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After temporary halt, dialysis back at Good Shepherd - Longview News-Journal |
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Some dialysis service was resumed this week at Good Shepherd Medical Center, which had suspended it June 19, hospital officials said.
The hospital is working in partnership with the Longview locations of DaVita, a national company providing dialysis and other services. The Denver company is set to assume all of the hospital's dialysis operations July 11.
Steve Altmiller, president and CEO of Good Shepherd Health System, said the hospital made the decision to halt dialysis service after a recent review by the Centers for Medicare and Medicaid Services.
"During the course of their survey, areas for improvement were identified within our hemodialysis unit," he said. "We temporarily halted dialysis services to take action to address those items."
The decision, Altmiller said, was not related to any concern over staph infection "or any other infectious organism."
The unit shutdown affected only patients at the center who needed dialysis in addition to other care, as Good Shepherd doesn't provide outpatient dialysis services. It required some emergency and heart cases to be diverted to other hospitals until dialysis returned to Good Shepherd.
Other area hospitals were contacted soon after notice of the shutdown. Seven patients were transferred to Good Shepherd Medical Center in Marshall, Longview Regional Medical Center and East Texas Medical Center.
Altmiller said the transfer of all seven patients requiring dialysis "occurred safely and without incident."
"Four of those seven patients chose to be transferred to Good Shepherd Medical Center in Marshall. (GSMC-Marshall) is not full and remains open to patients seeking care," he said. "The pediatric and cardiology units have been and remain open."
Stephanie Foster, chief nursing officer at Longview Regional, confirmed the facility had seen an increase of dialysis patients, and "every person needing this type of care has received it in a timely manner."
"We have a long established relationship with DaVita dialysis services," she said. "They have been very accommodating in helping us take care of this increased patient load."
In his weekly "Message from the CEO" issued Friday to hospital staff and others, Altmiller said after DaVita began services, the hospital would be "completely off diversion related to dialysis."
He also said that he couldn't speculate on the final outcome of the centers' recent survey, but called it eye opening.
"We have some of the best clinical outcomes in Texas, and in the nation," he wrote. "However; we still have areas to improve in." Most of those, Altmiller said, were in areas such as tracking building repairs, monitoring of trends and reporting.
"This day-to-day, nuts and bolts focus was our weak spot," he wrote. "They have not impacted our clinical outcomes and we can never let that happen."
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After temporary halt, dialysis back at Good Shepherd - Longview News-Journal ... - Longview News-Journal |
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Some dialysis service was resumed this week at Good Shepherd Medical Center, which had suspended it June 19, hospital officials said.
The hospital is working in partnership with the Longview locations of DaVita, a national company providing dialysis and other services. The Denver company is set to assume all of the hospital's dialysis operations July 11.
Steve Altmiller, president and CEO of Good Shepherd Health System, said the hospital made the decision to halt dialysis service after a recent review by the Centers for Medicare and Medicaid Services.
"During the course of their survey, areas for improvement were identified within our hemodialysis unit," he said. "We temporarily halted dialysis services to take action to address those items."
The decision, Altmiller said, was not related to any concern over staph infection "or any other infectious organism."
The unit shutdown affected only patients at the center who needed dialysis in addition to other care, as Good Shepherd doesn't provide outpatient dialysis services. It required some emergency and heart cases to be diverted to other hospitals until dialysis returned to Good Shepherd.
Other area hospitals were contacted soon after notice of the shutdown. Seven patients were transferred to Good Shepherd Medical Center in Marshall, Longview Regional Medical Center and East Texas Medical Center.
Altmiller said the transfer of all seven patients requiring dialysis "occurred safely and without incident."
"Four of those seven patients chose to be transferred to Good Shepherd Medical Center in Marshall. (GSMC-Marshall) is not full and remains open to patients seeking care," he said. "The pediatric and cardiology units have been and remain open."
Stephanie Foster, chief nursing officer at Longview Regional, confirmed the facility had seen an increase of dialysis patients, and "every person needing this type of care has received it in a timely manner."
"We have a long established relationship with DaVita dialysis services," she said. "They have been very accommodating in helping us take care of this increased patient load."
In his weekly "Message from the CEO" issued Friday to hospital staff and others, Altmiller said after DaVita began services, the hospital would be "completely off diversion related to dialysis."
