PROMISE: Working with the CF community to understand emerging clinical and research needs for those treated with highly effective CFTR modulator therapy

Highly effective CFTR modulator drug therapy is increasingly available to those with cystic fibrosis. Multiple observational research studies are now being conducted to better understand the impacts of this important therapeutic milestone on long-term outcomes, patient care needs, and future research priorities. PROMISE is a large, multi-disciplinary academic study focused on the broad impacts of starting elexacaftor/tezacaftor/ivacaftor in the US population age 6 years and older. The many areas of investigation and rationale for each are discussed by organ systems, along with recognition of remaining important questions that will not be addressed by this study alone. Knowledge gained through this and multiple complementary studies around the world will help to understand important health outcomes, clinical care priorities, and research needs for a large majority of people treated with these or similarly effective medications targeting the primary cellular impairment in cystic fibrosis.     

Tomography versus computed tomography for assessing step off in intraarticular distal radial fractures

Computed tomography scans have supplanted conventional tomography for many applications and often are considered the imaging study of choice for assessing intraarticular distal radial fractures. Concern about cost containment in healthcare delivery prompts the question of whether the two studies provide comparable information and at what cost. Common intraarticular distal radial fractures were created in 12 lightly embalmed cadaveric specimens. The fractures were fixed with radiolucent Kirschner wires. Articular step off was measured with a caliper. Plain radiographs, computed tomography scans, and trispiral tomograms were obtained of each specimen. Maximal step off was measured blindly by two musculoskeletal radiologists and four hand surgeons. The radiographic measurements were compared with the actual step off and expressed as a positive or negative deviation from the actual value. There was no statistically significant difference between computed tomography scans and tomograms in predicting step off. In addition, the difference between actual and radiographic measurements was insignificant in tomogram readings and different in one of the computed tomography measurements. In the authors' institution, a tomogram costs $200, and a computed tomography scan costs $562. Trispiral tomography is more accurate and cost effective than computed tomography, and thus when available should be considered the imaging modality of choice for assessing articular step off in distal radius fractures.     

Tumor antigenicity and the immune system in gynecological cancer: a review

A review of tumor immunology with particular emphasis on three gynecological malignancies, gestational trophoblastic disease, uterine cervical carcinoma, and ovarian carcinoma. Commentary includes the immune reactive cells and their functions as determined by in vitro and in vivo tests; serum and tissue antigen markers; and effects on the immune response of ionizing radiation, surgery, and chemotherapy.     

Nutrition research in the People's Republic of China

According to Mellander (1973), childhood malnutrition has been eliminated in the People's Republic of China, without recourse to international conferences, unusual protein sources, systems analysis, and apparently no applied nutrition programmes. The secret? "A genuine family level approach, providing simple food and simple advise to all families on a basis of absolute administrative priority for prevention in health services and in medical and paramedical education".