Psychological impacts of intervention to improve a therapeutic garden for older adults with dementia: a case study conducted at a care facility.

Introduction: Exposure to nature is known to support psychological wellbeing, and can support People with Dementia (PwD). Here we describe a case study conducted at a care facility for PwD to examine the effect of their exposure to nature after intervention to renovate an existing Therapeutic Garden (TG). Changes in frequency of attendance and behavior in the TG were examined.

Causal reasoning without mechanism.

Unobservable mechanisms that tie causes to their effects generate observable events. How can one make inferences about hidden causal structures? This paper introduces the domain-matching heuristic to explain how humans perform causal reasoning when lacking mechanistic knowledge. We posit that people reduce the otherwise vast space of possible causal relations by focusing only on the likeliest ones.

Patient-reported quality of life during definitive and postprostatectomy image-guided radiation therapy for prostate cancer.

Purpose: The importance of patient-reported outcomes is well-recognized. Long-term patient-reported symptoms have been described for individuals who completed radiation therapy (RT) for prostate cancer. However, the trajectory of symptom development during the course of treatment has not been well-described in patients receiving modern, image-guided RT.

Role of saliva in esophageal defense: implications in patients with nonerosive reflux disease.

Background: It has been previously demonstrated that patients with reflux esophagitis exhibit a significant impairment in the secretion of salivary protective components versus controls. However, the secretion of salivary protective factors in patients with nonerosive reflux disease (NERD) is not explored. The authors therefore studied the secretion of salivary volume, pH, bicarbonate, nonbicarbonate glycoconjugate, protein, epidermal growth factor (EGF), transforming growth factor alpha (TGF-α) and prostaglandin E2 in patients with NERD and compared with the corresponding values in controls (CTRL).

Racial Differences in Diffusion of Intensity-Modulated Radiation Therapy for Localized Prostate Cancer.

Intensity-modulated radiation therapy (IMRT), an innovative treatment option for prostate cancer, has rapidly diffused over the past decade. To inform our understanding of racial disparities in prostate cancer treatment and outcomes, this study compared diffusion of IMRT in African American (AA) and Caucasian American (CA) prostate cancer patients during the early years of IMRT diffusion using the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database. A retrospective cohort of 947 AA and 10,028 CA patients diagnosed with localized prostate cancer from 2002 through 2006, who were treated with either IMRT or non-IMRT as primary treatment within 1 year of diagnoses was constructed.

Application of human factors analysis and classification system model to event analysis in radiation oncology.

Purpose: To assess the applicability of the human factors analysis and classification system (HFACS) model for analyzing events in a radiation oncology environment by comparing the HFACS analysis results between novices and experts.

Methods And Materials: Four novices (resident physicians, 2-4 postgraduate years) volunteered to participate and were asked to independently perform the HFACS analysis on the selected 30 events. The events were divided into the following 2 sets: (1) the description of events was given in detail (eg, the conditions under which the events occurred including information about root causes of error); (2) the description of events was given without detailed information.

Comparative effectiveness of intensity-modulated radiotherapy and conventional conformal radiotherapy in the treatment of prostate cancer after radical prostatectomy.

Importance: Comparative effectiveness research of prostate cancer therapies is needed because of the development and rapid clinical adoption of newer and costlier treatments without proven clinical benefit. Radiotherapy is indicated after prostatectomy in select patients who have adverse pathologic features and in those with recurrent disease.

Objectives: To examine the patterns of use of intensity-modulated radiotherapy (IMRT), a newer, more expensive technology that may reduce radiation dose to adjacent organs compared with the older conformal radiotherapy (CRT) in the postprostatectomy setting, and to compare disease control and morbidity outcomes of these treatments.

Intensity-modulated radiation therapy, proton therapy, or conformal radiation therapy and morbidity and disease control in localized prostate cancer.

Context: There has been rapid adoption of newer radiation treatments such as intensity-modulated radiation therapy (IMRT) and proton therapy despite greater cost and limited demonstrated benefit compared with previous technologies.

Objective: To determine the comparative morbidity and disease control of IMRT, proton therapy, and conformal radiation therapy for primary prostate cancer treatment.

