technical skills, finances and hope, facing dilemmas of which doctor to choose, whether and how much, to 'shop around', how to do so, and whether and how much to give doctors 'second chances'...
November 26, 2017: Human Fertility: Journal of the British Fertility Society
https://www.readbyqxmd.com/read/29065748/twelve-tips-for-teaching-quality-improvement-in-the-clinical-environment
#7
Maya Narayanan, Andrew A White, Thomas H Gallagher, Somnath Mookherjee
Medical educators are expected to teach quality improvement (QI) skills alongside traditional clinical skills such as physical examination and bedside manner. Educational resources for intensive training in QI have proliferated. However, many physicians lack the time or resources to undergo this training, and may struggle with teaching these skills to their learners. In response, we offer twelve tips to help physicians teach basic QI concepts in the clinical environment. By following these tips physicians will be able to engage their learners interest in QI and provide experiential learning that makes a lasting impact...
October 24, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29054476/extracellular-vesicles-as-emerging-targets-in-cancer-recent-development-from-bench-to-bedside
#8
REVIEW
Kerui Wu, Fei Xing, Shih-Ying Wu, Kounosuke Watabe
Extracellular vesicles (EVs) have emerged as important players of cancer initiation and progression through cell-cell communication. They have been recognized as critical mediators of extracellular communications, which promote transformation, growth invasion, and drug-resistance of cancer cells. Interestingly, the secretion and uptake of EVs are regulated in a more controlled manner than previously anticipated. EVs are classified into three groups, (i) exosomes, (ii) microvesicles (MVs), and (iii) apoptotic bodies (ABs), based on their sizes and origins, and novel technologies to isolate and distinguish these EVs are evolving...
December 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29030678/clock-drawing-test-as-a-bedside-assessment-of-post-operative-delirium-risk-in-elderly-patients-with-accidental-hip-fracture
#9
Claudia C Vasilian, Simona C Tamasan, Diana Lungeanu, Dan V Poenaru
BACKGROUND: Currently applied cognitive tests for assessing the risk of post-operative delirium require time and specialised medical staff, in addition to the patients' mental strain. We investigated the four-point scoring Clock-Drawing Test (CDT-4) as a preoperative independent predictor for post-operative delirium. METHODS: A total of 100 consecutive patients aged over 65 years admitted for accidental hip fracture were assessed for delirium using the Confusion Assessment Method Scale...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28981971/team-science-and-the-physician-scientist-in-the-age-of-grand-health-challenges
#10
REVIEW
Clifford J Steer, Peter R Jackson, Hortencia Hornbeak, Catherine K McKay, P Sriramarao, Michael P Murtaugh
Despite remarkable advances in medical research, clinicians face daunting challenges from new diseases, variations in patient responses to interventions, and increasing numbers of people with chronic health problems. The gap between biomedical research and unmet clinical needs can be addressed by highly talented interdisciplinary investigators focused on translational bench-to-bedside medicine. The training of talented physician-scientists comfortable with forming and participating in multidisciplinary teams that address complex health problems is a top national priority...
September 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28979801/the-role-of-dickkopf-family-in-cancers-from-bench-to-bedside
#11
REVIEW
You-Cheng Shao, Yan Wei, Jin-Fang Liu, Xiao-Yan Xu
Numerous epidemiological studies indicate that cancer will be responsible for millions of deaths in one year. Although multiple therapeutic strategies exist, and vast research efforts are being focused on developing newer and better regimens, cancer-related morbidity and mortality remain high. Metastasis and recurrence are prominent causes of treatment failure in cancers. Moreover, early diagnosis and treatment initiation are difficult to achieve in clinical practice. Fortunately, targeted therapy, which exerts its function at the molecular level, has proved to be greatly beneficial in several human diseases including cancers...
2017: American Journal of Cancer Research
https://www.readbyqxmd.com/read/28959777/improving-mrcp-paces-pass-rates-through-the-introduction-of-a-regional-multifaceted-support-framework
#12
Richard Jerrom, Tayeba Roper, Narasimha Murthy
INTRODUCTION: Practical Assessment of Clinical Examination Skills (PACES) constitutes the final part of the mandatory Royal College of Physicians exam series for progression to higher specialty training. Pass rates were lower for core medical trainees (CMTs) in Coventry and Warwickshire in comparison to other regions within the West Midlands and nationally. OBJECTIVES: Our aim was to improve pass rates in the region through the introduction of a stimulating and supportive teaching framework, designed to enhance the quality and frequency of PACES teaching...
