1 October 2008 , Number 11

Nuclear, biological or chemical weapons and acts of terror may make the headlines, but it is conventional arms that take the lives in large numbers; maybe around a thousand a day. This month, a United Nations committee will try to find a way to limit the arms trade with a new treaty. For those facing the barrel of a gun, it cannot come a moment too soon.

Invitation Only Research Event

Event participants

Laurence Broers, Associate Fellow, Russia and Eurasia Programme, Chatham House
Chair: Lubica Pollakova, Senior Programme Manager, Russia and Eurasia Programme

MOSCOW (AP): United States (US) President Donald Trump and Russian President Vladimir Putin discussed progress in combating the coronavirus pandemic, along with arms-control issues and oil prices, in a phone call Thursday, the White House and the...

Abdominal aortic aneurysms (AAA) are usually asymptomatic until they rupture, which is fatal in more than 80% of cases. Screening aims to detect the aneurysm before it ruptures, enabling preventive surgery and hence reducing morbidity and mortality. However, preventive surgery has a mortality of 3.9-4.5%. As the prevalence of risk factors, ie...

Doctors considering strike action may worry about the effect on patients. David Metcalfe and colleagues examine the evidence and find that “patients do not come to serious harm during industrial action provided that provisions are made for emergency care.” Read the full analysis: http://www.bmj.com/content/351/bmj.h6231

Providing information to enable informed choices about healthcare sounds immediately appealing to most of us. But Minna Johansson, GP trainee and PhD student at the University of Gothenburg, argues that preventive medicine and expanding disease definitions have changed the ethical premises of informed choice and our good intentions may...

You’ll have read in a clinical trial “Most patients had an acceptable adverse-event profile.” Or that a drug “has a manageable and mostly reversible safety profile.” And that “the tolerability was good overall.” In this podcast, Bishal Gyawali (@oncology_bg) joins us to describe what events those terms were actually describing in cancer drug...

Welcome back to Talk Evidence - where Helen Macdonald and Carl Heneghan take you through what's happening in the world of Evidence. This month we'll be discussing tramadol being prescripted postoperatively, and a new EBM verdict says that should change(1.36). How much preventable harm does healthcare causes (11.20. A canadian project to help...

In this special edition of talk evidence, Helen Macdonald and Carl Henneghan talk about creating an evidence base from harms. We hear from a member of the pubic who experienced harm from a drug, and now advises the FDA. A former regulator who explains why reporting harms is so important. And finally, an investigative journalist who explains what...

Thomas A. Buchanan
Sep 1, 2002; 51:2796-2803
Pathophysiology

Long-term hyperglycemia in patients with diabetes leads to human serum albumin (HSA) glycation, which may impair HSA function as a transport protein and affect the therapeutic efficacy of anticoagulants in patients with diabetes. In this study, a novel mass spectrometry approach was developed to reveal the differences in the profiles of HSA glycation sites between patients with diabetes and healthy subjects. K199 was the glycation site most significantly changed in patients with diabetes, contributing to different interactions of glycated HSA and normal HSA with two types of anticoagulant drugs, heparin and warfarin. An in vitro experiment showed that the binding affinity to warfarin became stronger when HSA was glycated, while HSA binding to heparin was not significantly influenced by glycation. A pharmacokinetic study showed a decreased level of free warfarin in the plasma of diabetic rats. A preliminary retrospective clinical study also revealed that there was a statistically significant difference in the anticoagulant efficacy between patients with diabetes and patients without diabetes who had been treated with warfarin. Our work suggests that larger studies are needed to provide additional specific guidance for patients with diabetes when they are administered anticoagulant drugs or drugs for treating other chronic diseases.

St Petersburg is undoubtedly one of the most picturesque cities in the world – from its European-inspired architecture, its signature colourful, eclectic-style to its neoclassical and Baroque style to its water corridors, and the art, the city is a...

Current therapeutic strategies for diabetic foot ulcer (DFU) have focused on developing topical healing agents, but few agents have controlled prospective data to support their effectiveness in promoting wound healing. We tested a stem cell mobilizing therapy for DFU using a combination of AMD3100 and low-dose FK506 (tacrolimus) (AF) in streptozocin-induced type 1 diabetic (T1DM) rats and type 2 diabetic Goto-Kakizaki (GK) rats that had developed peripheral artery disease and neuropathy. Here, we show that the time for healing back wounds in T1DM rats was reduced from 27 to 19 days, and the foot wound healing time was reduced from 25 to 20 days by treatment with AF (subcutaneously, every other day). Similarly, in GK rats treated with AF, the healing time on back wounds was reduced from 26 to 21 days. Further, this shortened healing time was accompanied by reduced scar and by regeneration of hair follicles. We found that AF therapy mobilized and recruited bone marrow–derived CD133⁺ and CD34⁺ endothelial progenitor cells and Ym1/2⁺ M2 macrophages into the wound sites, associated with enhanced capillary and hair follicle neogenesis. Moreover, AF therapy improved microcirculation in diabetic and neuropathic feet in GK rats. This study provides a novel systemic therapy for healing DFU.

