001, Fig. 5D and E). Furthermore, expression of TNFR2, OX40 and 4-1BB on the splenic Tregs was also down-regulated by anti-TNF treatment (Fig. 5F). Thus, TNF and TNFRSF contribute to the in vivo expansion of Tregs after LPS challenge. In this study, we for the first time report that TNF, in the presence of common γ chain interleukins, had the capacity to up-regulate the expression of a number NVP-AUY922 of co-stimulatory TNFRSF members, including its own receptor,

TNFR2, as well as 4-1BB and OX40, preferentially on Tregs. This provides a means of amplifying Treg numbers to optimally attenuate the harmful excessive inflammatory responses. TNF is not sufficient to support the in vitro survival of Tregs and thus either IL-2 or IL-7 was used. TNF and IL-2 up-regulate both TNFR2 and CD25 on Tregs, resulting in a reciprocal-amplification loop in the activation of Tregs. Although Tregs express low levels of the IL-7 receptor α chain (CD127), which could not be up-regulated by TNF (data not shown), IL-7 and TNF nevertheless synergistically promoted the proliferative response of Tregs to TCR stimulation. In

addition, TNF, in combination with IL-15, also activated Tregs (data not shown). The relative potency in support of Treg-activating effect of TNF were IL-2>IL-7>IL-15. Further, the effect of TNF/IL-7 or TNF alone on Tregs was not blocked by neutralizing anti-IL-2 PF-02341066 datasheet Abs. Thus, the activating effects of both TNF and TNF/IL-7 on Tregs were not mediated by IL-2. The synergistic effects of TNF with other Cγ chain cytokines and TCR stimulation also likely contribute to the expansion and activation of Tregs at the inflammatory site. We favor the idea that the TNF-TNFR2 signaling pathway plays an important role in the activation of Tregs. A greater understanding of these fundamental mechanisms is needed for the discovery TCL of novel approaches to up- or down-regulate

Treg activity at signal transduction and molecular levels. 4-1BB and OX40 are members of the TNFRSF whose genes are clustered on mouse chromosome 4 together with TNFR2 25. These molecules have some activities in common, such as regulating the expression of anti-apoptotic members of Bcl-2 family, promoting proliferation and survival of CD4+ T cells 21. The effects of these two molecules, especially of OX40, on the function of Tregs remain controversial. It has been reported that the anti-tumor effect of OX86, an agonistic antibody for OX40, was associated with attenuation of the suppressive function of Tregs 26. However, when used together with cyclophosphamide, OX86 actually induced the overactivation of tumor infiltrating Tregs, leading to selective apoptosis and eventual depletion of Tregs 27. It has been proposed that if the “cytokine milieu is right,” OX40 agonist could promote Treg activity 20.

“
“Hereditary angiooedema (HAE) is a life-threatening disease with poor clinical phenotype correlation with its causal mutation in the C1 inhibitor (SERPING1) gene. It is characterized by substantial symptom variability even in affected members of the same family. Therefore, it is likely that genetic factors outside the SERPING1 gene have an influence on disease manifestation. In this study, functional polymorphisms in genes with a possible disease-modifying effect, B1 and B2 bradykinin receptors (BDKR1, BDKR2), angiotensin-converting enzyme (ACE) and mannose-binding lectin (MBL2), were analysed in 36 unrelated HAE patients. The same analysis was carried out in 69 HAE patients regardless of their

familial relationship. No significant influence Akt inhibitor of the studied polymorphisms in the BDKR1, BDKR2, ACE and MBL2 genes on buy Napabucasin overall disease severity, localization and severity of particular attacks, frequency of oedema episodes or age

of disease onset was detected in either group of patients. Other genetic and/or environmental factors should be considered to be responsible for HAE clinical variability in Caucasians. Hereditary angiooedema (HAE) results from a genetic deficiency of C1 inhibitor (C1 Inh). It is characterized by recurrent, acute attacks of localized subcutaneous or submucosal oedema [1]. The most severe clinical manifestations include potentially life-threatening laryngeal oedema and gastrointestinal symptoms that may imitate acute abdominal emergency. Subcutaneous limb and face tissue and, on rare

