Experiences of living with funnel chest prior to corrective surgery: An interview study.

Objectives: Pectus excavatum, or funnel chest, causes both physical and psychosocial issues, affecting health-related quality of life. However, the literature on how funnel chest affects daily living prior to corrective surgery is sparse. Therefore, the study aimed to describe the experiences of living with funnel chest prior to correctional surgery.

Safety and prescribing recommendations for verapamil in newly diagnosed pediatric type 1 diabetes (T1D): The CLVer experience.

Objectives: To report the safety and side effects associated with taking verapamil for beta-cell preservation in children with newly-diagnosed T1D.

Research Design And Methods: Eighty-eight participants aged 8.5 to 17.

Health-related quality of life after Nuss procedure for pectus excavatum: a cross-sectional study.

Objectives: Pectus excavatum (PE) can cause both physical and psychosocial symptoms and affect patients' health-related quality of life. Previous international studies have shown that the Nuss procedure increases both self-esteem and body image. The aim of the study was to evaluate the health-related quality of life in patients who have undergone the Nuss procedure for PE.

Impact of a Novel Diabetes Support System on a Cohort of Individuals With Type 1 Diabetes Treated With Multiple Daily Injections: A Multicenter Randomized Study.

Objective: Achieving optimal glycemic control for many individuals with type 1 diabetes (T1D) remains challenging, even with the advent of newer management tools, including continuous glucose monitoring (CGM). Modern management of T1D generates a wealth of data; however, use of these data to optimize glycemic control remains limited. We evaluated the impact of a CGM-based decision support system (DSS) in patients with T1D using multiple daily injections (MDI).

Translation and psychometric evaluation of the Swedish versions of the Nuss Questionnaire modified for Adults and the Single Step Questionnaire.

Background: Pectus excavatum (PE) is the most common congenital chest wall deformity. Most individuals with PE suffer from psychosocial problems, with low self-esteem and poor body image. Correctional surgery for PE is available, the most widely used is the Nuss procedure.

Safety and Performance of the Tandem t:slim X2 with Control-IQ Automated Insulin Delivery System in Toddlers and Preschoolers.

Glycemic control is particularly challenging for toddlers and preschoolers with type 1 diabetes (T1D), and data on the use of closed-loop systems in this age range are limited. We studied use of a modified investigational version of the Tandem t:slim X2 Control-IQ system in children aged 2 to 5 years during 48 h in an outpatient supervised hotel (SH) setting followed by 3 days of home use to examine the safety of this system in young children. Meals and snacks were not restricted and boluses were estimated per parents' usual routine.

Hybrid Closed-Loop Control Is Safe and Effective for People with Type 1 Diabetes Who Are at Moderate to High Risk for Hypoglycemia.

Typically, closed-loop control (CLC) studies excluded patients with significant hypoglycemia. We evaluated the effectiveness of hybrid CLC (HCLC) versus sensor-augmented pump (SAP) in reducing hypoglycemia in this high-risk population. Forty-four subjects with type 1 diabetes, 25 women, 37 ± 2 years old, HbA1c 7.

Predictive hyperglycemia and hypoglycemia minimization: In-home double-blind randomized controlled evaluation in children and young adolescents.

Objective: The primary objective of this trial was to evaluate the feasibility, safety, and efficacy of a predictive hyperglycemia and hypoglycemia minimization (PHHM) system vs predictive low glucose suspension (PLGS) alone in optimizing overnight glucose control in children 6 to 14 years old.

Research Design And Methods: Twenty-eight participants 6 to 14 years old with T1D duration ≥1 year with daily insulin therapy ≥12 months and on insulin pump therapy for ≥6 months were randomized per night into PHHM mode or PLGS-only mode for 42 nights. The primary outcome was percentage of time in sensor-measured range 70 to 180 mg/dL in the overnight period.

Home use of a bihormonal bionic pancreas versus insulin pump therapy in adults with type 1 diabetes: a multicentre randomised crossover trial.

Background: The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity.

Methods: We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA.

Training of public health personnel in handling CBRN emergencies: a table-top exercise card concept.

There is a large concern in the society today about the threat posed from releases of chemical, biological, radiological or nuclear (CBRN) materials, whether accidental or malicious. A rapid and adapted response to a CBRN incident combined with a thorough public communication is believed to decrease the detrimental impacts on health and to reduce the psychosocial effects. To facilitate CBRN exercises, which often can be regarded by non-specialists as rather complicated, a tool in the form of a set of Exercise cards for CBRN emergency response table-top exercises has been developed.

Formation and operation of a statewide commission on end-of-life care in Minnesota.

Background: Innovative approaches to improving end-of-life care are needed. One strategy involves government/community partnerships to improve care.

Objective: Engage health care provider and health care consumer communities in the State of Minnesota to improve end-of-life care.

The kitchen table discussion: a creative way to discuss end-of-life issues.

