Purpose: Prospective randomized controlled trials and long-term studies are essential future directions for building -evidence-based practices in developmental dysplasia of the hip (DDH), however, sufficient attrition in data (> 20%) can introduce bias deteriorating research quality. Pelvic radiography is synonymous with DDH assessment and so are -Gonadal Shield (GS) recommendations with pelvic radiography. -Nonetheless, losses to diagnostic information and inadequate protection have been increasingly implicated to GS usage, with significantly worse implications in female patients.
View Article and Find Full Text PDFIn this trans-ethnic multi-omic study, we reinterpret the genetic architecture of blood pressure to identify genes, tissues, phenomes and medication contexts of blood pressure homeostasis. We discovered 208 novel common blood pressure SNPs and 53 rare variants in genome-wide association studies of systolic, diastolic and pulse pressure in up to 776,078 participants from the Million Veteran Program (MVP) and collaborating studies, with analysis of the blood pressure clinical phenome in MVP. Our transcriptome-wide association study detected 4,043 blood pressure associations with genetically predicted gene expression of 840 genes in 45 tissues, and mouse renal single-cell RNA sequencing identified upregulated blood pressure genes in kidney tubule cells.
View Article and Find Full Text PDFIt is unclear whether N-terminal pro-brain type natriuretic peptide (NT-proBNP) level can be a biomarker for technique failure among long-term peritoneal dialysis (PD) patients. We prospectively included end-stage renal disease patients undergoing PD from a single center between December 2011 and December 2017. We divided the cohort into high or low NT-proBNP groups and analyzed the risk factors associated with the incidence of technique failure using Cox proportional hazard regression analysis.
View Article and Find Full Text PDFImmune checkpoint blockade targeting programmed cell death protein 1 (PD-1) is emerging as an important treatment strategy in a growing list of cancers, yet its clinical benefits are limited to a subset of patients. Further investigation of tumor-intrinsic predictors of response and how extrinsic factors, such as iatrogenic immunosuppression caused by conventional therapies, impact the efficacy of anti-PD-1 therapy are paramount. Given the widespread use of corticosteroids in cancer management and their immunosuppressive nature, this study sought to determine how corticosteroids influence anti-PD-1 responses and whether their effects were dependent on tumor location within the periphery versus central nervous system (CNS), which may have a more limiting immune environment.
View Article and Find Full Text PDFEvid Based Complement Alternat Med
November 2018
Chronic prostatitis (CP) is a chronic inflammation in the prostate with unsatisfactory management. Danggui Beimu Kushen Wan (DBKW) is a classic formula developed 1800 years ago for patients with difficult urination and it has been widely utilized for CP in modern days. However, scientific understanding of DBKW on CP has not been systematically reviewed.
View Article and Find Full Text PDFThe safety and efficacy of spironolactone is uncertain in end-stage renal disease. We randomized 129 maintenance hemodialysis patients to placebo (n=51) or spironolactone 12.5 mg (n=27), 25 mg (n=26), or 50 mg (n=25) daily for 36 weeks in a double-blind, placebo-controlled, multiple dosage trial to assess safety, tolerability and feasibility and to explore cardiovascular efficacy.
View Article and Find Full Text PDFIn the version of this article originally published, the name of author Martin H. de Borst was coded incorrectly in the XML. The error has now been corrected in the HTML version of the paper.
View Article and Find Full Text PDFBackground: Diabetes remains a growing public health threat but evidence supports the role that pharmacists can play in improving diabetes medication use and outcomes. To improve the quality of care, the Veterans Health Administration has widely adopted care models that integrate clinical pharmacists, but more data are needed to interpret the impact of these services. Our objective was to assess clinical pharmacy services' impact on outcomes and oral antidiabetic medication (OAD) use among veterans with uncontrolled diabetes in the first year of therapy.
View Article and Find Full Text PDFTumor-reactive T cell exhaustion prevents the success of immune therapies. Pegilodecakin activates intratumoral CD8 T cells in mice and induces objective tumor responses in patients. Here we report that pegilodecakin induces hallmarks of CD8 T cell immunity in cancer patients, including elevation of interferon-γ and GranzymeB, expansion and activation of intratumoral CD8 T cells, and proliferation and expansion of LAG-3 PD-1 CD8 T cells.
View Article and Find Full Text PDFAim: To evaluate whether recent low adherence to metformin monotherapy is associated with hypoglycaemia after addition of a sulfonylurea.
