Development of a New ICT-Based Multisensor Blood Pressure Monitoring System for Use in Hemodynamic Biomarker-Initiated Anticipation Medicine for Cardiovascular Disease: The National IMPACT Program Project.

We have developed a multisensor home and ambulatory blood pressure (BP) monitoring system for monitoring 24-h central and brachial BP variability concurrent with physical activity (PA), temperature, and atmospheric pressure. The new BP monitoring system utilizes our recently developed biological and environmental signal monitoring Information Communication Technology/Internet of Things system, which can simultaneously monitor the environment (temperature, illumination, etc.) of different rooms in a house (entryway, bedroom, living room, bathing room, and toilet), and a wrist-type high-sensitivity actigraph for identifying the location of patients.

Should Pre-hypertension Be Treated?

Hypertension is an important preventable risk factor for disease and death worldwide. In light of the world's population growth and aging, hypertension is a global public health issue. Many studies have shown associations between pre-hypertension and a higher risk of the future development of hypertension and cardiovascular disease in general populations.

Which blood pressure measurement, systolic or diastolic, better predicts future hypertension in normotensive young adults?

The impact of age-related differences in blood pressure (BP) components on new-onset hypertension is not known. A follow-up examination of 93 303 normotensive individuals (mean age 41.1 years) who underwent a health checkup in 2005 was conducted every year for 8 years.

Comparative Effects of an Angiotensin II Receptor Blocker (ARB)/Diuretic vs. ARB/Calcium-Channel Blocker Combination on Uncontrolled Nocturnal Hypertension Evaluated by Information and Communication Technology-Based Nocturnal Home Blood Pressure Monitoring - The NOCTURNE Study.

Background: Nocturnal blood pressure (BP) is an independent risk factor of cardiovascular events. The NOCTURNE study, a multicenter, randomized controlled trial (RCT) using our recently developed information and communication technology (ICT) nocturnal home BP monitoring (HBPM) device, was performed to compare the nocturnal HBP-lowering effects of differential ARB-based combination therapies in 411 Japanese patients with nocturnal hypertension (HT).

Methods and results: Patients with nocturnal BP ≥120/70 mmHg at baseline even under ARB therapy (100 mg irbesartan daily) were enrolled.

The Current State of Liver Transplantation in the United States: Perspective From American Society of Transplant Surgeons (ASTS) Scientific Studies Committee and Endorsed by ASTS Council.

This article is a review of the salient points and a future prospective based on the 2014 Organ Procurement and Transplantation Network (OPTN)/Scientific Registry of Transplant Recipients (SRTR) liver donation and transplantation data report recently published by the American Journal of Transplantation. Emphasis of our commentary and interpretation is placed on data relating to waitlist dynamics, organ utilization rates, the impact of recent advances in the treatment of hepatitis C, and the increases in end-stage renal disease among liver transplant candidates. Finally, we share our vision on potential areas of innovation that are likely to significantly improve the field of liver transplantation in the near future.

Exosomal Annexin II Promotes Angiogenesis and Breast Cancer Metastasis.

Unlabelled: Tumor-derived exosomes are emerging mediators of tumorigenesis and tissue-specific metastasis. Proteomic profiling has identified Annexin II as one of the most highly expressed proteins in exosomes; however, studies focused on the biological role of exosomal Annexin II (exo-Anx II) are still lacking. In this study, mechanistic insight was sought regarding exo-Anx II and its function in angiogenesis and breast cancer metastasis.

On-Boarding a New Chief Nursing Officer to Lead a Magnet Redesignation Visit: The Value of Relationships.

The chief nursing officer (CNO) is a critical senior executive in a hospital and serves as the architect of patient care. Recruiting, hiring, and on-boarding a new CNO present a challenge for any facility. Stakes are higher when the facility is replacing a CNO in the midst of its Magnet redesignation.

Extended Low-Dose Valganciclovir Is Effective Prophylaxis Against Cytomegalovirus in High-Risk Kidney Transplant Recipients With Near-Complete Eradication of Late-Onset Disease.

Background: Cytomegalovirus (CMV)-seronegative kidney transplant (KTx) recipients of organs from CMV-seropositive donors (D+/R-) are at increased risk for CMV infection. Despite valganciclovir (VGCV) prophylaxis (900 mg daily for 200 days), late-onset CMV (LO-CMV) occurs at excessive rates. VGCV-associated cost and toxicities remain problematic.

Biopsy Induced Arteriovenous Fistula and Venous Stenosis in a Renal Transplant.

Renal transplant vein stenosis is a rare cause of allograft dysfunction. Percutaneous stenting appears to be safe and effective treatment for this condition. A 56-year-old Caucasian female with end stage renal disease received a deceased donor renal transplant.

