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https://www.readbyqxmd.com/read/28538964/effect-of-a-modified-hospital-elder-life-program-on-delirium-and-length-of-hospital-stay-in-patients-undergoing-abdominal-surgery-a-cluster-randomized-clinical-trial
#1
Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien, Chiung-Nien Chen, Ming-Tsan Lin, Guan-Hua Huang, Sharon K Inouye
Importance: Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). Objective: To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. Design, Setting, and Participants: This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538950/association-of-adjuvant-chemotherapy-with-survival-in-patients-with-stage-ii-or-iii-gastric-cancer
#2
Yuming Jiang, Tuanjie Li, Xiaoling Liang, Yanfeng Hu, Lei Huang, Zhenchen Liao, Liying Zhao, Zhen Han, Shuguang Zhu, Menglan Wang, Yangwei Xu, Xiaolong Qi, Hao Liu, Yang Yang, Jiang Yu, Wei Liu, Shirong Cai, Guoxin Li
Importance: The current staging system of gastric cancer is not adequate for defining a prognosis and predicting the patients most likely to benefit from chemotherapy. Objective: To construct a survival prediction model based on specific tumor and patient characteristics that enables individualized predictions of the net survival benefit of adjuvant chemotherapy for patients with stage II or stage III gastric cancer. Design, Setting, and Participants: In this multicenter retrospective analysis, a survival prediction model was constructed using data from a training cohort of 746 patients with stage II or stage III gastric cancer who satisfied the study's inclusion criteria and underwent surgery between January 1, 2004, and December 31, 2012, at Nanfang Hospital in Guangzhou, China...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538930/dissatisfaction-with-the-dental-services-and-associated-factors-among-adults
#3
Luana Leal Roberto, Andréa Maria Eleutério de Barros Lima Martins, Alfredo Maurício Batista de Paula, Efigênia Ferreira E Ferreira, Desirée Sant' Ana Haikal
This study aimed to identify factors associated with dissatisfaction with dental services among adults. It analyzed 830 adult participants of an epidemiological survey of oral health. The dependent variable was dissatisfaction with the dental service, and the independent ones were selected according to the theoretical model set forth by Andersen and Davidson (1997). Estimates were corrected by the sample design effect, and Binary Logistic Regression was carried out. It was found that about 11% of adults were dissatisfied with the dental service...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538919/expert-communities-and-interest-formation-in-the-brazilian-aids-program
#4
Regina Ferro do Lago, Nilson do Rosário Costa
This paper examines the role of the Technical Advisory Committee for antiretroviral therapy of the Brazilian AIDS program in mediating the decision-making process of including new antiretroviral (ARV) drugs in the Unified Health System services by the end of the 2000s. We conducted documental analysis and interviews with key informants from the governmental sphere and professionals. The work features the Technical Advisory Committee as an "expert community", defined as a network of individuals with expertise and competence in a particular sphere and whose knowledge is relevant in critical public policy decision areas...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538876/combination-therapy-with-butyrate-and-docosahexaenoic-acid-for-keloid-fibrogenesis-an-in-vitro-study
#5
Kazuhiro Torii, Noriaki Maeshige, Michiko Aoyama-Ishikawa, Makoto Miyoshi, Hiroto Terashi, Makoto Usami
Background: A single, effective therapeutic regimen for keloids has not been established yet, and the development of novel therapeutic approaches is expected. Butyrate, a short-chain fatty acid, and docosahexaenoic acid (DHA), a ω-3 polyunsaturated fatty acid, play multiple anti-inflammatory and anticancer roles via their respective mechanisms of action. Objective: In this study, we evaluated the antifibrogenic effects of their single and combined use on keloid fibroblasts...
March 2017: Anais Brasileiros de Dermatologia
https://www.readbyqxmd.com/read/28538852/-prevalence-of-symptomatic-respiratory-cases-in-the-peruvian-population-aged-15-years-and-above-secondary-analysis-of-the-demographic-and-family-health-survey-2013-2015
#6
César Gutiérrez, Joel Roque, Franco Romaní, Jorge Zagaceta
The objective of this study was to estimate the prevalence of symptomatic respiratory (SR) cases in the Peruvian population aged 15 years and over between 2013 and 2015. A secondary analysis of the Demographic and Family Health Survey (ENDES) was carried out. The subjects of the study were people aged 15 years and over who answered these interview questions: Do you currently have a cough with phlegm? How long have you had a cough with phlegm? People who had had a cough and phlegm for 15 days or more were defined as having SR...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28538836/establishment-of-patient-derived-tumor-xenograft-pdtx-models-using-samples-from-ct-guided-percutaneous-biopsy
#7
Y-P Zhuang, Y-P Zhu, H-Y Wang, L Sun, J Zhang, Y-P Hao, L Wang
This study aimed to investigate the feasibility of the establishment of a human cancer xenograft model using samples from computed tomography (CT)-guided percutaneous biopsy. Fresh tumor tissues obtained from 10 cancer patients by CT-guided percutaneous biopsy were subcutaneously inoculated into NOD-Prkdcem26Il2rgem26Nju (NCG) mice to establish human patient-derived tumor xenograft (PDTX) models. The formation of first and second generation xenografts was observed, and tumor volume was recorded over time. Tumor tissue consistency between the PDTX model and primary tumors in patients was compared using H&E staining and immunohistochemistry...
