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https://www.readbyqxmd.com/read/28205271/lean-six-sigma-methodologies-improve-clinical-laboratory-efficiency-and-reduce-turnaround-times
#1
Tamer C Inal, Ozlem Goruroglu Ozturk, Filiz Kibar, Salih Cetiner, Selcuk Matyar, Gulcin Daglioglu, Akgun Yaman
BACKGROUND: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. METHODS: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems...
February 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28165510/stat2-is-an-essential-adaptor-in-usp18-mediated-suppression-of-type-i-interferon-signaling
#2
Kei-Ichiro Arimoto, Sara Löchte, Samuel A Stoner, Christoph Burkart, Yue Zhang, Sayuri Miyauchi, Stephan Wilmes, Jun-Bao Fan, Jürgen J Heinisch, Zhi Li, Ming Yan, Sandra Pellegrini, Frédéric Colland, Jacob Piehler, Dong-Er Zhang
Type I interferons (IFNs) are multifunctional cytokines that regulate immune responses and cellular functions but also can have detrimental effects on human health. A tight regulatory network therefore controls IFN signaling, which in turn may interfere with medical interventions. The JAK-STAT signaling pathway transmits the IFN extracellular signal to the nucleus, thus resulting in alterations in gene expression. STAT2 is a well-known essential and specific positive effector of type I IFN signaling. Here, we report that STAT2 is also a previously unrecognized, crucial component of the USP18-mediated negative-feedback control in both human and mouse cells...
February 6, 2017: Nature Structural & Molecular Biology
https://www.readbyqxmd.com/read/28139263/jak-inhibitors-in-dermatology-the-promise-of-a-new-drug-class
#3
REVIEW
William Damsky, Brett A King
New molecularly targeted therapeutics are changing dermatologic therapy. Janus kinase-signal transducer and activator of transcription (JAK-STAT) is an intracellular signaling pathway upon which many different proinflammatory signaling pathways converge. Numerous inflammatory dermatoses are driven by soluble inflammatory mediators, which rely on JAK-STAT signaling, and inhibition of this pathway using JAK inhibitors might be a useful therapeutic strategy for these diseases. Growing evidence suggests that JAK inhibitors are efficacious in atopic dermatitis, alopecia areata, psoriasis, and vitiligo...
January 28, 2017: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/28138088/multi-center-evaluation-of-the-automated-immunohematology-instrument-the-ortho-vision-analyzer
#4
Agnes Aysola, Leslie Wheeler, Richard Brown, Rebecca Denham, Connie Colavecchia, Katerina Pavenski, Elizabeth Krok, Chelsea Hayes, Ellen Klapper
BACKGROUND: ORTHO VISION Analyzer (Vision), is an immunohematology instrument using ID-MT gel card technology with digital image processing. It has a continuous, random sample access with STAT priority processing. The efficiency and ease of operation of Vision was evaluated at 5 medical centers. METHODS: De-identified patient samples were tested on the ORTHO ProVue Analyzer (ProVue) and repeated on the Vision mimicking the daily workload pattern. Turnaround times (TAT) were collected and compared...
February 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28101184/anti-inflammatory-effects-of-luteolin-on-experimental-autoimmune-thyroiditis-in-mice
#5
Nan Xia, Gang Chen, Min Liu, Xiaozhen Ye, Yahui Pan, Jiuyu Ge, Yanting Mao, Hongwei Wang, Jian Wang, Sijing Xie
Hashimoto's thyroiditis (HT) is the most common organ-specific autoimmune disease and is believed to be a predominately T cell-mediated autoimmunity. Signal transducer and activator of transcription (STAT)3 is a crucial transcription factor of T cell-mediated immunity, with key roles in the proliferation and migration of T helper (Th) cells, differentiation of Th cells into Th17 cells, and the balance between Treg cells and Th17 cells. Flavonoid luteolin has been shown to markedly inhibit Tyr705 activation/phosphorylation of STAT3 and exert anti-inflammatory effects in multiple sclerosis...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28096208/improving-door-to-needle-times-for-acute-ischemic-stroke-effect-of-rapid-patient-registration-moving-directly-to-computed-tomography-and-giving-alteplase-at-the-computed-tomography-scanner
#6
Noreen Kamal, Jessalyn K Holodinsky, Caroline Stephenson, Devika Kashayp, Andrew M Demchuk, Michael D Hill, Renee L Vilneff, Erin Bugbee, Charlotte Zerna, Nancy Newcommon, Eddy Lang, Darren Knox, Eric E Smith
BACKGROUND: The effectiveness of specific systems changes to reduce DTN (door-to-needle) time has not been fully evaluated. We analyzed the impact of 4 specific DTN time reduction strategies implemented prospectively in a staggered fashion. METHODS AND RESULTS: The HASTE (Hurry Acute Stroke Treatment and Evaluation) project was implemented in 3 phases at a single academic medical center. In HASTE I (June 6, 2012 to June 5, 2013), baseline performance was analyzed...
