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Rebecca Lewthwaite, Carolee J Winstein, Christianne J Lane, Sarah Blanton, Burl R Wagenheim, Monica A Nelsen, Alexander W Dromerick, Steven L Wolf
BACKGROUND: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many. OBJECTIVE: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. METHODS: On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC)...
February 2018: Neurorehabilitation and Neural Repair
Tony Zitek, Ignasia Tanone, Alexzza Ramos, Karina Fama, Ahmed S Ali
BACKGROUND: Urgent care centers (UCCs) can offer a cheap alternative to emergency departments (EDs) for some patients with acute complaints. However, if patients who initially present to a UCC are unnecessarily transferred to an ED, those patients may suffer undue financial harm. The group of patients transferred from UCCs to EDs have never previously been studied. OBJECTIVES: The primary objective of this study was to determine the fraction of transfers from a UCC to an ED that were unnecessary...
March 15, 2018: Journal of Emergency Medicine
Sugela Blancas, Rogelio Medina-Berlanga, Liliana Ortíz-García, Alfredo Loredo-Ramírez, Leticia Santos
Specific markers in lesions of the human uterine cervix cancer (UCC) are still needed for prognostic, diagnostic and/or therapeutic purposes. In this study we evaluated key molecules at protein level between normal epithelium, cervical intraepithelial neoplasia (CIN1-3) and invasive cancer of a group of molecules previously reported at mRNA level. For that purpose, human formalin-fixed paraffin embedded tissue microarrays (TMAs) were constructed containing 205 Mexican tissue core specimens. Immunohistochemistry and quantitative analysis of histological staining was performed against twenty-two distinct proteins for each core and the processing platform ImageJ...
March 12, 2018: Pathology Oncology Research: POR
Sjoerd Broekman, Elisabeth Van Gils-Van Rooij, Berthold Meijboom, Dingenus De Bakker, Christoffel Yzermans
INTRODUCTION In the Netherlands, general practitioners (GPs) and emergency departments (EDs) collaborate increasingly in urgent care collaborations (UCCs) in which the two services share one combined entrance and joint triage. AIM The objective of this study is to determine if UCCs are cost-effective compared to the usual care setting where out-of-hours GP services and EDs work separately. METHODS This observational study compared UCCs with the usual care setting on costs by performing linear regression analyses...
September 2017: Journal of Primary Health Care
Elisabeth Sybilla Johanna van Gils-van Rooij, Sjoerd Michael Broekman, Dingenus Herman de Bakker, Berthold Rudy Meijboom, Christoffel Joris Yzermans
BACKGROUND: In an attempt to redirect patients who are inappropriately attending hospital emergency departments (ED) and in doing so provide the right care at the right place, out-of-hours GP (General Practitioner) services and EDs increasingly collaborate in Urgent Care Collaborations (UCCs). Work satisfaction is an important factor in analysing the impact of this organisational change. The objective of this study is, firstly, to discover if there is a difference in the employee experiences between those working in UCCs and those in traditional out-of-hours services in which EDs and out-of-hours GP services operate separately (i...
February 17, 2018: BMC Health Services Research
Pierre-Antoine Dugué, Maree T Brinkman, Allison M Hodge, Julie K Bassett, Damien Bolton, Anthony Longano, John L Hopper, Melissa C Southey, Dallas R English, Roger L Milne, Graham G Giles
Nutrients involved in one-carbon metabolism may play a role in carcinogenesis through DNA replication, repair and methylation mechanisms. Most studies on urothelial cell carcinoma (UCC) have focused on folate. We sought to examine the association between B-group vitamins and methionine intake and UCC risk, overall and by subtype, and to test whether these associations are different for population subgroups whose nutritional status may be compromised. We followed participants in the Melbourne Collaborative Cohort Study (N=41,513) for over 20 years, and observed 500 UCC cases (89% originating in the bladder; superficial: 279, invasive: 221)...
February 15, 2018: International Journal of Cancer. Journal International du Cancer
Nicola Groom, Tara Kidd, Nicola Carey
AIM: Patient redirection can help reduce service demand by providing information about more appropriate services. There is, however, no evidence about the effect of nurse-led patient redirection in urgent care centre settings. The aim of this project was to develop and evaluate a nurse-led patient 'self-care and redirection first' intervention in an urgent care centre (UCC). METHOD: Adopting a prospective observational design, the intervention was delivered to an opportunity sample of patients who attended a south London hospital UCC, between June and July 2014, and evaluated through patient interviews five to ten days after initial attendance...
