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Rejection of Care

Tim Mitchell, Hannah Gooding, Cathy Mews, Leon Adams, Gerry MacQuillan, George Garas, Madhur Ravikumara, Ainslie Lopez, Megan Collins, Gary Jeffrey
Transition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single-center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity...
October 20, 2016: Pediatric Transplantation
Vanaja Konduri, Dali Li, Matthew M Halpert, Dan Liang, Zhengdong Liang, Yunyu Chen, William E Fisher, Silke Paust, Jonathan M Levitt, Qizhi Cathy Yao, William K Decker
Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer-related death in the United States, exhibiting a five-year overall survival (OS) of only 7% despite aggressive standard of care. Recent advances in immunotherapy suggest potential application of immune-based treatment approaches to PDAC. To explore this concept further, we treated orthotopically established K-ras(G12D)/p53(-/-) PDAC tumors with gemcitabine and a cell-based vaccine previously shown to generate durable cell-mediated (TH1) immunity...
2016: Oncoimmunology
Carl Savage, Louise Parke, Mia von Knorring, Pamela Mazzocato
BACKGROUND: Health care has experimented with many different quality improvement (QI) approaches with greater variation in name than content. This has been dubbed pseudoinnovation. However, it could also be that the subtleties and differences are not clearly understood. To explore this further, the purpose of this study was to explore how hospital managers perceive lean in the context of QI. METHODS: We used a qualitative study design with semi-structured interviews to explore twelve top managers' perceptions of the relationship between lean and quality improvement (QI) at a university-affiliated hospital...
October 19, 2016: BMC Health Services Research
Benjamin M Anderson, Jemma L Mytton, Felicity Evison, Charles J Ferro, Adnan Sharif
INTRODUCTION: Outcomes for weekend hospital admissions or emergency procedures have become a topical and controversial issue for the UK National Health Service (NHS). Deceased-donor kidney transplantation is frequently performed at weekends and evidence for its relative safety are lacking. METHODS: We undertook a population-based cohort analysis, obtaining data from every deceased-donor kidney-alone transplant procedure performed in England between January 2003 and December 2014...
October 17, 2016: Transplantation
Hada C Macher, G Suárez-Artacho, Pilar Jiménez-Arriscado, S Álvarez-Gómez, N García-Fernández, Juan M Guerrero, Patrocini Molinero, Elena Trujillo-Arribas, M A Gómez-Bravo, Amalia Rubio
The evaluation of the transplanted liver health by non-invasive approaches may offer an improvement in early clinical intervention. As transplanted organs have genomes that are distinct from the host's genome, the quantification of the specific DNA of the donated liver in the patient serum will allow us to obtain information about its damage. We evaluated the state of transplanted liver health by monitoring the RH gene in serum circulating DNA (cirDNA) from 17 recipient and donor mismatched for this gene. cirDNA RH gene was quantified by RT- PCR before, at the moment of transplantation (day 0) and during the stay at the intensive care unit...
2016: Advances in Experimental Medicine and Biology
Justyna Rajchert, Monika Rosa, Joanna Pawłowska, Milosz Parczewski, Marta Wawrzynowicz-Syczewska
BACKGROUND Despite excellent transplantation results, there is a vulnerable period of time in the post-transplant management of pediatric liver recipients, which is the time when a child becomes an adolescent. This period of psychological distress influences compliance and may result in premature transplant failure and graft loss. We performed a retrospective review of pediatric liver transplant recipients, transferred to our service for adults, in order to identify key issues associated with transition into the adult care...
October 18, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Ainhoa Coloma-Carmona, José Luis Carballo, Sonia Tirado-González
OBJECTIVE: Due to the lack of studies in the Spanish population, this study aims to analyze the barriers perceived by health professionals from different Spanish health centers when attempting to identify and treat problem drinkers and the importance given to this aspect, as well as analyzing the possible differences as a function of the professionals' health teams. We also analyze the psychometric properties of the questionnaire used to assess these barriers. METHOD: The participants included 107 health professionals: 62...
October 14, 2016: Gaceta Sanitaria
Juan Du, Takeshi Yagihashi
We examine how inputs for health production, in particular, medical care and health-enhancing time, are combined to improve health. The estimated elasticity of substitution from a constant elasticity of substitution production function is significantly less than one for the working-age population, rejecting the unit elasticity of substitution used in previous studies. Copyright © 2016 John Wiley & Sons, Ltd.
October 16, 2016: Health Economics
Hamde Nazar, Steven Brice, Nasima Akhter, Adetayo Kasim, Ann Gunning, Sarah P Slight, Neil W Watson
OBJECTIVES: To evaluate an electronic patient referral system from one UK hospital Trust to community pharmacies across the North East of England. SETTING: Two hospital sites in Newcastle-upon-Tyne and 207 community pharmacies. PARTICIPANTS: Inpatients who were considered to benefit from on-going support and continuity of care after leaving hospital. INTERVENTION: Electronic transmission of an information related to patient's medicines to their nominated community pharmacy...
October 14, 2016: BMJ Open
A Molina Raya, A García Navarro, C San Miguel Méndez, M Domínguez Bastante, M T Villegas Herrera, K Granero, A Becerra Massare, J M Villar Del Moral, M Expósito, Y Fundora Suárez
OBJECTIVE: The aim of this work was to determine the impact of obesity on the morbidity and mortality of liver transplantation (LT) recipients. METHODS: A single-center, observational-cohort, retrospective study was conducted in patients undergoing LT from January 2008 to December 2014 to compare complications and survival between those with body mass index (BMI) <35 kg/m(2) and those with BMI ≥35 kg/m(2). RESULTS: The study included 170 patients: 162 (95...
