Evaluation of intravenous cannula and administration set fixation methods

Intravenous cannula and administration set fixation is crucial for fluid resuscitation and intravenous administration of medications. Because conventional hospital fixations are insufficient for the military field scenario, two consecutive, prospective, randomized, clinical trials were performed in the Israel Defense Forces Medical School, to determine the most effective fixation method in the military arena. Gauze bandage, adhesive bandage, Coban wrap, and plastic wrap fixation methods were tested for field conditions and intravenous fluid flow. The results showed that plastic wrap is the fastest fixation method, withstands field conditions with minimal negative effects on the intravenous fluid flow, and is the most cost-effective.     

Balloon angioplasty of popliteal and crural arteries in elderly with critical chronic limb ischemia

OBJECTIVE: Elderly patients with extensive infrainguinal peripheral vascular disease and critical chronic limb ischemia (CCLI) are poor surgical candidates. Our purpose was to evaluate angiographic and clinical results of popliteal, infrapopliteal, and multi-level disease percutaneous transluminal angioplasty (PTA) in such patients. DESIGN: Retrospective study of angiographic and clinical files in selected group. MATERIALS AND METHODS: Between 1996 and 2002, 38 elderly patients aged 80-94 years old (mean age 83.3) with critical leg ischemia were treated with PTA. All patients were at high surgical risk. 31/38 (81.5%) patients had chronic non-healing wounds, and 14/38 (37%) had multi-level disease of superficial femoral, popliteal and crural arteries. One hundred and two lesions were treated by angioplasty. Immediate angiographic and 1 year clinical results were retrospectively analyzed. RESULTS: The overall procedural success rate was 32/38 (84.2%). There were three major complications (7.9%), but no deaths, and three technical failures, all were of infrapopliteal lesions. After 1 year, 27 patients could be followed, five patients died during the first year of unrelated causes. Twenty-three patients (85.2%), were clinically re-occluded within 1 year, but complete and partial wound healing was achieved in 80% (16/20) and rest pain improvement in 57% (4/7), so that overall limb salvage was 74% (20/27). CONCLUSIONS: Elderly patients with multi-level CCLI have a short patency term following angioplasty of 14.8% after 1 year. Nevertheless, this temporary vascular patency enables wound healing or improvement in 74% of these patients, thus such endovascular interventions are recommended in this age group.     

Therapeutic applications of embryonic stem cells

Embryonic stem (ES) cells have the potential to proliferate indefinitely in culture and can differentiate into any cell type. The emergence of ES cell lines from human embryos in the past 5 years has attracted profound public and scientific interest, given the far-reaching potential applications of these cells in regenerative medicine. In the future, it is possible that human ES (hES) cells might serve as an unlimited source of cells for transplantation therapy under conditions that result from cell degeneration or malfunction, and that genetically manipulated hES cells might serve as vectors to carry and express genes in target organs following transplantation in the course of gene therapy. This chapter reviews the properties of hES cells and their potential advantages and limitations for cell-based therapies. We also describe various approaches that might be utilized with hES cells to avoid potential immune rejection after allogeneic transplantation and hence circumvent the need for systemic immune suppression. Up-to-date research in establishing committed tissue-specific progenitors from ES cells and evidence of their function after transplantation in various animal disease models is also reviewed. The chapter concludes that hES cells show great promise for regenerative medicine although significant developments are still required to exploit their potential for cell and gene therapy.     

Troglitazone attenuates hypoxia-induced injury in cultured term human trophoblasts

OBJECTIVE: The purpose of this study was to test the hypothesis that the thiazolidinedione troglitazone, a peroxisome proliferator activated receptor-gamma ligand, attenuates hypoxia-induced trophoblast injury. STUDY DESIGN: Cytotrophoblasts from 4 term human placentas were cultured in the presence or absence of 10 mumol/L troglitazone in either 20% oxygen (standard conditions) or 1% oxygen (hypoxic conditions) for variable periods before cell harvest. Medium beta-human chorionic gonadotropin and human placental lactogen were analyzed by enzyme-linked immunosorbent assay. Apoptosis was quantified by cytokeratin-18 cleavage products staining; p53 expression was examined by Western blot analysis. RESULTS: beta-human chorionic gonadotropin and human placental lactogen levels were >/=2-fold higher in troglitazone-exposed cells at 16 hours of hypoxia, compared with vehicle control cells ( P <.05). The apoptotic index was reduced by >/=30% ( P <.001), and the expression of p53 was 2-fold lower ( P <.02) in troglitazone-exposed cells under hypoxia for 24 hours of low oxygen. CONCLUSION: Troglitazone attenuates the influence of acute hypoxia on cultured term human trophoblasts.     