February 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
A Pinto, M Alfadhel, R Akroyd, Y Atik Altınok, S M Bernabei, L Bernstein, G Bruni, G Caine, E Cameron, R Carruthers, B Cochrane, A Daly, F de Boer, S Delaunay, A Dianin, M Dixon, E Drogari, S Dubois, S Evans, J Gribben, G Gugelmo, C Heidenborg, I Hunjan, I L Kok, B Kumru, A Liguori, D Mayr, E Megdad, U Meyer, R B Oliveira, A Pal, A Pozzoli, R Pretese, J C Rocha, S Rosenbaum-Fabian, J Serrano-Nieto, E Sjoqvist, C Timmer, L White, T van den Hurk, M van Rijn, H Zweers, M Ziadlou, A MacDonald
BACKGROUND: In fructose 1,6 bisphosphatase (FBPase) deficiency, management aims to prevent hypoglycaemia and lactic acidosis by avoiding prolonged fasting, particularly during febrile illness. Although the need for an emergency regimen to avoid metabolic decompensation is well established at times of illness, there is uncertainty about the need for other dietary management strategies such as sucrose or fructose restriction. We assessed international differences in the dietary management of FBPase deficiency...
January 25, 2018: Orphanet Journal of Rare Diseases
Min Luo, Yi-Yang Jia, Zi-Wei Jing, Chen Li, Si-Yuan Zhou, Qi-Bing Mei, Bang-Le Zhang
The acidic environment of the stomach is a threat to the curative effect of antimicrobial drugs for the eradication of Helicobacter pylori (H. pylori) in the infected area. The conventional clinical formulations of antibiotics have low specificity to H. pylori, which disrupts the normal balance of intestinal microbiomes. Therefore, oral drug delivery system with better stability at low pH as well as higher specificity to target H. pylori would provide more effective strategy to eradicate H. pylori and reduce the side effect of antibiotics...
January 9, 2018: Colloids and Surfaces. B, Biointerfaces
Sanjay G Patel, Adam Benjamin Weiner, Kirk Keegan, Todd Morgan
Introduction: We aimed to evaluate the relative prognostic impact of the most common variant histologies on disease-specific survival (DSS) in patients undergoing radical cystectomy. Materials and Methods: The Surveillance, Epidemiology, and End Result database was used to identify patients who underwent radical cystectomy for bladder cancer from 1990 to 2007. Patients with urothelial cell carcinoma (UCC), squamous cell carcinoma (SCC), adenocarcinoma (AC), sarcoma, small cell carcinoma, signet ring carcinoma, and spindle cell carcinoma were included in the study...
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Li Zhang, Tieying Sun, Longteng Liu, Lifang Wang
Unexplained chronic cough (UCC) affects millions of patients worldwide. New therapeutic approaches to this condition are urgently needed, since current treatment options provide only symptomatic relief. Cough reflex hypersensitivity has been shown to play an important role in the pathogenesis of UCC. The transient receptor potential vanilloid type 1 (TRPV1) is present on peripheral terminals of airway sensory nerves and modulation of its activity represents a potential target for the pharmacological treatment of UCC...
December 27, 2017: Pulmonary Pharmacology & Therapeutics
Jasmina Ahmetovic-Djug, Sefik Hasukic, Haris Djug, Begzada Hasukic, Alan Jahic
Objectives: Each surgical patient is preoperatively, intraoperatively and postoperatively exposed to stress. The aim of this study was to determine the existence of preoperative anxiety, and to determine its impact on hemodynamic parameters (blood pressure, heart rate) in patients and dose of anesthetics during induction of anesthesia. Methods: A prospective clinical study conducted at the Department of Anesthesiology and Reanimation and Surgery Clinic of University Clinical Center Tuzla (UCC) in the period May 2012...
October 2017: Medical Archives
Daniel J Arenas, Lanair A Lett, Heather Klusaritz, Anne M Teitelman
BACKGROUND: Student Run Clinics (SRCs) are a common aspect of medical education, present at more than half of US medical schools, and noted for providing care to communities that might otherwise lack access, including the uninsured and underinsured. To date, few studies have rigorously quantified the health and economic benefits of SRCs, and the present study remedies that. METHODS AND FINDINGS: We used Monte Carlo simulations to estimate the health impact of common preventive health interventions applied to individuals in quality-adjusted life-years (QALYs)...
2017: PloS One
Hynek Mirka, Jan Baxa, Milan Hora, Ondrej Hes, Ondrej Topolcan, Jiri Ferda
BACKGROUND/AIM: The aim of this study was to evaluate the possibility to discriminate the blood clot from tumorous tissue in the assessment of transitional cell carcinoma (TCC), when CT data are used only from single-phase dual-energy CT (DECT). MATERIALS AND METHODS: A total of 18 patients were included into the retrospective analysis of the prospectively collected data (the average age was 67.3 years, range=62-79 years, 12 males, 6 females). DECT was performed in all patients after intravenous administration of the iodinated contrast material...
