223 research outputs found
Mantle Cell Lymphoma: Current Concepts
Mantle Cell Lymphoma is a rare B-cell malignancy that can invade almost any structure in the body and recur after short-lived clinical responses. The pathogenesis and clinical features are well defined, but management has not yet been optimized. Induction with traditional immune-chemotherapy regimens that are used in other nonHodgkin lymphomas rarely generate durable remissions. Therefore, clinical research is needed to improve treatment of de novo disease and to establish safe and effective regimens for maintenance and salvage options for relapsed or refractory disease. This comprehensive review discusses disease pathogenesis and focuses on emerging treatment paradigms using novel targeted therapies
Persistent Spin Dynamics in the V Molecular Nano-Magnet
We present muon spin lattice relaxation measurements in the V15 spin 1/2
molecular nano-magnet. We find that the relaxation rate in low magnetic fields
(<5 kG) is temperature independent below ~10 K, implying that the molecular
spin is dynamically fluctuating down to 12 mK. These measurements show that the
fluctuation time increases as the temperature is decreased and saturates at a
value of ~6 nsec at low temperatures. The fluctuations are attributed to V15
molecular spin dynamics perpendicular to the applied magnetic field direction,
induced by coupling between the molecular spin and nuclear spin bath in the
system.Comment: Accepted for publication in Phys. Rev. B, 5 pages, 5 figur
THE EFFECT OF A PERIPHERAL NOREPINEPHRINE PROTOCOL ON CENTRAL LINE UTILIZATION IN A SURGICAL ICU
INTRODUCTION: Central venous catheters (CVC) are associated with various complications. In several studies, the use of vasopressors through peripheral venous catheters (PVC) obviated the need for CVC insertion in 34-87% of patients. Although evidence indicates that the peripheral administration of vasopressors is safe, most health systems currently use protocols that favor the use of CVC over PVC. We proposed a quality improvement study evaluating the use of a protocol for the peripheral administration of a dilute norepinephrine solution (16 mcg/ml) in the surgical intensive care unit (SICU).
METHODS: This was a retrospective quality improvement study conducted at Henry Ford Hospital in Detroit, MI. We included 100 patients that were admitted to the SICU between June and December 2021 and received dilute norepinephrine for any cause through a PVC under our prespecified protocol. Guidelines for CVC insertion were present in the protocol to assist clinicians. An extravasation protocol was instituted which included application of 2% nitroglycerin ointment. The primary endpoint evaluated was the number of patients in which a CVC was placed, regardless of the cause, within 24 hours of discontinuation of norepinephrine through the PVC. Secondary endpoints included the indication for central line placement, dose of norepinephrine infused, duration of norepinephrine infusions, gauge and location of the PVC, frequency of extravasation events, and tissue injury.
RESULTS: Out of the 100 included in the study 51 patients (51%) did not receive a CVC, and 60 patients (60%) did not receive a CVC within the first 24 hours of discontinuation of peripheral norepinephrine. Norepinephrine extravasation was noted in 6 patients (6%). These incidents were successfully managed with nitroglycerin (2%) ointment.
CONCLUSIONS: We demonstrated that administration of diluted norepinephrine through a PVC following a protocol in the SICU was associated with a reduction in CVC placement. The incidence of extravasation of norepinephrine was rare. Careful assessment of the PVC allowed for early treatment with topical nitroglycerine and no harm was identified to any patient
Childhood chronic anterior uveitis associated with vernal keratoconjunctivitis (VKC): successful treatment with topical tacrolimus. Case series
Uveitis treatment involves topical corticosteroids along with cycloplegic-mydriatics. Particularly severe cases may require systemic corticosteroids and immunosuppressive drugs. Vernal keratoconjunctivitis (VKC) treatment consists of a brief period of topical corticosteroids and/or cyclosporine. In patients refractory to traditional treatment, the use of 0.1% topical ophtalmic FK- 506 (tacrolimus) ointment has been occasionally reported
Vector Transmission of Leishmania Abrogates Vaccine-Induced Protective Immunity
Numerous experimental vaccines have been developed to protect against the cutaneous and visceral forms of leishmaniasis caused by infection with the obligate intracellular protozoan Leishmania, but a human vaccine still does not exist. Remarkably, the efficacy of anti-Leishmania vaccines has never been fully evaluated under experimental conditions following natural vector transmission by infected sand fly bite. The only immunization strategy known to protect humans against natural exposure is “leishmanization,” in which viable L. major parasites are intentionally inoculated into a selected site in the skin. We employed mice with healed L. major infections to mimic leishmanization, and found tissue-seeking, cytokine-producing CD4+ T cells specific for Leishmania at the site of challenge by infected sand fly bite within 24 hours, and these mice were highly resistant to sand fly transmitted infection. In contrast, mice vaccinated with a killed vaccine comprised of autoclaved L. major antigen (ALM)+CpG oligodeoxynucleotides that protected against needle inoculation of parasites, showed delayed expression of protective immunity and failed to protect against infected sand fly challenge. Two-photon intra-vital microscopy and flow cytometric analysis revealed that sand fly, but not needle challenge, resulted in the maintenance of a localized neutrophilic response at the inoculation site, and removal of neutrophils following vector transmission led to increased parasite-specific immune responses and promoted the efficacy of the killed vaccine. These observations identify the critical immunological factors influencing vaccine efficacy following natural transmission of Leishmania
The optimal treatment of an infectious disease with two strains
This paper explores the optimal treatment of an infectious disease in a Susceptible-Infected-Susceptible model, where there are two strains of the disease and one strain is more infectious than the other. The strains are perfectly distinguishable, instantly diagnosed and equally costly in terms of social welfare. Treatment is equally costly and effective for both strains. Eradication is not possible, and there is no superinfection. In this model, we characterise two types of fixed points: coexistence equilibria, where both strains prevail, and boundary equilibria, where one strain is asymptotically eradicated and the other prevails at a positive level. We derive regimes of feasibility that determine which equilibria are feasible for which parameter combinations. Numerically, we show that optimal policy exhibits switch points over time, and that the paths to coexistence equilibria exhibit spirals, suggesting that coexistence equilibria are never the end points of optimal paths
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