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28088907/tofacitinib-an-oral-janus-kinase-inhibitor-perspectives-in-dermatology
#7
Kresimir Kostovic, Sandra Jerkovic Gulin, Zrinka Bukvic Mokos, Romana Ceovic
BACKGROUND: Tofacitinib (formerly known as CP-690,550, CP690550, tasocitinib), a novel selective immunosuppressant, is a small molecule classified as Janus kinase inhibitor. The aim of this review article is to present updated data summary on the tofacitinib in the field of dermatology. METHOD: We undertook a structured search of bibliographic databases for peer-reviewed scientific articles, including review articles, original research articles as well as case report articles based on inclusion/exclusion criteria...
January 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28077314/biological-or-pharmacological-activation-of-protein-kinase-c-alpha-constrains-hepatitis-e-virus-replication
#8
Wenshi Wang, Yijin Wang, Yannick Debing, Xinying Zhou, Yuebang Yin, Lei Xu, Elena Herrera Carrillo, Johannes H Brandsma, Raymond A Poot, Ben Berkhout, Johan Neyts, Maikel P Peppelenbosch, Qiuwei Pan
Although hepatitis E has emerged as a global health issue, there is limited knowledge of its infection biology and no FDA-approved medication is available. Aiming to investigate the role of protein kinases in hepatitis E virus (HEV) infection and to identify potential antiviral targets, we screened a library of pharmacological kinase inhibitors in a cell culture model, a subgenomic HEV replicon containing luciferase reporter. We identified protein kinase C alpha (PKCα) as an essential cell host factor restricting HEV replication...
April 2017: Antiviral Research
https://www.readbyqxmd.com/read/28057873/attainment-of-guideline-targets-in-eurodopps-haemodialysis-patients-are-differences-related-to-a-country-s-healthcare-expenditure-and-nephrologist-workforce
#9
Sophie Liabeuf, Karlijn J Van Stralen, Fergus Caskey, Francesca Tentori, Ronald L Pisoni, Ayesha Sajjad, Kitty J Jager, Ziad A Massy
BACKGROUND: In the field of chronic kidney disease, global clinical practice guidelines have been developed and implemented with a view to improving patient care and outcomes. The attainment of international and European guideline targets for haemodialysis patients in European countries has not been audited recently. Hence, we sought to establish whether the attainment of the targets set out in guidelines and inappropriate care are similar across European countries and whether inter-country differences are related to disparities in national healthcare expenditures (as a percentage of gross domestic product) and/or the nephrologist workforce per capita...
January 5, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28028299/gene-expression-in-obstetric-antiphospholipid-syndrome-a-systematic-review
#10
M Muhammad Aliff, S Muhammad Shazwan, M M Nur Fariha, A R Hayati, A R Nur Syahrina, M Maizatul Azma, A H Nazefah, S Jameela, A A Asral Wirda
BACKGROUND: Antiphospholipid syndrome (APS) is a multisystem disease that may present as venous or arterial thrombosis and/or pregnancy complications with the presence of antiphospholipid antibodies. Until today, heterogeneity of pathogenic mechanism fits well with various clinical manifestations. Moreover, previous studies have indicated that genes are differentially expressed between normal and in the disease state. Hence, this study systematically searched the literature on human gene expression that was differentially expressed in Obstetric APS...
