Does the Urinary Proteome Reflect ccRCC Stage and Grade Progression?

Due its ability to provide a global snapshot of kidney physiology, urine has emerged as a highly promising, non-invasive source in the search for new molecular indicators of disease diagnosis, prognosis, and surveillance. In particular, proteomics represents an ideal strategy for the identification of urinary protein markers; thus, a urinomic approach could also represent a powerful tool in the investigation of the most common kidney cancer, which is clear cell Renal Cell Carcinoma (ccRCC). Currently, these tumors are classified after surgical removal using the TNM and nuclear grading systems and prognosis is usually predicted based upon staging. However, the aggressiveness and clinical outcomes of ccRCC remain heterogeneous within each stratified group, highlighting the need for novel molecular indicators that can predict the progression of these tumors. In our study, we explored the association between the urinary proteome and the ccRCC staging and grading classification. The urine proteome of 44 ccRCC patients with lesions of varying severity was analyzed via label-free proteomics. MS data revealed several proteins with altered abundance according to clinicopathological stratification. Specifically, we determined a panel of dysregulated proteins strictly related to stage and grade, suggesting the potential utility of MS-based urinomics as a complementary tool in the staging process of ccRCC.

Implications of physicians and nurses’ professional satisfaction on patient care

<p><span lang="EN-GB">The patient outcomes of a health organization depend on the knowledge, skills and motivation of its individual employees. Therefore, it is important for health care employers to motivate their workers in order to meet the desired outcomes. It is widely acknowledged that health workers who are motivated facilitate the desired patient outcomes. This illustrates how the levels of physicians’ and nurses’ professional satisfaction influences the health care outcomes for patients based on a study of the Moi Teaching and Referral Hospital (MTRH). Descriptive quantitative research design was used. Data was collected using a structured questionnaire issued to <br /> a stratified group of 82 Physicians and 220 Nurses. <br /> All the completed questionnaires were entered into IBM SPSS 21.0 statistical software and data analysed for descriptive statistics. The results were presented in tables and figures. The study was powered to 95% confidence interval. With regards to effects of general practitioners’ and nurses’ work satisfaction on patient services, the study revealed that work associated with the respondents’ position allows contributions to be made to the hospital, <br /> the profession and to own sense of achievement. Furthermore, the study findings showed that praise received for work well done translates to improved job productivity and that the medicine/nursing practice allows autonomous professional decisions to be made which in turn promotes high levels of clinical competence. Based on these findings, the study concludes that health care practitioners’ work satisfaction has implications on <br /> patient care.</span></p>

Besicovitch Covering Property on graded groups and applications to measure differentiation

We give a complete answer to which homogeneous groups admit homogeneous distances for which the Besicovitch Covering Property (BCP) holds. In particular, we prove that a stratified group admits homogeneous distances for which BCP holds if and only if the group has step 1 or 2. These results are obtained as consequences of a more general study of homogeneous quasi-distances on graded groups. Namely, we prove that a positively graded group admits continuous homogeneous quasi-distances satisfying BCP if and only if any two different layers of the associated positive grading of its Lie algebra commute. The validity of BCP has several consequences. Its connections with the theory of differentiation of measures is one of the main motivations of the present paper. As a consequence of our results, we get for instance that a stratified group can be equipped with some homogeneous distance so that the differentiation theorem holds for each locally finite Borel measure if and only if the group has step 1 or 2. The techniques developed in this paper allow also us to prove that sub-Riemannian distances on stratified groups of step 2 or higher never satisfy BCP. Using blow-up techniques this is shown to imply that on a sub-Riemannian manifold the differentiation theorem does not hold for some locally finite Borel measure.

Detection of Secondary Causes and Coexisting Diseases in Hypertensive Patients: OSA and PA Are the Common Causes Associated with Hypertension

Background. Since the control rate of blood pressure is lower in mainland China, the aim of this study is to investigate the proportion of secondary causes and coexisting diseases of hypertension in hypertensive patients.Methods. Data on consecutive patients with hypertension who visited the Hypertension Center. Diseases were detected using an established strict screening protocol.Results. Detection rate of secondary causes and coexisting diseases of hypertension was 39.5% among 3003 hypertensive patients. Obstructive sleep apnea (OSA) was the most common, accounting for 24.7% of patients, followed by primary aldosteronism (PA) (5.8%) and PA + OSA (4.9%). Endocrine hypertension accounted for 12.1% of patients, including 10.7% of patients with PA, 1.1% with hypothyroidism, 0.1% with pheochromocytoma, 0.1% with Cushing’s syndrome, and 0.1% with hyperthyroidism, respectively. Those who smoke, those who are obese, and those who have diabetes accounted for 31.3%, 27.5%, and 16.6% of total patients, respectively. There were overlapping conditions in secondary causes and coexisting diseases of hypertension. OSA was the most common in each age- and BMI-stratified group.Conclusion. Findings from the current study suggest an increasing frequency of secondary forms of hypertension, highlighting the burden of OSA and PA in hypertensive patients.

The Longitudinal Course of Fatigue in Rheumatoid Arthritis: Results from the Norfolk Arthritis Register

Objective.Fatigue is common and burdensome in rheumatoid arthritis (RA). Despite RA fatigue progression varying significantly between individuals in practice, existing longitudinal analyses only examine symptom advancement on a population level. This study aimed to determine fatigue trajectories at an individual level and to characterize those patients with the poorest prognosis, with a view to enabling earlier interventions.Methods.Patients with RA reporting clinically relevant baseline fatigue (≥ 20 mm on a 0–100 mm visual analog scale) were identified from a longterm inflammatory polyarthritis cohort (the Norfolk Arthritis Register). Fatigue changes from baseline to 1- and 4-year followups were calculated, and sex-stratified group-based trajectory modeling (GBTM) determined trajectories of the symptom between which baseline characteristics were compared.Results.Among 338 patients, only minimal average changes were observed between recruitment to 1 year (6.0 mm, SD 26.9) and 4 years (5.5 mm, SD 29.3). This was despite 45.6% and 40.7% of participants reporting clinically significant improvements (≥ 10 mm) at these respective followups. GBTM revealed varied trajectories of fatigue, which for both sexes consisted of Improved (men, n = 48 and women, n = 81) or persistent Moderate-high paths (n = 54, n = 105), and further included a persistent High trajectory in women (n = 50). Participants who followed persistent trajectories were best distinguished from improvers by patient-reported rather than demographic or clinical variables.Conclusion.Among patients with RA presenting with clinically relevant fatigue, distinct longitudinal symptom trajectories were identified on an individual level despite nominal average changes in fatigue on a group level. It is possible to identify and characterize subgroups of participants who report persistent fatigue and should therefore be targeted to receive future fatigue-alleviating interventions.