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ATLS updates

Stefania Fochi, Simona Mutascio, Umberto Bertazzoni, Donato Zipeto, Maria G Romanelli
Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent of adult T-cell leukemia (ATL), an aggressive CD4+ /CD25+ T-cell malignancy and of a severe neurodegenerative disease, HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). The chronic activation or deregulation of the canonical and non-canonical nuclear factor kappa B (NF-κB) pathways play a crucial role in tumorigenesis. The HTLV-1 Tax-1 oncoprotein is a potent activator of the NF-κB transcription factors and the NF-κB response is required for promoting the development of HTLV-1 transformed cell lines...
2018: Frontiers in Microbiology
C Güsgen, A Franke, S Hentsch, E Kollig, R Schwab
The incidence of terrorist attacks is increasing worldwide, and they have also become a permanent threat in European cities. Due to its complexity, terrorist attack trauma places high demands on the strategy of surgical treatment. The combination of various mechanisms, explosions and gunshot injuries, with the characteristic pressure (blast) damage and a high proportion of penetrating trauma with simultaneous burns are characteristic features. Unlike in military conflicts, injuries to people of all ages and without ballistic body protection (body armor) are to be expected...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Takashi Ishida, Atae Utsunomiya, Tatsuro Jo, Kazuhito Yamamoto, Koji Kato, Shinichiro Yoshida, Shigeki Takemoto, Hitoshi Suzushima, Yukio Kobayashi, Yoshitaka Imaizumi, Kenichi Yoshimura, Kouichi Kawamura, Takeshi Takahashi, Kensei Tobinai, Ryuzo Ueda
The present study sought to elucidate the prognosis of adult T-cell leukemia-lymphoma (ATL) patients receiving mogamulizumab, a defucosylated anti-CCR4 monoclonal antibody. Progression-free survival (PFS) and overall survival (OS) of ATL patients enrolled in two studies are herein updated, namely NCT00355472 (phase I study of mogamulizumab in relapsed patients with ATL and peripheral T-cell lymphoma) and NCT00920790 (phase II study for relapsed ATL). Of 13 patients with relapsed aggressive ATL in the phase I study, four (31%) survived >3 years...
October 2017: Cancer Science
Bahman Akbari, Safar Farajnia, Shiva Ahdi Khosroshahi, Fatemeh Safari, Mohammadreza Yousefi, Hassan Dariushnejad, Leila Rahbarnia
Immunotoxins are a novel class of cancer therapeutics that contains a cytotoxic agent fused to a targeting moiety. Various toxic agents from different sources are used in immunotoxin development, including bacterial, plant and human origin cytotoxic elements. Although bacterial and plant-derived toxins are highly toxic and commonly used in immunotoxins, their immunogenicity for human restricted their application in cancer therapy. Here, we discuss the advantages and limitations of bacterial toxins such as Pseudomonas and Diphtheria toxins, plant toxins such as ricin and gelonin, and some endogenous protein of human origin such as RNases and Granzymes...
July 4, 2017: International Reviews of Immunology
Trygve Skonnord, Finn Steen, Holgeir Skjeie, Arne Fetveit, Mette Brekke, Atle Klovning
BACKGROUND: Electronic questionnaires can ease data collection in randomized controlled trials (RCTs) in clinical practice. We found no existing software that could automate the sending of emails to participants enrolled into an RCT at different study participant inclusion time points. OBJECTIVE: Our aim was to develop suitable software to facilitate data collection in an ongoing multicenter RCT of low back pain (the Acuback study). For the Acuback study, we determined that we would need to send a total of 5130 emails to 270 patients recruited at different centers and at 19 different time points...
November 22, 2016: Journal of Medical Internet Research
Shigeo Fuji, Takero Shindo
Adult T-cell leukemia/lymphoma (ATL/ATLL) is a peripheral T-cell neoplasm associated with human T-lymphotropic virus type-1 (HTLV-1). Even the currently most intensive chemotherapy regimen modified LSG15 (mLSG15, VCAP-AMP-VECP) results in a dismal clinical outcome, with a median overall survival of only around 1 year. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) may lead to long-term remission in a proportion of patients with aggressive ATL, the clinical outcome in patients with refractory or relapsed ATL is unsatisfactory...