Methods: We assembled a retrospective cohort of veterans who filled a new prescription for metformin between 2001 and 2011 and intensified treatment with a sulfonylurea after ≥1 year of metformin use. We calculated metformin adherence from pharmacy data using the proportion of days covered in the 180-day period before intensification.
Objectives: To evaluate automated performance metrics (APMs) and clinical data of experts and super-experts for four cardinal steps of robot-assisted radical prostatectomy (RARP): bladder neck dissection; pedicle dissection; prostate apex dissection; and vesico-urethral anastomosis.
Subjects And Methods: We captured APMs (motion tracking and system events data) and synchronized surgical video during RARP. APMs were compared between two experience levels: experts (100-750 cases) and super-experts (2100-3500 cases).
Objective: To better define the prevalence of protein-energy wasting (PEW) in kidney disease is poorly defined.
Methods: We performed a meta-analysis of PEW prevalence from contemporary studies including more than 50 subjects with kidney disease, published during 2000-2014 and reporting on PEW prevalence by subjective global assessment or malnutrition-inflammation score. Data were reviewed throughout different strata: (1) acute kidney injury (AKI), (2) pediatric chronic kidney disease (CKD), (3) nondialyzed CKD 3-5, (4) maintenance dialysis, and (5) subjects undergoing kidney transplantation (Tx).
The use of inhibitory checkpoint blockade in the management of glioblastoma has been studied in both preclinical and clinical settings. TIGIT is a novel checkpoint inhibitor recently discovered to play a role in cancer immunity. In this study, we sought to determine the effect of anti-PD-1 and anti-TIGIT combination therapy on survival in a murine glioblastoma (GBM) model, and to elucidate the underlying immune mechanisms.
View Article and Find Full Text PDFIntroduction: The pathophysiology of normal-pressure hydrocephalus and the correlation with its symptomatology is not well understood.
Objective: To monitor and evaluate the enlargement patterns of the ventricular system for each ventricle and its correlation with the presenting symptoms.
Methods: Bilateral kaolin injection into the subarachnoid space overlying the cranial convexities was done in 18 adult rats.
We discuss the differences in cognitive (thinking) and other non-technical skills (NTS) in robotic surgery training compared to other approaches to surgery. Recognition of the importance of NTS and cognitive training will aid the development of robotic surgery curricula.
View Article and Find Full Text PDFBackground: Obesity has become a worldwide health concern. Pharmacotherapies are now being introduced because lifestyle modifications alone are insufficient for weight management. The treatment outcomes of current approved anti-obesity agents are not satisfying due to drug-related intolerances.
View Article and Find Full Text PDFThe aim of this study was to investigate the effects of sex and dietary lecithin on growth performance, meat quality, muscle collagen content and gene expression of key genes involved in collagen synthesis in finisher pigs. A total of 256 pigs (Large White × Landrace) were allotted to a 2 × 2 factorial arrangement involving sex (gilt or immunocastrated [IC] male) and dietary treatment (0 or 5 g/kg of dietary lecithin). All diets were formulated to contain 4.
View Article and Find Full Text PDFBackground: Previous reports indicated an association between hemorrhagic presentation and flow-related aneurysms in arteriovenous malformation (AVM) patients. However, it remains unclear whether these flow-related aneurysms result in the hemorrhage of AVM.
Objective: To characterize this hemorrhage risk using our institutional experience over 25 yr.
Purpose: Robotic surgeries, especially in urology, have grown exponentially during the last decade. Various skills assessment tools have been developed. We reviewed the current status, the current challenges and the future needs of robotic evaluations with a focus on urological applications.
View Article and Find Full Text PDFPurpose: Several observational studies suggest that metformin reduces incidence cancer risk; however, many of these studies suffer from time-related biases and several cancer outcomes have not been investigated due to small sample sizes.
Methods: We constructed a propensity score-matched retrospective cohort of 84,434 veterans newly prescribed metformin or a sulfonylurea as monotherapy. We used Cox proportional hazard regression to assess the association between metformin use compared to sulfonylurea use and incidence cancer risk for 10 solid tumors.
Aim: To determine the association of adherence to oral antidiabetes medication with macrovascular and microvascular complications, time to insulin therapy, revascularization, admissions, and death among veterans with uncomplicated diabetes.
Methods: This was a retrospective cohort study using the Veterans Affairs Corporate Data Warehouse to examine 159 032 veterans diagnosed with uncomplicated diabetes during 2002-2014 and starting oral antidiabetes therapy for the first time. The first uncomplicated diabetes diagnosis was identified and confirmed by subsequent oral antidiabetes therapy initiation.