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Carbapenemase-Producing Enterobacteriaceae (CPE) Newborn Colonization within a Portugal Neonatal Demanding Treatment Product (NICU): Epidemiology along with Contamination Prevention and Handle Procedures.
an suggested in the literature. © The Author(s) 2020. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For permissions, please e-mail [email protected] Models of care are needed to address physical activity, nutrition promotion and weight loss in primary care settings, especially with underserved populations who are disproportionately affected by chronic illness. Group medical visits (GMVs) are one approach that can help overcome some of the barriers to behaviour change in underserved populations, including the amount of time required to care for these patients due to socio-economic stressors and psychosocial complexities (1). GMVs have been shown to improve care in coronary artery disease and diabetes, but more evidence is needed in underserved settings. OBJECTIVE This project sought to evaluate a GMV incorporating a physical activity component in an underserved patient population, measuring biometric and motivation outcome measures. METHODS This project used a pre-post intervention study design through patient surveys at baseline and 12 weeks. We included validated motivational measures along with self-reported demographic information. A GMV intervention promoting physical activity and nutrition to promote weight loss was delivered by an interdisciplinary primary care team and community partners in a Federally Qualified Health Center in Rochester, NY. The intervention consisted of six, 2-hour sessions that occurred every other week at the clinic site. RESULTS Participants lost a significant amount of weight and maintained the weight loss at 6 months. In addition, there was a significant improvement in motivation measures. CONCLUSION This study provides preliminary evidence that our GMV model can improve weight loss and autonomous motivation in an underserved population. This project has potential for scalability and sustainability. © The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail [email protected] Impaired glucose homeostasis is a common finding in pheochromocytoma (PHEO), especially with adrenergic phenotype. The possible contribution of incretin dysfunction to dysglycemia in PHEO patients has not been studied. OBJECTIVE To compare changes in pancreatic endocrine function and gut hormones' production during a liquid meal test before and one year after adrenalectomy. METHODS In a prospective study, we included 18 patients with PHEO (13 females) with adrenergic biochemical phenotype. A liquid meal test with predefined isocaloric enteral nutrition was performed to evaluate dynamic changes in pancreatic hormones and incretins. RESULTS During the meal test, insulin levels were significantly lower before adrenalectomy only in the early phase of insulin secretion, but changes in AUC did not reach statistical significance (AUC = 0.07). Plasma glucagon (AUC less then 0.01) and pancreatic polypeptide levels (AUC less then 0.01) were suppressed in comparison with the postoperative state. Impaired response to the meal was found preoperatively for GLP-1 (AUC P less then 0.05), but not GIP (AUC P = 0.21). No significant changes in insulin resistance indices were found, except for the HOMA-beta index, an indicator of the function of islet beta cells, which negatively correlated with plasma metanephrine (R = -0.66, P less then 0.01). CONCLUSIONS Our study shows suppression of pancreatic alpha and beta cell function and impaired GLP-1 secretion during a dynamic meal test in patients with PHEO, that is improved after its surgical treatment. These data demonstrate a novel and potentially significant interconnection between excessive catecholamine production and the secretion of glucoregulatory hormones. © Endocrine Society 2020. All rights reserved. For permissions, please e-mail [email protected] Post-treatment relapse is a major roadblock to stemming the global epidemic of tobacco-related illness. This article presents results from a pilot trial evaluating the feasibility and initial efficacy of Mindfulness-Based Relapse Prevention (MBRP) as an adjunct to standard relapse prevention treatment (ST) for smoking cessation. METHODS Smokers (n = 86) in the maintenance phase of treatment were randomized to receive either ST plus MBRP (MBRP) (n = 44) or ST alone (ST) (n = 42). Data were collected at baseline and at four, twelve and twenty-four week follow up points. We evaluated the feasibility of the protocol with frequency analysis, and the efficacy with both intention to treat (ITT) and complete case (CC) analyses of the effects of MBRP on abstinence. Secondary outcomes included mindfulness, craving, depression, anxiety and positive/negative affect. RESULTS High adherence suggested MBRP is acceptable and feasible. selleck products Participants in the MBRP group reported increases in mindfulness (M = -7.833, and merits further research. © The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail [email protected] randomization (RAR) has recently gained popularity in clinical trials. The intent is noble minimize the number of participants randomized to inferior treatments and increase the amount of information about better treatments. Unfortunately, RAR causes many problems, including 1) bias from temporal trends, 2) inefficiency in treatment effect estimation, 3) volatility in sample size distributions that can cause a nontrivial proportion of trials to assign more patients to an inferior arm, 4) difficulty of validly analyzing results, and 5) the potential for selection bias and other issues inherent from being unblinded to ongoing results. The problems of RAR are most acute in the very setting for which RAR has been proposed, namely long duration "platform" trials and infectious disease settings where temporal trends are ubiquitous. Response-adaptive randomization can eliminate the benefits that randomization, the most powerful tool in clinical trials, provides. Use of response adaptive randomization is discouraged.
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