Wire-Interwoven Nitinol Stent Outcome in the Superficial Femoral and Proximal Popliteal Arteries: Twelve-Month Results of the SUPERB Trial.

Background: Stent-based therapy in the superficial femoral and popliteal arteries in patients with peripheral artery disease is compromised by restenosis and risk of stent fracture or distortion. A novel self-expanding nitinol stent was developed that incorporates an interwoven-wire design (Supera stent, IDEV Technologies, Inc, Webster, TX) to confer greater radial strength, flexibility, and fracture resistance.

Methods And Results: This prospective, multicenter, investigational device exemption, single-arm trial enrolled 264 patients with symptomatic peripheral artery disease undergoing percutaneous treatment of de novo or restenotic lesions of the superficial femoral or proximal popliteal (femoropopliteal) artery.

Endoscopic Ultrasound-Guided Self-Expandable Metal Stent Placement for the Treatment of Infected Pancreatic Pseudocysts.

The standard endoscopic ultrasound (EUS) approach of cystogastrostomy involves the use of series of plastic pigtail stents that are placed through the wall of the cyst. The use of a single stent has also been described in the literature. Here we describe five cases of EUS-guided cystogastrostomy with irrigation of infected pancreatic pseudocysts using a single self-expandable metal stent (SEMS).

Dedifferentiated liposarcoma of the adult male breast.

A 66-year-old male presented with a right breast mass, enlarging insidiously over a one-year period after trauma to the site. After the findings were attributed to glandular injury and hematoma, the patient eventually underwent mammographic and ultrasonographic evaluation that demonstrated masses in the breast and the axilla. A subsequent ultrasound-guided biopsy of the breast mass yielded a diagnosis of fibromatosis.

A redesigned pressure ulcer program based on nurses' beliefs about the Braden Scale.

We examined nurses' perceptions about the value and applicability of the Braden Scale as an evidence-based practice assessment tool for determining nursing interventions. Findings revealed that nurses most often chose interventions associated with improving mobility over all other components of the Braden Scale assessment. The redesign of a clinical education program using targeted scenarios for aligning nurses' practice beliefs with comprehensive evidence-based practice interventions is described.

The interdepartmental ticket (IT) factor: enhancing communication to improve quality.

This article presents the implementation and 1-year evaluation of a staff nurse-driven initiative addressing a Joint Commission patient safety imperative to improve the consistency of handoff communication. An interdepartmental ticket was developed and implemented through a planned process. The interdepartmental ticket serves as a requisite passport for providing key communication of critical information to facilitate a safe transition between medical-surgical and progressive care nursing units and specific ancillary departments.

Diagnosis and management of primary pulmonary leiomyosarcoma.

Leiomyosarcomas are cancers of smooth muscle cells that can arise from any location but occur most often in the uterus, retroperitoneum, or intraabdominal region. Primary leiomyosarcomas of the lung are extremely rare and are often diagnosed as a mass on routine chest radiography. Metastasis is uncommon and typically occurs late in the disease process, indicating the importance of early detection.

When mom's the patient.

This verbatim on the author's mother's death was originally submitted to a Clinical Pastoral Education Group on November 02, 2007. Its purpose was (1) to incorporate a working knowledge of psychosocial disciplines and religious beliefs and practice in the provision of pastoral care, and (2) to process, reflect, and learn from the interpersonal, spiritual, and ethical dynamics that occurred during the chaplain's mother's dying process.

Intraoperative cerebral high-intensity transient signals and postoperative cognitive function: a systematic review.

Background: Much attention in the literature has focused on the relationship between perioperative microemboli during cardiac and vascular surgery and postoperative cognitive decline. Transcranial Doppler ultrasonography (TCD) has been used to measure high-intensity transient signals (HITS), which represent microemboli during cardiac, vascular, and orthopedic surgery. The purpose of this study was to systematically examine the literature with respect to HITS and postoperative cognitive function.

Pulmonary embolism mimicking anteroseptal acute myocardial infarction.

Pulmonary embolism (PE) is a potentially lethal condition that presents in patients with chest pain or shortness of breath. Although electrocardiograms (ECGs) typically demonstrate abnormalities associated with PE, ST-segment elevation, which can indicate anteroseptal acute myocardial infarction (AMI), has-on rare occasions-been noted on ECGs of patients with acute PE. The current report documents the case of a 57-year-old man who presented to the emergency department with chest pain.

Bowel preparation effectiveness: inpatients and outpatients.

This study describes colon visibility and case cancelations of patients taking self-administered outpatient colonoscopy preparation or inpatient preparation at a large north central Texas hospital. The convenience sample of 120 adult patients who were scheduled for a colonoscopy ranged in age from 25 to 88 years. A 33-item investigator-developed questionnaire was used to record patient demographics, type of bowel preparation, signs and symptoms, and colon visualization score obtained during the procedure.