Design, Setting, And Patients: Population-based study using Surveillance, Epidemiology, and End Results-Medicare-linked data from 2000 through 2009 for patients with nonmetastatic prostate cancer.

[Undergraduate teaching of internal medicine in a private hospital].

There is a 10 years teaching experience for fourth year medical students and interns in a Chilean private hospital. The students attend an eight weeks practical course. The interns rotate during 16 weeks by specialties and make shifts.

[Anisakiasis in a patient with a small hiatal hernia. Report of one case].

We describe the presence of anisakiasis in a patient who had a small hiatal hernia. A 60 year-old women presented general malaise, burning pain, flatulence, persistent nausea and abdominal distension during five days before consulting. She referred that she ate a dish of marinated raw fish with lemon and pepper ("cebiche") and after a few hours the symptoms began.

Unusual presentation of gastric adenocarcinoma metastatic to the orbit.

A 69-year-old woman with no history of malignant disease presented with complaints of ptosis, diplopia, and left upper eyelid fullness. Computed tomography showed soft tissue infiltration of the left superior orbit. Biopsy was performed through an anterior orbitotomy.

The potential role of the esophageal pre-epithelial barrier components in the maintenance of integrity of the esophageal mucosa in patients with endoscopically negative gastroesophageal reflux disease.

Objective: Patients with gastroesophageal reflux disease (GERD) accompanied by erosive reflux esophagitis (RE) exhibit an impairment within the esophageal pre-epithelial barrier protective components that may facilitate the development and/or progression of the mucosal injury. Little is known, however, whether such impairment is a general phenomenon affecting all patients with GERD or whether this is a characteristic feature only of patients with erosive RE. We therefore studied the rate of secretion of esophageal inorganic and organic protective factors in patients with endoscopically negative [E (-)] GERD and compared these results with the corresponding values in asymptomatic volunteers (CTRL).

Esophagoprotective potential of cisapride. An additional benefit for gastroesophageal reflux disease.

Cisapride is a novel prokinetic agent that releases acetylcholine at the level of the myenteric plexus. Acetylcholine also plays a role in the secretory function of salivary glands evoked by intraesophagal mechanical and chemical stimulation, mediated through the esophagosalivary reflex. The impact, however, of cisapride on salivary protective components mediated by esophagosalivary reflex remains unknown.

Impact of Helicobacter pylori colonization on immunoreactive epidermal growth factor and transforming growth factor-alpha in gastric juice. Its potential pathogenetic implications.

Epidermal growth factor (EGF), pivotal in mucosal protection, is partly degraded proteolytically at low pH in the gastric milieu; gastric acid secretion, on the other hand, remains influenced by H. pylori colonization. The aim of this study, therefore, was to evaluate the impact of low pH and H.

Stress-related mucosal damage. What to do or not to do.

SRMD and associated bleeding continue to challenge physicians caring for critically ill patients; however, the incidence of clinically significant bleeding appears to be decreasing. The reason for this decrease is multifactorial. Improved ICU support and early attention to patients' nutritional and metabolic needs have attenuated the pathogenic mechanisms leading to gastrointestinal mucosal injury.

Carcinoid tumor and the nephrotic syndrome: a novel association between neoplasia and glomerular disease.

Various malignancies are associated with the paraneoplastic evolution of the nephrotic syndrome. Renal biopsy in these instances frequently shows membranous glomerulonephritis. We describe a patient who had metastatic bronchial carcinoid tumor with development of microscopic hematuria and subsequent nephrotic syndrome in conjunction with another paraneoplastic process, a malignancy-related neuropathy.

Lidocaine elimination and monoethylglycinexylidide formation in the dehydrated camel.

The elimination kinetics and the formation of the monoethylglycinexylidide (MEGX), a major metabolite of lidocaine, were studied in camels deprived of water for 14 days. The study was conducted on four camels in a crossover design. Lidocaine was administered intravenously at a dose of 1 mg/kg to adult female camels when water was given ad libitum (stage 1) and to the same camels after 14 days of dehydration.