NCT00676130.

Physicians' diagnoses and admission decisions changed frequently after CT, and diagnostic uncertainty was alleviated.

Several studies have highlighted the important role played by murine natural killer (NK) cells in the control of influenza infection. However, human NK cell responses in acute influenza infection, including infection with the 2009 pandemic H1N1 influenza virus, are poorly documented. Here, we examined changes in NK cell phenotype and function and plasma cytokine levels associated with influenza infection and vaccination. We show that absolute numbers of peripheral blood NK cells, and particularly those of CD56bright NK cells, decreased upon acute influenza infection while this NK cell subset expanded following intramuscular influenza vaccination. NK cells exposed to influenza antigens were activated, with higher proportions of NK cells expressing CD69 in study subjects infected with seasonal influenza strains. Vaccination led to increased levels of CD25+ NK cells, and notably CD56bright CD25+ NK cells, whereas decreased amounts of this subset were present in the peripheral blood of influenza infected individuals, and predominantly in study subjects infected with the 2009 pandemic H1N1 influenza virus. Finally, acute influenza infection was associated with low plasma concentrations of inflammatory cytokines, including IFN-γ, MIP-1β, IL-2 and IL-15, and high levels of the anti-inflammatory cytokines IL-10 and IL-1ra. Altogether, these data suggest a role for the CD56bright NK cell subset in the response to influenza, potentially involving their recruitment to infected tissues and a local production and/or uptake of inflammatory cytokines.

In the management of patients presenting to the emergency department with nontraumatic abdominal complaints, CT changes the leading diagnosis, increases diagnostic certainty, and changes potential patient management decisions.

In this pilot, a standardized oral OSCE scoring system performed equally well in a simulator-based testing environment.

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increase in CT utilization (relative risk, 9.97 and 9.24, respectively) [2,3]. Repeat CT scans represent a large proportion of abdominal CT scans obtained in the ED. In a single-institution study performed from 2007 to 2010, Nojkov et al. [4] reported that 53% of CT examinations for nontraumatic abdominal pain were firsttime (i.e., index) examinations, whereas 47% were repeat CT examinations; in addition, they

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