ABSTRACT
PURPOSE: The extent and types of ophthalmic disease and non-battle injury (DNBI) seen by expeditionary ophthalmologists at deployed military medical treatment facilities have not previously been reported. We aim to characterise the extent and type of ophthalmic pathology including DNBI at a US military medical treatment facility in Afghanistan. METHODS: We conducted a retrospective non-interventional cohort study of all patients seen by ophthalmologists at Craig Joint Theater Hospital at Bagram Airfield (BAF), Afghanistan, between 1 October 2018 and 31 August 2019. RESULTS: There were 281 patients seen in 540 separate encounters, of which 146 patients seen were active duty military stationed at BAF with DNBI, of a population at risk of 6000 personnel. Diagnoses managed included open and closed globe injury, bacterial and herpetic keratitis and retinal detachment, with the most common being dry eye, corneal abrasion/foreign body, blepharitis, chalazion and uveitis. Thirteen patients (5%) required aeromedical evacuation out of theatre and 39 patients were aeromedically transferred within theatre for assessment. Expert consensus estimated that 89 patients (36%) would be likely to require aeromedical evacuation out of theatre without ophthalmic input. CONCLUSIONS: The rate of ophthalmic DNBI among deployed US, UK and coalition forces at BAF was 2.65% per year, of whom 97% were returned to duty (95% of all patients). We estimate that evacuation and loss to unit would increase from 5% to 36% without an ophthalmologist present. The low number of within-theatre aeromedical transfers suggests that the local presence of an ophthalmologist at a patient's deployed medical treatment facility affects access to deployed ophthalmic care.
Subject(s)
Military Personnel , Workload , Afghanistan , Cohort Studies , Humans , Retrospective StudiesABSTRACT
Fully dense bulk nanocomposites have been obtained by a novel two-step severe plastic deformation process in the immiscible Fe-Cu system. Elemental micrometer-sized Cu and Fe powders were first mixed in different compositions and subsequently high-pressure-torsion-consolidated and deformed in a two-step deformation process. Scanning electron microscopy, X-ray diffraction and atom probe investigations were performed to study the evolving far-from-equilibrium nanostructures which were observed at all compositions. For lower and higher Cu contents complete solid solutions of Cu in Fe and Fe in Cu, respectively, are obtained. In the near 50% regime a solid solution face-centred cubic and solid solution body-centred cubic nanograined composite has been formed. After an annealing treatment, these solid solutions decompose and form two-phase nanostructured Fe-Cu composites with a high hardness and an enhanced thermal stability. The grain size of the composites retained nanocrystalline up to high annealing temperatures.
ABSTRACT
Bone morphogenetic proteins (BMPs) are growth factors that exert important functions in cell proliferation, migration and differentiation. Till date, multiple human tumors have been reported to display a dysregulation of several members of the BMP pathway that is associated with enhanced malignant tumor growth and metastasis. BMPER (BMP endothelial cell precursor-derived regulator) is a direct BMP modulator that is necessary for BMPs to exert their full-range signaling activity. Moreover, BMPER is expressed by endothelial cells and their progenitors, and has pro-angiogenic features in these cells. Here, we describe the expression of BMPER in human specimens of lung, colon and cervix carcinomas and cell lines derived from such carcinomas. In contrast to healthy tissues, BMPER is highly expressed upon malignant deterioration. Functionally, loss of BMPER in the lung tumor cell line A549 impairs proliferation, migration, invasion as well as tumor cell-induced endothelial cell sprout formation. In contrast, stimulation of A549 cells with exogenous BMPER had no further effect. We found that the BMPER effect may be transduced by regulation of the BMP target transcription factor inhibitor of DNA binding 1 (Id1) and matrix metalloproteinases (MMPs) 9 and 2. These facilitators of cell migration are downregulated when BMPER is absent. To prove the relevance of our in vitro results in vivo, we generated Lewis lung carcinoma cells with impaired BMPER expression and implanted them into the lungs of C57BL/6 mice. In this model, the absence of BMPER resulted in severely reduced tumor growth and tumor angiogenesis. Taken together, these data unequivocally demonstrate that the BMP modulator BMPER is highly expressed in malignant tumors and tumor growth is dependent on the presence of BMPER.
Subject(s)
Carrier Proteins/biosynthesis , Neoplasm Invasiveness , Animals , Carcinoma, Lewis Lung/metabolism , Carcinoma, Lewis Lung/pathology , Carrier Proteins/analysis , Cell Line, Tumor , Cell Movement , Cell Proliferation , Colonic Neoplasms/metabolism , Colonic Neoplasms/pathology , Female , Humans , Inhibitor of Differentiation Protein 1/metabolism , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Matrix Metalloproteinase 2/metabolism , Matrix Metalloproteinase 9/metabolism , Mice , Mice, Inbred C57BL , Neovascularization, Pathologic/metabolism , Uterine Cervical Neoplasms/metabolism , Uterine Cervical Neoplasms/pathologySubject(s)
Spinal Dysraphism/rehabilitation , Activities of Daily Living , Adolescent , Child , Child, Preschool , Humans , Infant , Urinary CatheterizationABSTRACT
A new tube test for pregnancy, having a sensitivity of 0.5 I.U. of human chorionic gonadotropin per milliliter, was evaluated, along with two other commercially available kits, in a hospital patient population. Of 586 patients in the study, 302 were in nonobstetric services and many were acutely ill. Approximately one fourth of the women were age 40 or older. The medical records of 66% of the patients were retrieved to obtain information on the drugs administered prior to pregnancy testing. A small number of problems did occur in the pregnancy test procedures. Inconclusive results were recorded for both pregnant and nonpregnant patients and could not be correlated with disease states and/or medications. The importance of a reagent control for tube test procedures is discussed.
