Impact of Performing Nonurgent Interventional Radiology Procedures on Weekends

Ahmed, Muneeb; Sarwar, Ammar; Hallett, Donna; Guthrie, Marge; OʼBryan, Bridget; Mehta, Sahil V.; Fudim, Tali; Faintuch, Salomão

doi:10.1016/j.jacr.2018.05.029

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…TGF-β1 acts as a pro-fibrotic molecular mainly through stimulating the downstream Smad signaling pathway to trigger and facilitate subsequent fibrogenesis procession [25]. Previous studies have clearly demonstrated the underlying mechanisms in regulating the TGF-β1/Smad signaling pathway [3,26]. Among the Smad subfamily, Smad 7 was considered as a negative regulator of TGF-β1/Smad signaling transduction via blocking the recruitment and phosphorylation of the Smad 2-Smad 3 com-plex [27].…”

Section: Discussionmentioning

confidence: 99%

“…Chronic kidney disease (CKD) is a global health issue that leads to lower quality of life and higher social economic burden [1], especially for patients who need renal replacement therapy. The advent of dialysis and kidney transplantation improved the survival rate and quality of life for patients with End-stage renal disease (ESRD), however, both of the two treatments were costly and with multiple complications [2,3]. Thus, effective and affordable treatments need to be developed to delay or reverse the progression of CKD.…”

Section: Introductionmentioning

confidence: 99%

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Bone marrow mesenchymal stem cell-derived exosomes improve renal fibrosis via regulating Smurf 2/Smad 7

Liu¹,

Wei²,

Yan³

et al. 2022

Front. Biosci. (Landmark Ed)

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Background: Exosomes can be secreted from bone marrow mesenchymal stem cells (BMSCs) to extracellular space and exert antifibrotic effects, but the underlying mechanisms remain to be elucidated. Methods: 5/6 subtotal nephrotomy (SNx) rat models and TGF-β1-induced human renal proximal tubular epithelial cells (HRPTEpiCs) were established to simulate renal fibrosis. Renal function and fibrosis were assessed by Hematoxylin and Eeosin (HE) staining, Masson staining, immunohistochemistry, and western blot. The expression of Smad 7/Smurf 2 was detected in rats and HRPTEpiCs by western blot, and a further potential mechanism was explored using si-Smurf 2. Results: BMSC-Exo improved renal function, reduced the fibrotic region, down-regulated the expression of fibronectin, Collagen-I, α-SMA, and up-regulated E-cadherin in SNx models. In vitro study demonstrated that knocking down the expression of Smurf 2 significantly increased the expression of Smad 7, which could be enhanced by BMSC-Exo. BMSC-Exo could alleviate the fibrosis induced by TGF-β1 in tubular epithelial cells and enhanced the protective effect of si-Smurf 2 on renal fibrosis. Conclusions: BMSC-Exo inhibited renal fibrosis both in vivo and in vitro, partially, by regulating the Smurf 2/Smad 7 axis. BMSC-Exo enhanced the protective effect of si-Smurf 2 on fibrosis induced by transforming growth factor-β1 (TGF-β1).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bone marrow mesenchymal stem cell-derived exosomes improve renal fibrosis via regulating Smurf 2/Smad 7

Liu¹,

Wei²,

Yan³

et al. 2022

Front. Biosci. (Landmark Ed)

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“…Early advanced imaging has been associated with reduced length-of-stay, as well as improved patient outcomes [3][4][5]9,27]. Weekend-related imaging delays, as measured and presented in this study, will be incorporated into a province-wide general internal medicine performance dashboard [28].…”

Section: Plos Onementioning

confidence: 99%

“…Hospital leaders may further consider how delays in imaging at their institution compare to their peer hospitals, and the effect this may have on their patients' relative and absolute length-of-stay. Hospital initiatives to improve access to imaging procedures-for instance, through increased radiology coverage on weekends [9]-could shorten length-of-stay and improve other patient outcomes.…”

Section: Plos Onementioning

confidence: 99%

Imaging delays among medical inpatients in Toronto, Ontario: A cohort study

Bartsch

Shin²,

Roberts³

et al. 2023

PLoS ONE

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Background Imaging procedures are commonly performed on hospitalized patients and waiting for these could increase length-of-stay. The study objective was to quantify delays for imaging procedures in General Internal Medicine and identify contributing patient, physician, and system factors. Methods This was a retrospective cohort study of medical inpatients admitted to 5 hospitals in Toronto, Ontario (2010–2019), with at least one imaging procedure (CT, MRI, ultrasound, or peripherally-inserted central catheter [PICC] insertion). The primary outcome was time-to-test, and the secondary outcome was acute length-of-stay after test ordering. Results The study cohort included 73,107 hospitalizations. Time-to-test was longest for MRI (median 22 hours) and shortest for CT (median 7 hours). The greatest contributors to time-to-test were system factors such as hospital site (up to 22 additional hours), location of test ordering (up to 10 additional hours), the timing of test ordering relative to admission (up to 13 additional hours), and ordering during weekends (up to 21 additional hours). Older patient age, having more comorbidities, and residence in a low-income neighborhood were also associated with testing delays. Each additional hour spent waiting for a test was associated with increased acute length-of-stay after test ordering, ranging from 0.4 additional hours for CT to 1.2 hours for MRI. Conclusions The greatest contributors to testing delays relate to when and where a test was ordered. Wait times affect length-of-stay and the quality of patient care. Hospitals can apply our novel approach to explore opportunities to decrease testing delays locally.

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