Immunotherapy is becoming the mainstay for treatment of a variety of malignancies, but only a subset of patients responds to treatment. Tumor-infiltrating CD8-positive (CD8+) T lymphocytes play a central role in antitumor immune responses. Noninvasive imaging of CD8+ T cells may provide new insights into the mechanisms of immunotherapy and potentially predict treatment response. We are studying the safety and utility of ⁸⁹Zr-IAB22M2C, a radiolabeled minibody against CD8+ T cells, for targeted imaging of CD8+ T cells in patients with cancer. Methods: The initial dose escalation phase of this first-in-humans prospective study included 6 patients (melanoma, 1; lung, 4; hepatocellular carcinoma, 1). Patients received approximately 111 MBq (3 mCi) of ⁸⁹Zr-IAB22M2C (at minibody mass doses of 0.2, 0.5, 1.0, 1.5, 5, or 10 mg) as a single dose, followed by PET/CT scans at approximately 1–2, 6–8, 24, 48, and 96–144 h after injection. Biodistribution in normal organs, lymph nodes, and lesions was evaluated. In addition, serum samples were obtained at approximately 5, 30, and 60 min and later at the times of imaging. Patients were monitored for safety during infusion and up to the last imaging time point. Results: ⁸⁹Zr-IAB22M2C infusion was well tolerated, with no immediate or delayed side effects observed after injection. Serum clearance was typically biexponential and dependent on the mass of minibody administered. Areas under the serum time–activity curve, normalized to administered activity, ranged from 1.3 h/L for 0.2 mg to 8.9 h/L for 10 mg. Biodistribution was dependent on the minibody mass administered. The highest uptake was always in spleen, followed by bone marrow. Liver uptake was more pronounced with higher minibody masses. Kidney uptake was typically low. Prominent uptake was seen in multiple normal lymph nodes as early as 2 h after injection, peaking by 24–48 h after injection. Uptake in tumor lesions was seen on imaging as early as 2 h after injection, with most ⁸⁹Zr-IAB22M2C–positive lesions detectable by 24 h. Lesions were visualized early in patients receiving treatment, with SUV ranging from 5.85 to 22.8 in 6 target lesions. Conclusion: ⁸⁹Zr-IAB22M2C imaging is safe and has favorable kinetics for early imaging. Biodistribution suggests successful targeting of CD8+ T-cell–rich tissues. The observed targeting of tumor lesions suggests this may be informative for CD8+ T-cell accumulation within tumors. Further evaluation is under way.

A discussion featuring data on immigration trends and the agricultural workforce, and some of the adjustments that farm employers are making, including increased mechanization, improved wages and benefits, and the increased use of the H-2A program. University of California-Davis’s Phil Martin, along with researchers from the the U.S. Department of Agriculture, U.S. Department of Labor, present their findings on the foreign agricultural workforce in the United States, which is followed by comments from the President of Farmworker Justice on some of the policy implications.

The Armenian diaspora, which significantly exceeds the country's resident population, has played an instrumental role in Armenia's political and economic development since independence in 1991. Yet a picture emerges of divergent currents within the diaspora, often seen from above as a unified entity. Delve into differences in engagement among Armenia's "old" and "new" diasporas with this feature article.

Amid aging populations and the growth of chronic diseases, the demand for skilled health-care professionals is on the rise in the United States, Canada, and Mexico. This report explores the policy implications, benefits, and challenges of harmonizing nursing qualifications in the region, suggesting that a more collaborative approach could result in greater supply and quality of nurses.

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.

An expert discussion on the findings of the National Agricultural Workers Survey (NAWS) related to immigrants, along with an overview of farm labor in 2015 and discussion on how current and possible future immigration policies might impact immigrant workers in the agricultural sector.

As the source of dental procedure codes, the ADA has created a new online training course to ensure that dentists and their team members confidently understand CDT codes and how to use them correctly.

