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patient flow

Huma Siddiqui, Tsute Chen, Ardita Aliko, Piotr M Mydel, Roland Jonsson, Ingar Olsen
BACKGROUND: Reduced salivation is considered a major clinical feature of most but not all cases of primary Sjögren's syndrome (pSS). Reduced saliva flow may lead to changes in the salivary microbiota. These changes have mainly been studied with culture that typically recovers only 65% of the bacteria present. OBJECTIVE: This study was to use high throughput sequencing, covering both cultivated and not-yet-cultivated bacteria, to assess the bacterial microbiota of whole saliva in pSS patients with normal salivation...
2016: Journal of Oral Microbiology
Lauren E Marshall, Roy Koomullil, Andra R Frost, Joel L Berry
A preclinical testing model for cancer therapeutics that replicates in vivo physiology is needed to accurately describe drug delivery and efficacy prior to clinical trials. To develop an in vitro model of breast cancer that mimics in vivo drug/nutrient delivery as well as physiological size and bio-composition, it is essential to describe the mass transport quantitatively. The objective of the present study was to develop in vitro and computational models to measure mass transport from a perfusion system into a 3D extracellular matrix (ECM)...
October 21, 2016: Annals of Biomedical Engineering
Manuel Guerrero-Hernandez, Carlos A Hinojosa, Javier E Anaya-Ayala, Erika Elenes, Aldo Torre
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV...
October 20, 2016: Vascular and Endovascular Surgery
Mustafa Topuz, Fahrettin Oz, Oguz Akkus, Omer Sen, Ayse Nur Topuz, Atilla Bulut, Suleyman Ozbicer, Sefa Okar, Mevlut Koc, Mustafa Gur
OBJECTIVE: We aimed to investigate the compliance of plasma apelin-12 levels to show angiographic properties and hospital MACE in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). MATERIAL AND METHODS: The association of apelin-12 levels with the N/L ratio on admission was assessed in 170 consecutive patients with primary STEMI undergoing primary PCI. All patient SYNTAX scores and thrombolysis in myocardial infarction (TIMI) flow grades were also assessed...
October 20, 2016: Perfusion
Akil Patel, Timothy R Miller, Ravi Shivashankar, Gaurav Jindal, Dheeraj Gandhi
BACKGROUND AND OBJECTIVE: Acute thrombus formation following aneurysm treatment with the Pipeline embolization device (PED) is a potentially devastating complication that may result in significant thromboembolic sequelae if not promptly treated. We therefore evaluated PED cases complicated by acute thrombus formation at our institution, with an emphasis on identifying early angiographic signs that may portend this event. MATERIALS AND METHODS: We retrospectively identified cases of acute thrombosis following PED placement in 100 consecutive procedures performed at our institution from a prospectively maintained clinical database...
October 21, 2016: Journal of Neurointerventional Surgery
Per Martin Arvidsson, Johannes Töger, Marcus Carlsson, Katarina Steding-Ehrenborg, Gianni Pedrizzetti, Einar Heiberg, Hakan Arheden
Intracardiac blood flow is driven by hemodynamic forces that are exchanged between the blood and myocardium. Previous studies have been limited to 2D measurements or investigated only LV forces. Right ventricular forces and their mechanistic contribution to asymmetric redirection of flow in the RV have not been measured. We therefore aimed to quantify three-dimensional hemodynamic forces in both ventricles in a cohort of healthy subjects, using magnetic resonance imaging 4D flow measurements. 25 controls,14 elite endurance athletes, and two patients with left ventricular dyssynchrony were included...
October 21, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Jing Xue, Qinglan Zhao, Vishal Sharma, Linh P Nguyen, Yvonne N Lee, Kim L Pham, Mouad Edderkaoui, Stephen J Pandol, Walter Park, Aida Habtezion
BACKGROUND & AIMS: Cigarette smoke has been identified as an independent risk factor for chronic pancreatitis (CP). Little is known about the mechanisms by which smoking promotes development of CP. We assessed the effects of aryl hydrocarbon receptor (AhR) ligands found in cigarette smoke on immune cell activation in humans and pancreatic fibrosis in animal models of CP. METHODS: We obtained serum samples from patients with CP treated at Stanford University hospital and healthy individuals (controls) and isolated CD4+ T cells; levels of interleukin-22 (IL22) were measured by ELISA and smoking histories were collected...