May 18, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28538819/how-strong-is-the-relationship-between-rainfall-variability-and-caatinga-productivity-a-case-study-under-a-changing-climate
#8
Cleber Salimon, Liana Anderson
Despite the knowledge of the influence of rainfall on vegetation dynamics in semiarid tropical Brazil, few studies address and explore quantitatively the various aspects of this relationship. Moreover, Northeast Brazil is expected to have its rainfall reduced by as much as 60% until the end of the 21st Century, under scenario AII of the IPCC Report 2010. We sampled and analyzed satellite-derived monthly rainfall and a vegetation index data for 40 sites with natural vegetation cover in Paraíba State, Brazil from 2001 to 2012...
May 22, 2017: Anais da Academia Brasileira de Ciências
https://www.readbyqxmd.com/read/28538759/comparison-of-two-central-venous-pressure-control-strategies-to-prevent-atrial-fibrillation-after-coronary-artery-bypass-grafting
#9
Mario Augusto Cray da Costa, Wesley Lirani, Ana Caroline Wippich, Luana Lopes, Eduardo de Souza Tolentino, Beatriz Zampar, Marcelo Derbli Schafranski
Background: Atrial fibrillation (AF) takes place in 10-40% of patients undergoing coronary artery bypass grafting (CABG), and increases cardiovascular mortality. Enlargement of atrial chambers is associated with increased AF incidence, so patients with higher central venous pressure (CVP) are expected to have larger atrial distension, which increases AF incidence. Objective: To compare post-CABG AF incidence, following two CVP control strategies. Methods: Interventional, randomized, controlled clinical study...
April 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28538738/solid-phase-synthesis-cyclization-and-site-specific-functionalization-of-aziridine-containing-tetrapeptides
#10
Benjamin K W Chung, Christopher J White, Andrei K Yudin
Cyclic tetrapeptides comprise a potent and selective class of molecules with a wide range of biological activities, including the phytotoxic activity of tentoxin and the histone deacetylase (HDAC) inhibitory effects of chlamydocin. The incorporation of a functional aziridine group within cyclic peptides enables their conformational control and allows for late-stage and site-selective functionalization of these molecules, thereby creating the potential for covalent protein labeling. This protocol describes the solid-phase synthesis, cyclization, and site-specific structural modification of aziridine-containing tetrapeptides...
June 2017: Nature Protocols
https://www.readbyqxmd.com/read/28538632/implications-of-the-tqip-inclusion-of-non-survivable-injuries-in-performance-benchmarking-tqip-inclusion-of-non-survivable-injuries
#11
Jiselle B Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a level 1 high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with non-survivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013-2014 with length of stay (LOS) < 1 day to determine survivability of the injuries...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538625/a-metric-of-our-own-failure-to-rescue-after-trauma
#12
Daniel N Holena, Elinore J Kaufman, M Kit Delgado, Douglas J Wiebe, Brendan G Carr, Jason D Christie, Patrick M Reilly
BACKGROUND: Failure to rescue (FTR) is defined as death after an adverse event. The original metric was derived in elective surgical populations and reclassifies deaths not preceded by recorded adverse events as FTR cases under the assumption these deaths resulted from missed adverse events. This approach lacks face validity in trauma because patients often die without adverse events as a direct result of injury. Another common approach simply excludes deaths without recorded adverse events, but this approach reduces the reliability of the FTR metric...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538499/expectations-and-experiences-of-follow-up-and-self-care-after-living-kidney-donation-a-focus-group-study
#13
Karine E Manera, Camilla S Hanson, Jeremy R Chapman, John Kanellis, John Gill, Jonathan C Craig, Steve J Chadban, Germaine Wong, Angelique F Ralph, Allison Tong
BACKGROUND: Ensuring donor wellbeing warrants ongoing monitoring following living kidney donation. However, there is considerable variability in donor follow up processes, including information provided to donors regarding self-care. Loss to follow up is common, suggesting that the aims and benefits of monitoring and follow up may not be apparent. We aimed to describe the experiences and expectations of living kidney donors regarding follow up and self-care after donation. METHODS: Participants from 3 transplant centers in Australia and Canada participated in 14 focus groups (n=123)...
May 24, 2017: Transplantation
https://www.readbyqxmd.com/read/28538427/return-on-investment-of-advanced-practice-medical-degrees-nps-vs-pas
#14
Christopher K Craig, James H Holmes, Jeffery E Carter
As the United States faces a predicted physician shortage over the next 2 decades, physician assistants (PAs) and NPs are expected to fill the void. At the same time, because education is expensive, student loan and tuition increases have many potential applicants assessing differences in reimbursement and wondering about their return on investment (ROI). An analysis compared PA and NP salaries by incorporating national salary data, federal income tax, and student loans for a comparative analysis of each career pathway...
