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Petalas K.,Clinical Force
Rhinology | Year: 2013

Allergic rhinitis, a risk factor for bronchial asthma, is a global health problem that impairs patients` physical and social activity and consequently their quality of life. Specific Immunotherapy (SIT) involves the administration, subcutaneously or sublingually, of increasing doses of the causative allergen, in order to induce clinical and immunologic tolerance. SIT has been shown to be effective in those with a poor response to conventional drug therapy. Immunotherapy has been shown to have disease-modifying effects and result in long term remission of allergic symptoms and reduces the risk of progression from rhinitis to asthma, as well as the chances of developing new sensitizations to allergens. Injection immunotherapy is a safe treatment for allergic rhinitis with/without mild controlled asthma, provided that it is performed in the context of a harmonious interaction between trained medical personnel and appropriately selected patients. Immunotherapy suppresses early and late responses to allergen exposure by modifying both T-cell and B-cell responses to inhaled allergens. Immune deviation of allergen-specific T cell responses in favour of Th1 and/or the induction of regulatory T cells is crucial in achieving immune tolerance. Increased understanding of the mechanisms of immunotherapy has identified potential biomarkers of the response to treatment and highlighted new therapeutic pathways with potential for even more effective future standardized vaccines. Source


Bashore T.M.,The American College | Barac A.,The American College | Byrne J.G.,Society of Thoracic Surgeons Representative | Cavendish J.J.,The American College | And 12 more authors.
Journal of the American College of Cardiology | Year: 2012

The last expert consensus document on cardiac catheterization laboratory standards was published in 2001 (1). Since then, many changes have occurred as the setting has evolved from being primarily diagnostic based into a therapeutic environment. Technology has changed both the imaging and reporting systems. The lower risk of invasive procedures has seen the expansion of cardiac catheterization laboratories to sites without onsite cardiovascular surgery backup and even to community hospitals where primary percutaneous coronary intervention (PCI) is now being performed. This has increased the importance of quality assurance (QA) and quality improvement (QI) initiatives. At the same time, the laboratory has become a multipurpose suite with both diagnostic procedures to investigate pulmonary hypertension and coronary flow and with therapeutic procedures that now include intervention into the cerebral and peripheral vascular systems as well as in structural heart disease. These new procedures have impacted both the adult and pediatric catheterization laboratories. The approaches now available allow for the treatment of even very complex heart disease and have led to the development of hybrid cardiac catheterization laboratories where a team of physicians (including invasive cardiologists, cardiovascular surgeons, noninvasive cardiologists, and anesthesiologists) is required. © 2012 by the American College of Cardiology Foundation. Source


Moghissi E.S.,Clinical Force | Moghissi E.S.,University of California at Los Angeles
American Journal of Health-System Pharmacy | Year: 2010

Purpose. To review the risks of hyperglycemia in hospitalized patients, data supporting the benefits of treating hyperglycemia, and recommendations from the 2009 American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on the management of inpatient hyperglycemia. Summary. Inpatient hyperglycemia is common, costly, and associated with poor clinical outcomes in many disease states. Despite inconsistencies in clinical trial results, good glucose management in the hospital remains important. Target blood glucose concentrations (BGs) were recently modified to somewhat higher values with the expectation that the benefit of treatment will persist with a lower risk of hypoglycemia, which is itself another marker of poor outcome in critically and noncritically ill patients. In the intensive care unit (ICU), the threshold to start treatment is a BG of ≤180 mg/dL. I.V. insulin is the treatment of choice in critically ill patients because of its rapid onset and offset of action. Once i.v. insulin is started, the BG should be maintained between 140 and 180 mg/dL; a lower BG target (110-140 mg/dL) may be appropriate in selected patients. Targets of <110 mg/dL or >180 mg/dL are no longer recommended. In noncritically ill patients, premeal BG targets are <140 mg/dL; random BGs of <180 mg/dL are recommended. Scheduled subcutaneous insulin is the treatment of choice for hyperglycemia in noncritically ill patients; use of sliding-scale insulin is strongly discouraged. To avoid hypoglycemia, insulin regimens should be reassessed if BG falls to <100 mg/dL. Conclusion. Poor glycemic control in the hospital setting is a quality-of-care, safety, and cost issue. Safe and effective strategies to implement optimal glycemic control require multidisciplinary involvement. Insulin given i.v. in the ICU or subcutaneously on an as-scheduled regimen in other parts of the hospital is the treatment of choice. Copyright © 2010, American Society of Health-System Pharmacists, Inc. All rights reserved. Source


