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Clinical integration

Jing Jiang, You-Jin Zhao, Xin-Yu Hu, Ming-Ying Du, Zi-Qi Chen, Min Wu, Kai-Ming Li, Hong-Yan Zhu, Poornima Kumar, Qi-Yong Gong
BACKGROUND: Multiple meta-analyses of diffusion tensor imaging (DTI) studies have reported impaired white matter integrity in patients with major depressive disorder (MDD). However, owing to inclusion of medicated patients in these studies, it is difficult to conclude whether these reported alterations are associated with MDD or confounded by medication effects. A meta-analysis of DTI studies on medication-free (medication-naive and medication washout) patients with MDD would therefore be necessary to disentangle MDD-specific effects...
October 25, 2016: Journal of Psychiatry & Neuroscience: JPN
Jessica S Dalley, Patricia R Creary, Tiffany Durzi, C Meghan McMurtry
Although there are existing guidelines for teaching and learning skillful client communication, there remains a need to integrate a developmental focus into veterinary medical curricula to prepare students for interactions with children who accompany their companion animals. The objectives of this Teaching Tip are (1) to describe the use of a Teddy Bear Clinic Tour as an innovative, applied practice method for teaching veterinary students about clinical communication with children, and (2) to provide accompanying resources to enable use of this method to teach clinical communication at other facilities...
October 25, 2016: Journal of Veterinary Medical Education
Michele Tinazzi, Christian Geroin, Marialuisa Gandolfi, Nicola Smania, Stefano Tamburin, Francesca Morgante, Alfonso Fasano
Pisa syndrome was first described in 1972 in patients treated with neuroleptics. Since 2003, when it was first reported in patients with Parkinson's disease (PD), Pisa syndrome has progressively drawn the attention of clinicians and researchers. Although emerging evidence has partially clarified its prevalence and pathophysiology, the current debate revolves around diagnostic criteria and assessment and the effectiveness of pharmacological, surgical, and rehabilitative approaches. Contrary to initial thought, Pisa syndrome is common among PD patients, with an estimated prevalence of 8...
October 25, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Cheryl Fisher, Georgie Cusack, Kim Cox, Kathryn Feigenbaum, Gwenyth R Wallen
Organizations must ensure that nursing care delivery is based on best evidence. This article describes how a clinical research hospital used a competency-based approach to structure the development and execution of a strategic plan and integrated evidence-based practice concepts into the activities of nurses at all levels. The article will also describe the process for developing and implementing the competency across our department including outcomes achieved.
November 2016: Journal of Nursing Administration
Yoon Soo Park, Matthew Lineberry, Abbas Hyderi, Georges Bordage, Kuan Xing, Rachel Yudkowsky
PURPOSE: Medical schools administer locally developed graduation competency examinations (GCEs) following the structure of the United States Medical Licensing Examination Step 2 Clinical Skills that combine standardized patient (SP)-based physical examination and the patient note (PN) to create integrated clinical encounter (ICE) scores. This study examines how different subcomponent scoring weights in a locally developed GCE affect composite score reliability and pass-fail decisions for ICE scores, contributing to internal structure and consequential validity evidence...
November 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Yiwen Ouyang, Jingyi Li, Doris M Haverstick, James P Landers
We recently defined a magnetic bead-based assay that exploited an agglutination-like response for DNA and applied it to DNA-containing cell enumeration using inexpensive benchtop hardware [ J. Am. Chem. Soc. 2012 , 134 ( 12 ), 5689 - 96 ]. Although cost-efficient, the open-well format assay required numerous manual steps, and the magnetic field actuation scheme was not readily adaptable for integration. Here, we demonstrate a low-cost (<$2 in-lab), higher-throughput "pinwheel assay" platform that relies on a combination of a disposable rotation-driven microdisc (RDM), and a simple bidirectional rotating magnetic field (bi-RMF)...
October 25, 2016: Analytical Chemistry
Arthur Lalonde, Hugo Bouchard
To develop a general method for human tissue characterization with dual- and multi-energy CT and evaluate its performance in determining elemental compositions and quantities relevant to radiotherapy Monte Carlo dose calculation. Ideal materials to describe human tissue are obtained applying principal component analysis on elemental weight and density data available in literature. The theory is adapted to elemental composition for solving tissue information from CT data. A novel stoichiometric calibration method is integrated to the technique to make it suitable for a clinical environment...