He also said that he couldn't speculate on the final outcome of the centers' recent survey, but called it eye opening.
"We have some of the best clinical outcomes in Texas, and in the nation," he wrote. "However; we still have areas to improve in." Most of those, Altmiller said, were in areas such as tracking building repairs, monitoring of trends and reporting.
"This day-to-day, nuts and bolts focus was our weak spot," he wrote. "They have not impacted our clinical outcomes and we can never let that happen."
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Active Stocks News Update: AK Steel Holding Corporation, (NYSE:AKS), Ensco ... - wsnewspublishers |
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On Thursday, Shares of AK Steel Holding Corporation (NYSE:AKS),lost -6.82% to $3.55, hitting its lowest level.
On June 18, AK Steel Holding Corporation, offered guidance for its second quarter 2015 financial results. AK Steel said that it anticipates to report a net loss of $0.37 to $0.42 per diluted share of common stock for the second quarter of 2015. AK Steel said that the company’s predictable second quarter results continued to be negatively influenced by lower carbon steel prices due to the continued high level of what the company believes are unfairly traded imports. For the second quarter of 2015, AK Steel anticipates shipments of about 1.8 million tons, an enhance of about 3% contrast to the first quarter of 2015. The enhance in shipments quarter over quarter is primarily related to raised shipments to the carbon steel spot market and continued strength in the automotive market. AK Steel Holding Corporation, through its partner, AK Steel Corporation, produces flat-rolled carbon, stainless and electrical steel, and tubular products in the United States and internationally. It produces flat-rolled value-added carbon steels, counting coated, cold-rolled, and hot-rolled carbon steel products; and specialty stainless and electrical steels in sheet and strip forms. Shares of Ensco plc (NYSE:ESV),inclined 0.28% to $21.48, during its last trading session. Ensco plc, will hold its second quarter 2015 earnings conference call at 10:00 a.m. CDT (11:00 a.m. EDT and 4:00 p.m. London) on Thursday, 30 July 2015. The earnings release will be issued before the New York Stock Exchange opens that morning. Ensco plc provides offshore contract drilling services to the oil and gas industry worldwide. The company operates through three segments: Floaters, Jackups, and Other. The company owns and operates offshore drilling rig fleet of 70 rigs, counting 10 drillships, 13 semisubmersible rigs, 5 moored semisubmersible rigs, and 42 jackup rigs located in North and South America, the Middle East and Africa, the Asia Pacific rim, Europe and the Mediterranean, and Brazil. Finally, DaVita HealthCare Partners Inc. (NYSE:DVA),ended its last trade with -0.48% loss, and closed at $78.94. DaVita Kidney Care, a division of DaVita HealthCare Partners Inc. (DVA) and a leading provider of kidney care services, offers recipes that can assist people with chronic kidney disease (CKD) maintain a healthy diet during the Fourth of July weekend. “Our recipes aim to make it possible for those with kidney disease to continue their kidney-friendly eating plan even during the holidays,” said Sara Colman, DaVita Kidney Care dietitian and nutrition manager for DaVita.com. “The recipes we have compiled online and in our cookbooks comprise fresh ingredients with a balance of healthy proteins and produce to assist keep people with CKD nourished and satisfied all summer long.” DaVita’s most recent cookbook, Today’s Kidney Diet: Healthy Summertime Recipes, features 16 kidney-friendly meals that contain less sodium, phosphorus and potassium. It also comprises hydration and thirst-control suggestions, food-safety advice and tips for eating out while on vacation. DaVita HealthCare Partners Inc. provides kidney dialysis services for patients suffering from chronic kidney failure or end stage renal disease (ESRD). The company operates in two divisions, Kidney Care and HealthCare Partners. It operates kidney dialysis centers and provides related lab services primarily in outpatient dialysis centers and in contracted hospitals. DISCLAIMER: This article is published by www.wsnewspublishers.com. The Content included in this article is just for informational purposes only. All information used in this article is believed to be from reliable sources, but we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, or reliability with respect to this article. All visitors are advised to conduct their own independent research into individual stocks before making a purchase decision. Information contained in this article contains forward-looking information within the meaning of Section 27A of the Securities Act of 1933 and Section 21E of the Securities Exchange Act of 1934, counting statements regarding the predictable continual growth of the market for the corporation’s products, the corporation’s ability to fund its capital requirement in the near term and in the long term; pricing pressures; etc. Any statements that express or involve discussions with respect to predictions, expectations, beliefs, plans, projections, objectives, aims, assumptions, or future events or performance may be forward looking statements. Forward-looking statements are based on expectations, estimates, and projections at the time the statements are made that involve a number of risks and uncertainties which could cause actual results or events to differ materially from those presently anticipated. Forward looking statements may be identified through the use of such words as expects, will, anticipates, estimates, believes, or by statements indicating certain actions may, could, should/might occur.
