Comparison of Two Tourniquets on a Mid-Thigh Model: The Israeli Silicone Stretch and Wrap Tourniquet vs. The Combat Application Tourniquet.

Introduction: Experience from recent conflicts underlines the dramatic impact of effective tourniquet use on combat casualty mortality. Although the Combat Application Tourniquet (CAT) is replacing the silicone band tourniquets (IST; "Israeli Silicone Tourniquet") in the Israeli Defense Forces, no direct comparison was made between them. The purpose of this study is to compare the performance of the two tourniquets on a mid-thigh model. Methods: Participants were Israeli military recruits who previously had the military first aid course. Each participant applied both the CAT and the IST. Applications were assessed by the HapMed Leg Tourniquet Trainer, which measured the applied pressure and the time required to reach it. Results: IST application resulted in higher rates of effective occlusion pressure compared with the CAT (91% vs. 73.1%, p < 0.01), and a higher mean occlusion pressure (41 mmHg, p < 0.01) was recorded using the IST. Among effective attempts, application time did not differ significantly between the tourniquets. Conclusion: The IST was superior to the CAT in producing effective occlusion pressure while not prolonging application time. These results may indicate that the IST remains a valid option for controlling mid-thigh bleeding.

Infection of human fetal astrocytes with HIV-1: viral tropism and the role of cell to cell contact in viral transmission.

Astrocyte cultures from human fetal brain were infected with human immunodeficiency virus (HIV) either as free virus or with a chronically infected lymphoblastoid cell line and monitored for signs of infection. The lymphocytotropic strains HIV3B and HIVSF2(ARV-2) but not the monocytotropic strain HIVAda-M infected the human fetal astrocytes. The infected cells were monitored by immunocytochemistry, detection of p24 antigen in the supernatants and polymerase chain reaction amplification of the proviral DNA. No morphological or cytopathic effects were seen in these cells. Upon co-culture of astrocytes with a lymphoblastoid cell line chronically infected with HIVSF2(ARV-2), the lymphoblastoid cells readily adhered to the astrocytes as determined by a 51Cr adhesion assay and by light and electron microscopy. This cell to cell contact resulted in infection of increased numbers of astrocytes. Similar adhesion of lymphoblasts to microglia was not seen. Thus, astrocytes from human fetal brain can be infected in vitro directly by lymphocytotropic strains of HIV or by adherence to infected lymphoblastoid cells.

Lymphocyte emperipolesis in human glial cells.

Astrocytes have been observed to contain intact, viable lymphocytes within their cytoplasm (emperipolesis) in multiple sclerosis plaques and some brain tumors. This study characterizes the adhesive, emperipoletic and phagocytic properties of glial cells in culture. Human fetal and adult astrocytes engaged in adhesion and emperipolesis of lymphocytes. Emperipolesis, and not adhesion, was temperature- and cation-dependent. The CD8 and MHC Class I antigens played a role in emperipolesis. Lymphocytes most often remained viable within the cytoplasm of astrocytes but occasionally underwent lysis or caused disruption of the astrocyte intermediate filaments. The phenomenon of emperipolesis is distinct from phagocytosis, since microglia showed prominent phagocytic properties but did not engage in emperipolesis. Conversely, astrocytes were efficient emperipolites and rarely demonstrated phagocytic properties.

Carotid artery dissection secondary to seatbelt trauma: case report.

A postmortem report of a patient with traumatic internal carotid artery dissection, along with evidence strongly suggestive of a car seatbelt as a causative factor, is presented. In this 5-foot subject, the shoulder harness could have been high, over the anterior cervical area. The authors feel this mechanism deserves consideration as one of the important causes of traumatic carotid dissection. If supported by further studies, remedial measures in the form of changes in seatbelt design, or the use of alternate protective measures may be warranted.

[Nizatidine versus ranitidine in the treatment of acute duodenal ulcer. Comparison of 300 mg nizatidine and 300 mg ranitidine in a single evening dose]. / Nizatidin versus Ranitidin in der Behandlung des akuten Ulcus duodeni. Vergleich von 300 mg Nizatidin und 300 mg Ranitidin in einmal abendlicher Dosis.

In a double-blind, endoscopically controlled study on 367 duodenal ulcer patients, we compared the clinical efficacy of 300 mg ranitidine nocte with that of 300 mg nizatidine nocte, which is known to reliably provide selective inhibition of nocturnal acid secretion. Nizatidine was administered to 183, ranitidine to 184 patients. Endoscopy was performed at the start of the study, as well as at 2, 4 and 8 weeks. The presence of ulcer was defined as a benign lesion of the gastric mucosa measuring at least 5 mm in diameter; healing was characterized as complete reepithelialization. In the nizatidine group, as many as 76% of our patients were free from night pain at 2 weeks, and 88% at 4 weeks. Identical values were obtained in the group treated with 300 mg ranitidine nocte. The healing rates at 2, 4 and 8 weeks were comparable in the nizatidine and ranitidine groups (nizatidine: 57%, 87%, 92%, respectively; ranitidine: 63%, 90%, 96%, respectively). Clinically significant adverse effects were seen in neither of the two treatment groups. These results demonstrate that selective inhibition of nocturnal acid secretion achieves healing of duodenal ulcer and freedom from pain as rapidly and effectively as protracted inhibition of acid secretion provided by the administration of 300 mg ranitidine nocte.

[The course of schizophrenia in continued marriage and loss of the partner]. / Schizophrenieverlauf bei Ehekonstanz und Partnerverlust.

A sample representative of 52 schizophrenic patients has been studied five years after the first control. The patients with enduring relationships show a more favorable prognostic than those with a history of separation, divorce or loss of partner--especially concerning the social and professional skills. The enduring partnership is mostly evaluated by the patients as satisfactory even after repeated hospitalisations.