MHealth and perceived quality of care delivery: a conceptual model and validation.

Background: The objective of this research is to examine, conceptualize, and empirically validate a model of mobile health (mHealth) impacts on physicians' perceived quality of care delivery (PQoC).

Methods: Observational quasi-experimental one group posttest-only design was implemented through the empirical testing of the conceptual model with nine hypotheses related to the association of task and technology characteristics, self-efficacy, m-health utilization, task-technology fit (TTF), and their relationships with PQoC. Primary data was collected over a four-month period from acute care physicians in The Ottawa Hospital, Ontario, Canada.

Angiotensin-converting enzyme defines matrikine-regulated inflammation and fibrosis.

The neutrophil chemoattractant proline-glycine-proline (PGP) is generated from collagen by matrix metalloproteinase-8/9 (MMP-8/9) and prolyl endopeptidase (PE), and it is concomitantly degraded by extracellular leukotriene A4 hydrolase (LTA4H) to limit neutrophilia. Components of cigarette smoke can acetylate PGP, yielding a species (AcPGP) that is resistant to LTA4H-mediated degradation and can, thus, support a sustained neutrophilia. In this study, we sought to elucidate if an antiinflammatory system existed to degrade AcPGP that is analogous to the PGP-LTA4H axis.

Matrix Remodeling in Pulmonary Fibrosis and Emphysema.

Pulmonary fibrosis and emphysema are chronic lung diseases characterized by a progressive decline in lung function, resulting in significant morbidity and mortality. A hallmark of these diseases is recurrent or persistent alveolar epithelial injury, typically caused by common environmental exposures such as cigarette smoke. We propose that critical determinants of the outcome of the injury-repair processes that result in fibrosis versus emphysema are mesenchymal cell fate and associated extracellular matrix dynamics.

Therapeutic targeting of SRC kinase in myofibroblast differentiation and pulmonary fibrosis.

Myofibroblasts are effector cells in fibrotic disorders that synthesize and remodel the extracellular matrix (ECM). This study investigated the role of the Src kinase pathway in myofibroblast activation in vitro and fibrogenesis in vivo. The profibrotic cytokine, transforming growth factor β1 (TGF-β1), induced rapid activation of Src kinase, which led to myofibroblast differentiation of human lung fibroblasts.

An aberrant leukotriene A4 hydrolase-proline-glycine-proline pathway in the pathogenesis of chronic obstructive pulmonary disease.

Rationale: Chronic neutrophilic inflammation is a hallmark in the pathogenesis of chronic obstructive pulmonary disease (COPD) and persists after cigarette smoking has stopped. Mechanisms involved in this ongoing inflammatory response have not been delineated.

Objectives: We investigated changes to the leukotriene A4 hydrolase (LTA4H)-proline-glycine-proline (PGP) pathway and chronic inflammation in the development of COPD.

Sputum PGP is reduced by azithromycin treatment in patients with COPD and correlates with exacerbations.

Rationale: Proline-glycine-proline (PGP), a neutrophil chemoattractant derived from the enzymatic breakdown of collagen, is elevated in sputum of patients with chronic obstructive pulmonary disease (COPD) and may contribute to disease progression. Whether sputum levels of PGP respond to therapy for COPD or predict outcomes is unknown.

Objectives: We conducted a study ancillary to a multicenter trial of the efficacy of azithromycin treatment for 1 year in preventing COPD exacerbations to test whether sputum levels of PGP were altered by treatment or associated with exacerbation frequency.

Orbital Rosai-Dorfman disease with subperiosteal bone involvement mimicking eosinophilic granuloma.

The presentation of RDD as an anterior subperiosteal orbital mass with bone involvement has, to the authors' knowledge, not been previously reported. We describe a case of Rosai-Dorfman disease (RDD) presenting as an anterior superolateral subperiosteal orbital mass with erosion of overlying bone mimicking eosinophilic granuloma. It was debulked using endoscopic-guided curettage and the patient was given both local and systemic corticosteroids.

A review of combined orbital decompression and lower eyelid recession surgery for lower eyelid retraction in thyroid orbitopathy.

Background/aims: Eyelid retraction in thyroid orbitopathy is traditionally managed with staged surgery after orbital decompression. We review the benefit of concurrent inferior retractor recession at the time of orbital decompression when closing a swinging-eyelid flap.

Methods: A retrospective, comparative, non-randomised clinical audit of 34 eyes of 22 patients with thyroid orbitopathy over a 3-year period was carried out.

Delayed hypersensitivity reaction to Restylane ® SubQ.

Purpose: To report on 4 patients who developed delayed hypersensitivity reactions to Restylane(®) SubQ and their management. To our knowledge, no cases of delayed hypersensitivity to Restylane(®) SubQ have been previously reported.

Methods: A retrospective case series of 4 patients who were treated with preperiosteal Restylane(®) SubQ to their cheeks, for facial volume augmentation.

Our experience with the masquerade procedure for total eyelid loss.

Purpose: To describe our experience of the Masquerade Procedure, a historical procedure that is poorly described in the modern literature.

Methods: We performed a masquerade procedure in two complex surgical cases where traditional methods of eyelid reconstruction or closure were not possible. The first case suffered a partial de-gloving injury with a right sided anterior exenteration and loss of the upper and lower eyelids.

Towards improved healthcare performance: examining technological possibilities and patient satisfaction with wireless body area networks.

This paper investigates the benefits of using less intrusive wireless technologies for heart monitoring. By replacing well established heart monitoring devices (i.e.

