Lauritzenmosley1044
The New Brunswick Heart Centre (NBHC) entered a contractual partnership with Integrated Health Solutions (IHS) to help address increasing wait times in the province of New Brunswick.
Team leaders were identified from each of the target areas, including surgeons, anesthesiologists, nurses (operating room, intensive care unit [ICU] and postoperative ward), access coordinators and administrators. The methodology used was based on Lean principles and involved exercises by stakeholders aimed at identifying opportunities for improvement. A weekly dashboard was created to monitor and facilitate improvement efforts. No additional hospital beds or operating room theatres were added during the study period.
After 2 years, the annual number of cardiac surgical interventions increased from 788 to 873, representing a 10.8% increase in capacity. The best median wait time for patients decreased from 52 to 35 days (35% reduction). The best 90th percentile wait time decreased from 126 to 98 days (22% reduction). The overall increase in capacity could be explained in part by the significant increase in fast tracking from the ICU to the ward (> 2-fold) or bypassing the ICU altogether (4-fold increase reaching 13%). Despite these successes, challenges persist as the number of OR cancellations remained around 7.5% of all cases, mainly because of limited ICU resources.
The NBHC-IHS partnership on this project has resulted in excellent engagement by stakeholders and promoted team cohesiveness. Furthermore, it has allowed significant reorganization and realignment of efforts to limit wait times and maximize overall capacity.
The NBHC-IHS partnership on this project has resulted in excellent engagement by stakeholders and promoted team cohesiveness. Furthermore, it has allowed significant reorganization and realignment of efforts to limit wait times and maximize overall capacity.
Considering the critical role of early diagnosis and management of acute ischemic stroke, biomarkers that can reliable assist in the diagnosis are still needed. These biomarkers should rapidly analyze, have high specificity for brain damage, and be available in the emergency settings for early diagnosis and exclusion of other conditions that mimic acute ischemic stroke. Soluble tumor necrosis factor-like weak inducer of apoptosis, a protein involved in the regulation of several biological functions, could be a potential acute ischemic stroke biomarker.
To investigate the diagnostic value of soluble tumor necrosis factor-like weak inducer of apoptosis in patients with acute ischemic stroke and examine the relationship between ischemic area volume determined at diffusion-weighted magnetic resonance imaging and soluble tumor necrosis factor-like weak inducer of apoptosis.
A prospective, case-control study.
This case-control prospective study included 36 patients with acute ischemic stroke and 36 healthy er of poor prognosis and can be used in predicting early mortality.
Hirschsprung's disease and sigmoid volvulus can sometimes be seen in the same patient.
To investigate the presence of Hirschsprung's disease in patients with sigmoid volvulus and to discuss the diagnosis and treatment methods.
Systematic review.
This systematic review has been reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the methodological quality of systematic reviews guidelines. The PubMed and Scopus databases were scanned using the keywords "Hirschsprung* volvulus*" and "congenital aganglionic megacolon volvulus*". The reference list of the selected studies was reviewed for cross-checking. Two reviewers independently screened the available literature. Only the Hirschsprung's disease cases involving sigmoid volvulus were included, and cases of patients with volvulus in other sites was excluded. There was no restriction with respect to the publication language and type of writing. The primary outcome was morbidity and mortality.
A total of 31 cases were analyzed in 22 articles; 97% of the patients were under the age of 40, 90% were male. There was a statistically significant difference in the necessity for relaparotomy between patients who were scheduled for sigmoid volvulus therapy with the suspicion of Hirschsprung's disease and patients who were treated without suspicion of Hirschsprung's disease (0% vs 37.5%, p=0.02). While there was no postoperative death in cases with suspected Hirschsprung disease, this mortality rate was 25% in cases without suspicion (p = 0.08).
Hirschsprung's disease should be excluded with rectal biopsy if a patient with sigmoid volvulus is under 40 years of age and has complaints of constipation from childhood.
Hirschsprung's disease should be excluded with rectal biopsy if a patient with sigmoid volvulus is under 40 years of age and has complaints of constipation from childhood.
Thyroid cancer is the most common malignancy of the endocrine system and it has become the fastest growing cancer among women. The suspected risk factors include increased exposure to ionizing radiation during childhood, environmental pollutants, possible iodine deficiency, and excessive iodine exposure.
To analyze the thyroid cancer incidence between 1980 and 2013 in Bulgaria and to determine the incidence rate before and after the introduction of universal salt iodization in 1994 in regions with different iodine deficiency levels.
Retrospective cohort.
The study was a retrospective analysis of the total number of thyroid cancer cases with all histological types in Bulgaria (thyroid cancer, ICD10 code C73), diagnosed between 01/01/1980 and 31/12/2013, and retrieved from the anonymous cancer registry database of the Bulgarian National Cancer Registry. Age-standardized rates of thyroid cancer per 100,000 persons were calculated for each year of the periods mentioned below by sex and age, utilizing the latively high post-Chernobyl radiation exposure.
