Rethinking endometriosis care: applying the chronic care model via a multidisciplinary program for the care of women with endometriosis.

Endometriosis is a chronic, painful disease without a cure. Due largely to chronic pain, endometriosis can lead to significant physical, mental, relationship, and financial burdens. Within the conventional single provider model of care-in which the patient is primarily taken care of by her physician and complementary strategies based on psychology, nutrition, pain medicine, pelvic physical therapy, and so on may not be readily available in a coordinated manner-most women with endometriosis live with unresolved pain and the consequences of that pain.

Thiazide diuretics and risk of knee replacement surgery among patients with knee osteoarthritis: a general population-based cohort study.

Objective: Thiazide diuretic use is associated with higher bone mineral density (BMD) and possibly lower serum magnesium levels than loop diuretic use, and both high BMD and low serum magnesium have been linked to high prevalent knee osteoarthritis. This study aimed to compare the risk of a clinically relevant endpoint, knee replacement (KR) surgery, among initiators of thiazide and loop diuretics.

Design: Among patients aged ≥50 years with a diagnosis of knee osteoarthritis in The Health Improvement Network (THIN) in United Kingdom, we conducted a propensity score-matched cohort study to examine the relation of thiazide diuretic initiation vs loop diuretic initiation to the risk of KR over 5 years.

Dose-response relationship between lower serum magnesium level and higher prevalence of knee chondrocalcinosis.

Background: The aim was to assess serum magnesium levels in relation to prevalence of knee chondrocalcinosis in two population-based Chinese studies.

Methods: Data included in this analysis consisted of two population-based cross-sectional studies, i.e.

AMP-activated protein kinase suppresses urate crystal-induced inflammation and transduces colchicine effects in macrophages.

Objective: AMP-activated protein kinase (AMPK) is metabolic biosensor with anti-inflammatory activities. Gout is commonly associated with excesses in soluble urate and in nutrition, both of which suppress tissue AMPK activity. Gout is driven by macrophage-mediated inflammation transduced partly by NLRP3 inflammasome activation and interleukin (IL)-1β release.

Peroxisome proliferator-activated receptor γ coactivator 1α and FoxO3A mediate chondroprotection by AMP-activated protein kinase.

Objective: AMP-activated protein kinase (AMPK) inhibits chondrocyte procatabolic responses to inflammation and biomechanical injury. This study was undertaken to test the hypothesis that peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) and FoxO3A, 2 major AMPK downstream targets, mediate the chondroprotective effect of AMPK activation.

Methods: We assessed the activity of AMPKα (threonine 172 phosphorylation) and the expression of PGC-1α and FoxO3A in human chondrocytes and AMPKα1- or AMPKα2-knockout mouse chondrocytes by Western blotting, and in mouse knee cartilage by immunohistochemistry.

The incidence of acute urinary retention secondary to BPH is increasing among California men.

Background: Current epidemiological patterns of adverse events of clinical BPH remain unclear. We investigated trends in acute urinary retention (AUR) associated with BPH in a large, population-based cohort.

Methods: We utilized the California Office of Statewide Health Planning and Development Database to examine 3 724 016 emergency room (ER) visits in California among men aged  50 years from 2007 to 2010.

Higher education is not associated with greater cortical thickness in brain areas related to literacy or intelligence in normal aging or mild cognitive impairment.

Education may reduce risk of dementia through passive reserve, by increasing neural substrate. We tested the hypotheses that education is associated with thicker cortex and reduced rates of atrophy in brain regions related to literacy and intellectual ability. Healthy older adults and those with mild cognitive impairment were categorized into high (≥18 years) and low (≤13 years) education groups.

Inpatient safety trends in laparoscopic and open nephrectomy for renal tumours.

Unlabelled: Study Type--Cohort study Level of Evidence 2b. What's known on the subject? and What does the study add? Laparoscopic radical nephrectomy for renal cancer provides equivalent long-term cancer control with shorter hospital stays, less postoperative pain, and faster resumption of normal activities, but it has diffused slowly into clinical practice, perhaps as a result of perceptions about safety. Patient safety outcomes for laparoscopic and open radical nephrectomy using validated measures remain incompletely characterized.

Novel evidence-based colchicine dose-reduction algorithm to predict and prevent colchicine toxicity in the presence of cytochrome P450 3A4/P-glycoprotein inhibitors.

Objective: Drug-drug interactions can limit the safety of colchicine for treating rheumatic diseases. Seven separate drug-drug interaction (DDI) studies were performed to elucidate the in vivo effects of concomitant treatment with colchicine and known inhibitors of cytochrome P450 3A4 (CYP3A4)/P-glycoprotein (cyclosporine, ketoconazole, ritonavir, clarithromycin, azithromycin, verapamil ER [extended release]), and diltiazem ER) on the pharmacokinetics of colchicine. The objective was to develop colchicine-dosing algorithms with improved safety.

Chondrocyte AMP-activated protein kinase activity suppresses matrix degradation responses to proinflammatory cytokines interleukin-1β and tumor necrosis factor α.

Objective: Interleukin-1β (IL-1β) and tumor necrosis factor α (TNFα) stimulate chondrocyte matrix catabolic responses, thereby compromising cartilage homeostasis in osteoarthritis (OA). AMP-activated protein kinase (AMPK), which regulates energy homeostasis and cellular metabolism, also exerts antiinflammatory effects in multiple tissues. This study was undertaken to test the hypothesis that AMPK activity limits chondrocyte matrix catabolic responses to IL-1β and TNFα.