June 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28538377/time-distribution-of-injury-related-in-hospital-mortality-in-a-trauma-referral-center-in-south-of-iran-2010-2015
#15
Hamidreza Abbasi, Shahram Bolandparvaz, Mahnaz Yadollahi, Mehrdad Anvar, Zahra Farahgol
In Iran, there are no studies addressing trauma death timing and factors affecting time of death after injuries. This study aimed to examine time distribution of trauma deaths in an urban major trauma referral center with respect to victims' injury characteristics during 2010 to 2015.This was a cross-sectional study of adult trauma-related in-hospital deaths resulting from traffic-related accidents, falls, and violence-related injuries. Information on injury characteristics and time interval between admission and death was extracted from 3 hospital databases...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538262/parafoveal-microvascular-features-on-optical-coherence-tomography-angiography-in-eyes-with-circumscribed-choroidal-hemangioma
#16
Kareem Sioufi, Emil A T Say, Sandor C Ferenczy, Carol L Shields
PURPOSE: To evaluate parafoveal microvasculature in eyes with circumscribed choroidal hemangioma using optical coherence tomography angiography. METHODS: Fourteen eyes with unilateral circumscribed choroidal hemangioma were imaged using OCT for central macular thickness and optical coherence tomography angiography for superficial and deep foveal avascular zone area, and superficial and deep capillary density (CD), comparing affected and paired fellow eyes. RESULTS: Mean patient age was 53 years, and mean visual acuity was 20/60 in the involved eye and 20/25 in the fellow eye...
May 19, 2017: Retina
https://www.readbyqxmd.com/read/28538233/enewborn-the-information-technology-revolution-and-challenges-for-neonatal-networks
#17
Dominique Haumont, Cuong NguyenBa, Neena Modi
Among preterm infants, 1-2% are born before 32 weeks of gestation or have a birth weight below 1,500 g. They contribute disproportionately to the burden of mortality and morbidity related to preterm birth, whether in the neonatal period or later in life. They are the target population studied in neonatal networks. Improving neonatal care and later outcome is a major issue in public health. Neonatologists, health care providers, public authorities, parents and families, industry, and all organizations dedicated to infant health must bring their efforts together and dedicate their actions in order to do so...
2017: Neonatology
https://www.readbyqxmd.com/read/28538218/dialysis-therapy-and-conservative-management-of-advanced-chronic-kidney-disease-in-the-elderly-a-systematic-review
#18
Supakanya Wongrakpanich, Paweena Susantitaphong, Suramath Isaranuwatchai, Jirat Chenbhanich, Somchai Eiam-Ong, Bertrand L Jaber
BACKGROUND: Dialysis in older adults with chronic kidney disease (CKD) and comorbidities may not be associated with improved life expectancy compared to conservative management. To inform clinical practice, we performed a systematic review of all available studies examining this hypothesis. METHODS: We performed a systematic review of retrospective and prospective cohort studies of older adults with stage-5 CKD who chose dialysis (hemodialysis or peritoneal dialysis) or opted for conservative management (including management of complications of CKD and palliative care)...
May 25, 2017: Nephron
https://www.readbyqxmd.com/read/28538198/protein-and-metabolic-engineering-for-the-production-of-organic-acids
#19
Jingjing Liu, Jianghua Li, Hyun-Dong Shin, Long Liu, Guocheng Du, Jian Chen
Organic acids are natural metabolites of living organisms. They have been widely applied in the food, pharmaceutical, and bio-based materials industries. In recent years, biotechnological routes to organic acids production from renewable raw materials have been regarded as very promising approaches. In this review, we provide an overview of current developments in the production of organic acids using protein and metabolic engineering strategies. The organic acids include propionic acid, pyruvate, itaconic acid, succinic acid, fumaric acid, malic acid and citric acid...
April 14, 2017: Bioresource Technology
https://www.readbyqxmd.com/read/28538196/self-assembly-of-gd-3-sds-hepes-complex-and-curcumin-entrapment-for-enhanced-stability-fluorescence-image-in-cellular-system
#20
Chonticha Sahub, Gamolwan Tumcharern, Prae Chirawatkul, Vithaya Ruangpornvisuti, Sanong Ekgasit, Supasorn Wanichweacharungruang, Thawatchai Tuntulani, Tanapat Palaga, Boosayarat Tomapatanaget
At present, strategies to disperse hydrophobic molecules in water without altering their chemical structures include conventional surfactant-based micellar and vesicular systems, encapsulation into water dispersible polymeric nanoparticles, and loading onto the surface of various metal nanoparticles. Here, we report a simple and low cost platform to incorporate hydrophobic molecules into a stable water dispersible nanostructure that can significantly increase the stability of the encapsulated materials. The platform is based on the incorporation of hydrophobic molecules into the self-assembled complex of gadolinium ion (Gd(3+)), sodium dodecyl sulfate (SDS), and 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) called GdSH...
May 13, 2017: Colloids and Surfaces. B, Biointerfaces
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