Gujarat university, second MBBS examination, pharmacology question papers (2010-2014)

Gujarat university, second MBBS examination, pharmacology question papers, January 2015

MD pharmacology examination, question papers, Gujarat university, April 2012

MD pharmacology examination, question papers, Gujarat university, October 2012

MD pharmacology examination, question papers, Gujarat university, April 2013

A new scientific study published Monday found that global warming is fueling a destructive algal bloom that is disrupting fisheries in the Arabian sea.

Intensive farming, characterized by the overuse of antibiotics, large numbers of animals and limited genetic diversity, increases the odds of animal pathogens making the jump to humans and triggering an epidemic.

As the tropics get wetter, soils are likely experience greater rates of respiration and decomposition, limiting the carbon storage abilities of tropical soils and intensifying global warming.

A discussion featuring data on immigration trends and farm labor that could help inform future reform debates, including what adjustments farm employers are making, including increased mechanization, improved wages and benefits, and the increased use of the H-2A program.  

Researchers studying yellow warbler responses to the parasitic cowbird realized that red-winged blackbirds were eavesdropping on the calls and reacting to them, too.

-- Read more on ScientificAmerican.com

Whenever the United States goes to war, pro-war and antiwar advocates immediately reach for different history books. Hawks always equate the situation to a Hitler-Chamberlain standoff to show why hesitation can be fatal. Doves invariably pull the Vietnam War off the shelf to argue that plunging...

It's rare for me to cook fresh figs as I think there is little that can better a squishy-ripe, jammy fig eaten just as is. However just sometimes when they are cheap (well, relatively speaking!) and plentiful, I make this dish; it makes a lovely, simple summer dessert. The thing to be mindful of when you're buying figs, is that they're often picked when they're under-ripe as they're easier to handle and store, however if they're like this they're rarely worth eating; look for figs that feel softly squishy when you gently cup them in your hand, and ideally have tiny splits in the tender flesh...your care will pay off in spades.

A vegetarian dish with a tasty side salad

Cold damp weather prompts all manner of mushrooms and fungi to emerge from the forest floor. Having neighbours willing to share their regular harvest of field mushrooms is one of the many great privileges of living in the Southern Forests. However, this hearty winter soup can be equally delicious when made with cultivated mushrooms easily purchased from supermarkets and independent grocers.

Delicious summer tuna dish.

The local lady finger bananas are so sweet and moorish!

4 x 150 x g of pork loin steaks as your butcher to cut 3 x cup (210 g) Panko Breadcrumbs (Japanese bread crumb) 1/2 cup (80g) Plain flour Chopped flat leaf parsley, thyme, rosemary 2 Eggs, lightly beaten 1/2cup (80g) finely grated Parmesan CABBAGE SLAW 500 grams of Cabbage finely shredded Squeezed of Lemon juice 1/4 cup (60 ml) quality cider vinegar add to taste. May need less. 2 Tablespoon of Macadamia Oil 1 Tablespoon chop parsley Aioli just a little bit to bind Sea salt and cracked pepper 100 ml Macadamia oil for cooking 4 juicy lemon wedges to squeeze over Pork

Here's a healthy, rich and super tasty teff pudding for a stylish breakfast, brunch or anytime snack.

David Willens
Apr 1, 2011; 29:60-68
Feature Articles

Farmers keep us fed and our economies stable, but in the US they're retiring faster than they're being replaced. Take a crash course in agricultural policy with Eric Sannerud to see why this problem can't be solved by simply buying from your local farmer's market -- and learn how you can use your vote to create a better future for farmers.

By Jesse Singal. Study fails to replicate 2011 result, suggesting that word choice matters less as issue has become more politicised.

An Ohio appellate court struck down a district's policy allowing staff members to carry concealed weapons in school with 24 hours of "active shooter/killer training."

Lawmakers in Michigan, Mississippi, North Dakota, and Utah have all gave previews this to their 2018 fiscal year budget proposals.

Tennessee improved its teacher evaluation and training systems by integrating data and teacher voice, according to a new report. But value-added measures that evaluate teachers based on student test scores remain controversial.

Hawaii's schools are prepared to respond to ballistic missile threats, education officials wrote in a letter to parents after Saturday's false alarm.

Arming some school staff provides a needed safety option for rural districts far from law enforcement, educators told the Federal School Safety Commission during an Arkansas site visit Wednesday.

The Eugene, Ore., superintendent has led the district since 2015 and has emphasized diverse leadership, improved school facilities, and support services for newly arrived immigrant students and their families.