Does adenoviral transfer of the inducible nitric oxide synthase gene block endothelial cell apoptosis?
Vascular iNOS gene transfer, while inhibiting smooth muscle cell proliferation, does not impair EC mitogenesis or viability. Augmented NO synthesis may also protect ECs against apogenic stimuli such as lipopolysaccharide. Therefore iNOS gene transfer may promote endothelial regeneration and can perhaps accelerate vascular healing.
A significant discrepancy between emergent responses and actual ALS care rendered during intercept calls was demonstrated. Given the significant rate of EMS worker fatalities and transferable patient care costs, further study is needed to determine whether costs and safety are potentially improved by decreasing emergent responses. Future directions include developing or emulating Medical Priority Dispatch System triage protocols for advanced services providing intercepts. In addition, further study of patient outcomes between intercept and non-intercept cases is necessary.