A study of relationship between blood parameters with myocardial infractions

Background:The aim of this study was to find out the changes in blood parameters in a group of myocardial infarction patients in Jamnagar, Gujarat.Methods:In this cross sectional study conducted at the medicine clinic in GGH general hospital, Jamnagar between May 2012 and April 2013, a total of 100 subjects were included. Parameters like hemoglobin, RBC count, WBC count, platelet count, hematocrit, ESR, Mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, packed cell volume, differential WBC count used.Results: The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutrophil cells) in patients increased significantly (P <0.01) comparison to controls. While, the differential leukocyte count of lymphocyte & platelet count revealed to decrease significantly (P <0.01) in patients.Conclusion:Abnormal blood parameters are more common among diabetes patients. Elevated WBC count, ESR, neutrophils are present in patients as compared to control. While decreased in lymphocytes & platelets are seen in patients as compared to control

Clinical utilization of Chimeric Antigen Receptor T-cells (CAR-T) in B-cell acute lymphoblastic leukemia (ALL)-An expert opinion from the European Society for Blood and Marrow Transplantation (EBMT) and the American Society for Blood and Marrow Transplantation (ASBMT)

On August 30, 2017, the U.S. Food and Drug Administration (US-FDA) approved tisagenlecleucel (KYMRIAH, Novartis, Basel, Switzerland), a synthetic bioimmune product of anti-CD19 chimeric antigen receptor-T cells (CAR-T), for the treatment of children and young adults with relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). With this new era of personalized cancer immunotherapy, multiple challenges are present ranging from implementation of a CAR-T program to safe delivery of the drug, long-term toxicity monitoring and disease assessments. To address these issues, experts representing the American Society for Blood and Marrow Transplant (ASBMT), the European Group for Blood and Marrow Transplantation (EBMT), the International Society of Cell and Gene Therapy (ISCT), and the Foundation for the Accreditation of Cellular Therapy (FACT), formed a global CAR-T task force to identify and address key questions pertinent for hematologists and transplant physicians regarding the clinical use of anti CD19 CAR-T therapy in patients with B-ALL. This article presents an initial roadmap for navigating common clinical practice scenarios that will become more prevalent now that the first commercially available CAR-T product for B-ALL has been approved

Fragile X (CGG)(n )repeats induce a transcriptional repression in cis upon a linked promoter: Evidence for a chromatin mediated effect

BACKGROUND: Expansion of an unstable (CGG)(n )repeat to over 200 triplets within the promoter region of the human FMR1 gene leads to extensive local methylation and transcription silencing, resulting in the loss of FMRP protein and the development of the clinical features of fragile X syndrome. The causative link between (CGG)(n )expansion, methylation and gene silencing is unknown, although gene silencing is associated with extensive changes to local chromatin architecture. RESULTS: In order to determine the direct effects of increased repeat length on gene transcription in a chromatin context, we have examined the influence of FMR1 (CGG)(n )repeats upon transcription from the HSV thymidine kinase promoter in the Xenopus laevis oocyte. We observe a reduction in mRNA production directly associated with increasing repeat length, with a 90% reduction in mRNA production from arrays over 100 repeats in length. Using a kinetic approach, we show that this transcriptional repression is concomitant with chromatin maturation and, using in vitro transcription, we show that chromatin formation is a fundamental part of the repressive pathway mediated by (CGG)(n )repeats. Using Trichostatin A, a histone deacetylase inhibitor, we show reactivation of the silenced promoter. CONCLUSIONS: Thus, isolated fragile X associated (CGG)(n )repeat arrays can exert a modifying and transcriptionally repressive influence over adjacent promoters and this repressive phenomenon is, in part, mediated by histone deacetylation

Gravitomagnetic effects in compact binary systems : a study of spin-enhanced orbits around Kerr black holes

Thesis (S.B.)--Massachusetts Institute of Technology, Dept. of Physics, 2004.Includes bibliographical references (p. 77-78).An important subject in current gravity research concerns the evolution of compact binary systems in which both members spin, particularly in the extreme mass ratio limit. Previous research has suggested that the effect of spin in such systems may be particularly significant-possibly even chaotic-near the homoclinic set of orbits, which lie close to the separatrix dividing stable and unstable orbits. In this thesis we present a study of the spin-induced evolution of inclined, eccentric Kerr black hole orbits. The evolution of the orbital energy, angular momentum, and Carter constant for such orbits is driven by the local spin force on the orbiting body, which is inferred from the Papapetrou equations. We find that the variation of the constants which characterize the orbit (e.g., energy, angular momentum, and Carter constant) is complicated and occurs on orbital timescales, but is contained within well-defined bounds that expand smoothly as the spin on the orbiting body is increased. As a consequence, the total volume explored in the orbital phase space of a given orbit is finite. We also find that the phase space volume grows rapidly as one approaches the homoclinic set of orbits, but ceases to increase once the particle comes within a certain threshold distance of the separatrix.by Akash Pravin Kansagra.S.B

Exploring the Next Frontier for Tobacco Control: Nondaily Smoking among New York City Adults

