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Reducing avoidable hospital based care: re-thinking out of hospital clinical pathways

This report is intended as a guide for all stakeholders to improve clinical pathways and develop models of care that are less dependent on acute hospitals. Its recommendations are relevant to both acute and long term condition pathways. The report provides a detailed guide to managing acute symptoms and acute conditions out of hospital where safe and appropriate to do so. It also provides detailed guidance on effective common city based pathways for three common long term conditions: heart failure, respiratory conditions and patients living with and beyond cancer.
Source: Current Awareness Service for Health (CASH) - Category: Consumer Health News Source Type: news

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Cardiac myocytes, like kidney podocytes, have a limited capacity to regenerate, and myocyte injury and loss contribute to cardiac fibrosis, pathologic remodeling, and heart failure. The paucity of therapeutic options to address heart failure and chronic kidney disease has drawn attention to the role of the Hippo pathway and its downstream effector Yes-associated protein (YAP) in both the heart and kidney. Ongoing clinical trials of a small molecule YAP inhibitor as adjunctive therapy for several common cancers further highlight the importance of understanding the role of this pathway.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Nephrology Digest Source Type: research
We present a state-of-the-art review of the role of mitochondria in both the pathobiology of pulmonary hypertension and potential therapeutic targets in pulmonary vascular processes. PMID: 29345195 [PubMed - as supplied by publisher]
Source: American Journal of Physiology. Lung Cellular and Molecular Physiology - Category: Cytology Authors: Tags: Am J Physiol Lung Cell Mol Physiol Source Type: research
This article is part of the European guidelines on perioperative venous thromboembolism prophylaxis. For details concerning background, methods, and members of the ESA VTE Guidelines Task Force, please, refer to: Samama CM, Afshari A, for the ESA VTE Guidelines Task Force. European guidelines on perioperative venous thromboembolism prophylaxis. Eur J Anaesthesiol 2018; 35:73–76. A synopsis of all recommendations can be found in the following accompanying article: Afshari A, Ageno W, Ahmed A, et al., for the ESA VTE Guidelines Task Force. European Guidelines on perioperative venous thromboembolism prophylaxis. Execu...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Guidelines Source Type: research
Purpose of review Increasing numbers of geriatric patients will present for thoracic surgery as the population ages. The changes in physiologic reserve as well as the increase in comorbid conditions among this population must be considered in order to optimize patient care in the perioperative period. Recent findings For elderly patients with cancer, the risk–benefit relationship for thoracic surgery remains favorable. Consideration of comorbidities, especially chronic obstructive pulmonary disease and congestive heart failure, is important in the setting of surgical treatment, as they have implications for peri...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Paul M. Heerdt Source Type: research
Mitochondria are the power plants of the cell, a herd of self-replicating structures evolved from ancient symbiotic bacteria, now fully integrated into the cell. Their primary task is the production of chemical energy stores, an energetic process that produces damaging reactive molecules as a side-effect. Much of the original bacterial DNA of the distant ancestors of today's mitochondia has migrated to the cell nucleus, leaving only a tiny remnant genome in the mitochondria themselves. When looking across species with widely divergent life spans, researchers have found good correlations between species life span and some c...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
AbstractPurpose of ReviewCardiovascular diseases account for nearly one third of all deaths globally. Improving exercise capacity and cardiorespiratory fitness (CRF) has been an important target to reduce cardiovascular events. In addition, the American Heart Association defined decreased physical activity as the fourth risk factor for coronary artery disease. Multiple large cohort studies have evaluated the impact of CRF on outcomes. In this review, we will discuss the role of CRF in reducing cardiovascular morbidity and mortality.Recent FindingsRecent data suggest that CRF has an important role in reducing not only cardi...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
Abstract Purpose We sought to determine the long-term risk of cardiovascular disease (CVD)-stroke and myocardial infarction-and congestive heart failure (CHF) in older patients with colorectal cancer, as well as to understand the roles that preexisting comorbidities and cancer therapy play in increasing this risk. Patients and Methods We evaluated individuals from the SEER-Medicare database with incident stage I to III colorectal cancer at age older than 65 years between January 1, 2000, and December 31, 2011 (n = 72,408) and compared these patients with a matched cohort of Medicare patients without cancer (n = 72...
Source: Clinical Colorectal Cancer - Category: Cancer & Oncology Authors: Tags: J Clin Oncol Source Type: research
This study is the longest, prospective randomized controlled trial that has documented the physiological effects of supervised, structured exercise training in a group of sedentary but healthy middle-aged adults. The key finding is that 2 years of exercise training performed for at least 30 minutes, 4 to 5 days per week, and including at least 1 high-intensity interval session per week results in a significant reduction in LV chamber and myocardial stiffness. The use of high-resolution, invasively measured LV pressure-volume curves and comparison with an attention control group enhances the confidence in this conclusion. T...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
The prediction of cancer therapeutics-related cardiac dysfunction (CTRCD) is an essential aspect of care for individuals who receive potentially cardiotoxic oncologic treatments. Certain clinical risk factors have been described for incident CTRCD, and measurement of left ventricular (LV) longitudinal strain by speckle tracking 2-dimensional echocardiography (2DE) is the best-validated myocardial mechanical imaging assessment to detect subtle changes in LV function during cancer treatment. However, the direct integration of clinical and imaging risk factors to predict CTRCD has not yet been extensively examined.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
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Source: Journal of Cellular Physiology - Category: Cytology Authors: Tags: FROM THE BENCH Source Type: research
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