occasions, urogenital tract mucous membranes may also be affected. Markedly decreased expression of C1 Inh in the plasma is called type I HAE, while expression of a dysfunctional C1 Inh protein, together with decreased levels of normal protein, is termed type II HAE [2]. Even though the genetic basis of HAE has been clearly identified and almost Dynein 200 mutations in the C1 inhibitor (SERPING1) gene have been described so far [3, 4] (http://hae.enzim.hu), oedema pathogenesis has not been yet fully understood. Patients usually become symptomatic during childhood or adolescence and demonstrate variability in the frequency and severity of oedema episodes. The frequency of attacks is neither correlated with the age of onset nor with their localization or severity and is highly variable even among family members carrying the same mutation in the SERPING1 gene [2, 5, 6]. The character and location of mutation can only provide evidence for HAE type I and II, but it provides no information on the clinical course of the disease. A limited genotype–phenotype correlation has been described in some splicing-defective mutations that seemed to be associated with a milder course of the disease. A recent family-based study indicated that the c.−21t/c polymorphic variant at the second base of exon 2 in the SERPING1 gene, when present in a non-mutated allele, may confer an increased risk of severe forms of the disease [7].

001, r = 0.4268). After 3 months of preventive therapy, there was an increase in the fraction of foxp3+ Treg, but no differences in markers of activation or apoptosis. In conclusion, there seems to be an increased level of immune activation and Treg in both latent and active TB infection that is only modestly influenced by preventive therapy. Mycobacterium tuberculosis (TB) infection is a major global health problem, especially in the developing world. In 2008, there were an estimated Forskolin ic50 8.9–9.9 million incident cases and approximately 2 million deaths from TB [1]. In addition, it is estimated that one-third of the world’s population is infected by TB. If the immunological balance between host

and pathogen

is disturbed, reactivation of latent TB infection (LTBI) and development of active disease may occur. Globally, the human immunodeficiency virus (HIV) is the most dominant risk factor for reactivation of LTBI as well as contracting primary TB infection. The cellular immune system plays a pivotal role in the immune defense against TB, and there is a critical balance between anti-TB T cell responses and immune-mediated pathology. TB induces a state of immune activation in the infected host, and an increased expression of activation markers on T cells in blood from patients with active TB has been described [2, 3]. T regulatory cells (Treg) are CD4+ T cells involved in regulation selleck kinase inhibitor of self-tolerance, autoimmunity and suppression of immune responses during infections [4, 5]. Treg cells were first recognized as CD4+ CD25+ T cells, RNA Synthesis inhibitor but expression of the intracellular marker forkhead box p3 (foxp3) and low cell-surface expression of the IL-7 receptor α-chain (CD127) have been suggested as more accurate markers [6–8]. However, recent studies have questioned whether these markers represent different populations of Treg [9]. Patients with active TB seem to have higher levels of CD4+CD25high+foxp3+ Treg cells in blood when compared

to both subjects with LTBI and uninfected controls [10–12]. It has been shown that Treg depress T cell-mediated immune responses to protective TB antigens during active TB disease [11]. The level of Treg seems to decrease after 1 month of anti-tuberculous therapy [13]. Dendritic cells (DCs), professional antigen-presenting cells, initiate adaptive immune responses and stimulate induction and expansion of Treg [14]. Studies have shown that DCs serve an important role in the initiation and control of immune responses to TB [15]. Two DC subsets have been characterized in blood based on differences in phenotype markers and function; myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) [16]. Decreased numbers of both DC subsets have been found in patients with active TB when compared to controls as well as increased pDC levels following successful anti-tuberculous therapy [17].

