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Patient pathway

Kirsten Kaptain, Marie-Louise Ulsøe, Pia Dreyer
AIM: To explore patients' and healthcare professionals' experiences of patients' surgical pathways in a perioperative setting. BACKGROUND: Elective surgical pathways have improved over the past decades due to fast track programs, but patients desire more personalised and coordinated care and treatment. There is little knowledge of how healthcare professionals' collaboration and communication affect patients' pathways. DESIGN: The overall framework was complex intervention method...
February 20, 2019: Journal of Clinical Nursing
E Schepers, J van Os, R Lousberg
INTRODUCTION: Positive psychotic experiences are associated with increased rate of white noise speech illusions in patients and their relatives. However, findings have been conflicting to what degree speech illusions are associated with subclinical expression of psychosis in the general population. The aim of this study was to investigate the link between speech illusions and positive psychotic experiences in a general population sample. In addition, the hypothesis that speech illusions are on the pathway from known risk factors for psychosis (childhood adversity and recent life events) to subthreshold expression of psychosis, was examined...
2019: PloS One
Jsrg Saran, Jagadish R Padubidri
The concept of brain death has been a very intriguing topic and has taken many forms over the years. Brain stem death is a complex state of inactivity defined by the loss of reflexes of the pathways that pass through the brain stem, the 'shaft' of the brain which links the spinal cord to the cerebral cortex and the cerebellum where there is apnoea, loss of eye movement and pain sensation. There are many criteria, based on which a person can be said to be brain dead. The best recognised of these are the Harvard, Minnesota and Philadelphia criteria...
February 20, 2019: Medico-legal Journal
Meng Wang, Ji Hu, Linling Yan, Yeping Yang, Min He, Meng Wu, Qin Li, Wei Gong, Yang Yang, Yi Wang, Diane E Handy, Bin Lu, Chuanming Hao, Qinghua Wang, Yiming Li, Ronggui Hu, Robert C Stanton, Zhaoyun Zhang
Oxidative stress contributes substantially to podocyte injury, which plays an important role in the development of diabetic kidney disease. The mechanism of hyperglycemia-induced oxidative stress in podocytes is not fully understood. Glucose-6-phosphate dehydrogenase (G6PD) is critical in maintaining NADPH, which is an important cofactor for the antioxidant system. Here, we hypothesized that high glucose induced ubiquitination and degradation of G6PD, which injured podocytes by reactive oxygen species (ROS) accumulation...
February 20, 2019: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Aurélie Edwards, Muriel Auberson, Suresh K Ramakrishnan, Olivier Bonny
The objective of this study was to investigate theoretically the mechanisms underlying uric acid transport in the proximal tubule (PT) of rat kidneys, and their modulation by factors including Na+ , parathyroid hormone (PTH), Angiotensin II, and SGLT2 inhibitors. To that end, we incorporated the transport of uric acid and its conjugate anion urate in our mathematical model of water and solute transport in the rat PT. The model accounts for parallel urate reabsorption and secretion pathways on apical and basolateral membranes, and their coupling to lactate and alpha-ketoglutarate transport...
February 20, 2019: American Journal of Physiology. Renal Physiology
Jinyan Wang, Qian Zhang, Siying Zhou, Hanzi Xu, Dandan Wang, Jifeng Feng, Jianhua Zhao, Shanliang Zhong
AIM: We aimed to explore the roles of circular RNAs (circRNAs) in breast cancer (BCa). MATERIALS & METHODS: RNA was extracted from exosomes and BCa cells and analyzed using the RNA sequencing technique or microarray. RESULTS: Compared with controls, 1147 and 1195 circRNAs were dysregulated in exosomes from metastatic and localized BCa patients, respectively. A total of 480 dysregulated circRNAs were found in metastatic patients compared with localized patients, and these dysregulated circRNAs were enriched in eight pathways...
February 20, 2019: Epigenomics
Manar Gamal Helal, Eman Said
Silicosis is a well acknowledged occupational lung disorder with considerable negative impact on the patients' quality of life. Various signaling pathways have been reported to interplay in the pathogenesis of pulmonary fibro-proliferative disorders; of which, P-AKT/mTOR signaling pathway. The current study highlights the potential pulmonary protective effect of carvedilol; a non-selective α/β blocker against experimental silicosis-induced in rats by the intranasal installation of silica (50 mg/rat, 1 ml 0...