2016: Stem Cell Investigation
Tor Atle Rosness, Knut Engedal, Zeina Chemali
Today, frontotemporal dementia (FTD) remains one of the most common forms of early-onset dementia, that is, before the age of 65, thus posing several diagnostic challenges to clinicians since symptoms are often mistaken for psychiatric or neurological diseases causing a delay in correct diagnosis, and the majority of patients with FTD present with symptoms at ages between 50 and 60. Genetic components are established risk factors for FTD, but the influence of lifestyle, comorbidity, and environmental factors on the risk of FTD is still unclear...
September 2016: Journal of Geriatric Psychiatry and Neurology
Jessica L Martin, José O Maldonado, Joachim D Mueller, Wei Zhang, Louis M Mansky
Human T-cell leukemia virus type 1 (HTLV-1) was the first human retrovirus discovered. Studies on HTLV-1 have been instrumental for our understanding of the molecular pathology of virus-induced cancers. HTLV-1 is the etiological agent of an adult T-cell leukemia (ATL) and can lead to a variety of neurological pathologies, including HTLV-1-associated-myelopathy/tropical spastic paraparesis (HAM/TSP). The ability to treat the aggressive ATL subtypes remains inadequate. HTLV-1 replicates by (1) an infectious cycle involving virus budding and infection of new permissive target cells and (2) mitotic division of cells harboring an integrated provirus...
January 27, 2016: Viruses
Jacqueline Bustraan, Walter Henny, John B Kortbeek, Karen J Brasel, Marzellus Hofmann, Inger B Schipper
BACKGROUND: In Advanced Trauma Life Support (ATLS©) courses, multiple choice question (MCQ) tests are used to assess student's post course knowledge. As part of the ninth Edition Revision Process, existing MCQ tests were reviewed and revised by an International MCQ Revision group. The aim of this study was to evaluate the revision procedure and its effects. METHODS: Based on psychometric data and evidence based guidelines for adequate MCQ item and test development, a detailed stepwise approach was determined and followed to evaluate the existing MCQs, and to guide test item revision or replacement...
March 2016: Injury
B Donaubauer, J Fakler, A Gries, U X Kaisers, C Josten, M Bernhard
BACKGROUND: The recommendations still have to be implemented 3 years after publication of the S3 guidelines on the treatment of patients with severe and multiple injuries. AIM: This article reiterates some of the essential core statements of the S3 guidelines and also gives an overview of new scientific studies. MATERIAL AND METHODS: In a selective literature search new studies on airway management, traumatic cardiac arrest, shock classification, coagulation therapy, whole-body computed tomography, air rescue and trauma centers were identified and are discussed in the light of the S3 guideline recommendations...
November 2014: Der Anaesthesist
B Bouillon, C Probst, M Maegele, A Wafaisade, P Helm, M Mutschler, T Brockamp, S Shafizadeh, T Paffrath
Trauma management in the emergency room is an important part of the treatment chain of the severely injured. Important decisions with respect to diagnostics and treatment must be made under time pressure. Successful trauma management in the emergency room requires a hospital tailored treatment protocol. This written protocol needs consent from all participating disciplines and must be known by all members of the resuscitation team. The ATLS® and the recently published clinical practice guidelines on multiple trauma can be of help in order to establish or update such protocols...
September 2013: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Ahmad R Al-Haifi, Mohammad A Al-Fayez, Buthaina I Al-Athari, Fahhad A Al-Ajmi, Ahmad R Allafi, Hazzaa M Al-Hazzaa, Abdulrahman O Musaiger
BACKGROUND: The increasing rate of obesity among Kuwaiti adolescents is associated with immediate and long term-risks to their health and well-being. OBJECTIVE: To update data on the prevalence of overweight and obesity among Kuwaiti adolescents and to examine the relative contribution of selected lifestyle factors to overweight and obesity in this population. METHODS: The present study is part of the Arab Teens Lifestyle Study (ATLS). A total of 906 adolescents (463 boys and 443 girls) aged between 14 and 19 years were selected from Kuwaiti schools by a multistage stratified randomization process...
March 2013: Food and Nutrition Bulletin
Regina Kunz, Atle Fretheim, Françoise Cluzeau, Timothy J Wilt, Amir Qaseem, Monika Lelgemann, Marcia Kelson, Gordon Guyatt, Holger J Schünemann
BACKGROUND: Professional societies, like many other organizations around the world, have recognized the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the third of a series of 14 articles that were prepared to advise guideline developers in respiratory and other diseases on considerations for group compositions and group processes in guideline development, and how this can be effectively integrated in the context of respiratory disease guidelines on a national and international level...
