He's Got A Gun!

The aim of the review is to provide up-to-date information on the multiple roles of epidermal keratinocytes in the immune reactions associated with allergic contact dermatitis and atopic dermatitis skin diseases. In the last two decades, it has become clear that keratinocytes are highly active immunological cells, with major control over the acute and the chronic phases of skin inflammation by means of cytokine/chemokine production and surface molecule expression. Keratinocyte responses in skin allergic reactions are rather disease-specific and keratinocytes from genetically determined skin disorders, including atopic dermatitis, show intrinsic abnormalities in their capacity to respond to trigger factors. Lymphokines and cytokines released by T lymphocytes and other immune cells represent the most important stimuli that elicit the inflammatory activation of keratinocytes. Depending on the type and extent of T-cell infiltrate present in allergic contact dermatitis and atopic dermatitis skin lesions, keratinocytes are exposed to different cytokine micromilieu and, in turn, produce flogosis mediators qualitatively and quantitatively specific for each disease. Keratinocyte-derived inflammatory molecules amplificate skin immune responses associated with allergic contact dermatitis and atopic dermatitis, and contribute to the disease process and clinical phenotype development.

Device problems and improper usage may alter the EpiPen dose. Nurses should review proper EpiPen administration with patients and their families or caregivers.

Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population. Airway stenting is highly effective in palliating symptoms of airway obstruction. There are several types of stents available with different advantages and disadvantages depending mainly on the material they are made from. Clinical outcomes seem to be comparable between silicone and self-expanding metal stents. Self-expanding metal stents have proven to be efficient in recanalizing 'complex' central airway obstructions. Preliminary data show that a new self-expanding 'hybrid' stent appears to be effective and safe for malignant airway obstruction. Airway stent complications vary according to the type of stent and the type of obstruction. Multidetector computed tomography seems to be a valuable adjunct to bronchoscopy in detecting and characterizing stent complications. A clear definition of airway stent-related infection is urgently needed to provide adequate diagnosis and management of this complication. Metal stent fracture is less common in patients with malignant airway obstruction as compared with benign disease, and this could be partially explained by the decreased survival and shorter exposure to stent in the former population. Airway stents are of great help in palliating symptoms of malignant central airway obstruction. Unfortunately, there have been no recent striking advances in stent technology and the ideal stent has yet to be designed.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssueArchivesePub Ahead-of-Print Collections Acute/Critical CareContinuing EducationCOVID-19 Disaster and Emergency PreparednessEnvironmental Health and IssuesEthics Evidence-Based Practice, Step by StepFamily CaregiversGeriatric NursingHolistic NursingIn The CommunityInfectious DiseaseInternational TopicsLegal ClinicMental HealthNurse WellbeingNursing Research, Step By StepNursing ResourcesPalliative CarePatient SafetyPolicy and PoliticsProfessional Development, Leadership and ScholarshipProfessional Partners Supporting Diverse Family Caregivers Across SettingsQI: Quality ImprovementResearchSocial Media and Information TechnologySpecial SupplementsStrip SavvySupporting Family Caregivers: No Longer Home AloneSystematic Reviews Step by StepTeaching For PracticeTransforming Care at the Bedside (TCAB)Uniforms (Nursing)Uniting States, Sharing StrategiesWomen's HealthWriting Resources Videos Videos WebinarsFor Authors Call for ManuscriptsSubmit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalAdvertising and BusinessAward WinnersBook of the Year AwardsContact InfoEditorial BoardInformation for FacultyInformation for MediaInformation for Peer ReviewersLetters to the EditorNurse Faculty Scholars / AJN Mentored Writing AwardOpen AccessReprintsRights and PermissionsSubscription ServicesNurses: Submit Your Photos! All Articles Images Videos Podcasts Blogs Advanced Search

SummaryThe aim of postmortem toxicology is to help establish the role that drugs or other poisons played in a death, or in events immediately before death. It was thought that concentrations of poisons measured in blood obtained at autopsy reflected the situation perimortem. However, we now know tha

Every patient admitted to the postanesthesia care unit (PACU) requires critical assessment, monitoring and postsurgical care. The pediatric patient has additional needs based on differences in biophysical and cognitive development. These differences will significantly influence patient outcomes.

