Δευτέρα, 16 Ιανουαρίου 2017

Commonly-used versus less commonly-used methods in the loss of resistance technique for identification of the epidural space: A systematic review and meta-analysis of randomized controlled trials

To summarize the efficacy of less-commonly used modern methods (e.g. epidrum, lidocaine, acoustic device, Macintosh balloon) compared to more commonly-used methods (i.e. air, saline, both) in the loss of resistance technique for identification of the epidural space.

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A visual screen for diet-regulated proteins in the Drosophila ovary using GFP protein trap lines

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Publication date: Available online 16 January 2017
Source:Gene Expression Patterns
Author(s): Hwei-Jan Hsu, Daniela Drummond-Barbosa
The effect of diet on reproduction is well documented in a large number of organisms; however, much remains to be learned about the molecular mechanisms underlying this connection. The Drosophila ovary has a well described, fast and largely reversible response to diet. Ovarian stem cells and their progeny proliferate and grow faster on a yeast-rich diet than on a yeast-free (poor) diet, and death of early germline cysts, degeneration of early vitellogenic follicles and partial block in ovulation further contribute to the ∼60-fold decrease in egg laying observed on a poor diet. Multiple diet-dependent factors, including insulin-like peptides, the steroid ecdysone, the nutrient sensor Target of Rapamycin, AMP-dependent kinase, and adipocyte factors mediate this complex response. Here, we describe the results of a visual screen using a library of green fluorescent protein (GFP) protein trap lines to identify additional factors potentially involved in this response. In each GFP protein trap line, an artificial GFP exon is fused in frame to an endogenous protein, such that the GFP fusion pattern parallels the levels and subcellular localization of the corresponding native protein. We identified 53 GFP-tagged proteins that exhibit changes in levels and/or subcellular localization in the ovary at 12–16 h after switching females from rich to poor diets, suggesting them as potential candidates for future functional studies.



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The impact of liver disorders on perioperative management of reoperative cardiac surgery: a retrospective study in adult congenital heart disease patients

Abstract

Purpose

We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients.

Methods

This retrospective study included 32 ACHD patients who underwent reoperative cardiac surgery.

Results

Preoperatively, 38% of the study patients had risk factors, including congestive liver (CL) due to right heart failure (31%), chronic hepatitis C (HC) (22%), and both CL and HC (16%). The numbers of patients with Child-Pugh scores 5, 6, 7 and 8 were 22, 7, 2 and 1. Median (range) preoperative platelet count and fibrinogen values were 155 (61–330) × 103/μl and 250 (145–367) mg/dl, respectively. The patients with higher Child-Pugh scores tended to have longer duration of anesthesia and surgery (p = 0.078, 0.078, respectively), and had significantly higher platelet transfusion (p = 0.031). Lower platelet count was associated with longer duration of anesthesia, surgery and cardio pulmonary bypass (CPB), and larger amount of blood loss and platelet transfusion (p = 0.01, 0.011, 0.024, 0.033, 0.021). Lower fibrinogen value was associated with longer duration of anesthesia, surgery and CPB, and larger amount of platelet transfusion (p = 0.015, 0.009, 0.009, 0.023).

Conclusion

ACHD patients who underwent reoperative cardiac surgery had a high prevalence of risk factors for liver disorders preoperatively, and liver disorders aggravated some intraoperative outcomes. These findings suggest that the prevention of liver disorders is important for reducing the occurrence of poor outcomes, and that ACHD patients with liver disorders need attentive perioperative management.



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Appropriate Use of Progesterone to Prevent Preterm Birth: Approaches to Measurement for Driving Improvement

Abstract

Introduction Despite strong evidence supporting the benefit of 17-alpha hydroxyprogesterone caproate (17P) in preventing recurrent preterm birth, this treatment still does not reach most eligible patients. This study sought to identify approaches to measuring the appropriate use of 17P, with the goal of helping health systems better monitor and improve the implementation of this intervention. Methods Semi-structured telephone interviews were used to gather data on measures for 17P use being developed and implemented by state team members participating in the Infant Mortality Collaborative Improvement and Innovation Network (IM CoIIN)—a national quality improvement initiative. Strengths and limitations of these measurement approaches were described. Results Six approaches to measuring 17P use to prevent preterm birth were identified: practice-level data, population-based surveys, three measures employing insurance claims with or without linked birth certificate data, and revised birth certificates. Each measure had particular strengths and limitations. Practice-level measures were useful in rapid-cycle improvement, but were not generalizable across sites. In contrast, population-based measures (i.e., surveys, claims) were useful for broad comparisons, but were limited in their timeliness, and in how accurately they identified candidates who were truly eligible for 17P. Additionally, such measures required complex data linkage and analytic capabilities. Discussion A variety of imperfect measures for the appropriate use of 17P are available. No "best" measure was identified—the optimal measurement option must fit the specific needs of a health agency. Better data infrastructure and harnessing information from integrated electronic health records could improve the quality of 17P use measurement for improvement efforts.