Objective. Among current smokers, the proportion of Nondaily smokers is increasing. A better understanding of the characteristics and smoking behaviors of Nondaily smokers is needed. Methods. We analyzed data from the New York City (NYC) Community Health Survey to explore Nondaily smoking among NYC adults. Univariate analyses assessed changes in Nondaily smoking over time (2002–2010) and identified unique characteristics of Nondaily smokers; multivariable logistic regression analysis identified correlates of Nondaily smoking in 2010. Results. The proportion of smokers who engage in Nondaily smoking significantly increased between 2002 and 2010, from 31% to 36% (P = 0.05). A larger proportion of Nondaily smokers in 2010 were low income and made tax-avoidant cigarette purchases compared to 2002. Smoking behaviors significantly associated with Nondaily smoking in 2010 included smoking more than one hour after waking (AOR = 8.8, 95% CI (5.38–14.27)); buying “loosies” (AOR = 3.5, 95% CI (1.72–7.08)); attempting to quit (AOR = 2.3, 95% CI (1.36–3.96)). Conclusion. Nondaily smokers have changed over time and have characteristics distinct from daily smokers. Tobacco control efforts should be targeted towards “ready to quit” Nondaily smokers

Nocturnal Temazepam in the Treatment of Narcolepsy

Narcolepsy is characterized by fragmented nighttime sleep and frequent arousals. One treatment approach to improve daytime symptoms is to consolidate nighttime sleep through decreasing arousals. Sodium oxybate is the first FDA-approved medication that follows this approach. Benzodiazepines are known to also decrease arousals at night and have been proposed to help with sleep fragmentation. In one report, clonazepam was shown to improve cataplexy in 10 of 14 patients with narcolepsy although no improvement in daytime sleepiness was reported. The purpose of this case review was to share our experience of nocturnal temazepam on daytime sleepiness in patients with narcolepsy as measured by the Epworth Sleepiness Scale (ESS)

Risk of early versus later rebleeding from dural arteriovenous fistulas with cortical venous drainage

BACKGROUND: Cranial dural arteriovenous fistulas with cortical venous drainage are rare lesions that can present with hemorrhage. A high rate of rebleeding in the early period following hemorrhage has been reported, but published long-term rates are much lower. No study has examined how risk of rebleeding changes over time. Our objective was to quantify the relative incidence of rebleeding in the early and later periods following hemorrhage. METHODS: Patients with dural arteriovenous fistula and cortical venous drainage presenting with hemorrhage were identified from the multinational CONDOR (Consortium for Dural Fistula Outcomes Research) database. Natural history follow-up was defined as time from hemorrhage to first treatment, rebleed, or last follow-up. Rebleeding in the first 2 weeks and first year were compared using incidence rate ratio and difference. RESULTS: Of 1077 patients, 250 met the inclusion criteria and had 95 cumulative person-years natural history follow-up. The overall annualized rebleed rate was 7.3% (95% CI, 3.2-14.5). The incidence rate of rebleeding in the first 2 weeks was 0.0011 per person-day; an early rebleed risk of 1.6% in the first 14 days (95% CI, 0.3-5.1). For the remainder of the first year, the incidence rate was 0.00015 per person-day; a rebleed rate of 5.3% (CI, 1.7-12.4) over 1 year. The incidence rate ratio was 7.3 (95% CI, 1.4-37.7; CONCLUSIONS: The risk of rebleeding of a dural arteriovenous fistula with cortical venous drainage presenting with hemorrhage is increased in the first 2 weeks justifying early treatment. However, the magnitude of this increase may be considerably lower than previously thought. Treatment within 5 days was associated with a low rate of rebleeding and appears an appropriate timeframe

Greenhouse Gas Emission Reduction Plan

Our team aimed to compile a greenhouse gas inventory for the St. Louis region. Partnered with OneSTL, Ameren, and the USGBC, we determined that St. Louis has a goal to reduce emissions 50% by 2030 from 2005 levels, and become carbon neutral in 2050. After analyzing the Ameren’s Integrated Resource Plan and factors such as the cost and scope of emissions, we researched funding sources to improve energy efficiency and increase renewables in the region. Our top funding sources are the Inflation Reduction Act (IRA) and the Bipartisan Infrastructure Law (BIL). From the IRA, we found the following credits most effective:1. Energy Efficient Commercial Buildings Deduction2. Greenhouse Gas Reduction Fund3. IRA Extended Production Tax Credits4. Clean Energy Production Tax Credits5. Alternative Fuel Refueling Property CreditFrom the BIL, we found the following programs most effective:1. Civil Nuclear Credit Program2. Energizing Rural Communities Prize3. Energy Efficiency Rotating Loan Fund Capitalization4. Industrial Research and Assessment Centers ActOur next step was modeling emissions from now to 2050. Our emissions model has shown that for us to achieve the 2030 goal we must reduce electricity use by 20%, in order to achieve an EnergyStar rating of ES 75. Possible future steps for this project are updating the GHG emissions inventory for the region, implementing ICLEI modeling, and expanding our modeling for industrial buildings

Gastric Trichobezoar Causing Intermittent Small Bowel Obstruction: Report of a Case and Review of the Literature

We report the unusual case of a 45-year-old woman who presented with multiple episodes of small bowel obstruction. Initial exploratory lap-roscopy did not reveal an etiology of the obstruction. Subsequent upper endoscopy identified a non-obstructing gastric trichobezoar which could not be removed endoscopically but was not thought to be responsible for the small bowel obstruction given its location. One week postoperatively, the patient experienced recurrence of small bowel obstruction. Repeat endoscopy disclosed that the trichobezoar was no longer located in the stomach and upon repeat laparotomy was extracted from the mid-jejunum. In the following 8 months, the patient had no further episodes of small bowel obstruction. Consequently, gastric bezoars should be included in the differential diagnosis of recurrent small bowel obstruction