Saint Francis University

About: Saint Francis University is a education organization based out in Loretto, Pennsylvania, United States. It is known for research contribution in the topics: Population & Osteoblast. The organization has 1694 authors who have published 2038 publications receiving 87149 citations.

Clinical predictors of hypoxaemia in children with pneumonia

Abstract: A prospective study to determine which clinical factors identified children with acute lower respiratory infection who were hypoxaemic and at risk of death was done over a 9-month period on children under 5 years of age admitted to a district hospital in rural Zambia. Of 158 children studied, 55 (35%) were found to be hypoxaemic and 23 (14.6%) died. For the subgroup of children under 1 year of age, a respiratory rate of > 70 was the only significant predictor of hypoxaemia (p < 0.001, sensitivity 63%, specificity 89%). In older children, only the presence of crepitations/bronchial breathing was predictive (p = 0.018, sensitivity 75%, specificity 57%). The likelihood of death was increased in those children with low oxygen saturation (p = 0.021) and poor nutrition (p = 0.007). It is concluded that, on the basis of raised respiratory rate, the WHO guidelines are likely to identify children under 1 year of age who are hypoxaemic. However, it may be necessary to include auscultatory findings in the guidelines to recognize hypoxaemia in older children in order to ensure that they receive appropriate treatment with oxygen. This study demonstrates that hypoxaemia and malnutrition are risk factors for death.

CCAAT/Enhancer Binding Protein Homologous Protein (DDIT3) Induces Osteoblastic Cell Differentiation

Abstract: CCAAT/enhancer binding protein (C/EBP) homologous protein (CHOP/DDIT3), a member of the C/EBP family of transcription factors, plays a role in cell survival and differentiation. CHOP/DDIT3 binds to C/EBPs to form heterodimers that do not bind to consensus Cebp sequences, acting as a dominant-negative inhibitor. CHOP/DDIT3 blocks adipogenesis, and we postulated it could induce osteoblastogenesis. We investigated the effects of constitutive CHOP/DDIT3 overexpression in murine ST-2 stromal cells transduced with retroviral vectors. ST-2 cells differentiated toward osteoblasts, and CHOP/DDIT3 accelerated and enhanced the appearance of mineralized nodules, and the expression of osteocalcin and alkaline phosphatase mRNAs, particularly in the presence of bone morphogenetic protein-2. CHOP/DDIT3 overexpression opposed adipogenesis, and did not cause substantial changes in cell number. CHOP/DDIT3 overexpression did not modify C/EBPalpha or -beta mRNA levels but decreased C/EBPdelta after 24 d of culture. Electrophoretic mobility shift and supershift assays demonstrated that overexpression of CHOP/DDIT3 decreased the binding of C/EBPs to their consensus sequence by interacting with C/EBPalpha and -beta, confirming its dominant-negative role. In addition, CHOP/DDIT3 enhanced bone morphogenetic protein-2/Smad signaling. In conclusion, CHOP/DDIT3 enhances osteoblastic differentiation of stromal cells, in part by interacting with C/EBPalpha and -beta and also by enhancing Smad signaling.

Relation of Childhood Sexual Abuse and Other Forms of Maltreatment to 12-Month Postoperative Outcomes in Extremely Obese Gastric Bypass Patients

Abstract: Background: The prognostic significance of sexual abuse for extremely obese patients who undergo bariatric surgery is uncertain. This study examined self-reported childhood sexual abuse and other forms of childhood maltreatment in relation to preoperative presentation and to 12-month postoperative outcomes in gastric bypass patients. Methods: 137 extremely obese patients undergoing gastric bypass surgery completed a questionnaire battery before surgery and again 12 months after surgery. Weight loss was determined with measured weight and height, childhood maltreatment was assessed with the Childhood Trauma Questionnaire, and associated eating disorder and psychological functioning were assessed with established measures. Results: 32% of patients self-reported childhood sexual abuse, 37% reported some form of non-sexual childhood abuse or neglect, and 31% reported no form of childhood maltreatment. Significant and clinically robust improvements in weight and in all measures of eating and psychological functioning were observed at 12 months after surgery. Patients who reported histories of childhood sexual abuse and other forms of childhood maltreatment differed little from patients who reported no childhood maltreatment in body mass index, eating disorder features, and psychological functioning both pre- and postoperatively at 12-month follow-up. Patients who reported childhood sexual abuse had statistically significantly higher levels of depression at 12 months after surgery, although the depression levels represented significant reductions from pre-surgery and fell within the non-depressed range. Conclusion: Extremely obese patients who seek gastric bypass surgery report higher rates of childhood maltreatment than normative community samples. A history of childhood maltreatment, including reports of sexual abuse, does not appear to be a negative prognostic indicator for gastric bypass surgery.

Nurse Practitioners and Physician Assistants in Acute and Critical Care: A Concise Review of the Literature and Data 2008-2018.

Abstract: Objectives To provide a concise review of the literature and data pertaining to the use of nurse practitioners and physician assistants, collectively called advanced practice providers, in ICU and acute care settings. Data sources Detailed search strategy using the databases PubMed, Ovid MEDLINE, and the Cumulative Index of Nursing and Allied Health Literature for the time period from January 2008 to December 2018. Study selection Studies addressing nurse practitioner, physician assistant, or advanced practice provider care in the ICU or acute care setting. Data extraction Relevant studies were reviewed, and the following aspects of each study were identified, abstracted, and analyzed: study population, study design, study aims, methods, results, and relevant implications for critical care practice. Data synthesis Five systematic reviews, four literature reviews, and 44 individual studies were identified, reviewed, and critiqued. Of the research studies, the majority were retrospective with others being observational, quasi-experimental, or quality improvement, along with two randomized control trials. Overall, the studies assessed a variety of effects of advanced practice provider care, including on length of stay, mortality, and quality-related metrics, with a majority demonstrating similar or improved patient care outcomes. Conclusions Over the past 10 years, the number of studies assessing the impact of advanced practice providers in acute and critical care settings continue to increase. Collectively, these studies identify the value of advanced practice providers in patient care management, continuity of care, improved quality and safety metrics, patient and staff satisfaction, and on new areas of focus including enhanced educational experience of residents and fellows.