November 21, 2016: Physics in Medicine and Biology
Juan M González-Morena, María I Montañez, Giancarlo Aldini, Francisco J Sánchez-Gómez, Dolores Pérez-Sala
Drug hypersensitivity reactions result from the activation of the immune system by drugs or their metabolites. The clinical presentations of drug hypersensitivity can range from relatively mild local manifestations to severe systemic syndromes that can be life-threatening. As in other allergic reactions, the causes are multifactorial as genetic, metabolic and concomitant factors may influence the occurrence of drug hypersensitivity. Formation of drug protein adducts is considered a key step in drug adverse reactions, and in particular in the immunological recognition in drug hypersensitivity reactions...
September 27, 2016: Current Pharmaceutical Design
Giuseppina D'Onofrio, Mariadelina Simeoni, Paolo Rizza, Mariarita Caroleo, Maria Capria, Giovanni Mazzitello, Tiziana Sacco, Elena Mazzuca, Maria Teresa Panzino, Annamaria Cerantonio, Cristina Segura-Garcia, Michele Andreucci, Pasquale De Fazio, Giorgio Fuiano
RATIONAL: Our aim was to investigate the quality of life (QoL) in 103 patients undergoing chronic hemodialysis (HD) in an integrated assessment of clinical, personological, and adaptation parameters, also in a non-urban context. OBJECTIVES: We collected data from all chronic HD patients attending four HD units. Clinical status was assessed by Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines and by Age-adjusted Charlson Comorbidity Index (ACCI). Patients completed the following questionnaires: Kidney Disease Quality of Life Short Form (KDQOL-SF), Pittsburgh Sleep Quality Index (PSQI)...
October 25, 2016: Renal Failure
Beata Olas
Diet and nutrition have an important influence on the prophylaxis and progression of cardiovascular disease; one example is the inhibition of blood platelet functions by specific components of fruits and vegetables. Garlic, onion, ginger, dark chocolate and polyunsaturated fatty acids all reduce blood platelet aggregation. A number of fruits contain a range of cardioprotective antioxidants and vitamins, together with a large number of non-nutrient phytochemicals such as phenolic compounds, which may possess both antioxidant properties and anti-platelet activity...
October 25, 2016: Platelets
Yara Abdou, Christine Lohse, Nneka I Comfere
BACKGROUND: Timely pathologic diagnosis relies on the communication of specific clinical information in the requisition form (RF). Clinical information may use nonspecific terms such as "rule out", the use of which may result in diagnostic delays and the unnecessary application of pathology stains and sections. OBJECTIVE: This study was designed to evaluate the relationship between use of the term "rule out" and time to diagnosis, and the use of additional pathology stains and sections in integrated and non-integrated dermatopathology practices...
October 25, 2016: International Journal of Dermatology
Peter A Campochiaro, Kevin G Peters
Tie2 is a tyrosine kinase receptor located predominantly on vascular endothelial cells that plays a central role in vascular stability. Angiopoietin-1 (Angpt1), produced by perivascular cells, binds, clusters, and activates Tie2, leading to Tie2 autophosphorylation and downstream signaling. Activated Tie2 increases endothelial cell survival, adhesion, and cell junction integrity, thereby stabilizing the vasculature. Angiopoietin-2 (Angpt2) and vascular endothelial-protein tyrosine phosphatase (VE-PTP) are negative regulators increased by hypoxia; they inactivate Tie2, destabilizing the vasculature and increasing responsiveness to vascular endothelial growth factor (VEGF) and other inflammatory cytokines that stimulate vascular leakage and neovascularization...
December 2016: Current Diabetes Reports
Danielle Horyniak, Miguel Pinedo, Jose Luis Burgos, Victoria D Ojeda
Deported migrants face numerous challenges which may elevate their risk for drug use. We examined relationships between integration and drug use among deported migrants in Tijuana, Mexico. A cross-sectional survey conducted at a free health clinic included 255 deported Mexican-born migrants residing in Tijuana ≥6 months. Multivariable logistic regression examined associations between variables across four integration domains (public participation, social connections, macro-level facilitators and foundations) and recent (past 6-month) drug use...
October 24, 2016: Journal of Immigrant and Minority Health
Emmanuel Amabebe, Steven Reynolds, Victoria Stern, Graham Stafford, Martyn Paley, Dilly O C Anumba
Changes in vaginal microbiota that is associated with preterm birth (PTB) leave specific metabolite fingerprints that can be detected in the cervicovaginal fluid (CVF) using metabolomics techniques. In this study, we characterize and validate the CVF metabolite profile of pregnant women presenting with symptoms of threatened preterm labor (PTL) by both (1)H-nuclear magnetic resonance spectroscopy (NMR) and enzyme-based spectrophotometry. We also determine their predictive capacity for PTB, singly, and in combination, with current clinical screening tools - cervicovaginal fetal fibronectin (FFN) and ultrasound cervical length (CL)...
