The profound impact that vision loss has on human activities and quality of life necessitates understanding the etiology of potentially blinding diseases and their clinical management. The unique ...anatomic features of the eye and its sequestration from peripheral immune system also provides a framework for studying other diseases in immune privileged sites and validating basic immunological principles. Thus, early studies of intraocular inflammatory diseases (uveitis) were at the forefront of research on organ transplantation. These studies laid the groundwork for foundational discoveries on how immune system distinguishes self from non-self and established current concepts of acquired immune tolerance and autoimmunity. Our charge in this review is to examine how advances in molecular cell biology and immunology over the past 3 decades have contributed to the understanding of mechanisms that underlie immunopathogenesis of uveitis. Particular emphasis is on how advances in biotechnology have been leveraged in developing biologics and cell-based immunotherapies for uveitis and other neuroinflammatory diseases.
•Haloacetic acid, trihalomethane, and perchlorate were measured during disinfection.•No byproduct exceedances above regulatory levels for a 5-log pathogen removal.•Disinfection and byproduct ...formation corresponded to active chlorine generation.•Energy consumption and byproducts were most limited at low current densities.
Laboratory batch experiments were performed at room temperature to evaluate the electrochemical disinfection of surface water using Ti/IrO2 anodes. Disinfection was assessed as a function of applied current density (0–8mA/cm2) and specific charge Q (A-min/L), and active chlorine generation was measured. Generation of disinfection by-products, including haloacetic acids (HAAs), total trihalomethanes (TTHMs), and perchlorate, also was monitored. Results showed that the disinfection rate corresponded to the applied current density. With respect to the applied Q, the highest current density (8mA/cm2) showed the greatest rate of disinfection and highest rate of active chlorine generation. While no perchlorate generation was observed, HAAs and TTHMs were generated at a rate of 7.7 and 5.6μgA−1min−1, respectively. However, regulatory exceedances were not observed until greater than a 5-log decrease in bacteria was observed. HAA and TTHM formation, as well as energy consumption, associated with the highest current density were greater than the lower current densities for a given level of disinfection. Overall, this study demonstrates that effective disinfection without regulatory exceedances in TTHMs, HAAs, or perchlorate can be attained using a Ti/IrO2 anode for treatment of surface water.
In 2003, Repetto and colleagues2 published a review calling for incorporation of comprehensive geriatric assessment, which emphasises functional status and quality of life as key elements of ...treatment planning, into clinical care and research in older populations of patients with cancer.Clinical trials assessing therapies deemed appropriate for vulnerable populations are needed, but require incorporation of geriatric assessment instruments for risk stratification and evaluation of the effect of therapies on the pre-existing conditions in these populations.2 L Repetto, A Venturino, L Fratino, Geriatric oncology: a clinical approach to the older patient with cancer, Eur J Cancer, Vol. 39, 2003, 870-880 3 SM Swain, J Baselga, SB Kim, Pertuzumab, trastuzumab, and docetaxel in HER2-positive metastatic breast cancer, N Engl J Med, Vol. 372, 2015, 724-734 4 D Miles, J Baselga, D Amadori, Treatment of older patients with HER2-positive metastatic breast cancer with pertuzumab, trastuzumab, and docetaxel: subgroup analyses from a randomized, double-blind, placebo-controlled phase III trial (CLEOPATRA), Breast Cancer Res Treat, Vol. 142, 2013, 89-99 5 F Perrone, F Nuzzo, F Di Rella, Weekly docetaxel versus CMF as adjuvant chemotherapy for older women with early breast cancer: final results of the randomized phase III ELDA trial, Ann Oncol, Vol. 26, 2015, 675-682 6 L Orlando, A Cardillo, A Rocca, Prolonged clinical benefit with metronomic chemotherapy in patients with metastatic breast cancer, Anticancer Drugs, Vol. 17, 2006, 961-967 7 HA Perroud, CM Alasino, MJ Rico, Metastatic breast cancer patients treated with low-dose metronomic chemotherapy with cyclophosphamide and celecoxib: clinical outcomes and biomarkers of response, Cancer Chemother Pharmacol, Vol. 77, 2016, 365-374 8 L Biganzoli, S Lichtman, JP Michel, Oral single-agent chemotherapy in older patients with solid tumours: a position paper from the International Society of Geriatric Oncology (SIOG), Eur J Cancer, Vol. 51, 2015, 2491-2500 9 L Orlando, A Cardillo, R Ghisini, Trastuzumab in combination with metronomic cyclophosphamide and methotrexate in patients with HER-2 positive metastatic breast cancer, BMC Cancer, Vol. 6, 2006, 225
