Hickmandickerson6045

Acromegaly is associated with impaired quality of life (QoL). We investigated the effects of biochemical control of acromegaly by growth hormone receptor antagonism vs somatostatin analog therapy on QoL.

Cross-sectional.

116 subjects n=55 receiving a somatostatin analog (SSA group); n=29 receiving pegvisomant (PEG group); n=32 active acromegaly on no medical therapy (ACTIVE group).

Acromegaly QoL Questionnaire (AcroQoL), Rand 36-Item Short Form Survey (SF-36) and Gastrointestinal QoL Index (GIQLI); fasting glucose, insulin and IGF-1 levels (LC/MS, Quest Diagnostics).

There were no group differences in mean age, BMI or sex [(whole cohort mean ± SD) age 52±14years, BMI 30±6kg/m

, and male sex 38%]. Mean IGF-1 Z-scores were higher in ACTIVE (3.9±1.0) vs SSA and PEG, which did not differ from one another (0.5±0.7 and 0.5±0.7, P<.0001 vs ACTIVE). Eighty-three per cent of PEG previously received somatostatin analogs, which had been discontinued due to lack of efficacy (52%) or side effects (41%). There were no differences in the four QoL primary end-points (AcroQoL Global Score, SF-36 Physical Component Summary Score, SF-36 Mental Health Summary Score and GIQLI Global Score) between SSA and PEG. Higher HbA1c, BMI and IGF-1 Z-scores were associated with poorer QoL in several domains.

Our data support a comparable QoL in patients receiving pegvisomant vs somatostatin analogs, despite the fact that the vast majority receiving pegvisomant did not respond to or were not able to tolerate somatostatin analogs.

Our data support a comparable QoL in patients receiving pegvisomant vs somatostatin analogs, despite the fact that the vast majority receiving pegvisomant did not respond to or were not able to tolerate somatostatin analogs.In controlled human infection studies (CHIs), participants are deliberately exposed to infectious agents in order to better understand the mechanism of infection or disease and test therapies or vaccines. While most CHIs have been conducted in high-income countries, CHIs have recently been expanding into low- and middle-income countries (LMICs). One potential ethical concern about this expansion is the challenge of obtaining the voluntary informed consent of participants, especially those who may not be literate or have limited education. In some CHIs in LMICs, researchers have attempted to address this potential concern by limiting access to literate or educated populations. In this paper, we argue that this practice is unjustified, as it does not increase the chances of obtaining valid informed consent and therefore unfairly excludes illiterate populations and populations with lower education. Instead, ML 210 recommend that investigators improve the informed consent process by drawing on existing data on obtaining informed consent in these populations and interventions aimed at improving their understanding. Based on a literature review, we provide concrete suggestions for how to follow this recommendation and ensure that populations with lower literacy or education are given a fair opportunity to protect their rights and interests in the informed consent process.It is of great scientific interest to identify interactions between genetic variants and environmental exposures that may modify the risk of complex diseases. However, larger sample sizes are usually required to detect gene-by-environment interaction (G × E) than required to detect genetic main association effects. To boost the statistical power and improve the understanding of the underlying molecular mechanisms, we incorporate functional genomics information, specifically, expression quantitative trait loci (eQTLs), into a data-adaptive G × E test, called aGEw. This test adaptively chooses the best eQTL weights from multiple tissues and provides an extra layer of weighting at the genetic variant level. Extensive simulations show that the aGEw test can control the Type 1 error rate, and the power is resilient to the inclusion of neutral variants and noninformative external weights. We applied the proposed aGEw test to the Pancreatic Cancer Case-Control Consortium (discovery cohort of 3,585 cases and 3,482 controls) and the PanScan II genome-wide association study data (replication cohort of 2,021 cases and 2,105 controls) with smoking as the exposure of interest. Two novel putative smoking-related pancreatic cancer susceptibility genes, TRIP10 and KDM3A, were identified. The aGEw test is implemented in an R package aGE.This study aimed to describe concept of social competence as a theoretical background for social skills group intervention for children with autism spectrum disorder (ASD). A model of social competence comprised of three components social skills, social performance, and social adjustment. We also examined the feasibility and preliminary efficacy of the manualized Social Competence group intervention for children with autism spectrum disorder (SOCO) using a variety of outcome measures. The nine-month intervention included children groups, parental support groups and co-operation with teachers. A pilot study involved 23 children aged 7 to 12 years (n = 16 intervention, n = 7 control) and intervention outcomes were measured with questionnaires for parents and teachers, neuropsychological tests, and observations. #link# The parents of the intervention group reported improvements in social skills and social adjustment, whereas the teachers reported increases in social performance. Findings also indicated that affect recognition skills, social overtures, and reactions to peers were improved in the intervention group. Although the evidence of the pilot study should be considered as preliminary, it gives some indication of the feasibility of the SOCO group intervention and supports the usability of the theoretical background and approach for multiple outcome measures.Assuming that moral enhancement is morally permissible, I contend that a more careful theoretical treatment of emotion and the affective landscape is needed to advance both our understanding and the prospects of interventions aimed at moral enhancement. Using Douglas' proposal for the direct modulation of counter-moral emotions as a foil for discussion, I argue that the direct modulation of emotion fails to address underlying aspects of an agent's psychology that will give rise to a range of counter-moral motives beyond the emotion that is targeted. This is because the direct modulation of emotion does not accommodate the fact that an emotional episode or emotional disposition is part of a network of other dispositions and responses, against a backdrop of our having cares and goals, as well as other cognitive content that can mediate how we apprehend a situation. By focusing on emotion rather than on moral capacity as other critiques have done, I thus argue that direct modulation is likely to be ineffective, and, more positively, by drawing out patterns of connections across the affective landscape, we can better tease out what it is that we should really be targeting if we are to achieve robust and meaningful moral change.

