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Complex special needs

Sajad Hassanzadeh, Seyed Behnamedin Jameie, Mehdi Mehdizadeh, Mansooreh Soleimani, Zeinab Namjoo, Maryam Soleimani
Spinal cord injury (SCI) is a serious and complex medical condition that can happen to anyone. At present, therapy mainly focuses on rehabilitation and pharmacological treatment, such as methylprednisolone (MP). Supra-spinal changes in certain structures, such as the cerebellum, that receive many afferents from the spinal cord might be one reason for unsuccessful therapeutic outcomes. Recently, the expression of FNDC5 was reported in cerebellar Purkinje cells as a possible neuroprotective agent. In the present study, we considered the expression of FNDC5 in Purkinje cells following SCI with and without MP administration in adult rats with SCI...
May 7, 2018: Neuropeptides
Vincent Vanheule, Mieke Metzemaekers, Rik Janssens, Sofie Struyf, Paul Proost
Chemokines are important proteins involved in the regulation of directed leukocyte migration during inflammation and the homeostatic homing of immune cells. In addition, they play a role in angiogenesis, hematopoiesis, organogenesis, tumor growth and metastasis. Therefore, the chemokine/chemokine receptor network is highly complex and needs to be tightly controlled. An important mechanism of fine-tuning chemokine activity and reducing its apparent redundancy is post-translational modification (PTM) of chemokines and their receptors...
September 2018: Cytokine
Stella Baliou, Maria Adamaki, Anthony M Kyriakopoulos, Demetrios A Spandidos, Michalis Panagiotidis, Ioannis Christodoulou, Vassilis Zoumpourlis
One of the fundamental discoveries in the field of biology is the ability to modulate the genome and to monitor the functional outputs derived from genomic alterations. In order to unravel new therapeutic options, scientists had initially focused on inducing genetic alterations in primary cells, in established cancer cell lines and mouse models using either RNA interference or cDNA overexpression or various programmable nucleases [zinc finger nucleases (ZNF), transcription activator-like effector nucleases (TALEN)]...
June 6, 2018: International Journal of Oncology
Andrea Feldstain, Barry D Bultz, Janet de Groot, Amane Abdul-Razzak, Leonie Herx, Lyle Galloway, Srini Chary, Aynharan Sinnarajah
Background: Palliative care aims to improve suffering and quality of life for patients with life-limiting disease. This study evaluated an interdisciplinary palliative consultation team for outpatients with advanced cancer at the Tom Baker Cancer Centre. This team traditionally offered palliative medicine and recently integrated a specialized psychosocial clinician. Historic patient-reported clinical outcomes were reviewed. There were no a priori hypotheses. Methods: A total of 180 chart reviews were performed in 8 sample months in 2015 and 2016; 114 patients were included...
June 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Xuyin Zhang, Yan Ding, Keqin Hua, Songping Liu, Nan Jia
OBJECTIVE: To introduce a creation that combines laparoscopic and Wharton-Sheares-George cervicovaginal reconstruction using SIS graft in a patient with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome who had a rudimentary cavity (U5aC4V4). DESIGN: Video article introducing a new surgical technique. SETTING: University hospital. PATIENT(S): A 24-year-old patient had primary amenorrhea and irregular lower abdominal pain for 9 years...
June 8, 2018: Journal of Minimally Invasive Gynecology
Jessica Tompsett, Mathew Leonardi, Bassem Gerges, Chuan Lu, Shannon Reid, Mercedes Espada, George Condous
STUDY OBJECTIVE: To validate the preoperative ultrasound-based endometriosis staging system (UBESS) for predicting the correct Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and the Australasian Gynaecological Endoscopy and Surgery (AGES) Society's level of laparoscopic skill level required for endometriosis surgery. DESIGN: Multi-center retrospective cohort study (Canadian Task Force II-2). SETTING: A tertiary teaching hospital and a private gynecological clinic...
