Medicine
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Observational Study
Association between 30-day readmission rates and health information technology capabilities in US hospitals.
Health information technology (IT) is often proposed as a solution to fragmentation of care, and has been hypothesized to reduce readmission risk through better information flow. However, there are numerous distinct health IT capabilities, and it is unclear which, if any, are associated with lower readmission risk. To identify the specific health IT capabilities adopted by hospitals that are associated with hospital-level risk-standardized readmission rates (RSRRs) through path analyses using structural equation modeling. ⋯ These findings suggest that improving patient access to and use of their electronic health records may be helpful in improving hospital performance on readmission; however, computerized hospital discharge and information exchange among clinicians did not seem as beneficial - perhaps because of the quality or timeliness of information transmitted. Future research should use more recent data to study, not just adoption of health IT capabilities, but also whether their usage is associated with lower readmission risk. Understanding which capabilities impact readmission risk can help policymakers and clinical stakeholders better focus their scarce resources as they invest in health IT to improve care delivery.
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Observational Study
A novel biomarker, MRPS12 functions as a potential oncogene in ovarian cancer and is a promising prognostic candidate.
Ovarian cancer (OC) is the leading cause of gynecological cancer deaths. Extraordinary histologic and genetic heterogeneity presents as great hurdle to OC's diagnosis and treatment. MRPS12 (Mitochondrial Ribosomal Protein S12), encoding a 28S subunit protein, controls the decoding fidelity and susceptibility to aminoglycoside antibiotics. ⋯ GSEA showed that HALLMARK_G2M_CHECKPOINT, BIOCARTA_CELLCYCLE_PATHWAY, HALLMARK_PI3K_AKT_MTOR_SIGNALING, BIOCARTA_P53_PATHWAY were significantly enriched in high-MRPS12-expression phenotype. MRPS12 expression was positively correlated with the infiltration of macrophages and neutrophils in OC. These results reveal that MRPS12 could function as a potential oncogene and serve as a promising prognostic candidate in OC.
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Cholinergic modification by anticholinergic medication can produce adverse effects in central nervous system (CNS) and cyclopentolate is an antimuscarinic agent widely used for ophthalmologic management. We demonstrate a rare case of hyperactive delirium caused by topical administration of cyclopentolate in a patient with amnestic mild cognitive impairment (MCI) due to Alzheimer's disease (AD). ⋯ It is well known that several drugs with anticholinergic effects used in perioperative periods make the patients susceptible to delirium, but even the topical administration of cyclopentolate for cataract surgery also produce adverse CNS effects in a vulnerable patient who is diagnosed with MCI due to AD in this case.
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Patients with lung adenocarcinoma harboring EML4-ALK rearrangements respond well to multiple ALK tyrosine kinase inhibitors (TKIs). However, the tumor will invariably progress due to acquired resistance. Comprehensive genomic profiling appears to be a promising strategy to reveal the underlying molecular mechanisms of ALK-TKIs resistance. ⋯ We present a case of ALK-rearranged lung adenocarcinoma with acquired resistance to ALK inhibition, in which the BRAF V600E mutation is a novel resistance mechanism. This provides evidence that BRAF V600E mutation is one mechanism of ALK-TKI resistance.
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Primary renal carcinoid tumors are very rare and only about 100 cases have been reported in the medical literature. There are even fewer articles on the imaging manifestations of primary renal carcinoid tumors. ⋯ Primary renal carcinoid tumors mostly present as solid mass/cystic solid mass with calcification and delayed enhancement of heterogeneity on CT imaging, but the diagnosis depends on pathological diagnosis. Hence, raising awareness of the CT features of the rare tumor in the kidney may broaden the knowledge base of radiologists.