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AKI in ACLF: navigating the complex therapeutic puzzle.
Expert Rev Gastroenterol Hepatol
January 2025
Department of Hepatology, Institute of Liver & Biliary Sciences, New Delhi.
Introduction: Acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF) is driven by the severity of systemic inflammation, acute portal hypertension driving circulatory dysfunction, hyperbilirubinemia, and toxicity of bile acids. The spectrum is mostly structural, associated with reduced response to vasoconstrictors. The progression is rapid and need of renal replacement therapy and extracorporeal therapies may be required for the management.
View Article and Find Full Text PDFOlder adults exhibit lesser smoothness despite increased caution than younger adults when navigating turns during walking.
Hum Mov Sci
January 2025
Joint Department of Biomedical Engineering, UNC Chapel Hill & NC State University, Chapel Hill, NC, USA. Electronic address:
Straight line walking currently dominates research into mechanisms associated with walking-related instability; however, the dynamics of everyday walking behavior are far more complex. The figure-8 walk test (F8W) is a clinically-feasible activity that focuses on turning mobility and provides a convenient and relevant task for understanding age-related differences in walking beyond our present knowledge of steady-state behavior. Our purpose was to investigate the effects of age (n = 30 older versus n = 31 younger adults) on path characteristics and the "smoothness" of turning mobility - herein measured via normalized center of mass jerk - during the F8W.
View Article and Find Full Text PDFFrontline professionals' experiences of navigating boundaries in a layered care and support system for individuals with complex care needs in the Netherlands.
Soc Sci Med
January 2025
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Postbus 1738, 3000 DR, Rotterdam, the Netherlands. Electronic address:
Fragmented care systems, characterized by horizontal and vertical boundaries, hinder interprofessional collaboration for individuals with complex care needs. This study explores how frontline professionals navigate these boundaries to foster collaboration within a national program promoting integrated care for individuals with 'misunderstood behaviour' in the Netherlands. Using a boundary work lens, we analysed 44 semi-structured interviews with frontline professionals from the social, care, and safety domains.
View Article and Find Full Text PDFMalpractice or masterful practice? Navigating vicarious liability in healthcare.
World J Clin Cases
January 2025
Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai 600002, Tamil Nadu, India.
In the intricate landscape of healthcare, vicarious liability looms large, shaping the responsibilities and actions of healthcare practitioners and administrators alike. Illustrated by a poignant scenario of a medication error, this article navigates the complexities of vicarious liability in healthcare. It explains the legal basis and ramifications of this theory, emphasizing its importance in fostering responsibility, protecting patient welfare, and easing access to justice.
View Article and Find Full Text PDFFunction Preserving Gastrectomy and Quality of Life.
J Gastric Cancer
January 2025
Department of Surgery, Seoul National University Hospital, Seoul, Korea.
Advances in gastric cancer screening have enabled earlier detection, shifting the focus of treatment toward preserving patients' quality of life (QoL). Function-preserving gastrectomy (FPG), including pylorus-preserving gastrectomy, proximal gastrectomy, and sentinel node navigation surgery, represents a paradigm shift in the surgical management of early gastric cancer. These techniques aim to balance oncological safety with the preservation of gastric function, mitigating postgastrectomy syndromes such as dumping syndrome, bile reflux, and nutritional deficiencies.
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