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A novel technique for unilateral dissection of the penile neurovascular bundle to prevent loss of penile sensation during treatment of Peyronie's disease-Initial results of a pilot study

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Current Urology 2023年第4期17卷 299-302页

作者： Alexandr M.Pinkhasov Matthew Beamer Daniel Shulman Rachel Yakubov Esther Pinkhasov Sergey Kravchick Department of Urology SUNY Upstate Medical University HospitalSyracuseNY 13202USA

Background:Plaque incision/excision and grafting are surgical techniques used to treat patients with Peyronie's disease who are refractory to less invasive interventions,have severe penile curvature,or have an hourglass ***,the procedure carries the risk of penile sensory loss because of the need for dissection of the neurovascular bundle(NVB).The aim of this study was to assess the feasibility of a novel technique for unilateral NVB dissection and its ability to preserve penile sensitivity while maintaining adequate correction of the penile *** and methods:Charts of patients who underwent unilateral NVB dissection during Peyronie's plaque incision/excision and grafting were retrospectively *** patients received preprocedural intracavernosal injections of TriMix,and the curvature was measured to be>70 *** 3 cases,an incision and minimal excision of the plaque were performed at the point of maximum curvature on the concave side of the *** 3 cases,Tutoplast allografts(Coloplast US,Minneapolis,MN)were used,whereas autografts were used in 2 other *** patients were examined at 1,3,and 6 months after the procedure when curvature and penile sensation were ***:Five patients underwent this *** mean age of patients was 55 years(45-70 years).All plaques were dorsally *** mean preoperative curvature was 78 degrees(75-90 degrees).At the 6-month follow-up,all patients had<15 degrees residual curvature and were satisfied with their cosmetic *** 1 patient continued with phosphodiesterase-5 inhibitors to improve potency at the 6-month *** patients reported normal penile glans *** patients experienced decreased sensation at the site of NVB dissection,but this was only detected when compared with the contralateral *** 2 patients reported a difference after 6 months,and only a minor area of involvement was ***:Unilateral NVB dissection is a feasi

关键词： Peyronie's disease Neurovascular bundle dissection

A rare case of infectious colitis

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Gastroenterology Report 2016年第4期4卷 328-330,I0003页

作者： Aditya Kalakonda Shashank Garg Suraj Tandon Rakesh Vinayak Sudhir Dutta State university of New York(suny)upstate Medical university SyracuseNYUSA Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMDUSA

Methicillin-resistant Staphylococcus aureus(MRSA)is responsible for numerous infectious *** tract involvement is rather rare and only a handful of cases of MRSA colitis have been reported in North *** present a case of MRSA colitis in an adult without apparent risk *** computed tomography(CT)showed thickening of the sigmoid colon,indicative of colitis,and empiric therapy with ciprofloxacin and metronidazole was *** work-up for infection-including blood and stool cultures,and stool Clostridium difficile toxin assay-was *** patient’s clinical status improved but his diarrhea did not *** of stool culture demonstrated luxuriant growth of MRSA sensitive to *** vancomycin was administered and the patient’s symptoms promptly ceased.

关键词： methicillin-resistant Staphylococcus aureus infectious colitis stool culture

Value Based Purchasing and Nursing Case Management

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Open Journal of Nursing 2017年第2期7卷 307-317页

作者： Louise Pernisi Ronald Lagoe Barbara Drapola Shelly Littau upstate university hospital—suny umu Syracuse NY USA hospital Executive Council Syracuse NY USA Crouse hospital Syracuse NY USA

The implementation of value based purchasing will bring major changes to the delivery of health care in the United States. This effort is being led by the Medicare Access and CHIP Reauthorization Act (MACRA). Medicaid and private insurance plans are developing similar programs. These programs reflect a change in pay or incentives in the direction of primary and ambulatory care at the community level. This study described the use of nursing case management as a tool for monitoring and coordinating the impact of value based programs at the community level. It suggested that, under these programs, nursing case management can contribute to reduction of hospital admissions/discharges, emergency department visits, and hospital readmissions. This can be accomplished through monitoring of utilization levels for these indicators. These are major objectives of MACRA and related programs. The study also suggested that nursing case management can contribute to the development of new programs, such as Complex Care, as a means of reaching these objectives. The study included estimates of the costs and benefits of using case management to reduce hospital admissions for low severity of illness patients at the community level. It suggested that the service can provide important opportunities for health planning and development in this area.