June 8, 2018: Journal of Minimally Invasive Gynecology
Shivani Krishna, Tamar Keasar
Morphologically complex flowers are characterized by bilateral symmetry, tube-like shapes, deep corolla tubes, fused petals, and/or poricidal anthers, all of which constrain the access of insect visitors to floral nectar and pollen rewards. Only a subset of potential pollinators, mainly large bees, learn to successfully forage on such flowers. Thus, complexity may comprise a morphological filter that restricts the range of visitors and thereby increases food intake for successful foragers. Such pollinator specialization, in turn, promotes flower constancy and reduces cross-species pollen transfer, providing fitness benefits to plants with complex flowers...
June 6, 2018: International Journal of Molecular Sciences
Matthew K Mcbride, Maciej Podgórski, Shunsuke Chatani, Brady Worrell, Christopher N Bowman
Ductile, crosslinked films were folded as a means to program temporary shapes without the need for complex heating cycles or specialized equipment. Certain crosslinked polymer networks, formed here with the thiol-isocyanate reaction, possessed the ability to be pseudo plastically deformed below the glass transition, and the original shape was recovered during heating through the glass transition. In order to circumvent the large forces required to plastically deform a glassy polymer network, we have utilized folding, which localizes the deformation in small creases, and achieved large dimensional changes with simple programming procedures...
June 8, 2018: ACS Applied Materials & Interfaces
Lucy A Savitz, Lisa T Weiss
The purpose of this special issue is to disseminate learning from the High Value Healthcare Collaborative (HVHC). The HVHC is a voluntary, member-led organization based on trusted, working relationships among delivery system leaders. HVHC's mission is to be a provider-based learning health system committed to improving healthcare value through data, evidence, and collaboration. We begin by describing the organization and structure of HVHC in order to lay the context for a series of papers that feature work from this learning health system...
December 15, 2017: EGEMS
Amer Sebaaly, Marie-José Lahoud, Maroun Rizkallah, Gaby Kreichati, Khalil Kharrat
The study aimed to review the etiology of failed back surgery syndrome (FBSS) and to propose a treatment algorithm based on a systematic review of the current literature and individual experience. FBSS is a term that groups the conditions with recurring low back pain after spine surgery with or without a radicular component. Since the information on FBSS incidence is limited, data needs to be retrieved from old studies. It is generally accepted that its incidence ranges between 10% and 40% after lumbar laminectomy with or without fusion...
June 2018: Asian Spine Journal
Nastassia V Patin, Dimitrios J Floros, Chambers C Hughes, Pieter C Dorrestein, Paul R Jensen
Bacterial genome sequences consistently contain many more biosynthetic gene clusters encoding specialized metabolites than predicted by the compounds discovered from the respective strains. One hypothesis invoked to explain the cryptic nature of these gene clusters is that standard laboratory conditions do not provide the environmental cues needed to trigger gene expression. A potential source of such cues is other members of the bacterial community, which are logical targets for competitive interactions. In this study, we examined the effects of such interactions on specialized metabolism in the marine actinomycete Salinispora tropica...
June 7, 2018: Microbiology
A Gonzalez-Pena
When we speak of children with special needs, who require the aid of a number of professionals and who have a severe disability, it is necessary to have available a comprehensive group of different professionals (paediatrician, nurse, social worker, psychologist, etc.) who work together as a team. The specialist physician or doctor responsible for the sick child alone cannot take responsibility for all the psychosocial consequences that result from the neurological disease, which is a chronic illness that, generally speaking, means the families arrange their lives to revolve around the sick child...
June 5, 2018: Revista de Neurologia
Eva Braunwarth, Stefan Stättner, Margot Fodor, Benno Cardini, Thomas Resch, Rupert Oberhuber, Daniel Putzer, Reto Bale, Manuel Maglione, Christian Margreiter, Stefan Schneeberger, Dietmar Öfner, Florian Primavesi
Background: Owing to remarkable improvements of surgical techniques and associated specialities, liver surgery has become the standard of care for hepatocellular carcinoma and cholangiocarcinoma. Although applied with much greater safety, hepatic resections for primary liver tumours remain challenging and need to be integrated in a complex multidisciplinary treatment approach. Methods: This literature review gives an update on the recent developments regarding basics of open and laparoscopic liver surgery and surgical strategies for primary liver tumours...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Torbjørn Torsvik, Børge Lillebo, Morten Hertzum
BACKGROUND:  Electronic health records may present laboratory test results in a variety of ways. Little is known about how the usefulness of different visualizations of laboratory test results is influenced by the complex and varied process of clinical decision making. OBJECTIVE:  The purpose of this study was to investigate how clinicians access and utilize laboratory test results when caring for patients with chronic illness. METHODS:  We interviewed 10 attending physicians about how they access and assess laboratory tests when following up patients with chronic illness...