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A new tissue-specific FLCN-deficient mouse model of renal tumourigenesis - ScienceBlog.com (blog) |
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Animal models can be useful for understanding disease pathology and as preclinical models for drug testing. As BHD patients develop renal cell carcinomas (RCCs) of varied histologies, associated with a loss of FLCN, BHD animal models could be used to study of a wide range of renal cancer subtypes. Current BHD mouse models include kidney-specific Flcn-knockouts (Chen et al., 2008, Baba et al., 2008) and ubiquitous knockouts (Hasumi et al., 2009, Hartman et al., 2009, Hudon et al., 2010). The former develop polycystic kidneys and die within three weeks, the latter can only be studied as heterozygotes with tumourigenesis dependent on a “second hit” resulting in variable penetrance and making them less suitable for drug studies.
A new mouse model from Chen et al., (2015) uses the proximal tubule-specific promoter, Sglt2, with Cre-Lox recombination (Sauer & Henderson, 1988) to knockout Flcn. Western blot confirmed the loss of Flcn in homozygous knockout (Flcnflox/flox/Sglt2-Cre) mouse proximal tubules with sustained expression in other renal tissues. These mice show bilateral renal cyst and tumour formation within the first year. Survival is impaired compared to the heterozygous knockout (Flcnflxo/+/Sglt2-Cre) or wildtype mice (<24 months vs >24 months) but is significantly longer than other kidney-specific Flcn knockout mice (<21 days; Chen et al., 2008, Baba et al., 2008).
Renal cysts developed in all homozygous knockout mice (n=100) – in over 50% within the first month – but were rarely seen in heterozygous knockout (n=5/33) or wildtype (n=1/38) mice. Immunohistochemistry confirmed that the cysts had developed from proximal tubule cells and were Flcn-deficient. Where complete Flcn knockout was not achieved, mainly in younger mice, there was no evidence of cyst formation (Chen et al., 2015).
The majority of homozygous knockout mice developed RCC (n=41/54). Lower grade chromophobe RCC, oncocytomas and hybrid RCCs (most often seen in BHD patients) were more frequently identified in younger mice with increased prevalence of higher grade papillary RCC and clear cell RCC in aging mice. Whether high grade tumours are the result of lower grade tumour transformation over time is an area that requires further investigation. Only two heterozygous knockout mice developed renal tumours (at 27 and 29 months), a lower tumourigenic frequency than the ubiquitous heterozygous Flcn knockout models (Hasumi et al., 2009).
Tumours from homozygous knockout mice were negative for Flcn and showed increased levels of AKT, mTOR, MMP and TGF? signalling compared to healthy tissue. Activation of the mTOR pathway has previously been reported as a feature of BHD-mouse RCC development (Chen et al., 2008, Baba et al., 2008). However, a loss of Flcn has previously been linked to reduced TGF? signalling in human UOK-257 cells (Hong et al., 2010) and mouse embryonic stem cells (Cash et al., 2011); this discrepancy could represent a species-specific role for TGF? in mouse renal tumourigenesis or be the result of tissue-specific functions.
Chen et al., confirmed the applicability of their mice to drug testing by treating mice with rapamycin for ten months (started at two months old). Comparison of drug and sham treated mice showed a vast reduction in cyst and tumour development; the kidneys of treated mice did contain cysts but the authors suggest that these developed before treatment began. Based on this they claim “rapamycin effectively inhibited the development of new cysts and tumours”, but was unable to reverse pre-existing damage. However, as the number of cysts was only assessed at one time point it is possible that cysts continued to develop but treatment with rapamycin resulted in markedly slower growth and restricted transformation into tumours.