关键词： hospital Utilization hospital Admissions hospital Emergency Departments Managed Care Nursing Case Management

Addressing hospital length of stay outlier patients: A community wide approach

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Advances in Bioscience and Biotechnology 2014年第3期5卷 188-196页

作者： Ronald Lagoe Louise Pernisi Mary Luziani Shelly Littau hospital Executive Council Syracuse USA St. Joseph’s hospital Health Center Syracuse USA upstate university hospital SUNY UMU Syracuse USA

Length of stay outlier patients, who remain in hospitals for extended periods of time, is an important challenge to the improvement of health care efficiency. This study identified outlier patients and programs to address them in the metropolitan area of Syracuse, New York. It demonstrated that, during 2013, outlier patients accounted for 2.4 percent of adult medicine discharges and an excess average daily census of 53.3 patients in the Syracuse hospitals. During 2013, outlier patients accounted for 4.3 percent of adult surgery discharges and an excess average daily census of 44.1 patients. In two studies, the Syracuse hospitals identified the need for multiple intravenous therapy, extensive wound care, and total parenteral nutrition in the community, as major causes of outlier stays in hospitals. Each of the hospitals has developed a program with a long term care facility to address these needs. Efforts to address outlier lengths of stay are also focusing on Potentially Preventable Complications in Syracuse. The mean length of stay for inpatients with post admissions complications was almost three times the stay for the medical/surgical population during 2013.

关键词： hospital Utilization hospital Lengths of Stay hospital Outcomes

hospital Length of Stay Reduction: A Long-Term Study

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International Journal of Clinical Medicine 2016年第8期7卷 530-537页

作者： Ronald Lagoe Barbara Drapola Mary Luziani Louise Pernisi hospital Executive Council Syracuse NY USA Crouse hospital Syracuse NY USA St. Joseph’s hospital Health Center Syracuse NY USA upstate university hospital—suny umu Syracuse NY USA

This study evaluated length of stay reduction for adult medicine and adult surgery in the combined hospitals of Syracuse, New York between 1998 and 2016. The study was based on the All Patients Refined Severity of Illness System. Through this approach, it controlled for changes in the degree of illness of hospital populations. The study data indicated that reductions in adult medicine and adult surgery stays in the Syracuse hospitals between 1998 and 2012 reduced the annual number of excess days compared with severity adjusted national averages by 49,000, or an average daily census of 134.2. It appeared that the shift to reimbursement by discharges initiated by Medicare was a major cause of these reductions. The impact of this change was accompanied by length of stay reduction initiatives by the Syracuse hospitals, especially relating to long-term care. Between January-April 2012 and 2016, additional reductions brought the lengths of stay for adult medicine and adult surgery in the combined Syracuse hospitals close to the national average. The study suggested that remaining opportunities for length of stay reductions in Syracuse involved patients with high severity of illness and those discharged to nursing homes.

关键词： hospitalization hospital Lengths of Stay hospital Reimbursement Nursing Homes

Gut-lung crosstalk in pulmonary involvement with inflammatory bowel diseases

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World Journal of Gastroenterology 2013年第40期19卷 6794-6804页

作者： Hui Wang Jing-Shi Liu Shao-Hua Peng Xi-Yun Deng De-Mao Zhu Sara Javidiparsijani Gui-Rong Wang Dai-Qiang Li Long-Xuan Li Yi-Chun Wang Jun-Ming Luo Department of Radiation Oncology the Affiliated Hunan Provincial Tumor HospitalXiangya Medical SchoolCentral South University Department of Anesthesiology the Affiliated Hunan Provincial Tumor Hospital at Central South University Department of Pathology Medical College of Hunan Normal University Department of Pathology Changsha Central Hospital Department of Surgery SUNY Upstate Medical University Department of Pathology the Second Affiliated HospitalXiangya Medical SchoolCentral South University Department of Neurology Guangdong Medical College Affiliated Hospital Department of Pathology Qinghai Provincial People's Hospital