September 2016: Transplantation Proceedings
F Salazar Meira, J Zemiacki, A E Figueiredo, L Viliano Kroth, D Saute Kochhann, D O d'Avila, M Traesel, D Saitovitch, C E Poli-de-Figueiredo
BACKGROUND: One of the main postoperative complications of kidney transplant is delayed graft function (DGF), which means absence of graft function after transplant or the need for dialysis during the first week post procedure. The occurrence of DGF currently in our hospital is high and has been attributed to a combination of many factors. The aim of this study was to evaluate the factors associated to DGF and their influence in the outcome of kidney transplants. METHODS: Historical cohort of 150 patients transplanted with live or deceased donor kidneys from 2011 to 2013...
September 2016: Transplantation Proceedings
Sotiria Palioura, Kathryn Colby
PURPOSE: To evaluate the feasibility of Descemet stripping endothelial keratoplasty using grafts preloaded by an eye bank in a commercially available insertion device. METHODS: In this retrospective case series, a series of 35 eyes in 34 consecutive patients who underwent Descemet stripping endothelial keratoplasty for Fuchs endothelial dystrophy or previously failed full-thickness grafts at a single tertiary care center from March 2013 to March 2014 was included...
October 12, 2016: Cornea
Shaina Riciputi, Meghan H McDonough, Sarah Ullrich-French
Physical activity-based positive youth development (PYD) programs often aim to foster character development. This study examined youth perspectives of character development curricula and the impact these activities have on their lives within and beyond the program. This case study examined youth from low-income families in a physical activity-based summer PYD program that integrated one character concept (respect, caring, responsibility, trust) in each of 4 weeks. Participants (N = 24) included a cross-section of age, gender, ethnicity, and past program experience...
October 13, 2016: Journal of Sport & Exercise Psychology
Christopher Hartmann
Several Latin American countries are implementing a suite of so-called "postneoliberal" social and political economic policies to counter neoliberal models that emerged in the 1980s. This article considers the influence of postneoliberalism on public health discourses, policies, institutions, and practices in Bolivia, Ecuador, and Venezuela. Social medicine and neoliberal public health models are antecedents of postneoliberal public health care models. Postneoliberal public health governance models neither fully incorporate social medicine nor completely reject neoliberal models...
October 13, 2016: American Journal of Public Health
Neeraj Nagpal
Physicians and Internists in India have tended to brush under the carpet legal issues affecting their profession. Of concern to all Physicians is the judgment in a recent case where the NCDRC has stated that if MD Medicine Physicians write Physician & Cardiologist on their letterhead it is Quackery. What is MD Medicine degree holder in India qualified and trained to treat ? These are issues which need debate and that can only be initiated once we recognize that there is a problem. Either an MD Medicine is a cardiologist or he is not...
February 2016: Journal of the Association of Physicians of India
Jong Man Kim, Kwang-Woong Lee, Gi-Won Song, Bo-Hyun Jung, Hae Won Lee, Nam-Joon Yi, ChoonHyuck David Kwon, Shin Hwang, Kyung-Suk Suh, Jae-Won Joh, Suk-Koo Lee, Sung-Gyu Lee
BACKGROUND/AIMS: The relationship between patient survival and biopsy-proven acute rejection (BPAR) in liver transplant recipients with hepatitis C remains unclear. The aims of this study were to compare the characteristics of patients with and without BPAR and to identify risk factors for BPAR. METHODS: We retrospectively reviewed the records of 169 HCV-RNA-positive patients who underwent LT at three centers. RESULTS: BPAR occurred in 39 (23...
September 2016: Clinical and Molecular Hepatology
Nikolaj Bak, Lars K Hansen
Missing data is a common problem in many research fields and is a challenge that always needs careful considerations. One approach is to impute the missing values, i.e., replace missing values with estimates. When imputation is applied, it is typically applied to all records with missing values indiscriminately. We note that the effects of imputation can be strongly dependent on what is missing. To help make decisions about which records should be imputed, we propose to use a machine learning approach to estimate the imputation error for each case with missing data...
2016: PloS One
Jorge M Lobo
Experimental information on the roles played by climatic factors in determining the ecology and distribution of insect species is scarce. This has stimulated the increasing use of the climatic characteristics of the localities in which the species are observed to derive predictions under different climatic scenarios (the so called species-distribution models or SDMs). This text reviews the main limitations of these correlative models when they are applied to organisms, such as insects, that are characterized by a high degree of collector bias and incompleteness...
October 2016: Current Opinion in Insect Science
Takeshi Shiraishi, Akinori Iwasaki
The most frequent cause of death within a year after lung transplantation is infectious complications, which shifts to chronic allograft rejection or chronic lung allograft dysfunction(CLAD) thereafter. It is no doubt that minimization of the dose of immunosuppression within the acceptable therapeutic range is a best strategy to avoid infectious complications however, adequate dose of immunosuppressant is mandatory to protect lung allografts from acute or chronic rejection. Carefully balanced therapy of immunosuppression and infection control is extremely important for patient's long term survival after lung transplantation...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Sang Jun Eun, Jin Yong Lee, Hye-Min Jung, Jin-Seok Lee
This study aimed to identify the factors influencing South Korean voters' attitudes towards increasing public expenditure on health and to identify whether the issue of healthcare expenditure influenced candidate choice in the 2012 Korean presidential election. The study used the data from a survey conducted by the Institute of Korean Politics at Seoul National University immediately following the 2012 presidential election. The survey was completed by a nationwide sample of 1,200 people aged 19 or over using a face-to-face interview method and proportional quota sampling based on sex, age, and region...
2016: PloS One
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