January 2018: Anticancer Research
Hsiang-Lin Lee, Hui-Ling Chiou, Shian-Shiang Wang, Sheng-Chun Hung, Ming-Chih Chou, Shun-Fa Yang, Ming-Ju Hsieh, Ying-Erh Chou
OBJECTIVES: Urothelial cell carcinoma (UCC) of the urinary bladder is a major malignancy of the genitourinary tract. Etiological factors, such as the environment, ethnicity, genetics, and diet, contribute to UCC carcinogenesis. WNT1-inducible signaling pathway protein 1 (WISP1), also known as CCN4, a cysteine-rich protein belonging to the Cyr61, CTGF, Nov (CCN) family of matricellular proteins, has many developmental functions and might be involved in carcinogenesis. This study investigated WISP1 single-nucleotide polymorphisms to evaluate UCC susceptibility and clinicopathological characteristics...
December 22, 2017: Urologic Oncology
Bernardo J Reyes, Javier M Lopez, Diana J Galindo, Maria Briceno, Joseph G Ouslander
OBJECTIVES: To determine the most common clinical conditions associated with older adults visiting Urgent care centers (UCCs) and the potential need for further resource use. DESIGN: Cross-sectional retrospective study. SETTING: Nonprofit academic medical center with campuses and multiple satellite offices in Ohio and Florida. PARTICIPANTS: Individuals aged 55 and older who visited UCCs between August 2014 and March 2015 (N = 9,445; average age 63...
December 2017: Journal of the American Geriatrics Society
Isabelle Rousseau-Nepton, Céline Huot, Diane Laforte, Elise Mok, Daphna Fenyves, Evelyn Constantin, John Mitchell
BACKGROUND: Glycemic control in hepatic glycogen storage diseases (GSDs) relies on specific nutritional recommendations, including strict avoidance of a fasting period. Uncooked cornstarch (UCCS) is an important therapeutic component. A new modified UCCS, Glycosade™, was created with the objective of prolonging euglycemia. We aimed to determine the length of euglycemia on Glycosade™ using a continuous glucose monitor (CGM) and to evaluate whether longer euglycemia and thus less nighttime interruptions would improve sleep and quality of life (QoL) after the introduction of the modified cornstarch...
March 2018: Molecular Genetics and Metabolism
Douglas A Blank, Graeme R Polglase, Martin Kluckow, Andrew William Gill, Kelly J Crossley, Alison Moxham, Karyn Rodgers, Valerie Zahra, Ishmael Inocencio, Fiona Stenning, Domeic A LaRosa, Peter G Davis, Stuart B Hooper
OBJECTIVE: Umbilical cord milking (UCM) at birth may benefit preterm infants, but the physiological effects of UCM are unknown. We compared the physiological effects of two UCM strategies with immediate umbilical cord clamping (UCC) and physiological-based cord clamping (PBCC) in preterm lambs. METHODS: At 126 days' gestational age, fetal lambs were exteriorised, intubated and instrumented to measure umbilical, pulmonary and cerebral blood flows and arterial pressures...
December 5, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Charity B Wilkinson, Zachary P Infantolino, Annmarie Wacha-Montes
The purpose of this study was to evaluate the impact of changes in perceptions about patient volume and severity of clinical presentations in university counseling centers (UCCS) on burnout. It was hypothesized that perceptions of increased workload and severity of conditions treated would be positively correlated with burnout. It was also hypothesized that self-reported use of evidence-based practice (EBP) would be negatively correlated with burnout. Counseling center clinicians (n = 80) completed the Copenhagen Burnout Inventory (CBI), the Evidence-Based Practice Attitudes Scale (EPBAS), and reported on factors that have been shown to impact burnout...
November 2017: Psychological Services
Yung-Wei Lin, Shian-Shiang Wang, Yu-Ching Wen, Min-Che Tung, Liang-Ming Lee, Shun-Fa Yang, Ming-Hsien Chien
Melatonin counteracts tumor occurrence and tumor cell progression in several cancer types in vitro and in vivo. It acts predominantly through its melatonin receptor type 1A (MTNR1A), and genetic variations of MTNR1A affect the susceptibility several diseases and cancer. The purpose of this study was to explore the effect of MTNR1A gene polymorphisms on the susceptibility to and clinicopathological characteristics of urothelial cell carcinoma (UCC). We recruited 272 patients with UCC and 272 normal controls to analyze three common single-nucleotide polymorphisms (SNPs) (rs2119882, rs13140012, and rs6553010) of MTNR1A related to cancer risk and clinicopathological relevance according to a TaqMan-based real-time polymerase chain reaction (PCR)...
2017: International Journal of Medical Sciences
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