Our results showed that, in different regions, the age-standardized thyroid cancer rates between endemic and non-endemic differ greatly depending on the radiation dose from the Chernobyl accident. The role of iodine intake in thyroid cancer remains uncertain, but iodine deficiency could be a contributing factor to the increased risk of thyroid cancer.
Our results showed that, in different regions, the age-standardized thyroid cancer rates between endemic and non-endemic differ greatly depending on the radiation dose from the Chernobyl accident. The role of iodine intake in thyroid cancer remains uncertain, but iodine deficiency could be a contributing factor to the increased risk of thyroid cancer.
Today, the role of microRNAs in the pathogenesis of breast cancer has been established. Genetic mutations play a significant role in determining the risk factors of cancer. The polymorphism of these two genes can alter their expression. This study has been performed to investigate the relationship between polymorphisms of rs6715345 of miR-375 gene and rs4939827 of the SMAD7 gene and development of breast cancer in a population in southeastern Iran.
This case-control study was performed on the blood sample of 205 patients with breast cancer and 225 healthy individuals for investigating the rs34917480 and rs4939827 polymorphisms using the PCR-RFLP method. The data were analyzed by t-test, χ2, and logistic regression. The SPSS v18.0 used for data analysis.
The findings of this study indicated that the risk of developing breast cancer does not have a significant relationship with rs6715345 polymorphism of miR-375 gene (p=0.1). see more However, the rs4939827 polymorphism of the SMAD7 gene was significantly linked to the risk of developing breast cancer in the southeastern population in Iran (p=0.01).
The results suggest that the rs4939827 polymorphism of the SMAD7 gene can lead to an increased risk of incidence of breast cancer in the southeastern population in Iran.<br />.
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Many studies suggested that fucoidan has anticancer potential. The objective of the present study was to determine the cytotoxic effects and mechanism of cell death induced by fucoidan extracted from Fucus vesiculosus on HSC-3 oral squamous cell carcinoma.
HSC-3 cells were treated with 0, 100, 200, and 400 μg/mL of fucoidan. Cell viability was measured using MTT assay. Apoptosis and cell cycle were measured with a flow cytometry-based assay. Chromatin condensation and nuclear fragmentation were determined using Hoechst 33342 staining. Mitochondrial membrane potential (ΔΨm) was determined using the JC-1 kit. The apoptotic, anti-apoptotic, and autophagic markers study were done by western blot analysis.
the viable cell number of treated HSC-3 cells was decreased. Moreover, treated cells were arrested in the G0/G1 phase. Annexin V/PI staining revealed that fucoidan could induce apoptosis in HSC-3 cells. Western blot analysis suggested the up-regulation of apoptotic markers including cleaved caspase-3, cleaved PARP, Bax, and autophagic markers including LC3-II and Beclin-1 but down-regulation of anti-apoptotic markers, Bcl-2. Fucoidan could disturb ΔΨm and induce chromatin condensation with nuclear fragmentation.
fucoidan has potential in anticancer properties against HSC-3 cells manifested by the induction of apoptosis, cell cycle arrest, and autophagy.<br />.
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Metabolic processes in the body of people with and without esophageal cancer (EC) are significantly different. Therefore, changes in the metabolism of amino acids in the body of EC patients can lead to metabolic disorders, such as increased gluconeogenesis. The aim of this study was the comparison of the plasma levels of gluconeogenic amino acids between patients with EC and the control group.
Plasma samples of 37 patients with EC who were selected before any treatment or surgery, and 37 healthy adults who did not have history of family cancer and malignant diseases were taken. Analysis of the plasma levels of amino acids including, alanine, asparagine, aspartate, glutamate, glutamine, glycine, serine, arginine, histidine, methionine, threonine, valine, tyrosine, isoleucine, phenylalanine, tryptophan was done by High Performance Liquid Chromatography (HPLC) based on reverse-phase-chromatography. Data analysis was done by SPSS-16 software.
In the patient group the mean age ± SD was 63±13.64 and 21 (56.8%r.The chemotherapy drug doxorubicin (DOX) is effective in treating many types of cancers. However, due to its pro-inflammatory and cardiotoxic side effects, other remedies have also been explored as alternative treatments. The plant Alangium longiflorum was reported to contain cytotoxic activity against cancer cells, but it is unclear whether this plant would also yield side effects similar to doxorubicin. Hence, this study investigated cytotoxic activity of A. longiflorum leaf extract against lung cancer cells and compared its pro-inflammatory and cardiotoxic side effects with those of DOX.
Cytotoxic activity of A. longiflorum in human lung (A549) and breast (MCF-7) cancer cells was initially assessed by MTT assay and then was compared with doxorubicin. Presence of secondary metabolites in the leaf extract was examined by phytochemical screening. The ability of the plant extract to induce apoptosis was determined by measuring caspase-3/7 activity and apoptosis-related gene expression. Pro-inflammatory response was assessed by quantifying NFκB transcriptional activity and nuclear translocation with dual luciferase reporter and immunofluorescence assays, respectively.