December 2016: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/27942695/from-stats-to-stage-translational-research-in-performing-arts-medicine
#11
EDITORIAL
Bronwen J Ackermann
Medical Problems of Performing Artists, since its inception under the legendary Alice Brandfonbrener's guidance and vision, has always recognized the need for voices to be heard from the clinic, stage, and experimental research. This has been important in a relatively young field like performing arts medicine, where there is not yet a robust base of evidence to draw from for the complex range of physical, psychological, and institutional challenges that can affect performer health. Evidence-based medicine has long been described as using the best available research in conjunction with clinical expertise, while considering patient beliefs, characteristics, and circumstances...
December 2016: Medical Problems of Performing Artists
https://www.readbyqxmd.com/read/27922565/a-perspective-on-brain-gut-communication-the-american-gastroenterology-association-and-american-psychosomatic-society-joint-symposium-on-brain-gut-interactions-and-the-intestinal-microenvironment
#12
Olga C Aroniadis, Douglas A Drossman, Magnus Simren
BACKGROUND: Alterations in brain-gut communication and the intestinal microenvironment have been implicated in a variety of medical and neuropsychiatric diseases. Three central areas require basic and clinical research: (1) how the intestinal microenvironment interacts with the host immune system, central nervous system and enteric nervous system; (2) the role of the intestinal microenvironment in the pathogenesis of medical and neuropsychiatric disease; (3) the effects of diet, prebiotics, probiotics and fecal microbiota transplantation on the intestinal microenvironment and the treatment of disease...
January 17, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/27890885/medication-adherence-improvement-by-using-administration-timing-simplification-protocol-atsp-in-cardiovascular-disease-patients
#13
Sun Hoi Jung, Ok Sang Lee, Hyang Sook Kim, Chan Soon Park, Hyun Jung Lee, Kyeng Hee Kwon, Hae Young Lee
AIMS: In chronic diseases, keeping adherence to medication is very difficult. The objective of this study was to evaluate the impact of administration timing simplification protocol (ATSP) on medication adherence and clinical parameters of cardiovascular diseases. METHODS: 210 out-patients with cardiovascular disease, who were taking two or more pills of any type of medication per day for more than one year, were enrolled and randomized. The intervention group followed the simplified administration schedule of ATSP with two main strategies: 1) moving medication from "pc" (30 minute after meal) to "stat...
November 25, 2016: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/27881648/modeling-severe-fever-with-thrombocytopenia-syndrome-virus-infection-in-golden-syrian-hamsters-importance-of-stat2-in-preventing-disease-and-effective-treatment-with-favipiravir
#14
Brian B Gowen, Jonna B Westover, Jinxin Miao, Arnaud J Van Wettere, Johanna D Rigas, Brady T Hickerson, Kie-Hoon Jung, Rong Li, Bettina L Conrad, Skot Nielson, Yousuke Furuta, Zhongde Wang
: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease endemic in parts of Asia. The etiologic agent, SFTS virus (SFTSV; family Bunyaviridae, genus Phlebovirus) has caused significant morbidity and mortality in China, South Korea, and Japan, with key features of disease being intense fever, thrombocytopenia, and leukopenia. Case fatality rates are estimated to be in the 30% range, and no antivirals or vaccines are approved for use for treatment and prevention of SFTS...
February 1, 2017: Journal of Virology
https://www.readbyqxmd.com/read/27766088/effectiveness-of-caregiver-training-in-mindfulness-based-positive-behavior-support-mbpbs-vs-training-as-usual-tau-a-randomized-controlled-trial
#15
Nirbhay N Singh, Giulio E Lancioni, Bryan T Karazsia, Jeffrey Chan, Alan S W Winton
Caregivers of individuals with intellectual and developmental disabilities (IDD) often end up having their medical and psychological well-being compromised due to the stressful nature of caregiving, especially when those in their care engage in aggressive behavior. In this study, we provided caregivers with mindfulness-based training to enable them to better manage their psychological well-being and, through this, to also enhance specific indices of quality of life of the individuals in their care. Thus, the aim of the present study was to evaluate in a randomized controlled trial (RCT) the comparative effectiveness of Mindfulness-Based Positive Behavior Support (MBPBS) and Training-as-Usual (TAU) for caregivers in a congregate care facility for individuals with severe and profound IDD...