Adnexal torsion: review of the literature Sasaki, Kirsten J; Miller, Charles E
Journal of minimally invasive gynecology,
03/2014, Volume:
21, Issue:
2
Journal Article
Peer reviewed
Adnexal torsion is one of a few gynecologic surgical emergencies. Misdiagnosis or delay in treatment can have permanent sequelae including loss of an ovary with effect on future fertility, ...peritonitis, and even death. A PubMed search was performed between 1985 and 2012 for reviews, comparative studies, and case reports to provide a review of the epidemiology, risk factors, clinical presentation, common laboratory and imaging findings, and treatments of adnexal torsion. Common symptoms of torsion include pain, nausea, and vomiting, with associated abdominal or pelvic tenderness, and may differ in premenarchal and pregnant patients. Laboratory and imaging findings including ultrasound with Doppler analysis, computed tomography, and magnetic resonance imaging can assist in making the diagnosis but should not trump clinical judgment; normal Doppler flow can be observed in up to 60% of adnexal torsion cases. Treatment depends on the individual patient but commonly includes detorsion, even if the adnexae initially seem necrotic, with removal of any associated cysts or salpingo-oophorectomy, because recurrence rates are higher with detorsion alone or detorsion with only cyst aspiration.
To date, no civilian studies have demonstrated that pre-hospital (PH) tourniquets improve survival. We hypothesized that late, trauma center (TC) tourniquet use would increase death from hemorrhagic ...shock compared to early (PH) placement.
All patients arriving to a Level 1, urban TC between October 2008 and January 2016 with a tourniquet placed before (T-PH) or after arrival to the TC (T-TC) were evaluated. Cases were assigned the following designations: indicated (absolute indication vascular injury requiring repair/ligation, operation within 2 hours for extremity injury, or traumatic amputation or relative indication major musculoskeletal/soft tissue injury requiring operation 2-8 hours after arrival, documented large blood loss) or non-indicated. Outcomes were death from hemorrhagic shock, physiology upon arrival to the TC, and massive transfusion requirements. After univariate analysis, logistic regression was carried out to assess independent predictors of death from hemorrhagic shock.
A total of 306 patients received 326 tourniquets for injuries to 157 upper and 147 lower extremities. Two hundred eighty-one (92%) had an indication for placement. Seventy percent of patients had a blunt mechanism of injury. T-TC patients arrived with a lower systolic blood pressure (SBP, 101 86, 123 vs. 125 100, 145 mm Hg, p < 0.001), received more transfusions in the first hour of arrival (55% vs. 34%, p = 0.02), and had a greater mortality from hemorrhagic shock (14% vs. 3.0%, p = 0.01). When controlling for year of admission, mechanism of injury and shock upon arrival (SBP ≤90 mm Hg or HR ≥120 bpm or base deficit ≤ 4) indicated T-TC had a 4.5-fold increased odds of death compared to T-PH (OR 4.5, 95% CI 1.23-16.4, p = 0.02).
Waiting until TC arrival to control hemorrhage with a tourniquet was associated with worsened blood pressure and increased transfusion within the first hour of arrival. In routine civilian trauma patients, delaying to T-TC was associated with 4.5-fold increased odds of mortality from hemorrhagic shock.
Level IV.
Stem cells and the heart-the road ahead Murry, Charles E; MacLellan, W Robb
Science (American Association for the Advancement of Science),
2020-Feb-21, Volume:
367, Issue:
6480
Journal Article
Is neocortex essentially multisensory? Ghazanfar, Asif A.; Schroeder, Charles E.
Trends in cognitive sciences,
06/2006, Volume:
10, Issue:
6
Journal Article
Peer reviewed
Open access
Although sensory perception and neurobiology are traditionally investigated one modality at a time, real world behaviour and perception are driven by the integration of information from multiple ...sensory sources. Mounting evidence suggests that the neural underpinnings of multisensory integration extend into early sensory processing. This article examines the notion that neocortical operations are essentially multisensory. We first review what is known about multisensory processing in higher-order association cortices and then discuss recent anatomical and physiological findings in presumptive unimodal sensory areas. The pervasiveness of multisensory influences on all levels of cortical processing compels us to reconsider thinking about neural processing in unisensory terms. Indeed, the multisensory nature of most, possibly all, of the neocortex forces us to abandon the notion that the senses ever operate independently during real-world cognition.
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