The average duration between the time of problem detection and the time of starting reexploration was 54 min in 7 cases, and other 2 cases were delayed to enter the operating room

which had been occupied by other cases of major trauma. Only two flaps were lost completely, two patients developed narrowing selleck products at the junction of cervical esophagus and thoracic esophagus. The rate of salvage for intestinal flap is apparently higher than those reported in the literature. In the postoperative management of microsurgery in ICU, telecommunication can help to reduce the ischemia time after vascular compromise in the transfer of free intestinal flap. Telecommunication is really an easy and effective tool in improving the outcome of reconstructive surgery. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012. “
“Despite the advantages of a fibula flap, many surgeons would often be hesitant in its use in patients with a history of distal fibular fracture. The chief concern is the potential vascular damage sustained during the injury. From our experience, however, we noticed that the blood supply RAD001 supplier of various components of a fibula flap rarely relies on its distal part alone. Avoiding the use of this flap may unnecessarily forgo the optimal reconstructive option in many patients. Free fibula flap was harvested from a 41-year-old man who had a history of left fibula fracture 10 years before surgery.

The fracture was treated with open reduction with internal fixation. The plate was removed 1 year after the trauma surgery. We used this fractured and healed fibula to reconstruct the intraoral and mandibular defect after tumor extirpation. ASK1 The harvesting process was straight-forward and the flap survived uneventfully. On the basis of our experience and current evidence in the literature, we believe that a history of previous fibular fracture should not be considered as an absolute contraindication for free fibular flap harvesting. With a good knowledge of the lower limb anatomy and appropriate patient selection, the fibular flap can still be a safe

option that incurs no additional risk. © 2014 Wiley Periodicals, Inc. Microsurgery, 2014. “
“Eleven patients over 40 years old, with median nerve lesions at the wrist, were operated on an average of 5 months after their injury. In six patients, the median nerve was repaired using a polypropylene mesh applied to secure the nerve stumps in contact, thereby allowing for direct repair with microsutures. Six patients had their median nerve repaired with sural grafts. The average gap length was 2.8 cm for the mesh repair, whereas it was 3.7 cm for the graft repair group. Eighteen months after surgery, pressure thresholds were perceived in the index and thumb pulp by all six patients with a mesh repair but in only two of five patients with a graft repair. Five in the mesh repair group recovered function in the abductor pollicis brevis muscle, versus none in the graft group.

HLA-DR3/DR4 alleles were also analysed. All T1AD patients satisfied the American Diabetes Association (ADA) classification criteria for type 1A diabetes [37]. This project was approved by the Ethics Committee for Research Project Analysis of Hospital das Clínicas, University of São Paulo School of Medicine. All the VX-809 in vivo samples were collected after the patients were provided with guidance and had signed a consent form. Autoantibodies against insulin

(IAA), glutamic acid decarboxylase (GAD65), tyrosine phosphatase (IA2) and 21-hydroxylase (21-OH) were assessed by radioimmunoassay (RSR Limited, Cardiff, UK). Autoantibodies against thyroid peroxidase (TPO) and thyroglobulin (TG) were evaluated by fluorometry (AutoDELPHIA, Turku, Finland). Anti-nuclear antibody (ANA), anti-liver/kidney microsomal

type 1 antibody (LKM1) and anti-smooth muscle (ASM) antibody were quantified using indirect immunofluorescence. Rheumatoid factor (RF) was evaluated using nephelometry, and TSH receptor autoantibody (TRAb) was assessed using iodine radioreceptor assay (RSR Limited). Genomic DNA was extracted by salting-out in blood leucocytes. The region encompassing −448 to +83 base pairs (bp) of the IL-21 gene was amplified and sequenced from samples of 309 Brazilian T1AD patients and 189 control individuals. The following www.selleckchem.com/products/Nolvadex.html primers were used for the IL-21 gene: (−448) forward: 5′-CCTTATGACTGTCAGAGAGAACA-3′ and (+83) reverse: 5′-CTTGATTTGTGGACCAGTGTC-3′. Direct sequencing of polymerase chain