Home care and hospice nurses are uniquely positioned to facilitate early discussions about patient's care wishes and goals at the end of life. This article presents a definition of advance care planning, why it is important, a model for facilitating the discussion, suggestions for overcoming barriers, and tools to assist nurses in feeling more comfortable integrating the subject into daily practice.

The relationship of pain and suffering in a hospice population.

Although suffering is frequently encountered in the hospice setting, few studies examine this condition. The purpose of this study was to examine the relationship between terminally ill hospice patients' pain and their physical, spiritual, and personal or family suffering. Using a tool developed to measure suffering in those categories, a convenience sample of 92 patients were asked to rate their worst pain within the last 24 hours, and to rate their suffering at the time of the interview.

The ballet of baseball: lessons of the game for hospice.

As Yogi Berra once said, "The future ain't what it used to be." In the era of rapid change in health care, hospice and palliative care programs will survive only through organizational teamwork. Using the lessons of baseball, we present a stadium-eye perspective on how programs can take the three fundamentals of baseball--pitching, batting, and fielding--and translate them into the three fundamentals of organizational teamwork--clinical, operational, and financial.

Death at home following a targeted advance-care planning process at home: the kitchen table discussion.

Objective: To determine whether home health agency patients' preferences to die at home can be honored following a structured, professionally facilitated advance-care planning (ACP) process provided in the home.

Design: A case series of patients who were identified by their home health agency nurses as having a life-limiting illness and then referred for social service assessment, followed for at least 6 months, with median follow-up of 191 days.

Setting: A large, urban, home health agency owned by a not-for-profit integrated healthcare system.

A case of Q fever acquired in Sweden and isolation of the probable ethiological agent, Coxiella burnetii from an indigenous source.

Serologically verified indigenous Q fever is described in a 52-y-old male, who presented with persistent fever, muscle and joint pain, headache and non-purulent cough. Institution of doxycycline resulted in prompt recovery. Coxiella burnetii was isolated from mouldy hay in a barn.

Q fever epidemiology and pathogenesis.

The lungs are a port of entry and primary infectious focus of Coxiella burnetii, the obligate intracellular contagium of the worldwide zoonosis Q fever. The infectious process and immune response are characterised by studies in cell culture and animal systems. Following endocytosis, replication exclusively occurs in the phagolysosome.

Early cytokine induction in mouse P388D1 macrophages infected by Coxiella burnetii.

Q-fever is caused by Coxiella burnetii, which is an obligate intracellular bacterium with a broad spectrum of host cells, including macrophages. Cytokines produced from macrophages infected by intracellular bacteria play a critical role in the expression of innate immune responses as well as in the subsequent triggering of protective acquired cell-mediated immunity. We followed the induction and secretion of the pro-inflammatory cytokines interleukin 1 alpha (IL-1alpha), tumor necrosis factor alpha (TNF-alpha), and interleukin 12 (IL-12) in the macrophage-like mouse cell line P388D1 during the initial phase of an in vitro infection by virulent C.

Effect of endocytosis inhibitors on Coxiella burnetii interaction with host cells.

The obligate intracellular rickettsia Coxiella burnetii has previously been reported to reach the intravacuolar compartment of host cells by phagocytosis. With the aim to further examine the mechanisms of C. burnetii internalisation, macrophage monolayers were treated with well characterised inhibitors of endocytosis.

Identification of a 71-kilodalton surface-associated Hsp70 homologue in Coxiella burnetii.

A Coxiella burnetii Hsp70 homologue was identified by using an acid activation in vitro system in which protein synthesis has been followed by [35S]methionine labeling, autoradiography, and immunoblotting. The protein was one of those predominantly labeled, and the immunoblots revealed that it was recognized by anti-DnaK antibodies. The corresponding gene was isolated, and its nucleotide sequence was determined and analyzed.

Genotypic and phenotypic characterization of two Swedish isolates and two prototypic strains of Coxiella burnetii.

Two Swedish isolates of Coxiella burnetii and the two prototype strains of the species, Nine Mile and Priscilla, were characterized with regard to their multiplication and cytopathic effect on BGM cells and by PCR-based amplification of repetitive element DNA and the C. burnetii-specific plasmids QpH1 and QpRS. Moreover, 1330 bp of each 16S rRNA gene were sequence-determined.

Specific detection of Coxiella burnetii through partial amplification of 23S rDNA.

A previously published sequence of the 23S rRNA gene of Coxiella burnetii has been reported to contain an intervening sequence of 444 base pairs (bp). The sequence information on the intervening sequence and the 23S rRNA gene was exploited to develop a specific PCR-based assay for C. burnetii.

A survey of Q-fever in Sweden.

Coxiella burnetii, the etiological agent of Q-fever has recently been isolated from sheep in southern Sweden. In this region 24-30% of sheep farmers have been exposed to the organism as shown by serological measurements. In veterinarians, another group with high risk of exposure to C.