Edematous processes within Kager fat pad: magnetic resonance imaging, gross anatomical, and histological studies in cadavers with clinical correlation.

Objective: To demonstrate the anatomical features of Kager fat pad (KFP) and its fasciae using magnetic resonance imaging, gross anatomy, and histology in cadavers; and to correlate the data with image findings in patients.

Methods: The KFP was analyzed in 10 fresh human cadavers and 152 clinical cases. The retrospective clinical study was institutional review board approved.

Evaluation of the anti-inflammatory effects of ellagic acid.

Few studies have investigated the anti-inflammatory properties of ellagic acid and no published studies have examined the effects of ellagic acid in combination with anesthetic adjuvants. In this study, 54 Sprague-Dawley rats were assigned to one of six groups: (1) vehicle; (2) ketorolac and vehicle; (3) meloxicam and vehicle; (4) ellagic acid and vehicle; (5) ellagic acid, ketorolac, and vehicle; and (6) ellagic acid, meloxicam, and vehicle. Groups 5 and 6 investigated interactions between ellagic acid and cyclooxygenase inhibitors.

Prostate cancer prevention: concepts and clinical recommendations.

Prevention is an important strategy for limiting prostate cancer morbidity and mortality. Two major types of prevention are primary (reduction of incident cases) and tertiary (inhibition of disease progression and recurrence). Pharmacological and dietary interventions have potential functions in both the primary and tertiary prevention of prostate cancer.

Accessory head of biceps brachii muscle: anatomy, histology, and MRI in cadavers.

Objective: The purpose of our study is to describe and define an anatomic variation located close to the bicipital groove using MRI with gross anatomic and histologic correlation in cadavers.

Materials And Methods: Ten fresh male human shoulders were harvested and used in this investigation. They were derived from persons with a mean age of death of 78.

Chiasma crurale: intersection of the tibialis posterior and flexor digitorum longus tendons above the ankle. Magnetic resonance imaging-anatomic correlation in cadavers.

Purpose: To determine the precise anatomy and magnetic resonance (MR) imaging appearance of the chiasma crurale in cadavers, paying special attention to degenerative changes

Material And Methods: Twelve fresh human ankles were harvested from 11 nonembalmed cadavers (mean age at death 77 years) and used according to institutional guidelines. MR imaging and MR tenography were used to investigate the anatomy of the chiasma crurale using proton density-weighted sequences. The gross anatomy of the chiasma crurale was evaluated and compared to the MR imaging findings.

Differences between radial and ulnar deviation of the wrist in the study of the intrinsic intercarpal ligaments: magnetic resonance imaging and gross anatomic inspection in cadavers.

Objective: To demonstrate how radial and ulnar deviation of the wrist can affect the visualization of the intrinsic intercarpal ligaments using magnetic resonance (MR) imaging, MR arthrography and gross anatomic inspection in cadavers.

Materials And Methods: The detectability of the intrinsic intercarpal ligaments of ten fresh human wrists was analyzed in coronal, axial and sagittal images in the neutral position and in radial and ulnar deviation with MR imaging and MR arthrography. The findings were then correlated with gross anatomic inspection.

Changes in the acetabular fossa of the hip: MR arthrographic findings correlated with anatomic and histologic analysis using cadaveric specimens.

Objective: The objective of our study was to determine the morphologic and histologic pattern of tissue changes in the acetabular fossa and evaluate its association with osteoarthritis of the hip joint.

Materials And Methods: Eleven cadaveric hip joints derived from elderly persons were examined using MR arthrography. All 11 joints were then sectioned.

Distal attachment of the brachialis muscle: anatomic and MRI study in cadavers.

Objective: The purpose of this study was to use MRI and anatomic correlation in cadavers to delineate the anatomic features of the distal attachment of the brachialis muscle.

Materials And Methods: MRI was performed on 13 cadaveric elbows. The MRI findings were compared with those in anatomic sections and histologic preparations.

Review on natriuretic peptides: where we are, where we are going.

Background: Tremendous advances have been made in our understanding of the pathophysiology and treatment of congestive heart failure. However, diagnosis of the disease still remains difficult, even with a comprehensive physical examination. Symptoms such as dyspnea are nonspecific and insensitive indicators for heart failure, which can go largely undetected.

Interdisciplinary care planning and the written care plan in nursing homes: a critical review.

Purpose: This article is a critical review the history, research evidence, and state-of-the-art technology in interdisciplinary care planning and the written plan of care in American nursing homes.

Design And Methods: We reviewed educational and empirical literature.

Results: Interdisciplinary care planning and the written care plan are mandated processes that are imbedded in the regulatory fabric and routines of the American nursing home.

The future of surfactant therapy for patients with acute lung injury - new requirements and new surfactants.

New requirements must be considered when designing trials of new lung surfactants for patients with acute lung injury (ALI). Radiographic inclusion criteria must be carefully applied if they are to generate reproducible patient groups. Strategies for ventilation are now known to significantly affect outcome and also must be clearly defined and applied.

Human factors research in anesthesia patient safety.

Patient safety has become a major public concern. Human factors research in other high-risk fields has demonstrated how rigorous study of factors that affect job performance can lead to improved outcome and reduced errors after evidence-based redesign of tasks or systems. These techniques have increasingly been applied to the anesthesia work environment.