reaction (PCR)-amplified products was performed using an ABI 3100 capillary sequencer (Applied Biosystems, Tokyo, Anidulafungin (LY303366) Japan) with the ABI PRISM BigDye Terminator version 3·1 cycle sequencing kit (Applied Biosystems) and analysed using an ABI PRISM 3730 genetic analyser (Applied Biosystems). The following PCR amplification reaction primers were used: PTPN22 forward: 5′-TCACCAGCTTCCTCAACCACA-3′ and PTPN22 reverse: 5′-GATAATGTTGCTTCAACGGAATTT-3′. PCR amplification products were digested enzymatically using the Xcml restriction enzyme (Uniscience-New England BioLabs, Inc., Ipswich, MA, USA), which resulted in a 215-bp product for the CC variant (wild-type); 215-bp, 169-bp and 46-bp products for the CT variant; and 169-bp and 46-bp products for the TT variant. PTPN22 genotyping was performed in 689 controls and 434 T1AD patients. All results were confirmed using an RsaI restriction enzyme assay (Uniscience). HLA class II typing for DRB1 was performed using PCR with One Lambda’s SSP™ Generic HLA class II (DRB) DNA typing trays (One Lambda, Canoga Park, CA, USA).

While the prevalence of AVF use in Australia and New Zealand is 75%, the number of prevalent patients

using a catheter has increased.[2] In addition, the proportion of patients commencing haemodialysis with an AVF is decreasing. Currently only 40% of patients start dialysis with an AVF or arteriovenous graft (AVG) in Australia and 25% in New Zealand.[2] In the USA the proportion of patients with a maturing or functional fistula at the start of haemodialysis is 31–34% with four Venetoclax datasheet out of five patients starting dialysis with a catheter.[3] AVF use in prevalent patients is 24% in the USA compared with 80% in Europe.[4, 5] Vascular access creation is a time consuming process as it involves patient education, surgical referral, surgical assessment, vascular access creation and subsequent maturation. Patients should be referred early to the nephrologist and vascular surgeon to allow sufficient time for education, planning, access creation and maturation.[6] At present, the optimum timing for referral to vascular surgery for vascular access placement is based on expert opinion and choices made by patients and physicians.[7] Thrombosis, stenosis, and infection are the three most prevalent complications of AVF and AVG increasing

reliance on central vascular catheters for dialysis access.[8] Good cannulation technique, examination Wee1 inhibitor of the fistula or graft, and implementing proven infection control practices are essential to minimizing risk factors which compromise an efficient vascular access. Patient education on monitoring the site and prompt

reporting of any changes, and adherence to good hygiene, are crucial in preventing AVF/AVG failure. The objective of this guideline is to review and summarize the evidence on selection of type of access with reference to mortality, access type, access patency and cost. Ribose-5-phosphate isomerase Evidence on the use of diagnostic tests such as ultrasound and venography to determine access creation will also be examined. Recommendations for the preparation, placement and care of the vascular access will be addressed. No recommendations possible based on Level I or II evidence. * (Suggestions are based on Level III and IV evidence) Whenever possible it is suggested that a native AVF is created and used for haemodialysis, as it is superior to an AVG and to a central venous catheter. When a native AVF is not possible, an artificial AVG should be used in preference to a central venous catheter. AVGs have similar patency to AVF after accounting for AVF primary failure at the expense of greater interventions to maintain patency. Preoperative ultrasound should be performed where there are no obvious veins on clinical examination, or there are any concerns about size or patency.