Asmarines I, J, and K and nosyberkol: four new compounds from the marine sponge Raspailia sp

Five asmarines, the known A and F and three new ones, I, J, and K, and four diterpenes, the known chelodane, barekoxide, and zaatirin and a new one, nosyberkol, were isolated from the Nosy Be Islands (Madagascar) sponge Raspailia sp. The structures of all these compounds were established on the basis of MS and NMR data. A biogenesis for the various Raspailia sp. diterpenes is suggested.     

AK37: the first pyridoacridine described capable of stabilizing the topoisomerase I cleavable complex

Pyridoacridines are marine natural products that contain planar structures. Almost all are cytotoxic and capable of DNA intercalation. Several pyridoacridines have demonstrated anti-cancer activity, being able to generate reactive oxygen species or to inhibit topoisomerase (Topo) II. Synthetic pyridoacridines were characterized and compared to other pyridoacridines as well as the Topo-inhibiting drugs (etoposide, 9-aminocamptothecin and wakayin) in a series of in vitro enzyme systems. We found AK37 was able to stabilize a DNA-Topo I cleavable complex, but not a DNA-Topo II cleavable complex. To our knowledge, this is the first report of a DNA-Topo I cleavable complex stabilizing pyridoacridine. Structure comparison studies demonstrated that this activity was lost when an extra 'F' ring was added, but activity was not affected when the 'D' ring was removed. AK37 inhibited the catalytic activity of both human Topo I and II.     

Low-Concentration PM2.5 and Mortality: Estimating Acute and Chronic Effects in a Population-Based Study

Background

Both short- and long-term exposures to fine particulate matter (≤ 2.5 μm; PM_2.5) are associated with mortality. However, whether the associations exist at levels below the new U.S. Environmental Protection Agency (EPA) standards (12 μg/m³ of annual average PM_2.5, 35 μg/m³ daily) is unclear. In addition, it is not clear whether results from previous time series studies (fit in larger cities) and cohort studies (fit in convenience samples) are generalizable.

Objectives

We estimated the effects of low-concentration PM_2.5 on mortality.

Methods

High resolution (1 km × 1 km) daily PM_2.5 predictions, derived from satellite aerosol optical depth retrievals, were used. Poisson regressions were applied to a Medicare population (≥ 65 years of age) in New England to simultaneously estimate the acute and chronic effects of exposure to PM_2.5, with mutual adjustment for short- and long-term exposure, as well as for area-based confounders. Models were also restricted to annual concentrations < 10 μg/m³ or daily concentrations < 30 μg/m³.

Results

PM_2.5 was associated with increased mortality. In the study cohort, 2.14% (95% CI: 1.38, 2.89%) and 7.52% (95% CI: 1.95, 13.40%) increases were estimated for each 10-μg/m³ increase in short- (2 day) and long-term (1 year) exposure, respectively. The associations held for analyses restricted to low-concentration PM_2.5 exposure, and the corresponding estimates were 2.14% (95% CI: 1.34, 2.95%) and 9.28% (95% CI: 0.76, 18.52%). Penalized spline models of long-term exposure indicated a larger effect for mortality in association with exposures ≥ 6 μg/m³ versus those < 6 μg/m³. In contrast, the association between short-term exposure and mortality appeared to be linear across the entire exposure distribution.

Conclusions

Using a mutually adjusted model, we estimated significant acute and chronic effects of PM_2.5 exposure below the current U.S. EPA standards. These findings suggest that improving air quality with even lower PM_2.5 than currently allowed by U.S. EPA standards may benefit public health.

Citation

Shi L, Zanobetti A, Kloog I, Coull BA, Koutrakis P, Melly SJ, Schwartz JD. 2016. Low-concentration PM_2.5 and mortality: estimating acute and chronic effects in a population-based study. Environ Health Perspect 124:46–52; http://dx.doi.org/10.1289/ehp.1409111     

Anatomical basis for celiac trunk and superior mesenteric artery entrapment

Forty-six cadaveric specimens were dissected in order to study the anatomical relations between the median arcuate ligament (MAL), the celiac ganglion, and the origin of both the celiac and superior mesenteric arteries. We found that in 40 cases (87.5%) both vessels were held together by the ganglionic mass, and in 90.6%, the celiac trunk was covered, either partially or completely, by the MAL. These data indicated that this is a normal occurrence. In 10% of the cases both vessels were covered by the MAL. These anatomical findings may possibly contribute to the understanding of the socalled “median arcuate ligament syndrome.”