13 research outputs found
A Technique to Address Peritoneal Dialysis Catheter Malfunction
Malpositioned peritoneal dialysis catheters may be repositioned laparoscopically with a testicular prosthesis used as an anchoring weight
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PD-1 blockade induces reactivation of non-productive T cell responses characterized by NF-kB signaling in patients with pancreatic cancer
Abstract Purpose: Pancreatic ductal adenocarcinoma (PDAC) trials have evaluated CTLA-4 and/or PD-(L)1 blockade in patients with advanced disease where bulky tumor burden and limited time to develop anti-tumor T cells may have contributed to poor clinical efficacy. Here we evaluated peripheral blood and tumor T cells from patients with PDAC receiving neoadjuvant chemoradiation plus anti-PD-1 (pembrolizumab) versus chemoradiation alone. We analyzed whether PD-1 blockade successfully reactivated T cells in the blood and/or tumor to determine whether lack of clinical benefit could be explained by lack of reactivated T cells versus other factors. Experimental Design: We used single cell transcriptional profiling and TCR clonotype tracking to identify TCR clonotypes from blood that match clonotypes in the tumor. Results: PD-1 blockade increases the flux of TCR clonotypes entering cell cycle and induces an IFNγ signature like that seen in patients with other GI malignancies who respond to PD-1 blockade. However, these reactivated T cells have a robust signature of NF-κB signaling not seen in cases of PD-1 antibody response. Among paired samples between blood and tumor, several of the newly cycling clonotypes matched activated T cell clonotypes observed in the tumor. Conclusions: Cytotoxic T cells in the blood of PDAC patients remain sensitive to reinvigoration by PD-1 blockade and some have tumor-recognizing potential. Although these T cells proliferate and have a signature of IFN exposure, they also upregulate NF-κB signaling, which potentially counteracts the beneficial effects of anti-PD-1 reinvigoration and marks these T cells as non-productive contributors to anti-tumor immunity
Ergonomics in surgical environments
The majority of work-related musculoskeletal disorders (WRMDs) in surgery are mostly related to sustained position and awkward postures, forcing non-natural gestures in surgeon ́s body.This arti- cle points to describe the different ailments studied during surgical tasks over the years: causes which increase the discomfort and fatigue, and effects related with them, in order highlight the cur- rent working conditions and how might be improved. To do that, a research is done to understand the main issues related on full body ailments and how is have been evaluated in different types of surgery, for which, the lead postural analysis technologies are presented, understanding Rapid Upper Limb Assessment system (RULA) the most suitable method to stablish priorities for preven- tive/corrective actions.Knowing the ailment ́s causes it have been necessary to define the critical points related with the causes, as instrumentation design, regulations in operating tables and chairs, pedal drives, and other surgical elements that require a ergonomic improvements, so that, the main design guidelines have been col- lected in this document and have been compared with a sample of current products available in the market, with the purpose of knowing the degree of implication between the requirements re- quested by the surgical teams and the companies dedicated to their design