Pulmonary abnormalities,dysfunction or hyper-reactivity occurs in association with inflammatory bowel disease(IBD) more frequently than previously *** evidence suggests that subtle inflammation exists in the airways among IBD patients even in the absence of any bronchopulmonary symptoms,and with normal pulmonary functions. The pulmonary impairment is more pronounced in IBD patients with active disease than in those in remission. A growing number of case reports show that the IBD patients develop rapidly progressive respiratory symptoms after colectomy,with failure to isolate bacterial pathogens on repeated sputum culture,and often request oral corticosteroid therapy. All the above evidence indicates that the inflammatory changes in both the intestine and lung during IBD. Clinical or subclinical pulmonary inflammation accompanies the main inflammation of the *** there are clinical and epidemiological reports of chronic inflammation of the pulmonary and intestinal mucosa in IBD,the detailed mechanisms of pulmonaryintestinal crosstalk remain unknown. The lung has no anatomical connection with the main inflammatory site of the bowel. Why does the inflammatory process shift from the gastrointestinal tract to the airways? The clinical and subclinical pulmonary abnormalities,dysfunction,or hyper-reactivity among IBD patients need further evaluation. Here,we give an overview of the concordance between chronic inflammatory reactions in the airways and the gastrointestinal tract. A better understanding of the possible mechanism of the crosstalk among the distant organs will be beneficial in identifying therapeutic strategies for mucosal inflammatory diseases such as IBD and allergy.

关键词： Inflammatory bowel disease Pulmonary symptoms Gut-lung crosstalk Biao-Li relationship Social manner

Tolerance in liver transplantation: Biomarkers and clinical relevance

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World Journal of Gastroenterology 2016年第34期22卷 7676-7691页

作者： Alberto Baroja-Mazo Beatriz Revilla-Nuin Pascual Parrilla Laura Martínez-Alarcón Pablo Ramírez José Antonio Pons Biomedical Research Institute of Murcia (IMIB-Arrixaca-umu) 30120 Murcia Spain Division of Gastroenterology and Hepatology and Liver Transplant Unit University Hospital Virgen de la Arrixaca 30120 Murcia Spain

Transplantation is the optimal treatment for end-stage organ failure,and modern immunosuppression has allowed important progress in short-term outcomes. However,immunosuppression poorly influences chronic rejection and elicits chronic toxicity in current clinical practice. Thus,a major goal in transplantation is to understand and induce tolerance. It is well established that human regulatory T cells expressing the transcription factor Fox P3 play important roles in the maintenance of immunological self-tolerance and immune homeostasis. The major regulatory T cell subsets and mechanisms of expansion that are critical for induction and long-term maintenance of graft tolerance and survival are being actively investigated. Likewise,other immune cells,such as dendritic cells,monocyte/macrophages or natural killer cells,have been described as part of the process known as "operational tolerance". However,translation of these results towards clinical practice needs solid tools to identify accurately and reliably patients who are going to be tolerant. In this way,a plethora of genetic and cellular biomarkers is raising and being validated worldwide in large multicenter clinical trials. Few of the studies performed so far have provided a detailed analysis of the impact of immunosuppression withdrawal on pre-existing complications derived from the long-term administration of immunosuppressive drugs and the side effects associated with them. The future of liver transplantation is aimed to develop new therapies which increase the actual low tolerant vs non-tolerant recipients ratio.

关键词： Liver transplantation Operational tolerance Regulatory T cells Dendritic cells Biomarkers

Children with obesity have poorer circadian health as assessed by a global circadian health score

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World Journal of Pediatrics 2024年第8期20卷 787-800页

作者： María Rodríguez-Martín Nuria Martínez-Lozano Vicente Santaclara-Maneiro Antonio Gris-Peñas Diego Salmerón Rafael Ríos Asta Tvarijonaviciute Marta Garaulet Department of Physiology Regional Campus of International ExcellenceUniversity of Murcia30100MurciaCPSpain Biomedical Research Instituteof Murcia IMIB-Arrixaca-UMUUniversity Clinical Hospital30120MurciaSpain Health Area of Lorca LorcaMurciaSpain Health and Social Sciences Department University ofMurciaMurciaSpain Consortium for Biomedical Research in Epidemiology and Public Health MadridSpain Interdisciplinary Laboratory of Clinical Analysis(Interlab-umu) University of MurciaMurciaSpain Division of Sleep and Circadian Disorders Brigham and Women's Hospital(BWH)and Division of Sleep MedicineHarvard Medical SchoolBostonMA 02115USA