December 2012: Proceedings of the American Thoracic Society
Sigbjørn Tveterås, Frank Asche, Marc F Bellemare, Martin D Smith, Atle G Guttormsen, Audun Lem, Kristin Lien, Stefania Vannuccini
World food prices hit an all-time high in February 2011 and are still almost two and a half times those of 2000. Although three billion people worldwide use seafood as a key source of animal protein, the Food and Agriculture Organization (FAO) of the United Nations-which compiles prices for other major food categories-has not tracked seafood prices. We fill this gap by developing an index of global seafood prices that can help to understand food crises and may assist in averting them. The fish price index (FPI) relies on trade statistics because seafood is heavily traded internationally, exposing non-traded seafood to price competition from imports and exports...
2012: PloS One
Sophie Witter, Atle Fretheim, Flora L Kessy, Anne Karin Lindahl
BACKGROUND: There is a growing interest in paying for performance as a means to align the incentives of health workers and health providers with public health goals. However, there is currently a lack of rigorous evidence on the effectiveness of these strategies in improving health care and health, particularly in low- and middle-income countries. Moreover, paying for performance is a complex intervention with uncertain benefits and potential harms. A review of evidence on effectiveness is therefore timely, especially as this is an area of growing interest for funders and governments...
2012: Cochrane Database of Systematic Reviews
Robert Pajdo, Tomasz Brzozowski, Aleksandra Szlachcic, Peter C Konturek, Agata Ptak-Belowska, Danuta Drozdowicz, Aneta Targosz, Stanislaw J Konturek, Wieslaw W Pawlik
Previous studies revealed that prostaglandins contribute to the mechanism of maintenance of gastrointestinal integrity and mediate various physiological aspects of mucosal defense. The suppression of prostaglandin synthesis in the stomach is a critical event in terms of the development of mucosal injury after administration of various NSAID including aspirin (ASA). A worldwide use of ASA is now accepted due to its remarkable analgesic, antipyretic and anti-thrombotic prophylactics against myocardial infarct and coronary disorders despite the fact that the use of NSAIDs is associated with the risk of gastrointestinal bleedings, haemorrhagic lesions and ulcerations...
2011: Current Pharmaceutical Design
C G Wölfl, B Gliwitzky, A Wentzensen
INTRODUCTION: Standardised management improves treatment results in seriously injured patients. For conditions like stroke or acute coronary syndrome (ACS) there are set treatment pathways which have been established for prehospital and primary hospital care. The treatment of critical trauma patients, however, follows varying procedures in both the prehospital and primary hospital phases. From an analysis of the trauma register of the German Society for Trauma Surgery (DGU), we know that a seriously injured patient remains on the road for 70 min on average before transferral to hospital...
October 2009: Der Unfallchirurg
Sudha Jayaraman, Dinesh Sethi
BACKGROUND: Injury is responsible for an increasing global burden of death and disability. As a result, new models of trauma care have been developed. Many of these, though initially developed in high-income countries (HICs), are now being adopted in low and middle-income countries (LMICs). One such trauma care model is advanced trauma life support (ATLS) training in hospitals, which is being promoted in LMICs as a strategy for improving outcomes for victims of trauma. The impact of this health service intervention, however, has not been rigorously tested by means of a systematic review in either HIC or LMIC settings...
2009: Cochrane Database of Systematic Reviews
Michael A Albert, Atle Fretheim, Diadié Maïga
BACKGROUND: Research findings are increasingly being recognized as an important input in the formation of health policy. There is concern that research findings are not being utilized by health policy-makers to the extent that they could be. The factors influencing the utilization of various types of research by health policy-makers are beginning to emerge in the literature, however there is still little known about these factors in developing countries. The object of this study was to explore these factors by examining the policy-making process for a pharmaceutical policy common in developing countries; an essential medicines list...
March 5, 2007: Health Research Policy and Systems
Andrew D Oxman, Holger J Schünemann, Atle Fretheim
BACKGROUND: The World Health Organization (WHO), like many other organisations around the world, has recognised the need to use more rigorous processes to ensure that health care recommendations are informed by the best available research evidence. This is the last of a series of 16 reviews that have been prepared as background for advice from the WHO Advisory Committee on Health Research to WHO on how to achieve this. OBJECTIVES: We reviewed the literature on evaluating guidelines and recommendations, including their quality, whether they are likely to be up-to-date, and their implementation...
December 8, 2006: Health Research Policy and Systems
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