This new Flcnflox/flox/Sglt2-Cre knockout BHD-RCC model clearly represents the developmental stages of human renal tumour progression: cyst development (months 1-4), hyperplasia (month 5), microtumours (from 6 months) and large tumours (from 12 months).The high and constant penetrance afforded by highly-tissue specific homozygous knockout coupled with early onset and longer lifespan compared to other kidney specific Flcn-knockout mice make them a powerful tool for understanding tumourigenesis and for preclinical testing.
- Baba M, Furihata M, Hong SB, Tessarollo L, Haines DC, Southon E, Patel V, Igarashi P, Alvord WG, Leighty R, Yao M, Bernardo M, Ileva L, Choyke P, Warren MB, Zbar B, Linehan WM, Schmidt LS. Kidney-targeted Birt-Hogg-Dube gene inactivation in a mouse model: Erk1/2 and Akt-mTOR activation, cell hyperproliferation, and polycystic kidneys. J Natl Cancer Inst. 2008 Jan 16;100(2):140-54. PubMed PMID: 18182616.
- Cash TP, Gruber JJ, Hartman TR, Henske EP, Simon MC. Loss of the Birt-Hogg-Dubé tumor suppressor results in apoptotic resistance due to aberrant TGF?-mediated transcription. Oncogene. 2011 Jun 2;30(22):2534-46. PubMed PMID: 21258407.
- Chen J, Futami K, Petillo D, Peng J, Wang P, Knol J, Li Y, Khoo SK, Huang D, Qian CN, Zhao P, Dykema K, Zhang R, Cao B, Yang XJ, Furge K, Williams BO, Teh BT. Deficiency of FLCN in mouse kidney led to development of polycystic kidneys and renal neoplasia. PLoS One. 2008;3(11) PubMed PMID: 18974783.
- Chen J, Huang D, Rubera I, Futami K, Wang P, Zickert P, Khoo SK, Dykema K, Zhao P, Petillo D, Cao B, Zhang Z, Si S, Schoen SR, Yang XJ, Zhou M, Xiao GQ, Wu G, Nordenskjöld M, Tauc M, Williams BO, Furge KA, Teh BT. Disruption of tubular Flcn expression as a mouse model for renal tumor induction. Kidney Int. 2015 Jun [Epub ahead of print] PubMed PMID: 26083655.
- Hartman TR, Nicolas E, Klein-Szanto A, Al-Saleem T, Cash TP, Simon MC, Henske EP. The role of the Birt-Hogg-Dubé protein in mTOR activation and renal tumorigenesis. Oncogene. 2009 Apr 2;28(13):1594-604. PubMed PMID: 19234517.
- Hasumi Y, Baba M, Ajima R, Hasumi H, Valera VA, Klein ME, Haines DC, Merino MJ, Hong SB, Yamaguchi TP, Schmidt LS, Linehan WM. Homozygous loss of BHD causes early embryonic lethality and kidney tumor development with activation of mTORC1 and mTORC2. Proc Natl Acad Sci U S A. 2009 Nov 3;106(44):18722-7. PubMed PMID: 19850877.
- Hong SB, Oh H, Valera VA, Stull J, Ngo DT, Baba M, Merino MJ, Linehan WM, Schmidt LS. Tumor suppressor FLCN inhibits tumorigenesis of a FLCN-null renal cancer cell line and regulates expression of key molecules in TGF-beta signaling. Mol Cancer. 2010 Jun 23;9:160. PubMed PMID: 20573232.
- Hudon V, Sabourin S, Dydensborg AB, Kottis V, Ghazi A, Paquet M, Crosby K, Pomerleau V, Uetani N, Pause A. Renal tumour suppressor function of the Birt-Hogg-Dubé syndrome gene product folliculin. J Med Genet. 2010 Mar;47(3):182-9. PubMed PMID: 19843504.
- Sauer B, Henderson N. Site-specific DNA recombination in mammalian cells by the Cre recombinase of bacteriophage P1. Proc Natl Acad Sci U S A. 1988 Jul;85(14):5166-70. PubMed PMID: 2839833.
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