Temporal trends in rates of patient harm resulting from medical care.

Background: In the 10 years since publication of the Institute of Medicine's report To Err Is Human, extensive efforts have been undertaken to improve patient safety. The success of these efforts remains unclear.

Methods: We conducted a retrospective study of a stratified random sample of 10 hospitals in North Carolina.

Group cognitive behavioural therapy for postnatal depression: a systematic review of clinical effectiveness, cost-effectiveness and value of information analyses.

Background: Postnatal depression (PND) describes a wide range of distressing symptoms that can occur in women following childbirth. There is substantial evidence to support the use of cognitive behaviour therapy (CBT) in the treatment of depression, and psychological therapies are recommended by the National Institute for Health and Clinical Excellence as a first-line treatment for PND. However, access is limited owing to expense, waiting lists and availability of therapists.

Lung transplantation for patients with cystic fibrosis and Burkholderia cepacia complex infection: a single-center experience.

Background: Pre-operative infection with organisms from the Burkholderia cepacia complex (BCC), particularly B cenocepacia, has been linked with a poorer prognosis after transplantation compared to patients with cystic fibrosis (CF) without this infection. Therefore, many transplant centers do not list these patients for transplantation.

Methods: We report the early and long-term results of a cohort of lung transplant recipients with CF and pre-operative BCC infection.

Rare occurrence of a bigeye tuna Thunnus obesus in British waters, with notes on other occurrences of sub-tropical tunas.

A freshly dead bigeye tuna Thunnus obesus was washed ashore near Burry Port, Wales (51 degrees 40' N; 4 degrees 15' W) in August, 2006. This is only the third occasion that the species has been observed in British waters, and is the largest and most northerly recorded specimen.

Performance characteristics of a methodology to quantify adverse events over time in hospitalized patients.

Objective: To assess the performance characteristics of the Institute for Healthcare Improvement Global Trigger Tool (GTT) to determine its reliability for tracking local and national adverse event rates.

Data Sources: Primary data from 2008 chart reviews.

Study Design: A retrospective study in a stratified random sample of 10 North Carolina hospitals.

Quantitation of p95HER2 in paraffin sections by using a p95-specific antibody and correlation with outcome in a cohort of trastuzumab-treated breast cancer patients.

Purpose: p95HER2 is an NH(2)-terminally truncated form of HER2 that lacks the trastuzumab binding site and is therefore thought to confer resistance to trastuzumab treatment. In this report, we introduce a new antibody that has enabled the first direct quantitative measurement of p95HER2 in formalin-fixed paraffin-embedded (FFPE) breast cancer tissues. We sought to show that quantitative p95HER2 levels would correlate with outcome in trastuzumab-treated HER2-positive metastatic breast cancer.

Outcomes following infant listing for cardiac transplantation: the impact of strategies introduced to counteract limited donor availability.

Background: Survival following cardiac transplantation in infancy has improved substantially. There is a growing shortage of donors, the impact of which may be offset by increase in ABO-incompatible transplants, size-mismatching and mechanical support. The authors reviewed their results and outcomes following infant listing for cardiac transplantation over 22 years.

Cardiac transplantation in adults with congenital heart disease.

Background: Due to increasing success with repair or palliation in childhood, there is a rapidly growing population of adult patients with complex congenital heart disease who may require transplantation. There remains little data on outcomes of cardiac transplantation in this group.

Methods: 38 orthotopic cardiac transplants were performed in 37 patients (18 men) > or =18 years of age with congenital heart disease (CHD) from 1988 to 2009 in our institution.

Evaluation of NT-proBNP to predict outcomes in advanced heart failure.

Aims: To determine which factors predict outcomes in a group of patients with advanced heart failure, and in particular if NT-proBNP provides additional clinical and prognostic information to other haemodynamic and biochemical data.

Methods And Results: Ninety-one patients were studied who were being evaluated for heart transplantation, with 166 assessments. The patients had advanced heart failure as determined by median cardiac index of 2.

The acceptability of computerised cognitive behavioural therapy for the treatment of depression in people with chronic physical disease: a qualitative study of people with multiple sclerosis.

Background: People with chronic physical conditions are at elevated risk of depression. Due to a shortage of Cognitive Behavioural Therapy (CBT) practitioners, computerised CBT (CCBT) is recommended for people with mild to moderate depression. We assessed the applicability of CCBT for the treatment of depression in people with multiple sclerosis (MS).

Nitrate-responsive miR393/AFB3 regulatory module controls root system architecture in Arabidopsis thaliana.

One of the most striking examples of plant developmental plasticity to changing environmental conditions is the modulation of root system architecture (RSA) in response to nitrate supply. Despite the fundamental and applied significance of understanding this process, the molecular mechanisms behind nitrate-regulated changes in developmental programs are still largely unknown. Small RNAs (sRNAs) have emerged as master regulators of gene expression in plants and other organisms.

Recurrent chest wall abscesses overlying a pneumonectomy scar: an unusual presentation of a cholecystocutaneous fistula.

We report a case of recurrent chest wall abscesses overlying a right thoracotomy scar four years after a pneumonectomy for a right middle lobe bronchus squamous cell carcinoma. Exploration of the abscess cavities revealed no intra-thoracic or intra-abdominal communication. The patient developed sinuses in his thoracotomy scar and two years later, two gallstones were expelled from these sinuses.