2016: Frontiers in Medicine
Aude Le Corre, Kym Phuong Huynh, Rasmeet Singh Dhaliwal, Gregory Ian Bain
Background Single-photon emission computed tomography and computed tomography (SPECT/CT) is a hybrid diagnostic imaging modality that allows clinicians to integrate their diagnostic evaluations and deliver a definitive diagnosis in musculoskeletal disorders. Specifically, in identification of osseous pathology, the conventional bone scan delivers greater specificity compared with magnetic resonance imaging (MRI). However, use of SPECT/CT enhances the sensitivity and specificity. Use of this modality denotes the possibility to specify the lesion more accurately and precisely while grading the activity according to osseous structural changes...
November 2016: Journal of Wrist Surgery
Greg Ogrinc, Emily S Cohen, Robertus van Aalst, Beth Harwood, Ellyn Ercolano, Karyn D Baum, Adam J Pattison, Anne C Jones, Louise Davies, Al West
BACKGROUND : Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. OBJECTIVE : We sought to determine the clinical and educational impact of an integrated QI curriculum. METHODS : This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum...
October 2016: Journal of Graduate Medical Education
Kendra Johnson, Lukasz Mazur, Janet Chadwick, Pegah Pooya, Alison Amos, John McCreery
PURPOSE: To explore how Lean can add value during the schematic phase of design through providing additional resources and support to project leadership and the architectural design team. BACKGROUND: This case study-based research took place at one large academic hospital during design efforts of surgical tower to house 19 operating rooms (ORs) and support spaces including pre- and post-op, central processing and distribution, and materials management. Surgical services project leadership asked for Lean practitioners' support during the design process...
October 24, 2016: HERD
Barry C Jones, Helen Rollison, Susanne A Johansson, Kajsa P Kanebratt, Craig Lambert, Karthick Vishwanathan, Tommy B Andersson
Induction of cytochrome P450 (CYP) can impact the efficacy and safety of a drug molecule upon multiple dosing of co-administered drugs. This strategy is focused on CYP3A since the majority of clinically relevant cases of CYP induction are related to this enzyme. However, the in vitro evaluation of induction is applicable to other CYP enzymes but the in vivo relevance cannot be assessed because the scarcity of relevant clinical data. In the pre-clinical phase, compounds are screened using PXR reporter gene assay and, if necessary, structure-activity relationships (SAR) are developed...
October 24, 2016: Drug Metabolism and Disposition: the Biological Fate of Chemicals
Takashi Yamashita, Yoshihide Asano, Takashi Taniguchi, Kouki Nakamura, Ryosuke Saigusa, Shunsuke Miura, Tetsuo Toyama, Takehiro Takahashi, Yohei Ichimura, Ayumi Yoshizaki, Maria Trojanowska, Shinichi Sato
Systemic sclerosis (SSc) is a multisystem inflammatory and vascular disease resulting in extensive tissue fibrosis. Glycyrrhizin, clinically used for chronic hepatic diseases and itching dermatitis, modulates the pathological processes of inflammation, vasculopathy, and fibrosis in human diseases and their animal models. Therefore, we investigated a potential impact of glycyrrhizin on the key pathological manifestations of SSc, including inflammation, vasculopathy, and tissue fibrosis, with bleomycin (BLM)-treated mice mimicking the fibrotic and inflammatory components of SSc and endothelial cell-specific Fli1 knockout mice recapitulating SSc vasculopathy...
October 21, 2016: Journal of Investigative Dermatology
Rachel S Kelly, Amber Dahlin, Michael J McGeachie, Weiliang Qiu, Joanne Sordillo, Emily S Wan, Ann Chen Wu, Jessica Lasky-Su
Asthma is a complex disease well suited to metabolomic profiling, both for the development of novel biomarkers and for the improved understanding of pathophysiology. In this review, we summarize the 21 existing metabolomic studies of asthma in humans, all of which reported significant findings and concluded that individual metabolites and metabolomic profiles measured in exhaled breath condensate, urine, plasma and serum could identify asthmatics and asthma phenotypes with high discriminatory ability. There was considerable consistency across the studies in terms of the reported biomarkers, regardless of biospecimen, profiling technology and population age...
October 21, 2016: Chest
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