Drugs are effective only if they reach their site of action. This is usually achieved by oral administration, but other routes are possible. Here I describe the uses and characteristic adverse effects of commonly used routes of administration. In this part I deal with intramuscular and subcutaneous injection and in part 2 other routes.

According to this study: The pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 has a wide range of presenting signs and symptoms and disease severity. This syndrome appears to differ from other inflammatory disorders seen in children.

In response to COVID-19 pandemic social distancing restrictions, ambulatory care settings have largely transitioned to virtual health care delivery. As local, state, and federal officials discuss timelines for these restrictions to be lifted, ambulatory leadership is tasked with the responsibility of developing reactivation plans for its clinics to resume in-person care. This article discusses a method in which ambulatory leadership can determine the clinic's deficit in patient encounters, set a time period to return to normal operations, planning for space and scheduling changes, balancing in-person virtual visits, and thoughtfully communicating these plans to clinic staff and providers.

Hydroxyethyl starch (HES) is a widely used plasma substitute for correcting perioperative hypovolemia. HES preparations are defined by concentration, molar substitution (MS), mean molecular weight (M(w)), the C(2)/C(6) ratio of substitution, the solvent, and the origin. The possible unwanted side effects of HES are anaphylactic reactions, alterations of hemostasis resulting in increased bleeding, kidney dysfunction, accumulation, and pruritus. In view of the potential side effects, it is crucial to distinguish among the different HES preparations; all HES preparations are not the same. The first generation of HES preparation showing a high M(w) (>450 kD) and a high MS (>0.7) was associated with negative effects with regard to coagulation, organ function, and accumulation. This review is focused on whether modern (third generation), more rapidly degradable HES preparations with a lower M(w) (130 kD) and a lower MS (<0.5) are safer and have fewer side effects. Several studies demonstrated that such modern HES preparations appear to be safe with regard to hemostasis, kidney function, itching, and accumulation. Modern HES preparations are dissolved in balanced, plasma-adapted solutions that no longer contain unphysiological amounts of sodium and chloride and are thus suitable for correcting hypovolemia.

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Online FirstCurrent IssuePrevious IssuesSupplements Editor's Picks Current Editor's PicksArchived Editor's Picks Collections COVID in TransplantationXenotransplantationTop Altmetric ArticlesTop 100 Articles in TransplantationFree AccessSocial MediaHand and Composite Tissue TransplantationRandomized Control TrialsAntibody Mediated RejectionBelatacept Mediated Costimulation BlockadeTTS Guidelines and Updates from the Vancouver CongressHumoral Autoimmunity and Transplant VasculopathyBiomarkersView All Social Media VideosVisual Abstracts For Authors Submit a ManuscriptInformation for AuthorsOpen AccessLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and PermissionsTransplantation DirectReviewer Thank You All Articles Images Videos Podcasts Blogs Advanced Search October 1972 - Volume 14 - Issue 4 Previous Abstract Next Abstract Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Transplantation. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection ARTICLE: PDF OnlyMACROPHAGES IN SYNGENEIC ANIMAL TUMOURSEVANS, R. Author Information Chester Beatty Research Institute, Belmont, Sutton, Surrey, England Transplantation 14(4):p 468-473, October 1972. Free Abstract The macrophage content of a number of syngeneic mouse and rat fibrosarcomas was estimated after trypsinization of minced tumour fragments, and techniques are described for identification of such macrophages. The possible significance of their presence in low or high concentrations within the actively growing tumours is discussed. Copyright © 1972 Wolters Kluwer Health, Inc. All rights reserved. Source MACROPHAGES IN SYNGENEIC ANIMAL TUMOURS Transplantation14(4):468-473, October 1972. Full-Size Email + Favorites Export View in Gallery Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Transplantation. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Transplantation. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Article Level Metrics Related Links Articles in PubMed by R. EVANS Articles in Google Scholar by R. EVANS Other articles in this journal by R. EVANS Related Videos Data is temporarily unavailable. Please try again soon. Back to Top Never Miss an Issue Get new journal Tables of Contents sent right to your email inbox Get New Issue Alerts Browse Journal Content Most Popular For Authors About the Journal Past Issues Current Issue Register on the website Subscribe Get eTOC Alerts For Journal Authors Submit an article How to publish with us Customer Service Live Chat Chat Offline Activate your journal subscription Activate Journal Subscription Browse the help center Help Contact us at: EMAIL: [email protected] TEL: (USA): TEL: (Int’l): 800-638-3030 (within USA) 301-223-2300 (international) Cookie Settings Privacy Policy (Updated December 15, 2022) Legal Disclaimer Terms of Use Open Access Policy Feedback Sitemap RSS Feeds LWW Journals Copyright © 2023 Wolters Kluwer Health, Inc. and/or its subsidiaries. All rights reserved.