February 20, 2019: International Immunopharmacology
Yeo Min Yoon, SangMin Kim, Yong-Seok Han, Chul Won Yun, Jun Hee Lee, Hyunjin Noh, Sang Hun Lee
Although autologous human mesenchymal stem cells (hMSCs) are a promising source for regenerative stem cell therapy in chronic kidney disease (CKD), the barriers associated with pathophysiological conditions limit therapeutic applicability to patients. We confirmed that level of cellular prion protein (PrPC ) in serum was decreased and mitochondria function of CKD-derived hMSCs (CKD-hMSCs) was impaired in patients with CKD. We proved that treatment of CKD-hMSCs with tauroursodeoxycholic acid (TUDCA), a bile acid, enhanced the mitochondrial function of these cells through regulation of PINK1-PrPC -dependent pathway...
February 16, 2019: Redox Biology
Donglei Liu, Min Gao, Kai Wu, Dengyan Zhu, Yang Yang, Song Zhao
Long non-coding RNAs (LncRNAs) have been found to be associated with the biological behaviors of human cancers. LINC00152 is reported as an oncogene in many kinds of malignancies. However, the functions and mechanisms of LINC00152 involved in esophageal squamous cell carcinoma (ESCC) remain elusive. Our results revealed that LINC00152 expression was up-regulated in ESCC, and correlated with advanced TNM stage, lymph node metastasis, and poor prognosis of ESCC patients. Functionally, LINC00152 knockdown suppressed proliferation, decreased colony forming ability, and induced apoptosis in ESCC cells...
February 19, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Bowen Yang, Neng Wang, Shengqi Wang, Xiong Li, Yifeng Zheng, Min Li, Juxian Song, Fengxue Zhang, Wenjie Mei, Yi Lin, Zhiyu Wang
BACKGROUND: Breast cancer remains the most common female malignancy and metastasis is the leading cause of death in breast cancer patients. Oldenlandia diffusa has been empirically and extensively used as an adjuvant therapy for metastatic breast cancer patients in Traditional Chinese Medicine (TCM) with proven efficacy. However, its anti-metastasis mechanism has been poorly revealed. METHODS: Multiple molecular biology experiments as well as network pharmacology, bioinformatics analysis were conducted to investigate the anti-metastasis mechanism of Oldenlandia diffusa in breast cancer...
February 20, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Jue Yang, Li Chen, Ying Yan, Jianfei Qiu, Juan Chen, Jingrui Song, Qing Rao, Yaacov Ben-David, Yanmei Li, Xiaojiang Hao
C-21 steroids displayed the activities of immunosuppressive, anti-inflammatory and anti-virus effects by the reports. However, its antitumor effects and molecular mechanism remain unclear. We previously isolated and identified a C-21 steroidal glycoside (BW18) from the root of Cynanchum atratum Bunge. This study was aimed to assess anti-leukemia activity and its underlying mechanism in K562 cells. MTT assay results showed that BW18 inhibited cell viability and proliferation of K562 cells. We also found that BW18 could induce S phase cell cycle arrest and apoptosis...
February 19, 2019: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Sarah Wright, Mary Porteous, Diane Stirling, Oliver Young, Charlie Gourley, Nina Hallowell
Changes in the nature and structure of healthcare pathways have implications for healthcare professionals' jurisdictional boundaries. The introduction of treatment focused BRCA1 and 2 genetic testing (TFGT) for newly diagnosed patients with breast cancer offers a contemporary example of pathway change brought about by technological advancements in gene testing and clinical evidence, and reflects the cultural shift towards genomics. Forming part of an ethnographically informed study of patient and practitioner experiences of TFGT at a UK teaching hospital, this paper focuses on the impact of a proposal to pilot a mainstreamed TFGT pathway on healthcare professionals' negotiations of professional jurisdiction...
February 13, 2019: Social Science & Medicine
Ye Yuanxin, Zhou Yanhong, Zheng Qin, Tang Sishi, Dai Yang, Zhou Yi, Wang Minjin, Zhou Juan, Lu Xiaojun, Wang Lanlan, Ying Binwu
The BCR-ABL fusion gene (BCR-ABL) has different subtypes such as p210 and p190 with p190 appear to lead to a worse prognosis. To explore the mechanism of difference in pathogenesis and prognosis in different BCR-ABL subtype-related leukemia, expression profile microarray analysis was conducted between p190 and p210 patients and verified by RT-PCR. The p21-activated kinase (PAK1) gene was chosen and regulation of the PAK1-STAT5 biological axis and its influence on proliferation and apoptosis in leukemia cells were also analyzed...
