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Imran Hameed Khaliq, Hafiz Zahid Mahmood, Naveed Akhter, Muhammad Danish Sarfraz, Khadija Asim, Khalid Masood Gondal
PURPOSE: Breast cancer is one of the major causes of death incurring highest morbidity and mortality amongst women of Pakistan. The purpose of this study was to assess and compare the role of two public sector tertiary care hospitals' management in reducing out of pocket (OOP) expenses on direct medical costs borne by breast carcinoma patients' household from diagnosis through treatment. Moreover, the study intended to explore the reasons of opting private diagnostic facilities by the said patients during the services taken from the foresaid tertiary care centers...
January 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Nishant Saran, Chaim Locker, Sameh M Said, Richard C Daly, Simon Maltais, John M Stulak, Kevin L Greason, Alberto Pochettino, Hartzell V Schaff, Joseph A Dearani, Lyle D Joyce, Brian D Lahr, David L Joyce
BACKGROUND: We sought to identify the trends in bilateral internal thoracic artery use and determine the degree to which the survival advantage of bilateral internal thoracic artery revascularization persists among perceived "high-risk" patients, compared with the use of left internal thoracic artery alone. METHODS: A retrospective review was conducted of patients who underwent isolated coronary artery bypass grafting for multivessel coronary artery disease at the Mayo Clinic between January 2000 and December 2015...
February 23, 2018: Journal of Thoracic and Cardiovascular Surgery
A Budzynska, M Gawron-Kiszka, E Nowakowska-Dulawa, J Spiewak, M Lesinska, M Kukla, M Waluga, M Hartleb
Serum neutrophil gelatinase-associated lipocalin (NGAL) is a low molecular weight protein released from activated neutrophils and intestine epithelium whose mRNA expression is increased in inflamed intestinal tissue. The purpose of this study was to explore the relationship between serum NGAL level and activity of inflammatory bowel diseases. A total of 120 patients, 79 with Crohn's disease (CD) and 41 with ulcerative colitis (UC) were prospectively included into the study. Serum NGAL was measured by ELISA...
December 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
John R Sims, Travis E Grotz, Barbara A Pockaj, Richard W Joseph, Robert L Foote, Clark C Otley, Amy L Weaver, James W Jakub, Daniel L Price
BACKGROUND: Merkel cell carcinoma (MCC) is a rare cutaneous malignancy of neuroendocrine origin with a high propensity for lymph node metastasis. Sentinel lymph node (SLN) status is important for accurate staging; however, the optimal treatment following SLN biopsy, regardless of nodal status, remains unclear. METHODS: 150 patients with MCC who underwent SLN biopsy from 1995 to 2011 at 3 Mayo Clinic sites were reviewed. RESULTS: Of 150 patients with MCC who underwent SLN biopsy, 39 (26%) were positive and 111 (74%) were negative...
March 2018: Surgical Oncology
Palak J Trivedi, Ralf Kiesslich, James Hodson, Neeraj Bhala, Ralph A Boulton, Rachel Cooney, Xianyong Gui, Tariq Iqbal, Ka-Kit Li, Saqib Mumtaz, Shri Pathmakanthan, Mohammed Nabil Quraishi, Vandana M Sagar, Ashit Shah, Naveen Sharma, Keith Siau, Samuel Smith, Stephen Ward, Monika M Widlak, Raf Bisschops, Subrata Ghosh, Marietta Iacucci
INTRODUCTION: Electronic virtual chromoendoscopy (EVC) can demonstrate ongoing disease activity in ulcerative colitis (UC), even when Mayo subscores suggest healing. However, applicability of EVC technology outside the expert setting has yet to be determined. METHODS: 15 participants across 5 centers reviewed a computerized training module outlining high-definition (HD) and EVC (i-Scan) colonoscopy modes. Interobserver agreement was then tested (Mayo score, UCEIS and the Paddington International virtual ChromoendoScopy ScOre [PICaSSO] for UC), using a colonoscopy video library (n=30 cases reviewed pre- and n=30 post-training)...
March 13, 2018: Gastrointestinal Endoscopy
Alexandra M V Wennberg, Clinton E Hagen, Mary M Machulda, John H Hollman, Rosebud O Roberts, David S Knopman, Ronald C Petersen, Michelle M Mielke
Levels of insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, and their ratio in the blood may be useful for monitoring those at risk of cognitive and functional decline. However, the association between IGF measures and functional and cognitive outcomes has been mixed, and the associations may vary by sex. The present study investigated the cross-sectional, sex-specific associations between serum measures total IGF-1, IGFBP-3, and the IGF-1/IGFBP-3 ratio, gait speed, and cognition in 1320 cognitively unimpaired participants aged 50-95 years enrolled in the Mayo Clinic Study of Aging...
February 19, 2018: Neurobiology of Aging
Marco A Moro-García, Juan C Mayo, Rosa M Sainz, Rebeca Alonso-Arias
T lymphocytes, from their first encounter with their specific antigen as naïve cell until the last stages of their differentiation, in a replicative state of senescence, go through a series of phases. In several of these stages, T lymphocytes are subjected to exponential growth in successive encounters with the same antigen. This entire process occurs throughout the life of a human individual and, earlier, in patients with chronic infections/pathologies through inflammatory mediators, first acutely and later in a chronic form...