2017: BMJ Open Quality
https://www.readbyqxmd.com/read/28956551/a-return-to-humane-medicine-osler-s-legacy
#13
Lucia Craxì, Simona Giardina, Antonio Gioacchino Spagnolo
Sir William Osler is celebrated today not only for his contributions to the advancement of medical education, but also for the humanism he brought to the practice of medicine. He was a doctor whose bedside skills and manners were emulated, and can legitimately be called an infectious diseases specialist. Nonetheless, he was also a humanist in the broader sense of the term, a student of human affairs and human nature, who emphasised compassion for the individual. To what extent, if any, are today's challenges influenced by departures from the paradigms created by Osler? In this paper we sought to ascertain whether such a tradition is still relevant to current practice and may foster a new perspective...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28947683/headspace-volatile-organic-compounds-from-bacteria-implicated-in-ventilator-associated-pneumonia-analysed-by-td-gc-ms
#14
Oluwasola Lawal, Howbeer Muhamadali, Waqar Ahmed, Iain R White, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Ventilator-associated pneumonia (VAP) is a healthcare-acquired infection arising from the invasion of the lower respiratory tract by opportunistic pathogens in critically ill ventilated patients. The current method of diagnosis requires the culture of an airway sample such as bronchoalveolar lavage, which is invasive to obtain and may take up to seven days to identify a causal pathogen, or indeed rule out infection. While awaiting results, patients are administered empirical antibiotics; risks of this approach include lack of effect on the causal pathogen, contribution to the development of antibiotic resistance and downstream effects such as increased length of intensive care stay, cost, morbidity and mortality...
September 26, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28945643/variation-in-spine-surgeon-selection-criteria-between-neurosurgery-and-orthopedic-surgery-patients
#15
Fady Y Hijji, Ankur S Narain, Brittany E Haws, Christopher D Witiw, Krishna T Kudaravalli, Kelly H Yom, Harel Deutsch, Kern Singh
STUDY DESIGN: A cross-sectional survey study. OBJECTIVE: The objective of this study is to determine if there are any differences in spine surgeon selection criteria between neurosurgery patients and orthopedic patients. BACKGROUND INFORMATION: The evolution of the health care delivery system has allowed for increased patient autonomy in provider selection. However, the process and criteria by which patients choose particular spine surgeons is not well understood...
September 22, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28924919/use-of-accessible-examination-tables-in-the-primary-care-setting-a-survey-of-physical-evaluations-and-patient-attitudes
#16
Megan A Morris, Allysha C Maragh-Bass, Joan M Griffin, Lila J Finney Rutten, Tara Lagu, Sean Phelan
BACKGROUND: Accessible diagnostic equipment, including height-adjustable examination tables, is necessary to accommodate patients with disabilities. Studies demonstrate that only a minority of clinics provide accessible equipment. For clinics with this equipment, no studies have examined the use of such equipment in routine clinical care. OBJECTIVE: In primary care clinics with and without height-adjustable examination tables, we compared the frequency and variation in physical evaluations on examination tables and patients' perceptions of quality care...
December 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28885901/bedside-manners-how-to-deal-with-delirium
#17
EDITORIAL
Rudi G J Westendorp
No abstract text is available yet for this article.
September 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28862551/isolated-abducens-nerve-palsy-associated-with-subarachnoid-hemorrhage-a-localizing-sign-of-ruptured-posterior-inferior-cerebellar-artery-aneurysms
#18
Jan-Karl Burkhardt, Ethan A Winkler, George F Lasker, John K Yue, Michael T Lawton
OBJECTIVE Compressive cranial nerve syndromes can be useful bedside clues to the diagnosis of an enlarging intracranial aneurysm and can also guide subsequent evaluation, as with an acute oculomotor nerve (cranial nerve [CN] III) palsy that is presumed to be a posterior communicating artery aneurysm and a surgical emergency until proven otherwise. The CN VI has a short cisternal segment from the pontomedullary sulcus to Dorello's canal, remote from most PICA aneurysms but in the hemodynamic pathway of a rupturing PICA aneurysm that projects toward Dorello's canal...
September 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28836828/navigating-the-social-synapse-the-neurobiology-of-bedside-manner
#19
Sophia Parnas, Sophie Isobel
OBJECTIVES: This paper seeks to explore the application of neurobiology to further understanding the importance of developing, refining and modelling good bedside manner in psychiatry. The concept of a social synapse is used as a framework to understand the impact of verbal and non-verbal information that crosses between two attuned individuals. Research shows that widely distributed cortical and subcortical networks are involved in processing of social information and the perception of safety...
August 1, 2017: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/28713235/connecting-the-brain-to-itself-through-an-emulation
#20
Mijail D Serruya
Pilot clinical trials of human patients implanted with devices that can chronically record and stimulate ensembles of hundreds to thousands of individual neurons offer the possibility of expanding the substrate of cognition. Parallel trains of firing rate activity can be delivered in real-time to an array of intermediate external modules that in turn can trigger parallel trains of stimulation back into the brain. These modules may be built in software, VLSI firmware, or biological tissue as in vitro culture preparations or in vivo ectopic construct organoids...
2017: Frontiers in Neuroscience
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