A novel approach for the treatment of ovarian cancer includes immunotherapy with genetically engineered T cells targeted to ovarian cancer cell antigens. Using retroviral transduction, T cells can be created that express an artificial T cell receptor (TCR) termed a chimeric antigen receptor (CAR). We have generated a CAR, 4H11-28z, specific to MUC-16 antigen, which is the over-expressed on a majority of ovarian tumor cells and is the retained portion of MUC-16 after cleavage of CA-125. We previously demonstrated that T cells modified to express the 4H11-28z CAR eradicate orthotopic human ovarian cancer xenografts in SCID-Beige mice. However, despite the ability of CAR T cells to localize to tumors, their activation in the clinical setting can be inhibited by the tumor microenvironment, as is commonly seen for endogenous antitumor immune response. To potentially overcome this limitation, we have recently developed a construct that co-expresses both MUC16 CAR and IL-12 (4H11-28z/IL-12). , 4H11-28z/IL-12 CAR T cells show enhanced proliferation and robust IFNγ secretion compared to 4H11-28z CAR T cells. In SCID-Beige mice with human ovarian cancer xenografts, IL-12 secreting CAR T cells exhibit enhanced antitumor efficacy as determined by increased survival, prolonged persistence of T cells, and higher systemic IFNγ. Furthermore, in anticipation of translating these results into a phase I clinical trial which will be the first to study IL-12 secreting CAR T cells in ovarian cancer, an elimination gene has been included to allow for deletion of CAR T cells in the context of unforeseen or off-tumor on-target toxicity.

Alternative rock, hip-hop/rap, modern rock, heavy metal/hard rock, and country music concerts had higher levels of medical resource utilization. High heat indices and music festivals also increase the MUR. This information can assist event planners with preparation and resource utilization. Future research should focus on prospective validation of the regression equation. Westrol MS , Koneru S , McIntyre N , Caruso AT , Arshad FH , Merlin MA . Music genre as a predictor of resource utilization at outdoor music concerts. Prehosp Disaster Med. 2017;32(3):289-296.

In this prehospital study, we confirmed that intranasal naloxone is effective in reversing suspected opioid toxicity. Nine percent of patients required two or more doses of naloxone to achieve clinical reversal of suspected opioid toxicity. Two percent of patients received a third dose of naloxone.

<p>Exostosis is benign tumor. Osteochondromas are benign metaphyseal osseous growths occurring in long bones of body.  They contain cartilaginous cap which are present before closure of physis plate. Growth of these structures ends with physis fusion. Being benign in nature, they don’t require any surgery. Unless and until they cause compression symptoms on nerves and blood vessels, difficulty in movements of joints, and patients request for cosmetic appearance. Here by we present a rare case of 19 years old male patient with right foot exostosis. The same patient has multiple Exostosis in bilateral ankle, knee and humerus but without any family history. Exostosis was found on plantar aspect of foot, which made it difficult for him to walk. Surgical excision was done. Pre, per and post-operative period was fine. Patient was able to walk normally thereafter. There was no recurrence of growth thereafter.</p>

Introduction: Proximal femur fractures account for mortality and morbidity in elderly population. Postmenopausal women, decreased physical work in urban population, estrogen deficiency can cause osteoporosis in Indian population. Osteoporosis can result in proximal femur fracture. Decreased oseoblastic response, in elderly population results in osteoporosis. Here by we intend to find the correlation between cortical thickness Index and type of fracture in proximal femur. Null Hypothesis: Cortical Thickness Index cannot determine the type of proximal femur fracture Materials and Methods: A retrospective study was carried out, over a period of 2 months. All patients admitted into hospital with proximal femur fractures into hospital were included into study. Radiological evaluation of Singh's Osteoporosis Index Grading, Cortical Thickness Index (CTI) in anterior-posterior (AP), and canal calcar ratio were calculated. Results: 100 patients were included into study. 45 females and 55 males were present. Average age of patients in the study was 71 years. 31 Intracapsular (Neck of Femur) and 69 extra capsular (Intertrochanteric and Sub trochanteric) fractures were found. Average CTI (AP) was 0.53, and canal calcar ratio was 0.63. Conclusion:There exists a Negative correlation exists between CTI (AP) and CC Ratio. Null Hypothesis remains rejected.