2018: Frontiers in Immunology
Jason W Sahl, Mark Mayo, Erin P Price, Derek S Sarovich, Mirjam Kaestli, Talima Pearson, Charles H D Williamson, Roxanne Nottingham, Krystal Sheridan, David M Wagner, Bart J Currie, Paul Keim
The Burkholderia pseudomallei isolate MSHR1435 is a fully virulent environmental sequence type 131 (ST131) isolate that is epidemiologically associated with a 17.5-year chronic melioidosis infection. The completed genome will serve as a reference for studies of environmental ecology, virulence, and chronic B. pseudomallei infections.
March 15, 2018: Genome Announcements
Marnie J Meylor de Mooij, Rachael L Hodny, Daniel A O'Neil, Matthew R Gardner, Mekayla Beaver, Andrea T Brown, Barbara A Barry, Lorna M Ross, Amy J Jasik, Katharine M Nesbitt, Susan M Sobolewski, Susan M Skinner, Rajeev Chaudhry, Brian C Brost, Bobbie S Gostout, Roger W Harms
Using a human-centered design method, our team sought to envision a new model of care for women experiencing low-risk pregnancy. This model, called OB Nest, aimed to demedicalize the experience of pregnancy by providing a supportive and empowering experience that fits within patients' daily lives. To explore this topic, we invited women to use self-monitoring tools, a text-based smartphone application to communicate with their care team, and moderated online communities to connect with other pregnant women...
March 9, 2018: Mayo Clinic Proceedings
Bei Tan, Pan Li, Hong Lv, Hong Yang, Yue Li, Ji Li, Ou Wang, Jiaming Qian
AIMS: To assess the necessity and efficacy of vitamin D supplementation in Chinese inflammatory bowel disease (IBD) patients with vitamin D insufficiency/deficiency. METHODS: Seventy-four ulcerative colitis (UC) patients and 71 Crohn's disease (CD) patients were randomly assigned into one of 3 arms for 12 months: Arm A (vitamin D3 150000IU per 3 months plus calcium 600mg oral daily); Arm B (calcium 600mg oral daily), and Arm C (vehicle control group), all in addition to conventional IBD treatment...
March 15, 2018: Journal of Digestive Diseases
Rizwan Haider, Muhammad Salman Bashir, Muhammad Adeel, Muhammad Junaid Ijaz, Azhar Ayub
OBJECTIVE: To determine the effect of conservative exercise therapy with and without Maitland thoracic manipulation in patients with subacromial pain. METHODS: The randomised controlled trial study was conducted at the Mayo Hospital, Lahore, Pakistan, from June 2015 to February 2016, and comprised patients with subacromial pain (group 1) and controls (group 2).Pre-assessment was done by using numeric pain rating scale and shoulder pain and disability index as subjective measurements, while range of motion was taken as objective measurement...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Thomas J Whitaker, Charles S Mayo, Daniel J Ma, Michael G Haddock, Robert C Miller, Kimberly S Corbin, Michelle Neben-Wittich, James L Leenstra, Nadia N Laack, Mirek Fatyga, Steven E Schild, Carlos E Vargas, Katherine S Tzou, Austin R Hadley, Steven J Buskirk, Robert L Foote
Patient- and provider-reported outcomes are recognized as important in evaluating quality of care, guiding health care policy, comparative effectiveness research, and decision-making in radiation oncology. Combining patient and provider outcome data with a detailed description of disease and therapy is the basis for these analyses. We report on the combination of technical solutions and clinical process changes at our institution that were used in the collection and dissemination of this data. This initiative has resulted in the collection of treatment data for 23 541 patients, 20 465 patients with provider-based adverse event records, and patient-reported outcome surveys submitted by 5622 patients...
March 12, 2018: Journal of Radiation Research
Peter M Irving, Tariq Iqbal, Chuka Nwokolo, Sreedhar Subramanian, Stuart Bloom, Neeraj Prasad, Ailsa Hart, Charles Murray, James O Lindsay, Adam Taylor, Rachel Barron, Stephen Wright
Background: Cannabidiol (CBD) exhibits anti-inflammatory properties that could improve disease activity in inflammatory bowel disease. This proof-of-concept study assessed efficacy, safety and tolerability of CBD-rich botanical extract in ulcerative colitis (UC) patients. Methods: Patients aged 18 years or older, with left-sided or extensive UC, Mayo scores of 4-10 (endoscopy scores ≥1), and on stable 5-aminosalicylic acid dosing, were randomized to 10-weeks' CBD-rich botanical extract or placebo capsules...
