Development of Indicators to Assess Quality of Care for Prostate Cancer.

Background: The development, monitoring, and reporting of indicator measures that describe standard of care provide the gold standard for assessing quality of care and patient outcomes. Although indicator measures have been reported, little evidence of their use in measuring and benchmarking performance is available. A standard set, defining numerator, denominator, and risk adjustments, will enable global benchmarking of quality of care.

Campylobacter jejuni response to human mucin MUC2: modulation of colonization and pathogenicity determinants.

Campylobacter jejuni is the main cause of bacterial acute gastroenteritis worldwide. In its colonization of the host intestinal tract, it encounters secreted mucins in the mucus layer and surface mucins in the epithelial cells. Mucins are complex glycoproteins that comprise the major component of mucus and give mucus its viscous consistency.

Muc1 mucin limits both Helicobacter pylori colonization of the murine gastric mucosa and associated gastritis.

Background & Aims: The MUC1 mucin is expressed on the cell surface of epithelial cells lining the gastric mucosa. Epidemiologic studies suggest that functional allelic variations in the MUC1 gene may play a role in human susceptibility to Helicobacter pylori-associated pathologies, including gastric adenocarcinoma. We have evaluated the impact of Muc1 expression on the colonization and pathogenesis of gastric Helicobacter infections.

Designing 'balanced' crystalloids.

Objective: To present a rationale for the design of balanced resuscitation and renal replacement crystalloids based on Stewart's physical chemical approach to acid-base.

Data Sources: Articles and published abstracts on acid-base physiology, crystalloid infusions and renal replacement therapy.

Summary Of Review: Although it is uncertain that crystalloid-induced metabolic acidosis causes significant harm, Stewart's approach assists in designing balanced fluids without this side effect.

The value of electrical impedance tomography in assessing the effect of body position and positive airway pressures on regional lung ventilation in spontaneously breathing subjects.

Objective: Functional electrical impedance tomography (EIT) measures relative impedance changes in lung tissue during tidal breathing and creates images of local ventilation distribution. A novel approach to analyse the effect of body position and positive pressure ventilation on intrapulmonary tidal volume distribution was evaluated in healthy adult subjects.

Design And Setting: Prospective experimental study in healthy adult subjects in the intensive care unit at university hospital.

The meaning of acid-base abnormalities in the intensive care unit: part III -- effects of fluid administration.

Stewart's quantitative physical chemical approach enables us to understand the acid-base properties of intravenous fluids. In Stewart's analysis, the three independent acid-base variables are partial CO2 tension, the total concentration of nonvolatile weak acid (ATOT), and the strong ion difference (SID). Raising and lowering ATOT while holding SID constant cause metabolic acidosis and alkalosis, respectively.

Pregnancy outcomes in women of very advanced maternal age.

Objective: To assess outcomes for pregnancies progressing beyond 20 weeks' gestation in women of very advanced maternal age.

Design: Retrospective cohort study.

Setting: Two tertiary level obstetric hospitals.

Whole-body turbo STIR MR imaging: controversies and avenues for development.

The idea of a non-ionizing high-resolution technique to screen the entire body for occult disease is immensely appealing. This article outlines an evolving technique, controversies and clinical application of whole-body scanning using MRI with turbo short tau inversion recovery tissue excitation.

Randomised clinical trial to assess anal sphincter function following forceps or vacuum assisted vaginal delivery.

Objective: To compare, in a prospective, randomised controlled trial, differences in anal sphincter function following forceps or vacuum assisted vaginal delivery in an institution practising standardised management of labour.

Design: Prospective, randomised controlled trial.

Setting: Tertiary-referral maternity teaching hospital.

Scurvy: a cutaneous clinical diagnosis.

Two cases of scurvy diagnosed following presentation with a purpuric rash are presented. A 44-year-old man developed scurvy as a result of poor dietary intake of vitamin C. This occurred because of a number of factors.

Experiences of the generalist nurse caring for adolescents with mental health problems.

Mental healthcare for adolescents is currently provided in a range of settings, including general hospital wards and paediatric wards, although care of adolescents with mental health problems in general settings has not been evaluated. This descriptive study surveyed generalist nurses who provide care to adolescents with mental health problems in the general hospital setting to determine satisfaction with their abilities to provide care, challenges encountered in care provision and strategies to provide optimal care by these nurses. Participants included 30 generalist nurses (response rate of 73%) from two wards in a tertiary paediatric hospital in Queensland, Australia.

Characterization of human blood dendritic cell subsets.