To evaluate the difference between early and delayed removal of indwelling urinary catheter after radical hysterectomy (RH) or radical trachelectomy (RT).

An ambispective study was conducted in early-stage cervical cancer patients who underwent RH or RT. Delayed indwelling urinary catheter removal occurred on a postoperative day (POD) 7 in the retrospective group (January 2012-November 2013), and early removal occurred on POD 1 in the prospective group (May 2014-June 2017).The postvoid residual (PVR) test was performed after indwelling catheter removal in both groups.

Our sample included 47 patients in the delayed group and 48 in the early one. There was no difference in age, body mass index, tumor size, histology, stage, surgical approach, and intraoperative and postoperative complications. Indwelling urinary catheter reinsertion was needed in 16 (34%) patients in the delayed group and 12 (25%) in the early group (P = .37), with no statistical difference between the median PVR volumes -82.5 and 45 mL (P = .06), respectively. Seven (14.9%) patients in the delayed group presented with 30-day urinary tract infection vs two (4.2%) in the early group (P = .09).

Early indwelling urinary catheter removal, in regard to the rate of catheter reinsertion and PVR volume, does not differ from delayed removal.

Early indwelling urinary catheter removal, in regard to the rate of catheter reinsertion and PVR volume, does not differ from delayed removal.

The adoption of an emergency action plan for athletics (AEAP) minimizes the consequences of injuries. School nurses may play an important role in the adoption of an AEAP. The purpose of our study was to describe school nurse's knowledge and perceptions related to AEAP adoption.

An online survey, following the Precaution-Adoption Process Model, examining respondents' readiness to act, was distributed to 1228 school nurses to evaluate their knowledge and perception of an AEAP, with N=131 (10.6%) responding.

Sixty-one school nurses were unaware of AEAP adoption at their school. A lack of athletic training services at the school was associated with not adopting an AEAP. The most frequently reported barrier to adopting an AEAP related to finances. When nurses reported perceiving more barriers to adopting an AEAP, their schools were less likely to adopt one.

A large number of nurses were unaware if their school adopted an AEAP. There is a need to improve nurses' knowledge and perceptions to promote AEAP development.

A large number of nurses were unaware if their school adopted an AEAP. There is a need to improve nurses' knowledge and perceptions to promote AEAP development.

To determine the rate of incisional infections after gastrointestinal surgery in dogs and cats and describe the aerobic bacteria isolated from these infections.

Retrospective study.

Client-owned dogs (n = 210) and cats (n = 66).

Records of dogs and cats that underwent gastrointestinal surgery at the Matthew J. link2 Ryan Veterinary Hospital at the University of Pennsylvania were reviewed for surgical procedures, presence of an infection, bacterial species isolated, perioperative antimicrobials administered, and outcome.

The median duration of follow-up was 14 days (4-35). Incisional infections were recorded in 7% (20/276) of cases. Among those 20 cases, culture results were available in 12 of 20 cases. The most common bacterial isolate cultured was Escherichia coli. The most common perioperative antimicrobials administered to treat incisional infection were cefazolin and cefoxitin. Only two of the bacterial isolates were susceptible to these antimicrobials. Bacteria isolated from incisional infections were most often susceptible to chloramphenicol, imipenem, and gentamicin.

Bacterial isolates from incisional infections in this population consisted of native gastrointestinal flora, which was often resistant to the most commonly used perioperative antimicrobials.

Contamination at time of surgery is the most likely source of incisional infection after gastrointestinal surgery. link3 This rate of infection justifies more rigorous intraoperative hygiene protocols and evaluation of the antimicrobials' susceptibility of causative bacteria to guide antimicrobial treatment.

Contamination at time of surgery is the most likely source of incisional infection after gastrointestinal surgery. This rate of infection justifies more rigorous intraoperative hygiene protocols and evaluation of the antimicrobials' susceptibility of causative bacteria to guide antimicrobial treatment.