March 10, 2018: Inflammatory Bowel Diseases
Clara Gregori-Pla, Gianluca Cotta, Igor Blanco, Peyman Zirak, Martina Giovannella, Anna Mola, Ana Fortuna, Turgut Durduran, Mercedes Mayos
MOTIVATION: Obstructive sleep apnea (OSA) can impair cerebral vasoreactivity and is associated with an increased risk of cerebrovascular disease. Unfortunately, an easy-to-use, non-invasive, portable monitor of cerebral vasoreactivity does not exist. Therefore, we have evaluated the use of near-infrared diffuse correlation spectroscopy to measure the microvascular cerebral blood flow (CBF) response to a mild head-of-bed position change as a biomarker for the evaluation of cerebral vasoreactivity alteration due to chronic OSA...
2018: PloS One
Volha Dziadzko, Marie-Annick Clavel, Mikhail Dziadzko, Jose R Medina-Inojosa, Hector Michelena, Joseph Maalouf, Vuyisile Nkomo, Prabin Thapa, Maurice Enriquez-Sarano
BACKGROUND: Mitral regurgitation is the most common valve disease worldwide but whether the community-wide prevalence, poor patient outcomes, and low rates of surgical treatment justify costly development of new therapeutic interventions remains uncertain. Therefore, we did an observational cohort study to assess the clinical characteristics, outcomes, and degree of undertreatment of mitral regurgitation in a community setting. METHODS: We used data from Mayo Clinic electronic health records and the Rochester Epidemiology Project to identify all cases of moderate or severe isolated single-valvular mitral regurgitation (with no other severe left-sided valvular disease or previous mitral surgery) diagnosed during a 10-year period in the community setting in Olmsted County (MN, USA)...
March 10, 2018: Lancet
Thomas K F Foo, Evangelos Laskaris, Mark Vermilyea, Minfeng Xu, Paul Thompson, Gene Conte, Christopher Van Epps, Christopher Immer, Seung-Kyun Lee, Ek T Tan, Dominic Graziani, Jean-Baptise Mathieu, Christopher J Hardy, John F Schenck, Eric Fiveland, Wolfgang Stautner, Justin Ricci, Joseph Piel, Keith Park, Yihe Hua, Ye Bai, Alex Kagan, David Stanley, Paul T Weavers, Erin Gray, Yunhong Shu, Matthew A Frick, Norbert G Campeau, Joshua Trzasko, John Huston, Matt A Bernstein
PURPOSE: To build and evaluate a small-footprint, lightweight, high-performance 3T MRI scanner for advanced brain imaging with image quality that is equal to or better than conventional whole-body clinical 3T MRI scanners, while achieving substantial reductions in installation costs. METHODS: A conduction-cooled magnet was developed that uses less than 12 liters of liquid helium in a gas-charged sealed system, and standard NbTi wire, and weighs approximately 2000 kg...
March 13, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Patama Gomutbutra, Kittika Kanjanaratanakorn, Nantaporn Tiyapun
Background: Previous studies have shown that Parkinson's disease (PD) patients who have REM behavior disorder (PD with RBD) might be a PD subtype since they have different symptom clusters and disease trajectories from PD without RBD. Objective: To study the prevalence of PD with pRBD and to compare the clinical characteristics with PD without pRBD. The feasibility of clinical interview of items adopted from the Mayo Sleep Questionnaire was also to be determined...
2018: Parkinson's Disease
Stephen Brimijoin, Yang Gao, Liyi Geng, Vicky P Chen
Butyrylcholinesterase (BChE), a plasma enzyme that hydrolyses the neurotransmitter, acetylcholine relatively well, with far lower efficiency than acetylcholinesterase (AChE) but with the capability to degrade a broad range of bioactive esters. AChE is universally understood as essential to cholinergic neurotransmission, voluntary muscle performance, and cognition, among other roles, and its catalytic impact is essential for life. A total absence of BChE activity, whether by enzyme inhibition or simple lack of enzyme protein is not only compatible with life, but does not lead to obvious physiologic disturbance...
2018: Frontiers in Pharmacology
Diego Z Carvalho, Erik K St Louis, David S Knopman, Bradley F Boeve, Val J Lowe, Rosebud O Roberts, Michelle M Mielke, Scott A Przybelski, Mary M Machulda, Ronald C Petersen, Clifford R Jack, Prashanthi Vemuri
Importance: Aging is associated with excessive daytime sleepiness (EDS), which has been linked to cognitive decline in the elderly. However, whether EDS is associated with the pathologic processes of Alzheimer disease remains unclear. Objective: To investigate whether EDS at baseline is associated with a longitudinal increase in regional β-amyloid (Aβ) accumulation in a cohort of elderly individuals without dementia. Design, Setting, and Participants: This prospective analysis included participants enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study in Olmsted County, Minnesota...
March 12, 2018: JAMA Neurology
Kay Dickersin, Evan Mayo-Wilson
We find standards useful in everyday life and in science, although we do not always follow them. Adopting new standards can be expensive, so there may be a strong incentive to maintain the status quo rather than adopt new standards. The scientific community has many standards encompassing both doing clinical research and reporting it, including standards for design and measurement. Although existing research standards have improved both research and its reporting, we need to unify existing standards and to fill the gaps between steps throughout the research process...
March 13, 2018: Proceedings of the National Academy of Sciences of the United States of America
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