Complex regulation of the TIR1/AFB family of auxin receptors.

Auxin regulates most aspects of plant growth and development. The hormone is perceived by the TIR1/AFB family of F-box proteins acting in concert with the Aux/IAA transcriptional repressors. Arabidopsis plants that lack members of the TIR1/AFB family are auxin resistant and display a variety of growth defects.

Patient safety attitudes of paediatric trainee physicians.

Objectives: To measure the patient safety attitudes of trainee physicians at an academic paediatric hospital.

Design: Cross-sectional survey.

Setting: An academic paediatric hospital.

Non-recurrent SEPT9 duplications cause hereditary neuralgic amyotrophy.

Background: Genomic copy number variants have been shown to be responsible for multiple genetic diseases. Recently, a duplication in septin 9 (SEPT9) was shown to be causal for hereditary neuralgic amyotrophy (HNA), an episodic peripheral neuropathy with autosomal dominant inheritance. This duplication was identified in 12 pedigrees that all shared a common founder haplotype.

Safety, tolerability, and cerebrospinal fluid penetration of ursodeoxycholic Acid in patients with amyotrophic lateral sclerosis.

Objective: Amyotrophic lateral sclerosis is a progressive degenerative disease, which typically leads to death in 3 to 5 years. Neuronal cell death offers a potential target for therapeutic intervention. Ursodeoxycholic acid is a cytoprotective, endogenous bile acid that has been shown to be neuroprotective in experimental Huntington and Alzheimer diseases, retinal degeneration, and ischemic and hemorrhagic stroke.

EGFR over-expression and activation in high HER2, ER negative breast cancer cell line induces trastuzumab resistance.

HER2 is gene amplified or over-expressed in 20-25% of breast cancers resulting in elevated HER2 activation. Trastuzumab (Herceptin), a humanized monoclonal antibody, targets activated HER2 and is clinically effective in HER2-over-expressing breast cancers. However, despite prolonged survival, treated breast cancer patients develop resistance.

Acute hemodynamic effects of intravenous sildenafil citrate in congestive heart failure: comparison of phosphodiesterase type-3 and -5 inhibition.

Background: The reversibility of elevated pulmonary vascular resistance in heart failure bears an important relation to outcome after cardiac transplantation. The phosphodiesterase 3 (PDE3) and PDE5 inhibitors both increase levels of cyclic nucleotides in the vascular smooth muscle, causing vasodilatation. PDE3 inhibitors also have direct inotropic effects.

Post cardiac transplantation lymphoproliferative disorder presenting as t(8;14) Burkitt leukaemia/lymphoma treated with low intensity chemotherapy and rituximab.

Background: Post-transplant lymphoproliferative disorder (PTLD) occasionally presents as Burkitt lymphoma/L3 leukaemia (BLL).

Procedure: We reviewed records of cases of PTLD post-cardiac transplantation (1990-2007) occurring in our unit.

Results: There were 15 episodes in 13 patients including four cases of EBV-driven Burkitt-type disease with t(8;14) translocations presenting with advanced stage disease.

Inflammatory demyelinating neuropathies.

Early and effective treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) is important to minimize axonal degeneration that occurs secondary to demyelination. The disease course is invariably chronic, so long-term treatment is often required, and adverse effects and costs are important considerations in devising a treatment plan. CIDP responds to prednisone, but long-term treatment can result in significant adverse effects.

Health and use of health services: a comparison between Gypsies and Travellers and other ethnic groups.

Objectives: To examine the health status of adults from black and minority ethnic groups and from a socio-economically mixed White population, all resident in England.

Design: A cross-sectional questionnaire survey using validated standardised health measures of a sample of Gypsies and Travellers, Pakistani Muslims, African Caribbean, and White adults living in five geographical locations. Health outcomes included general health, health in the past year, limiting long-term illness, anxiety, depression, respiratory symptoms and angina.

The effect of hospital bed occupancy on throughput in the pediatric emergency department.

Study Objective: Although it has been suggested that high hospital occupancy leads to emergency department (ED) overcrowding and impedes ED throughput, there are limited data defining this relationship. The objective of this study is to examine whether high inpatient hospital occupancy negatively affects throughput in a pediatric ED.

Methods: This cross-sectional analysis evaluated patient visits to an urban pediatric ED and hospital occupancy rates.

In vivo biodistribution, PET imaging, and tumor accumulation of 86Y- and 111In-antimindin/RG-1, engineered antibody fragments in LNCaP tumor-bearing nude mice.

Unlabelled: To optimize in vivo tissue uptake kinetics and clearance of engineered monoclonal antibody (mAb) fragments for radiotherapeutic and radiodiagnostic applications, we compared the biodistribution and tumor localization of four (111)In- and (86)Y-labeled antibody formats, derived from a single antimindin/RG-1 mAb, in a prostate tumor model. The IgG, diabody, single-chain variable domain (scFv), and novel miniantibody formats, composed of the human IgE-C(H)4 and a modified IgG1 hinge linked to scFv domains, were compared.

Methods: Antibodies were first derivatized with the bifunctional chelator CHX-A''-diethylenetriamine pentaacetic acid and then bound to the radiometal to create radiolabeled immunoconjugates.