Fryekristiansen3959

Liver transplantation is conducted with strict oversight of organizational structure and clinical practice. However, specific regulations pertaining to the delivery of anesthetic services are lacking and consideration of departmental structure and mechanisms for quality control must occur at a local level. Busy centers collect and process sufficient data to guide this process but those with low case loads may not generate enough data for useful analysis. In Australia and New Zealand, pediatric liver transplants are performed at only four locations. As these operations are not equally distributed geographically or temporally there are periods of low activity at some centers. As anesthesia affects patient outcome, quality assurance activities are important in this setting.

Provide a global overview of the structure and function of liver transplantation networks. Identify issues related to provision of pediatric anesthetic services with specific reference to Australasia. Examine anesthetic data from a singlet database.

Combining the anesthetic liver transplant data from all sites in a single registry would expand data collection and generate broadly applicable findings. We propose the establishment of an Australasian pediatric anesthetic liver transplant database.The status and prognostic value of the disagreement between physician and patient assessments of symptomatic adverse events (AEs) remain unclear for patients with metastatic colorectal cancer treated with first-line cetuximab plus chemotherapy. Paired data on patient-reported outcomes using the EORTC QLQ-C30 and physician-reported outcomes using the NCI-CTCAE for eight symptomatic AEs (fatigue, pain, insomnia, dyspnea, constipation, appetite loss, nausea/vomiting, and diarrhea) were collected from a prospective trial assessing the relationships between treatment efficacy, AEs, and quality of life. The overall agreement rates between patient and physician reporting at 4 weeks ranged from 40.2% to 76.5% for 129 patients. Bimiralisib The level of agreement based on Cohen's κ statistics was slight to poor for dyspnea, pain, fatigue, and insomnia, while it was moderate to fair for the remaining AEs. No clinicopathological characteristics of disagreement were found. The underreporting by physicians ranged from 12.5% (nausea/vomiting) to 56.7% (fatigue). The 2-year overall survival (OS) rate was more favorable for patients with high agreement than for those with low agreement (71.2% vs. 46.5%, p = .016), and the agreement status was an independent factor of OS (HR, 2.31; 95% CI, 1.13-4.71; p = .022). For patients who were reported as asymptomatic by the physician, the presence of patient-reported symptoms resulted in a trend toward poor prognostic outcomes for appetite loss, dyspnea, diarrhea, and constipation. These findings provide the clinical importance of the monitoring of patient-reported symptoms that can be complementary to physician-reported data to ensure more accurate clinical outcomes.

Centrality measures identify items that are central to a network, which may inform potential targets for oral interventions.

We tested whether centrality measures in a cross-sectional network of mothers' baseline factors are able to predict the association with children's dental outcomes at age 5years.

A network approach was applied to longitudinal data from a randomised controlled trial of dental caries prevention delivered to 448 women pregnant with an Indigenous child in South Australia. Central items were identified at baseline using three centrality measures (strength, betweenness, and closeness). Centrality values of mothers' outcomes were regressed with their predictive values to dental caries experience and dental service utilisation at child age 5years.

Items of oral health self-efficacy and oral health literacy were central to mothers' baseline network. Strength at baseline explained 51% and 45% of items' predictive values to dental caries experience and dental service utilisation at child age 5years, respectively. Adjusted and unadjusted values of node strength for the children's oral health network were highly correlated.

Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5years.

Strength at baseline successfully identified mothers' items with greater importance to dental caries experience and dental service utilisation at child age 5 years.

Blood transfusion may improve renal oxygenation during cardiopulmonary bypass (CPB). In an ovine model of experimental CPB, we tested whether increasing blood haemoglobin concentration [Hb] from ~7g dL

to ~9g dL

improves renal tissue oxygenation.

Ten sheep were studied while conscious, under stable isoflurane anaesthesia, and during 3hours of CPB. In a randomized cross-over design, 5 sheep commenced bypass at a high target [Hb], achieved by adding 600mL donor blood to the priming solution. After 90minutes of CPB, PlasmaLyte

was added to the blood reservoir to achieve low target [Hb]. For the other 5 sheep, no blood was added to the prime, but after 90minutes of CPB, 800-900mL of donor blood was given to achieve a high target [Hb].

Overall, CPB was associated with marked reductions in renal oxygen delivery (-50±12%, mean±95% confidence interval) and medullary tissue oxygen tension (PO

, -54±29%). Renal fractional oxygen extraction was 17±10% less during CPB at high [Hb] than low [Hb] (P=.04). Nevertheless, no increase in tissue PO

in either the renal medulla (0±6mmHg change, P>.99) or cortex (-19±13mmHg change, P=.08) was detected with high [Hb].

In experimental CPB blood transfusion to increase Hb concentration from ~7g dL

to ~9g dL

did not improve renal cortical or medullary tissue PO

even though it decreased whole kidney oxygen extraction.

In experimental CPB blood transfusion to increase Hb concentration from ~7 g dL-1 to ~9 g dL-1 did not improve renal cortical or medullary tissue PO2 even though it decreased whole kidney oxygen extraction.Decreased circulating 25-hydroxyvitamin D (25[OH]D) and increased inflammatory marker concentrations have been reported separately in canine cancer. Correlations between the two exist in humans, but little work has examined links in dogs. This study aimed to determine plasma 25(OH)D and inflammatory marker concentrations in healthy dogs and dogs with cancer and to assess correlations in each group. Newly diagnosed dogs with B-cell lymphoma (B-cell, n = 25), T-cell lymphoma (T-cell, n = 9), osteosarcoma (OSA, n = 21), and mast cell tumour (MCT, n = 26) presenting to a tertiary oncology centre, and healthy dogs (n = 25), were enrolled. Plasma samples were analysed for 25(OH)D, C-reactive protein (CRP), haptoglobin (HP), serum amyloid A (SAA), alpha-1-acid glycoprotein (AAG), and 13 chemokines and cytokines. Dogs with B-cell had decreased plasma 25(OH)D (P = .03), and increased plasma CRP, AAG, HP, KC-like and MCP-1 concentrations (P  less then  =.001, .011, less then .001, .013 and .009, respectively) compared with healthy dogs.