October 18, 2016: Gastroenterology
Arpa Surapaitoon, Sutas Suttiprapa, Narong Khuntikeo, Chawalit Pairojkul
The carcinogenic liver fluke Opisthorchis viverrini causes chronic inflammation in the bile duct and resulting in unremitting tissue damage that lead to hepatobiliary diseases, including cholangiocarcinoma (CCA). Despite inflammatory cytokine expression having been studied in the animal model, so far no studies have been carried out on cytokines in human CCA cases. Here we report the profile of cytokine production in peripheral blood mononuclear cells (PBMCs) collected from O. viverrini-associated human CCA and uninfected normal controls after stimulation with O...
October 18, 2016: Parasitology International
Shigeaki Aoyagi, Eiki Tayama, Takeshi Oda, Tomokazu Kosuga, Hiroshi Yasunaga
In patients with atrial fibrillation, closure of the left atrial appendage (LAA) is recommended to prevent thromboembolic events, however, conventional exclusion or excision techniques have potential drawbacks such as persistent blood flow into the appendage and a residual stump. We propose a simple and easy technique for LAA closure consisting of intra-atrial excision of the LAA, which is invaginated into the left atrium (LA), and direct suture closure of the orifice from inside the LA. In this technique, complete elimination of the LAA was achieved without leaving a residual stump because the LAA was excised at the orifice and was closed at the base of the LAA...
September 9, 2016: Heart, Lung & Circulation
Kristine Moltu, Karen Henjum, Nikolaus G Oberprieler, Bjørn A Bjørnbeth, Kjetil Taskén
Patients with colorectal cancer (CRC) have been shown to have elevated levels of circulating prostaglandin E2(PGE2) which promotes cancer progression and suppresses T-cell immune responses. In this study we evaluated whether signaling responses in T lymphocytes obtained from peripheral blood of CRC patients were affected by the sustained exposure to increased levels of PGE2. The phosphorylation status of an extended panel of proteins involved in downstream signaling cascades in T cells was profiled at a single cell level both in naïve and antigen-experienced cells after triggering T cell-, prostaglandin- and interleukin-2 receptors...
October 18, 2016: Human Immunology
Caitlin McConnico, Suzanne L Jed, Eva Marumo, Sipho Mazibuko, Gladys Makati Mema, Julia DeKadt, King K Holmes, Pamela K Kohler
Sexually transmitted infection (STI) service delivery in the context of integrated care and the South African HIV epidemic is complex. We aimed to document STI care and HIV testing processes in public health clinics in South Africa, revealing bottlenecks to patient flow and identifying opportunities for improvement. Clinic mapping, with semi-structured interviews and clinic observation, was conducted with facility representatives at three clinical sentinel surveillance sites. Facility surveys assessed patient volume and staffing...
September 17, 2016: Journal of the Association of Nurses in AIDS Care: JANAC
Fangming Liu, Honglian Zhang, Zhenhua Wu, Haidao Dong, Lin Zhou, Dawei Yang, Yuqing Ge, Chunping Jia, Huiying Liu, Qinghui Jin, Jianlong Zhao, Qiqing Zhang, Hongju Mao
Carcinoembryonic antigen (CEA) is an important biomarker in cancer diagnosis. Here, we present an efficient, selective lateral-flow immunoassay (LFIA) based on magnetic nanoparticles (MNPs) for in situ sensitive and accurate point-of-care detection of CEA. Signal amplification mechanism involved linking of detection MNPs with signal MNPs through biotin-modified single-stranded DNA (ssDNA) and streptavidin. To verify the effectiveness of this modified LFIA system, the sensitivity and specificity were evaluated...
December 1, 2016: Talanta
Greg Hodge, Eugene Roscioli, Hubertus Jersmann, Hai B Tran, Mark Holmes, Paul N Reynolds, Sandra Hodge
BACKGROUND: Corticosteroid resistance is a major barrier to effective treatment of COPD. We have shown that the resistance is associated with decreased expression of glucocorticoid receptor (GCR) by senescent CD28nullCD8+ pro-inflammatory lymphocytes in peripheral blood of COPD patients. GCR must be bound to molecular chaperones heat shock proteins (Hsp) 70 and Hsp90 to acquire a high-affinity steroid binding conformation, and traffic to the nucleus. We hypothesized a loss of Hsp70/90 from these lymphocytes may further contribute to steroid resistance in COPD...
