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.     

乳头腺管口挑拨治疗急性乳腺炎32例

0　引言　急性乳腺炎是产后妇女的常见病 .我们采用针头挑拨治疗急性乳腺炎 32例 ,疗效显著 .1　临床资料　患者 32例 ,年龄 2 3～ 34 (平均 2 5 .3)岁 ,均为产后哺乳产妇 .其中患乳胀痛为共有症状 .伴发热 10例 ;右侧乳腺炎 14例 ,左侧乳腺炎 16例 ,双侧乳腺炎 2例 ;外上象限胀痛 6例 ,外下象限胀痛 8例 ,内上象限胀痛 7例 ,内下象限胀痛 6例 ,二象限同时胀痛 5例 .乳头均无破损 .患者取卧位 ,显露患乳 ,乳头以碘伏严密消毒后 ,术者持五号针头以指腹常规触诊患乳 ,触摸到肿胀部位后 ,沿乳腺管走行方向找到对应的乳头腺管口 ,以针尖轻轻挑拨…     

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.     

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".     

Dosimeter for oxides of nitrogen.

A simple, lightweight, prototype dosimeter, based on wet chemical principles, has been developed for personal monitoring of NO2. A simple modification provides for the determination of NOx. This device requires no auxiliary equipment and is intrinsically safe for use in coal mines. In use, NO2 permeates a membrane and is absorbed in acidic aqueous solution containing hydrogen peroxide. The latter oxidizes NO2 to nitrate. When a total NOx determination is required, an oxidizing prefilter converts NO to NO2 prior to conversion to nitrate in solution. The NO3--is determined in the laboratory with a specific ion electrode. The NO2 or NOx is determined from the NO3--found with reasonably good precision and accuracy. Caution should be exercised when using a dosimeter to determine compounds having a "C" value. These devices will not indicate an excursion concentration existing during a limited time. Effects due to dosimeter orientation, liquid evaporation, and temperature (above 15 degrees) were insignificant. Prior to field testing, it would be desirable to conduct more extensive laboratory tests. The entire TLV range of NO (up to 25 ppm) should be covered, and exposure of the dosimeters to known mixtures of NO and NO2 should be evaluated. Tests against specific interferences should also be performed.