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Background: The Choosing Wisely Campaign was launched in 2012 and has been applied to a broad spectrum of disciplines in almost thirty countries, with the objective of reducing unnecessary or potentially harmful investigations and procedures, thus limiting costs and improving outcomes. In Canada, patients with burn injuries are usually initially assessed by primary care and emergency providers, while plastic or general surgeons provide ongoing management. We sought to develop a series of Choosing Wisely statements for burn care to guide these practitioners and inform suitable, cost-effective investigations and treatment choices., Methods: The Choosing Wisely Canada list for Burns was developed by members of the Canadian Special Interest Group of the American Burn Association. Eleven recommendations were generated from an initial list of 29 statements using a modified Delphi process and SurveyMonkey™., Results: Recommendations included statements on avoidance of prophylactic antibiotics, restriction of blood products, use of adjunctive analgesic medications, monitoring and titration of opioid analgesics, and minimizing 'routine' bloodwork, microbiology or radiological investigations., Conclusions: The Choosing Wisely recommendations aim to encourage greater discussion between those involved in burn care, other health care professionals, and their patients, with a view to reduce the cost and adverse effects associated with unnecessary therapeutic and diagnostic procedures, while still maintaining high standards of evidence-based burn care., (Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved.)

The numbers of immune-activated brain mononuclear phagocytes (MPs) affect the progression of human immunodeficiency virus (HIV)-1-associated dementia (HAD). Such MPs originate, in measure, from a pool of circulating monocytes. To address the mechanism(s) for monocyte penetration across the blood-brain barrier (BBB), we performed cross-validating laboratory, animal model, and human brain tissue investigations into HAD pathogenesis. First, an artificial BBB was constructed in which human brain microvascular endothelial and glial cells-astrocytes, microglia, and/or monocyte-derived macrophages (MDM)-were placed on opposite sides of a matrix-coated porous membrane. Second, a SCID mouse model of HIV-1 encephalitis (HIVE) was used to determine in vivo monocyte blood-to-brain migration. Third, immunohistochemical analyses of human HIVE tissue defined the relationships between astrogliosis, activation of microglia, virus infection, monocyte brain infiltration, and beta-chemokine expression. The results, taken together, showed that HIV-1-infected microglia increased monocyte migration through an artificial BBB 2 to 3.5 times more than replicate numbers of MDM. In the HIVE SCID mice, a marked accumulation of murine MDM was found in areas surrounding virus-infected human microglia but not MDM. For human HIVE, microglial activation and virus infection correlated with astrogliosis, monocyte transendothelial migration, and beta-chemokine expression. Pure cultures of virus-infected and activated microglia or astrocytes exposed to microglial conditioned media produced significant quantities of beta-chemokines. We conclude that microglial activation alone and/or through its interactions with astrocytes induces beta-chemokine-mediated monocyte migration in HAD.

Changes of intracellular sodium concentrations are often an indication of disease or malfunction. In this work, shift reagent-aided 23Na NMR spectroscopic determination of intracellular sodium was adapted to measurements with perfused cells embedded in agarose gel threads. Ehrlich ascites tumor cells (EHR2) and their multidrug-resistant counterparts (EHR2/DNR+) were immobilized and perfused until the metabolic steady state had been reached as shown by 31P NMR spectroscopy. Subsequent addition of 5 mM dysprosium(III) bis(tripolyphosphate) to the perfusion medium caused a separation of extracellular and intracellular 23Na NMR signals, making quantification of the intracellular sodium possible. The dysprosium shift reagent was apparently nontoxic to the cells, as shown by the unchanged level of ATP and other intracellular phosphates. NMR visibility of the intracellular sodium was determined in suspensions of EHR2 and EHR2/DNR+ cells by treatment with digitonin; the increase of intensity of the extracellular sodium resonance observed after the digitonin treatment corresponded well (97 +/- 3%) to the sum of intracellular and extracellular sodium observed with intact cells prior to the digitonin treatment. The resistant EHR2/DNR+ cells contained a moderately higher intracellular sodium level than the wild-type EHR2 cells, 1.02 +/- 0.10 and 0.77 +/- 0.07 mumol Na/mg protein, respectively. Closely similar levels of intracellular sodium were found by flame photometry. Thus, 23Na NMR offers a reliable method for noninvasive quantification of intracellular sodium in perfused cancer cells.

Interleukin-2 (IL-2), a growth factor for T-lymphocytes, has been postulated to cause the accumulation of T-lymphocytes at sites of inflammation by inducing proliferation of these cells. We hypothesized that IL-2 might also serve to attract T-lymphocytes to inflammatory sites. To test this hypothesis, human T-lymphocytes were purified from the peripheral blood of normal volunteers by rosetting with neuraminidase-treated sheep red blood cells and tested for chemotactic activity by using a blind-well chamber technique. Purified IL-2 caused a greater than 20-fold attraction of T-lymphocytes compared with medium alone (P less than 0.001). This attraction was shown to be chemotactic rather than chemokinetic by checkerboard analysis. The T-lymphocyte chemotaxis could be completely inhibited by adsorption of the IL-2 with an IL-2-dependent cell line, and could be neutralized by monoclonal anti-IL-2 antibody. Further specificity of IL-2-directed chemotaxis was demonstrated by using species-specific IL-2. Mouse IL-2 was ineffective at promoting human T-lymphocyte chemotaxis. These data suggest that IL-2 may be responsible for the localized accumulation of T-lymphocytes both by causing attraction of these cells and by modulating their proliferation.

Randerath's procedure for 32P postlabeling of 3'-monophosphate deoxyribonucleotides from digests of cellular DNA has been modified. 3'-Monophosphate deoxyribonucleotides are converted to 3',5'-bis[32P]phosphate deoxyribonucleotides with polynucleotide kinase and [32P]ATP; these products are enzymatically converted by P1 nuclease and polynucleotide kinase into 5'-[32P]monophosphate deoxyribonucleotides, which are separated from [32P]ATP on an anion-exchange column eluted with 0.1 M NaH2PO4, pH 6.5. Labeled mononucleotides in the effluent are separated by high-performance liquid chromatography. Values for the base composition of calf thymus DNA determined with this modified assay compare very favorably with reported values. The assay was used to measure the level of incorporation of the clinically useful agent bromodeoxyuridine into the DNA of 9L rat brain tumor cells. The modified assay appears to be a very accurate method for the determination of levels of base analogs incorporated into DNA.

We have investigated the induction of sister-chromatid exchanges (SCEs) in 9L rat brain tumor cells treated with the alkylating agent 1-ethyl-1-nitrosourea (ENU) and 3-(4-amino-2-methyl-5-pyrimidinyl)methyl-1-(2-chloroethyl)-1-nitrosourea (ACNU), an agent that both alkylates and crosslinks DNA. Induction of SCEs by ACNU was found to be 143-fold greater than for ENU. However, on an equimolar basis, the alkylation of DNA by 14C-ACNU was approximately 3.2-fold higher than for 14C-ENU. After correction for this difference was made, the induction of SCEs by ACNU was calculated to be 45-fold greater than for ENU. While DNA alkylation products formed by ACNU and ENU are similar, the chloroethyl alkylation product(s) of ACNU can form DNA-interstrand crosslinks; the ethyl alkylation product(s) of ENU cannot. Based on these findings, we propose that the increased induction of SCEs caused by ACNU is a result of the formation of DNA interstrand crosslinks.