October 21, 2016: Respiratory Research
Ahmed Almashrafi, Laura Vanderbloemen
BACKGROUND: Postoperative adverse events are known to increase length of stay and cost. However, research on how adverse events affect patient flow and operational performance has been relatively limited to date. Moreover, there is paucity of studies on the use of simulation in understanding the effect of complications on care processes and resources. In hospitals with scarcity of resources, postoperative complications can exert a substantial influence on hospital throughputs. METHODS: This paper describes an evaluation method for assessing the effect of complications on patient flow within a cardiac surgical department...
October 21, 2016: BMC Medical Informatics and Decision Making
Estelle Seyman, Hilla Shaim, Shani Shenhar-Tsarfaty, Tali Jonash-Kimchi, Natan M Bornstein, Hen Hallevi
BACKGROUND: Acute ischemic stroke (AIS) is a common neurological event that causes varying degrees of disability. AIS outcome varies considerably, from complete recovery to complete loss of tissue and function. This diversity is partly explained by the compensatory ability of the collateral circulation and the ensuing cerebral flow grade. The collateral flow to the anterior circulation largely supplies the cortical areas. The deep brain tissue is supplied by penetrating arteries and has little or no collateral supply...
October 21, 2016: BMC Neurology
Deying Liu, Jinxiang Liu, Jinghua Wang, Congcong Liu, Sirui Yang, Yanfang Jiang
BACKGROUND: Circulating follicular helper T (Tfh) cells are a heterogeneous population of CD4(+) helper T cells that promotes pathogenic immune responses in autoimmune diseases. In this study, we examined the status of different subpopulations of Tfh cells in peripheral circulation and their associations with various clinical characteristics of IgA vasculitis (IgAV). METHODS: According to the phenotypic expressions of different molecules, focus was given on six subpopulations of Tfh cells: CD4(+)CXCR5(+), CD4(+)CXCR5(+)ICOS(+), CD4(+)CXCR5(+)ICOS(+)PD-1(+), CD4(+)CXCR5(+)ICOS(high)PD-1(high), CD4(+)CXCR5(+)ICOS(-)PD-1(+), and CXCR5(+)CD45RA(-)IL-21(+)...
October 21, 2016: BMC Immunology
Qiyong Jiang, Yimin Liu, Shijuan Zhang, Naikun Li, Gaoling Sun
MiRNAs are emerging as important epigenetic modulators of multiple target genes, leading to abnormal cellular signaling involving cellular proliferation in cancers. Aberrant miRNA expression has been observed in human glioblastoma (GBM). The present study was to evaluate the expression and molecular mechanisms of COX-2 and miR-26b in human GBM tissues and GBM cell lines T98G, U87 and U251. In the present study, we found that expression of miR-26b was markedly downregulated in GBM cell lines and human GBM tissues, compared to matched non-tumor associated tissues...
October 17, 2016: Oncotarget
Jacob J Glaser, Cassandra Cardarelli, Samuel Galvagno, Thomas M Scalea, Sarah B Murthi
BACKGROUND: Point-of-care ultrasound often includes cardiac ultrasound. It is commonly used to evaluate cardiac function in critically ill patients but lacks the specific quantitative anatomic assessment afforded by standard transthoracic echocardiography (TTE). We developed the Focused Rapid Echocardiographic Examination (FREE), a hybrid between a cardiac ultrasound and TTE that places an emphasis on cardiac function rather than anatomy. We hypothesized that data obtained from FREE correlate well with TTE while providing actionable information for clinical decision making...
November 2016: Journal of Trauma and Acute Care Surgery
Anders J Davidson, Lucas P Neff, Joseph J DuBose, James B Sampson, Christopher M Abbot, Timothy K Williams
Peripheral vascular injuries carry significant risk for permanent functional impairment, limb loss, and death. Definitive correction of these injuries requires significant operative time and has traditionally been resource and skill set intensive. In the initial surgical treatment of the physiologically depleted trauma patient, faster techniques may prove more appropriate. Damage control techniques, including vascular shunting, rapidly restore distal flow but require additional vascular intervention and risk shunt thrombosis with prolonged use...
November 2016: Journal of Trauma and Acute Care Surgery
Aparna Singhal, Joel K Curé
Time-of-flight magnetic resonance angiography is used for craniocervical arterial evaluation. Absent flow-related signal may be the result of slow flow, complex flow, or focal susceptibility effects. We report a case with complete absence of flow-related signal in the intracranial and cervical vessels due to ferumoxytol infusion given 5 days before magnetic resonance angiography. Ferumoxytol is a newly approved parenteral therapy for iron-deficiency anemia in patients with renal failure and awareness of this drug-magnetic resonance imaging interaction is needed...
October 20, 2016: Journal of Computer Assisted Tomography
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