January 24, 2019: Leukemia Research
Ida-Fong Ukor, Keith R Walley
Vasodilatory shock is the final common pathway for all forms of severe shock, with sepsis the most common primary etiology and the leading cause of critical illness-related mortality. The pathophysiology of this condition remains incompletely elucidated. Deficiency of the neuropeptide hormone vasopressin seems to play a significant role. The physiology of vasopressin and its interaction with the pathophysiology of vasodilatory shock are described in this review. A brief review of the major randomized controlled trials assessing the efficacy and safety of vasopressin and its analogs in this complex patient cohort is also provided...
April 2019: Critical Care Clinics
Yue Leng, Erik S Musiek, Kun Hu, Francesco P Cappuccio, Kristine Yaffe
Dysfunction in 24-h circadian rhythms is a common occurrence in ageing adults; however, circadian rhythm disruptions are more severe in people with age-related neurodegenerative diseases, including Alzheimer's disease and related dementias, and Parkinson's disease. Manifestations of circadian rhythm disruptions differ according to the type and severity of neurodegenerative disease and, for some patients, occur before the onset of typical clinical symptoms of neurodegeneration. Evidence from preliminary studies suggest that circadian rhythm disruptions, in addition to being a symptom of neurodegeneration, might also be a potential risk factor for developing Alzheimer's disease and related dementias, and Parkinson's disease, although large, longitudinal studies are needed to confirm this relationship...
March 2019: Lancet Neurology
Michelle Helena van Velthoven, Carlos Cordon, Goutam Challagalla
BACKGROUND: This paper builds on an integrated framework of digital opportunities, based on information theory that was initially proposed by Claude Shannon: 1) providers of infrastructure for transmitting information; 2) platforms, devices, and software to bundle, store and deliver others' content; 3) original content creator); 4) platforms enabling peer-to-peer exchange; and 5) connected intelligence embed in devices. We aimed to clarify the meaning of digitization of organisations in the healthcare landscape and answer 'how can healthcare organisations compete in a world that is rapidly digitizing?'...
April 2019: International Journal of Medical Informatics
Yebei Li, Daijin Ren, Gaosi Xu
Glomerular endothelial cell injury plays an important role in the development and progression of diabetic nephropathy (DN). The expression and function of klotho in glomerular endothelial cells remain unclear. Thus, this study aimed to investigate the expression and the functional role of klotho in DN progression in mice and in high glucose (HG)-induced cell injury of human renal glomerular endothelial cells (HRGECs) and the underlying mechanism. In this study, HRGECs were cultured with media containing HG to induce endothelial cell injury and db/db mice were used as DN model mice...
February 20, 2019: Cell Cycle
Marco Mula
Depression is one of the most frequent comorbidities in epilepsy affecting between 17% and 22% of patients but it is still underdiagnosed and undertreated. Areas covered: This paper discusses recent advances about screening, diagnosis and treatment of depression in epilepsy taking into account the heterogeneity of clinical scenarios where depression can occur. Expert opinion: A number of screening instruments are now validated for adults with epilepsy and their psychometric properties are discussed but the NDDIE is the most practical and cost-effective...
February 20, 2019: Expert Review of Neurotherapeutics
Han Guan, Zonghao You, Can Wang, Fang Fang, Rui Peng, Likai Mao, Bin Xu, Ming Chen
Prostate cancer is still considered a significant health care challenge worldwide due in part to the distinct transformation of androgen-dependent prostate cancer (ADPC) into treatment-refractory castration-resistant prostate cancer (CRPC). Consequently, there is an urgent need to explore novel molecular mechanisms underlying treatment resistance in ADPC. Although numerous studies have alluded to the role of miR-200a in several cancers, the biological significance of miR-200a in prostate cancer remains unknown...
February 19, 2019: Cancer Medicine
Jin Shang, Luyao Wang, Ya Zhang, Shiyi Zhang, Lina Ning, Jifang Zhao, Genyang Cheng, Dong Liu, Jing Xiao, Zhanzheng Zhao
Diabetic nephropathy (DN) is characterized by inflammation of renal tissue. Glomerular endothelial cells (GEnCs) play an important role in inflammation and protein leakage in urine in DN patients. Chemerin and its receptor ChemR23 are inducers of inflammation. The aim of this study was to investigate the function of chemerin/ChemR23 in GEnCs of DN patients. Immunohistochemical staining and qRT-PCR were used to measure the expression of chemerin, ChemR23 and inflammatory factors in renal tissues of DN patients...
February 19, 2019: Journal of Cellular and Molecular Medicine
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