April 2018: Applied Clinical Informatics
Linda Sandberg, Lena Borell, David Edvardsson, Lena Rosenberg, Anne-Marie Boström
Introduction: An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff's well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. Aim: To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors...
2018: Journal of Multidisciplinary Healthcare
Günther Pass
Insect wings consist almost entirely of lifeless cuticle; yet their veins host a complex multimodal sensory apparatus and other tissues that require a continuous supply of water, nutrients and oxygen. This review provides a survey of the various living components in insect wings, as well as the specific contribution of the circulatory and tracheal systems to provide all essential substances. In most insects, hemolymph circulates through the veinal network in a loop flow caused by the contraction of accessory pulsatile organs in the thorax...
May 30, 2018: Arthropod Structure & Development
Bernhard Schaefke, Wei Sun, Yi-Sheng Li, Liang Fang, Wei Chen
"DNA makes RNA makes protein." After transcription, mRNAs undergo a series of intertwining processes to be finally translated into functional proteins. The "posttranscriptional" regulation (PTR) provides cells an extended option to fine-tune their proteomes. To meet the demands of complex organism development and the appropriate response to environmental stimuli, every step in these processes needs to be finely regulated. Moreover, changes in these regulatory processes are important driving forces underlying the evolution of phenotypic differences across different species...
May 31, 2018: Wiley Interdisciplinary Reviews. RNA
Rosario Spina, Baudolino Mussa, Lara Tollapi, Fabio Conti, Enrico Cortesi, Roberto Verna
Vascular access is the commonest invasive procedure in secondary care. Vascular access is understood as being access to the bloodstream of acute and chronic patients for diagnostic and therapeutic purposes such as blood sampling, vessel pressure monitoring, fluid infusions (blood transfusions, parenteral nutrition), pharmacological treatments (e.g. antibiotic therapies, chemotherapy, analgesic therapies) or apheresis/dialysis through catheters that may remain in the vessels for weeks or months. There is a wide variety of options available for venous access...
June 2018: Minerva Medica
Marlene Christina Rosengaard Møller, Anna Mygind, Flemming Bro
BACKGROUND: Collaborative care treatment is widely recognized as an effective approach to improve the quality of mental healthcare through enhanced and structured collaboration between general practice and specialized psychiatry. However, studies indicate that the complexity of collaborative care treatment interventions challenge the implementation in real-life general practice settings. Four Danish Collaborative Care Models were launched in 2014 for patients with mild/moderate anxiety and depression...
May 30, 2018: BMC Family Practice
Karina M O Roda, Rodrigo Vincenzi, Eduardo A Fonseca, Marcel Benavides, Plínio Turine, Rogerio C Afonso, Tassia Tonon, Ida Schwartz, Irene K Miura, Renata Pugliese, Gilda Porta, Paulo Chapchap, Joao Seda Neto
BACKGROUND: Data describing the technical aspects of living donor domino liver transplantation (LD-DLT) in maple syrup urine disease (MSUD) are limited. The largest published series includes only 3 cases. One great challenge of this procedure is to ensure adequate vascular stumps for the living donor, the MSUD patient, and the recipient of the domino graft. Here, we describe our experience in 11 cases of LD-DLT in MSUD, highlighting the technical aspects of LD-DLT. METHODS: From September 2012 to September 2017, 11 patients with MSUD underwent LDLT at our institution, and MSUD livers were used as domino grafts in 11 children...
May 25, 2018: Transplantation
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