Ma Y.L.,Clinical Force
Zhongguo shi yan xue ye xue za zhi / Zhongguo bing li sheng li xue hui = Journal of experimental hematology / Chinese Association of Pathophysiology | Year: 2010

The aim of this study was to investigate the effect of Celastrol on induction of HL-60 cell apoptosis and its possible mechanism. The proliferative activity of HL-60 cells treated with 0.25 - 8.0 μmol/L of Celastrol for 24 - 72 hours was assayed by MTT method, the effects of Celastrol on apoptosis and cell cycle of HL-60 were detected by TUNEL staining and flow cytometry with Annexin V-FITC/PI double labeling, the expression of pAkt and cyclin D1 at protein and gene level in HL-60 cells treated with Celastrol were measured by Western blot and RT-PCR. The results showed that the Celastrol could obviously inhibit the proliferation of HL-60 cells in concentration-and time-dependent manners, the IC value of Celastrol for 24 hours was 6.21 ± 0.242 μmol/L. The Celastrol concentration-dependently induced the apoptosis of HL-60 cells, accompanying with morphological changes of apoptotic cells, which may be related with arrest of cells in G/G phase. The Celastrol suppressed the expression of pAkt and Cyclin D1 in HL-60 cells to a varying degree which showed obvious concentration-and time-dependent manners. It is concluded that the Celastrol inhibits the proliferation and induced the apoptosis of HL-60 cells. Its mechanism may be related with down-regulation of p-Act and cyclin D1 expressions. Source


Zhang M.-H.,Clinical Force
Chinese Journal of Cerebrovascular Diseases | Year: 2014

Objective: To analyze the changes of plasma phosphorylated a-synuclein (α-Syn) level and α-Syn phosphorylation rate in patients with ischemic stroke. Methods: The clinical data of 45 patients with acute stroke admitted to the Department of Neurology, the Affiliated Hospital of Logistics University of People's Armed Force Police from May 2013 to September 2013 were analyzed retrospectively, and the age and sex matched 45 healthy subjects were recruited as a control group at the same time. The plasma phosphorylated α-Syn level was measured by a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) .besides, the gene-recombinated α-Syn was added into plasma, and the phosphorylated α-Syn accounting for the total ratio of α-Syn was calculated. Results: The plasma phosphorylated α-Syn level of patients with ischemic stroke was significantly higher than that of the control group (0.0472 ±0.0042 μmol/L vs.0.0312 ±0.0043 μmol/L). The plasma α-Syn phosphorylation rate of patients with ischemic stroke was higher than that of the control group (0.1170 ± 0.0176 vs. 0.0364 ± 0.0098 μmol/(100 μmol · h). Receiver operating characteristic (ROC) curve analysis showed that the specificity and sensitivity of the plasma phosphorylated a-Syn concentration changes in determining ischemic stroke were 0.88 and 0.81 respectively. The area under curve (AUC) was 0.91 and the cut-off value was 0.060 mol/L;AUC 95% confidence interval (CI) was 0.889 to 0.961 ; the specificity and sensitivity of the plasma α-Syn phosphorylation rate changes in determining ischemic stroke were 0.84 and 0.81 respectively, AUC was 0.90 and the cut-off value was 0.055 mol/L; AUC 95% CI was 0.898 to 0.971. Conclusion: The plasma phosphorylated α-Syn level and plasma α-Syn phosphorylation rate in patients with ischemic stroke were higher than those of the normal control group. Copyright 2014 by the Chinese Medical Doctor Association. Source

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