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Critical Congenital Heart Disease Newborn Screening Implementation: Lessons Learned

Abstract

Introduction The purpose of this article is to present the collective experiences of six federally-funded critical congenital heart disease (CCHD) newborn screening implementation projects to assist federal and state policy makers and public health to implement CCHD screening. Methods A qualitative assessment and summary from six demonstration project grantees and other state representatives involved in the implementation of CCHD screening programs are presented in the following areas: legislation, provider and family education, screening algorithms and interpretation, data collection and quality improvement, telemedicine, home and rural births, and neonatal intensive care unit populations. Results The most common challenges to implementation include: lack of uniform legislative and statutory mandates for screening programs, lack of funding/resources, difficulty in screening algorithm interpretation, limited availability of pediatric echocardiography, and integrating data collection and reporting with existing newborn screening systems. Identified solutions include: programs should consider integrating third party insurers and other partners early in the legislative/statutory process; development of visual tools and language modification to assist in the interpretation of algorithms, training programs for adult sonographers to perform neonatal echocardiography, building upon existing newborn screening systems, and using automated data transfer mechanisms. Discussion Continued and expanded surveillance, research, prevention and education efforts are needed to inform screening programs, with an aim to reduce morbidity, mortality and other adverse consequences for individuals and families affected by CCHD.



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Surgical treatment of perihilar cholangiocarcinoma: Early results of en bloc portal vein resection

Langenbeck's Archives of Surgery

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Effect of Vonoprazan, a Potassium-Competitive Acid Blocker, on the 13C-Urea Breath Test in Helicobacter pylori-Positive Patients

Digestive Diseases and Sciences

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MABp1 as a novel antibody treatment for advanced colorectal cancer: A randomised, double-blind, placebo-controlled, phase 3 study

The Lancet Oncology

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Cantabrians help find gene changes associated with poor Crohn's disease outcomes

University of Otago News

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Fatty acid and non-alcoholic fatty liver disease: Meta-analyses of case-control and randomized controlled trials

Clinical Nutrition

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Preliminary investigation of whole-pancreas 3D histogram ADC metrics for predicting progression of acute pancreatitis

Clinical Imaging

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Dual sexual and drug-related predictors of hepatitis C incidence among sex workers in a Canadian setting: Gaps and opportunities for scale-up of HCV prevention, treatment and care

International Journal of Infectious Diseases

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Prophylaxis of post-ERC infectious complications in patients with biliary obstruction by adding antimicrobial agents into ERC contrast media- A single center retrospective study

BMC Gastroenterology

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Are the current guidelines for the surgical management of intraductal papillary mucinous neoplasms of the pancreas adequate? A multi-institutional study

Journal of the American College of Surgeons

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Investigation of underlying comorbidities as risk factors for symptomatic human hepatitis E virus infection

Alimentary Pharmacology and Therapeutics

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Effects of aspartame-, monk fruit-, stevia- and sucrose-sweetened beverages on postprandial glucose, insulin and energy intake

International Journal of Obesity

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Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies

International Journal of Cancer

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Efficacy and safety of vedolizumab in ulcerative colitis and Crohn’s disease patients stratified by age

Advances in Therapy

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Influences of proton pump inhibitor on Helicobacter pylori adherence to the gastrointestinal cell lines

The Turkish Journal of Gastroenterology

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Epidemiology and outcome of acute pancreatitis in end-stage renal disease dialysis patients: A 10-year national cohort study

Nephrology Dialysis Transplantation

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Ethical issues with colorectal cancer screening--A systematic review

Journal of Evaluation in Clinical Practice

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The risk predictive values of UK-PBC and GLOBE scoring system in Chinese patients with primary biliary cholangitis: The additional effect of anti-gp210

Alimentary Pharmacology and Therapeutics

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The utility of abbreviated patient-reported outcomes for predicting survival in early stage colorectal cancer

Cancer

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Pasireotide for the prevention of pancreatic fistula following pancreaticoduodenectomy: A cost-effectiveness analysis

Annals of Surgery

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Randomized clinical trial of preoperative dexamethasone on postoperative nausea and vomiting after laparoscopy for suspected appendicitis

British Journal of Surgery

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