Dendritic cells (DCs) are key antigen-presenting cells for stimulating immune responses and they are now being investigated in clinical settings. Although defined as lineage-negative (Lin(-)) HLA-DR(+) cells, significant heterogeneity in these preparations is apparent, particularly in regard to the inclusion or exclusion of CD14(+), CD16(+), and CD2(+) cells. This study used flow cytometry and a panel of monoclonal antibodies (mAbs), including reagents from the 7th Leukocyte Differentiation Antigen Workshop, to define the cellular composition of 2 standardized peripheral blood mononuclear cell (PBMCs)-derived Lin(-) HLA-DR(+) preparations.

MUC1 epithelial mucin (CD227) is expressed by activated dendritic cells.

The MUC1 mucin (CD227) is a cell surface mucin originally thought to be restricted to epithelial tissues. We report that CD227 is expressed on human blood dendritic cells (DC) and monocyte-derived DC following in vitro activation. Freshly isolated murine splenic DC had very low levels of CD227; however, all DC expressed CD227 following in vitro culture.

Cost comparison of hospital- and home-based treatment models for acute chronic obstructive pulmonary disease.

This trial compared the cost of an integrated home-based care model with traditional inpatient care for acute chronic obstructive pulmonary disease (COPD). 25 patients with acute COPD were randomised to either home or hospital management following request for hospital admission. The acute care at home group costs per separation ($745, CI95% $595-$895, n = 13) were significantly lower (p < 0.

Sertoli-Leydig cell tumor of the ovary, a rare cause of precocious puberty in a 12-month-old infant.

We report a 12-month-old infant who presented with a 4-month history of isosexual precocious puberty secondary to an estrogenizing Sertoli-Leydig cell tumor of the ovary. Total serum immunoreactive inhibin and subunits A and B were markedly elevated before surgical resection and subsequently decreased 7 wk later into the normal prepubertal range. Twenty weeks following surgical removal, the patient presented again with central precocious puberty; inhibin B levels were raised on this occasion, a luteinizing releasing hormone stimulation test confirmed central precocious puberty.

New nurse graduates' understanding of competence.

This article describes the findings of a phenomenographic research approach used to understand the experiences of competence of new nurse graduates. The aim of phenomenography is to describe the qualitatively different ways in which people understand a phenomenon. Six new graduates, who had been employed in two paediatric metropolitan hospitals in Australia, participated in the research.

Muc13, a novel human cell surface mucin expressed by epithelial and hemopoietic cells.

Transmembrane mucins are glycoproteins involved in barrier function in epithelial tissues. To identify novel transmembrane mucin genes, we performed a tblastn search of the GenBanktrade mark EST data bases with a serine/threonine-rich search string, and a rodent gene expressed in bone marrow was identified. We determined the cDNA sequence of the human orthologue of this gene, MUC13, which localizes to chromosome band 3q13.

Developing and testing a self medication protocol in the acute environment.

This study aimed to develop and test strategies, and demonstrate the feasibility and desirability of a self-medication program in an acute care hospital setting. Ten patients admitted with an acute exacerbation of their asthma were recruited to test the protocol. Although the use of the protocol was more time-consuming than the previous nurse administered process, patients and staff found it worthwhile.

The treatment of uterine papillary serous carcinoma (UPSC): are we doing the right thing?

Tay EH, Ward BG. The treatment of uterine papillary serous carcinoma (UPSC): are we doing the right thing? In an earlier study(1) of 21 patients with uterine papillary serous carcinoma (UPSC), Ward et al. found a poor 3-year survival, even for patients with surgically documented localized disease, and a high rate of recurrence outside the field of treatment.

The role of dendritic cells in the innate immune system.

Dendritic cells (DCs) are bone-marrow-derived leucocytes that are specialised antigen-presenting cells capable of stimulating a primary T-lymphocyte response to specific antigen. In this chapter we discuss the role DCs play in the innate response acting as a critical link with the adaptive response and the influence of the innate response on dendritic cells.

The CMRF-35H gene structure predicts for an independently expressed member of an ITIM/ITAM pair of molecules localized to human chromosome 17.

The CMRF-35 monoclonal antibody recognizes an epitope found on at least two cell surface molecules, differentially expressed by many leukocytes. These molecules, the CMRF-35H (9) and CMRF-35A (CMRF-35) antigens are both members of the immunoglobulin (Ig) superfamily with a single V-like Ig domain. The function of these molecules is unknown, however the presence of putative immunoreceptor tyrosine-based inhibitory motifs (ITIM) in the cytoplasmic domain of the CMRF-35H molecule suggests that this molecule may play a regulatory role in leukocyte function.