Appendicitis is the most common cause of abdominal pain requiring surgery in children. Missed appendicitis is also a frequent cause of professional liability in an emergency department (ED). A retrospective review of all patients with appendicitis diagnosed in the ED was undertaken to identify: 1) how many patients required more than one visit to diagnose appendicitis and 2) the clinical characteristics that distinguished the patients who visited twice from patients who were diagnosed on the first visit. A total of 87 patients with appendicitis were seen by pediatricians in the ED from 1987 to 1989. The patients included 43 girls and 44 boys (mean age, 8.9 years). Six patients (7%) were seen twice before the diagnosis of appendicitis was made. They returned to the ED on average 29 hours after the first visit. The ED discharge diagnosis of the six "missed" patients included: probable Campylobacter (n = 1), viral urinary tract infection (n = 1), gastroenteritis (n = 2), and abdominal pain (n = 2). The six missed patients were different from the other patients with appendicitis. They were more likely to have a normal appetite, to have diarrhea, and to be afebrile. All the patients had at least two of the four following signs and symptoms: vomiting, tenderness, guarding, and right lower quadrant (RLQ) pain. At the time of surgery, 23/81 (28%) of the one-visit group had a ruptured appendix, whereas 3/6 (50%) of the missed patients had a ruptured appendix. 1) Seven percent of the patients were seen twice in our ED before the diagnosis of appendicitis was made.(ABSTRACT TRUNCATED AT 250 WORDS)

Teen mothers often face a stigmatizing gaze based on the belief that early childbearing jeopardizes their life chances and the health and development of their children. Growing evidence suggests that the poor maternal-child outcomes associated with early childbearing have been overstated and may be explained by teen mothers' childhood disadvantage and adversities. After reviewing what is currently known about the relationships between early childbearing and maternal-child outcomes, as well as teen mothers' perspectives on mothering, clinical practices are suggested that address teen mothers' concerns, strengths, aspirations, and the long-term inequities that contribute to poor outcomes.

Foreign bodies being forced into the esophagus as a form of fatal child abuse is rare. A 4.5-month-old female infant presented to clinicians with respiratory distress. Several coins were recovered from the esophagus. One month later, she was found dead in her crib. At autopsy, there were three coins in the esophagus. In addition, there were cutaneous contusions of various ages, acute and partially healed fractures of the extremities, old aspirated foreign material in the lungs, and pulmonary fat emboli. Although the fat emboli may have contributed to the death, several potentially fatal mechanisms from the esophageal foreign bodies deserve consideration. These include vagal stimulation from esophageal distention, aspiration of swallowed fluids after esophageal obstruction, compression of the trachea or the heart by the coins, and cardiac compression or airway occlusion by the introducing finger.

WHIM syndrome (the association of warts, hypogammaglobulinemia, recurrent bacterial infections, and 'myelokathexis') is a rare congenital form of neutropenia associated with an unusual immune disorder involving hypogammaglonulinemia and abnormal susceptibility to warts. In this review, we describe the clinical, laboratory and genetic features of WHIM syndrome. The identification of chemokine receptor CXCR4 as the causative gene of WHIM syndrome yields new interest in the study of this disease as a model for the comprehension of CXCR4 biology in humans and highlights the importance of the chemokine network for inducing effective immune responses and governing leukocyte trafficking. CXCR4 participates in several biological processes (bone marrow hematopoiesis, cardiogenesis, angiogenesis, neurogenesis) and is implicated in different clinical pathologic conditions (WHIM, HIV infection, tumor metastatization, autoimmunity). Pharmacologic agents that modulate CXCR4 expression/function are already available and promise a wide range of future clinical applications.