2016: Frontiers in Psychology
https://www.readbyqxmd.com/read/27742706/hsp90-inhibition-overcomes-ibrutinib-resistance-in-mantle-cell-lymphoma
#16
Caron Jacobson, Nadja Kopp, Jacob V Layer, Robert A Redd, Sebastian Tschuri, Sarah Haebe, Diederik van Bodegom, Liat Bird, Amanda L Christie, Alexandra Christodoulou, Amy Saur, Trevor Tivey, Stefanie Zapf, Deepak Bararia, Ursula Zimber-Strobl, Scott J Rodig, Oliver Weigert, David M Weinstock
The Bruton tyrosine kinase (BTK) inhibitor ibrutinib induces responses in 70% of patients with relapsed and refractory mantle cell lymphoma (MCL). Intrinsic resistance can occur through activation of the nonclassical NF-κB pathway and acquired resistance may involve the BTK C481S mutation. Outcomes after ibrutinib failure are dismal, indicating an unmet medical need. We reasoned that newer heat shock protein 90 (HSP90) inhibitors could overcome ibrutinib resistance by targeting multiple oncogenic pathways in MCL...
November 24, 2016: Blood
https://www.readbyqxmd.com/read/27734126/independent-risk-factors-for-surgical-site-infection-after-cesarean-delivery-in-a-rural-tertiary-care-medical-center
#17
Manuel C Vallejo, Ahmed F Attaallah, Robert E Shapiro, Osama M Elzamzamy, Michael G Mueller, Warren S Eller
BACKGROUND: We aimed to determine the incidence of surgical site infection (SSI) after cesarean delivery (CD) and identify the risk factors in a rural population. METHODS: We identified 218 SSI patients by International Classification of Disease codes and matched them with 3131 parturients (control) from the electronic record database in a time-matched retrospective quality assurance analysis. RESULTS AND DISCUSSION: The incidence of SSI after CD was 7...
October 12, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27709092/antegrade-cerebral-perfusion-at-25-%C3%A2-c-for-arch-reconstruction-in-newborns-and-children-preserves-perioperative-cerebral-oxygenation-and-serum-creatinine
#18
Bhawna Gupta, Ali Dodge-Khatami, Juan Tucker, Mary B Taylor, Douglas Maposa, Miguel Urencio, Jorge D Salazar
BACKGROUND: Antegrade cerebral perfusion (ACP) typically is used with deep hypothermia for cerebral protection during aortic arch reconstructions. The impact of ACP on cerebral oxygenation and serum creatinine at a more tepid 25 °C was studied in newborns and children. METHODS: Between 2010 and 2014, 61 newborns and children (<5 years old) underwent aortic arch reconstruction using moderate hypothermia (25.0±0.9 °C) with ACP and a pH-stat blood gas management strategy...
July 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27671823/natural-withanolides-in-the-treatment-of-chronic-diseases
#19
Peter T White, Chitra Subramanian, Hashim F Motiwala, Mark S Cohen
Withanolides, and in particular extracts from Withania somnifera, have been used for over 3,000 years in traditional Ayurvedic and Unani Indian medical systems as well as within several other Asian countries. Traditionally, the extracts were ascribed a wide range of pharmacologic properties with corresponding medical uses, including adaptogenic, diuretic, anti-inflammatory, sedative/anxiolytic, cytotoxic, antitussive, and immunomodulatory. Since the discovery of the archetype withaferin A in 1965, approximately 900 of these naturally occurring, polyoxygenated steroidal lactones with 28-carbon ergostane skeletons have been discovered across 24 diverse structural types...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27611442/utility-of-electroencephalography-experience-from-a-u-s-tertiary-care-medical-center
#20
Kapil Gururangan, Babak Razavi, Josef Parvizi
OBJECTIVE: To investigate the utility of electroencephalography (EEG) for evaluation of patients with altered mental status (AMS). METHODS: We retrospectively reviewed 200 continuous EEGs (cEEGs) obtained in ICU and non-ICU wards and 100 spot EEGs (sEEGs) obtained from the emergency department (ED) of a large tertiary medical center. Main outcomes were access time (from study request to hookup), and diagnostic yield (percentage of studies revealing significant abnormality)...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
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