Haptoglobin-alpha subunit as potential serum biomarker in ovarian cancer: identification and characterization using proteomic profiling and mass spectrometry.

PURPOSE: The objective of this study was to identify and characterize new serum biomarkers in ovarian cancer patients using mass spectrometric protein profiling and specific immunological assays. Experimental Design: Serum samples from 80 cancer patients and 91 healthy women were analyzed by surface enhanced laser desorption and ionization-mass spectrometry (MS) profiling. A candidate biomarker was purified by affinity chromatography, and its sequence was determined by liquid chromatography-tandem MS. An antibody was generated from the synthesized peptide for quantitative validation in the cases and controls. CA125 was determined and compared with the same set of specimens. RESULTS: Using surface enhanced laser desorption and ionization, we found a serum biomarker at approximately 11700 Da, which had peak intensity significantly higher in cases (1.366) compared with controls (0.208, P = 0.002), and subsequently identified this as the alpha chain of haptoglobin. ELISA indicated that Hp-alpha was 相似文献   

Role of Nurse Practitioners in the Management of Cirrhotic Patients

Patients with end-stage liver disease (ESLD) often suffer from complications that require ongoing management with outpatient providers. Complications include ascites, hepatic encephalopathy, hyponatremia, pulmonary vascular complications, and esophageal varices. Patients with cirrhosis need to be referred to a hepatologist to establish care and potential evaluation for liver transplantation. Nurse practitioners (NPs) involved in the care of cirrhotic patients are well positioned to provide supportive care, improve symptom management, and prevent complications associated with further decompensation. This article discusses the role of NPs in the management of patients with cirrhosis.     

Editorial Commentary: SLAP Repair—The Anterosuperior Portal for Anchor Placement Is Best

The anterosuperior rotator interval portal for SLAP repair anchor placement is the perfect balance between obtaining the proper anchor trajectory and respecting the rotator cuff integrity.     

Application of osteopathic manipulative treatment to a patient with unremitting chest pain and shortness of breath undergoing “Rule-Out Myocardial Infarction” protocol for one week

Chest pain and shortness of breath are both common complaints of patients presenting to an emergency room (ER) or urgent care facility. A 67-year-old married white female was seen in the ER complaining of chest pain and shortness of breath. Our education and training has us admit these patients where they may be monitored and assessed according to protocols developed to rule-out serious etiologies. Accordingly, the patient was admitted to the cardiac care unit and placed on the “Rule-Out Myocardial Infarction” protocol. The patient’s symptoms persisted despite adherence to rigorous diagnostic and therapeutic regimens and which stymied attempts to arrive at a definitive diagnosis and provide care. The case presented here demonstrates how an osteopathic approach can enable us to provide appropriate care and resolve some problems that appear to be otherwise unremitting. There is potential for savings in terms of actual costs and utilization of resources. The use of an osteopathic structural exam identified an abnormality that could be easily treated with Osteopathic Manipulative Treatment (OMT), which completely resolved the patient’s presenting complaints. Had this been done earlier in the course of managing this patient, preferably as part of the admission work-up, the patient’s confinement would have been drastically reduced, and repeated expensive tests would not have had to have been performed. The application of OMT to reducing patient morbidity is instructive of the efficacy of the osteopathic approach in this case and suggests that further research is warranted.     

Rapid improvement in post-infectious gastroparesis symptoms with mirtazapine

We report the case of a 34-year-old woman with severe post-infectious gastroparesis who was transferred from an outside medical facility for a second opinion regarding management.This patient had no prior history of gastrointestinal symptoms.However,in the aftermath of a viral illness,she developed two months of intractable nausea,vomiting,and oral intake intolerance that resulted in numerous hospitalizations for dehydration and electrolyte disturbances.A solid-phase gastric emptying scan had confirmed delayed emptying,confirming gastroparesis.Unfortunately,conventional pro-kinetic agents and numerous anti-emetic drugs provided little or no relief of the patient’s symptoms.At our institution,the patient experienced a cessation of vomiting,reported a significant reduction in nausea,and toler-ated oral intake shortly after taking mirtazapine.Based on mirtazapine’s primary action as a serotonin(5-HT)1a receptor agonist,we infer that this receptor system mediated the clinical improvement through a combination of peripheral and central neural mechanisms.This report highlights the potential utility of 5-HT1a agonists in the management of nausea and vomiting.We conclude that mirtazapine may be effective in treating symptoms associated with non-diabetic gastroparesis that are refractory to conventional therapies.     

Time Since Death: A Novel Approach to Dating Skeletal Remains

Criminal investigators dealing with skeletal remains have the primary concern for determining whether the remains are of anthropological or archaeological interest. If the remains are determined to be from an anthropological era, the next concern becomes the determination of time since death (TSD). Despite advances in modern technology, TSD remains a most elusive determinant. It has critical value for providing police with a time frame in which the person may have gone missing, increasing the likelihood of a positive identification. This article outlines a novel approach to dating skeletal remains in an Australian context, but with global connotations.     

Community-Engaged Research Perspectives: Then and Now

To fully appreciate the health of an individual, it is necessary to understand the effect of a person's attitudes, beliefs, and behaviors within their social, environmental, and cultural context. The medical model, although extremely useful, has its limitations when it comes to understanding the health of people as they live in the world. Wellness does not happen in the doctor's office alone, akin to the fact that scientific discovery is not limited to a laboratory. In this perspectives article, we posit that by using a community-engaged research approach, we not only allow for the translation of scientific discovery into clinical practice and public health initiatives, but we also create a new way of generating and integrating knowledge to improve health outcomes. In short, community-engaged research is not only a tool for translation, it is unique method for scientific discovery bringing transdisciplinary teams together that study health problems in real-world contexts and consider sustainability at the front end of asking the research question.