Neutrophils contain prolyl endopeptidase and generate the chemotactic peptide, PGP, from collagen.

Prolyl endopeptidase (PE), a protease that cleaves after proline residues in oligopeptides, is highly active in brain and degrades neuropeptides in vitro. We have recently demonstrated that PE, in concert with MMP's, can generate PGP (proline-glycine-proline), a novel, neutrophil chemoattractant, from collagen. In this study, we demonstrate that human peripheral blood neutrophils contain PE, which is constitutively active, and can generate PGP de novo from collagen after activation with LPS.

Augmentation of macular pigment following implantation of blue light-filtering intraocular lenses at the time of cataract surgery.

Purpose: (Photo)-oxidative stress is believed to play a role in the pathogenesis of age-related macular degeneration (AMD), with the threshold for retinal damage being lowest for short-wavelength (blue) light. Macular pigment (MP), consisting of the carotenoids lutein (L), zeaxanthin (Z) and meso-Z, has a maximum absorption at 460 nm and protects the retina from (photo)-oxidative injury. This study was designed to investigate whether the blue light-filtering properties of the Alcon AcrySof Natural intraocular lens (ANIOL) implanted during cataract surgery affects MP optical density (MPOD).

N-alpha-PGP and PGP, potential biomarkers and therapeutic targets for COPD.

Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder for which new diagnostic and therapeutic approaches are required. Hallmarks of COPD are matrix destruction and neutrophilic airway inflammation in the lung. We have previously described two tri-peptides, N-alpha-PGP and PGP, which are collagen fragments and neutrophil chemoattractants.

A novel proteolytic cascade generates an extracellular matrix-derived chemoattractant in chronic neutrophilic inflammation.

Chronic neutrophilic inflammation is a manifestation of a variety of lung diseases including cystic fibrosis (CF). There is increasing evidence that fragments of extracellular matrix proteins, such as collagen and elastin, play an important role in inflammatory cell recruitment to the lung in animal models of airway inflammation. Unfortunately, the association of these peptides with human disease and the identification of therapeutic targets directed toward these inflammatory pathways have remained elusive.

Interfering with extracellular matrix degradation to blunt inflammation.

Chemoattractant properties of matrix proteins, like collagen and elastin, for neutrophils and monocytes in vitro have long been recognized. This activity often resides in fragments of these proteins. These peptides may play a role in diseases of the lung matrix, such as chronic obstructive pulmonary disease.

Clinical use of exhaled biomarkers in COPD.

Exhaled breath analysis holds great promise as a diagnostic and investigative tool in COPD and is a new and rapidly expanding field of research in pulmonary disease. Generally speaking, exhaled breath analysis focuses on two areas: measurement of exhaled nitric oxide (ENO) and the detection of biomarkers in exhaled breath condensate (EBC). ENO measurement may not be as useful in COPD as in other pulmonary diseases, such as asthma, due to the lower levels of ENO found in COPD, although this is an area of ongoing research.

Long-term continuous oxygen treatment in chronic obstructive pulmonary disease: proper use, benefits and unresolved issues.

Purpose Of Review: Long-term oxygen treatment is one of the few interventions that improve survival in chronic obstructive pulmonary disease and it is widely used even though published evidence supporting the use of this treatment in chronic obstructive pulmonary disease is scanty. In addition, some studies do not demonstrate a mortality benefit for long-term oxygen treatment in this disease. It is important that long-term oxygen treatment be administered only to those patients who will benefit and in a manner that maximizes its efficacy.

Age and sex profile of patients having cataract surgery between 1986 and 2003.

Purpose: To investigate the age and sex profile of patients having cataract surgery by 2 consulting ophthalmic surgeons over an 18-year period.

Setting: Waterford Regional Hospital, Waterford, Republic of Ireland.

Methods: Operating theater logbooks were reviewed, and all patients having cataract surgery between January 1986 and December 2003 in Waterford Regional Hospital were identified.

Renal replacement therapy III: IHD, CRRT, SLED.

Acute renal failure in critically ill patients is a growing clinical problem. Options for renal replacement therapy in these patients use convective and diffusive clearance and may be intermittent, as in classic hemodialysis, or continuous. New ways of delivering dialysis in the intensive care unit, such as sustained low-efficiency dialysis, are also under development.

Hyperoxia impairs antibacterial function of macrophages through effects on actin.

Oxidative stress may impair alveolar macrophage function in patients with inflammatory lung diseases or those exposed to high concentrations of oxygen. We investigated putative mechanisms of injury to macrophages by oxidative stress, using RAW 264.7 cells exposed to 95% oxygen for 48 h.

Oxidant-antioxidant balance in acute lung injury.

ARDS is a disease process that is characterized by diffuse inflammation in the lung parenchyma. The involvement of inflammatory mediators in ARDS has been the subject of intense investigation, and oxidant-mediated tissue injury is likely to be important in the pathogenesis of ARDS. In response to various inflammatory stimuli, lung endothelial cells, alveolar cells, and airway epithelial cells, as well as activated alveolar macrophages, produce both nitric oxide and superoxide, which may react to form peroxynitrite, which can nitrate and oxidize key amino acids in various lung proteins, such as surfactant protein A, and inhibit their functions.

The role of nitric oxide in lung innate immunity: modulation by surfactant protein-A.

Surfactant protein A (SP-A) and alveolar macrophages are essential components of lung innate immunity. Alveolar macrophages phagocytose and kill pathogens by the production of reactive oxygen and nitrogen species. In particular, peroxynitrite, the reaction product of superoxide and nitric oxide, appears to have potent antimicrobial effects.