Objective.— To report a case of improved pain control and function in a patient with chronic migraine after treatment with auriculotemporal nerve stimulation.
Methods.— The patient is a 52‐year‐old ...woman with refractory pain in the bilateral temporal distribution and marked phonophobia as a result of chronic migraine.
Results.— After a successful trial period, the patient underwent implantation of bilateral peripheral nerve stimulators targeting the auriculotemporal nerves. At 16 months of follow up, her average pain intensity declined from 8‐9/10 on the numeric rating scale to 5/10. Her function improved as assessed by the Migraine Disability Assessment, from total disability (grade IV) to mild disability (grade II). Her phonophobia became far less debilitating.
Conclusion.— Auriculotemporal nerve stimulation may be useful tool in the treatment of refractory pain in the temporal distribution due to chronic migraine.
Investigational cancer therapies being tested in clinical trials may be available outside of trials, or off-protocol (OPRx). We evaluated the practices and attitudes among US oncologists with regard ...to this controversial practice.
We mailed an anonymous survey to a random sample of US medical oncologists evaluating frequency and prevalence of OPRx and evaluated the correlation between demographic factors, attitudes, and practice.
One hundred forty-six (31%) of 471 oncologists responded. Ninety-three percent reported ever discussing and 81% ever prescribing OPRx. Academic oncologists were more likely than community oncologists to have ever provided OPRx (89% v 75%; P = .06), to discuss OPRx at least once/month (41% v 19%; P = .0004), and to deny requests for OPRx at least once/month (16% v 2%; P = .004). While 61% of oncologists believed that patients should be discouraged from OPRx, only 31% felt it should not be available. With regard to trial recruitment, 53% felt that informed consent requires discussion of OPRx, 34% disagree, and 26% feel that patients should be provided OPRx on request, while 56% disagree. There was lack of consensus on access to OPRx in scenarios based on open trials at the time of the survey, such as adjuvant trastuzumab, which 41% would provide, 59% would not.
US oncologists report common discussion and use of OPRx, but attitudes and practices may vary substantially. There is need for greater debate regarding OPRx in oncology, further definition of the ethical and clinical issues at stake, and development of guidelines in this area.
BACKGROUND: In healthy humans, continuous treatment with nitroglycerin (GTN) causes nitric oxide synthase dysfunction, probably through the reduced bioavailability of tetrahydrobiopterin. Recent ...studies proposed that folic acid is involved in the regeneration of tetrahydrobiopterin in different disease states. Therefore, we investigated whether folic acid administration would prevent this phenomenon. We also sought to determine if folic acid supplementation could prevent the development of tolerance to GTN. METHODS AND RESULTS: On the first visit, 18 healthy male volunteers (aged 19 to 32 years) were randomized to receive either oral folic acid (10 mg once a day) or placebo for 1 week in a double-blind designed study. All subjects also received continuous transdermal GTN (0.6 mg/h). On the second visit, forearm blood flow was measured with venous occlusion strain gauge plethysmography in response to incremental infusions of acetylcholine (7.5, 15, and 30 microgram/min), N-monomethyl-L-arginine (1, 2, and 4 micromol/min), and GTN (11 and 22 nmol/min). Folic acid prevented GTN-induced endothelial dysfunction, as assessed by responses to intraarterial acetylcholine and N-monomethyl-L-arginine (P<0.01). Moreover, in the subjects treated with folic acid plus transdermal GTN, responses to intraarterial GTN were significantly greater than those observed after transdermal GTN plus placebo (P<0.05). CONCLUSION: Our data demonstrate that supplemental folic acid prevents both nitric oxide synthase dysfunction induced by continuous GTN and nitrate tolerance in the arterial circulation of healthy volunteers. We hypothesize that the reduced bioavailability of tetrahydrobiopterin is involved in the pathogenesis of both phenomena. Our results confirm the view that oxidative stress contributes to nitrate tolerance.
Multiple factors regulate the development and maintenance of humoral immune responses. The cytokines produced by helper T cells are major determinants of the magnitude and phenotype of antibody ...responses to protein antigens. Th2-derived cytokines are most effective at initiating primary B cell responses, whereas Th1 cells are effective helpers for B cells exposed to multivalent antigens and for previously activated B cells. In addition, different cytokines stimulate B cell switching to particular antibody isotypes. Cytokine production can be regulated in vivo by the conditions of antigen exposure, and by the nature of antigens. Tolerogenic antigens alter the phenotypes of antibody responses by preferentially inactivating selected subsets of helper T cells. Morphologic techniques provide potentially valuable approaches for studying T/B cell interactions and the nature and consequences of local cytokine production in situ, in lymphoid tissues.
This paper describes a novel combination of Java program analysis and automated learning and planning architecture to the domain of Java vulnerability analysis. The key feature of our “HACKAR: ...Helpful Advice for Code Knowledge and Attack Resilience” system is its ability to analyze Java programs at development-time, identifying vulnerabilities and ways to avoid them. HACKAR uses an improved version of NASA’s Java PathFinder (JPF) to execute Java programs and identify vulnerabilities. The system features new Hierarchical Task Network (HTN) learning algorithms that (1) advance stateof-theart HTN learners with reasoning about numeric constraints, failures, and more general cases of recursion, and (2) contribute to problem-solving by learning a hierarchical dataflow representation of the program from the inputs of the program. Empirical evaluation demonstrates that HACKAR was able to suggest fixes for all of our test program suites. It also shows that HACKAR can analyze programs with string inputs that original JPF implementation cannot.
Communications Gadler, Steve J.; Davenport, John H.; Spinrad, Bernard I. ...
Bulletin of the atomic scientists,
19/3/1/, Letnik:
28, Številka:
3
Journal Article
Recenzirano
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
18.
Communications Gadler, Steve J.; Davenport, John H.; Spinrad, Bernard I. ...
Bulletin of the atomic scientists,
03/1972, Letnik:
28, Številka:
3
Journal Article
Recenzirano
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