Background Circadian health refers to individuals’well-being and balance in terms of their circadian *** is influenced by external *** adults,a close relationship between circadian-related alterations and obesity has been ***,studies in children are scarce,and circadian health and its association with obesity have not been evaluated *** aimed to assess whether circadian health differed between children with and without obesity as determined by a global circadian score(GCS)in a school-age *** Four hundred and thirty-two children(7–12 years)were recruited in ***-invasive tools were used to calculate the GCS:(1)7-day rhythm of wrist temperature(T),activity(A),position(P),an integrative variable that combines T,A,and P(TAP);(2)cortisol;and(3)7-day food and sleep *** mass index,body fat percentage,waist circumference(WC),melatonin concentration,and cardiometabolic marker levels were *** Circadian health,as assessed by the GCS,differed among children with obesity,overweight,and normal weight,with poorer circadian health among children with *** with obesity and abdominal obesity had 3.54 and 2.39 greater odds of having poor circadian health,respectively,than did those with normal weight or low *** percentage of rhythmicity,a marker of the robustness of the TAP rhythm,and the amplitude,both components of the GCS,decreased with increasing *** lifestyle behaviors were involved in the association between circadian health and obesity,particularly protein intake(P=0.024),physical activity level(P=0.076)and chronotype(P=0.029).Conclusions The GCS can capture the relationship between circadian health and obesity in school-age *** intake,physical activity level,and chronotype were involved in this *** intervention based on improving circadian health may help to prevent childhood obesity.

关键词： Children Chronodisruption Circadian Lifestyle Obesity

The Role of KDM2A and H3K36me2 Demethylation in Modulating MAPK Signaling During Neurodevelopment

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Neuroscience Bulletin 2024年第8期40卷 1076-1092页

作者： Zongyao Ren Haiyan Tang Wendiao Zhang Minghui Guo Jingjie Cui Hua Wang Bin Xie Jing Yu Yonghao Chen Ming Zhang Cong Han Tianyao Chu Qiuman Liang Shunan Zhao Yingjie Huang Xuelian He Kefu Liu Chunyu Liu Chao Chen Center for Medical Genetics&Hunan Key Laboratory of Medical Genetics School of Life Sciencesand Department of PsychiatryThe Second Xiangya HospitalCentral South UniversityChangsha 410028China National Clinical Research Center on Mental Disorders The Second Xiangya HospitalCentral South UniversityChangsha 410028China National Clinical Research Center for Geriatric Disorders Xiangya HospitalCentral South UniversityChangsha 410011China Furong Laboratory Changsha 410000China Department of Psychiatry SUNY Upstate Medical UniversitySyracuseNY 13210USA Precision Medical Center Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital)Tongji Medical CollegeHuazhong University of Science&TechnologyWuhan 430014China Department of Medical Genetics Hunan Children's HospitalChangsha 410007China

Intellectual disability(ID)is a condition characterized by cognitive impairment and difficulties in adaptive *** our research,we identified two de novo mutations(c.955C>T and c.732C>A)at the KDM2A locus in individuals with varying degrees of *** addition,by using the Gene4Denovo database,we discovered five additional cases of de novo mutations in *** mutations we identified significantly decreased the expression of the KDM2A *** investigate the role of KDM2A in neural development,we used both 2D neural stem cell models and 3D cerebral *** findings demonstrated that the reduced expression of KDM2A impairs the proliferation of neural progenitor cells(NPCs),increases apoptosis,induces premature neuronal differentiation,and affects synapse *** ChIP-Seq analysis,we found that KDM2A exhibited binding to the transcription start site regions of genes involved in *** addition,the knockdown of KDM2A hindered H3K36me2 binding to the downstream regulatory elements of *** integrating ChIP-Seq and RNA-Seq data,we made a significant discovery of the core genes'remarkable enrichment in the MAPK signaling ***,this enrichment was specifically linked to the p38 MAPK ***,disease enrichment analysis linked the differentially-expressed genes identified from RNA-Seq of NPCs and cerebral organoids to neurodevelopmental disorders such as ID,autism spectrum disorder,and ***,our findings suggest that KDM2A plays a crucial role in regulating the H3K36me2 modification of downstream genes,thereby modulating the MAPK signaling pathway and potentially impacting early brain development.

关键词： Intellectual disability KDM2A Neurodevelopmental disorder Cerebral organoids