OD was measured with a microplate reader (detection wavelength: 570 nm; reference wavelength: 630 nm), and the tumouricidal activity was determined. Tumouricidal activity

(%) = [1−(ODexperiment–ODeffector cells)/ODtarget cells] × 100%. Statistical analysis.  Analysis was performed using spss 11.5 statistics software (SPSS inc., Chicago, IL, USA), and data were expressed as mean ± SD. Group comparisons were carried out by t-tests. The significance level was set at the P-value of 0.05. Pearson correlation coefficient was selected for bivariate correlation analysis. Correlations between variables were evaluated using Spearman’s correlation coefficient (rho). Wnt inhibitor review Flow cytometry plots of T cells, Th cells, NK cells and B lymphocytes from PBMCs were shown in Fig. 1. There were no marked differences

in the absolute numbers of see more peripheral blood T lymphocytes, NK cells or B lymphocytes among the three groups (P > 0.05 for each). In addition, there were no significant differences in T lymphocyte subsets or CD4+/CD8+ ratios noted among the three groups (Table 1) (P > 0.05 for each). As described in Methods, T lymphocytes were obtained from peripheral blood samples from 10 randomly selected members of each of the three subject groups. MTT assays were used to determine T cell proliferation. The stimulation index (SI) was the highest in group C (5.7 ± 1.9) and the lowest in group A (11.9 ± 2.8), and that in group B was 8.6 ± 2.6. There were significant differences in SI among the three groups (Table 2 and Fig. 2A) (P < 0.05). Bivariate correlation analysis revealed that the decrease in T lymphocyte stimulation index (SI) was age dependent, with a significant decrease in of individuals aged above 70 years, compared with the lower-age groups (r = −0.75; P < 0.0001) (Fig. 3A). As also described in Methods, CIK cells were prepared from PBMC samples of 10 randomly selected subjects from each of the three groups. These CIK cells were assessed for their tumouricidal activities. CIK tumouricidal activity was the highest in group C

(67.8 ± 10.1%) and the lowest in group A (43.8 ± 11.7%), and that in group B was 57.4 ± 10.3%. There were significant differences among the three groups (P < 0.05); CIK tumouricidal activity decreased with an increase in subject age (Table 2 and Fig. 2B). Bivariate correlation analysis revealed that the decrease in CIK tumouricidal activity was age dependent, with a significant decrease in individuals aged above 70 years, compared with the lower-age groups (r = −0.59; P < 0.001) (Fig. 3B). Ageing populations will present great challenges in the 21st century, and changes in immune function with increased age are closely related to senescence. In studies of immune-related senescence, various diseases, medical interventions, unhealthy lifestyles and other factors, except for ageing, that can affect immune function should be excluded.

However, whether GA acts directly on the monocyte population or through promiscuous modulation of multiple APC subsets to induce type II suppressor function in vivo is yet to be determined. To expand our understanding of the suppressive mechanisms of GA and elucidate whether GA https://www.selleckchem.com/products/pifithrin-alpha.html targets specific subsets of APC, we investigated the association between GA treatment and blood monocyte function. We found that following intravenous administration, GA directly and selectively targeted

blood monocytes in vivo without the requirement for MHC class II. GA+ monocytes exhibited enhanced suppression of T cell proliferation in vitro. Upon intravenous GA treatment, proliferation of myelin-specific T cells was also impaired in vivo. Interestingly, although TSA HDAC purchase subcutaneous GA treatment afforded protection from EAE, protection was associated with selective inhibition of IFN-γ production, rather than IL-17 or suppression of T cell proliferation. Our findings not only provide further examples of the mechanisms involved in GA-dependent suppression of autoimmune

reactivity but also illustrate that the different routes of GA administration engage different immunosuppressive pathways. Mice.  Breeding pairs of C57BL/6J (CD45.2+) mice were originally purchased from the Jackson Laboratory (Bar Harbor, ME, USA), and the congenic CD45.1+ mice (B6.SJLPtprca/Pepcb/BoyJ) were from the Animal Resource Centre (Canning Vale, WA, Australia). MHC class II–deficient B6Aa0/Aa0 mice were obtained from Dr H. Bluethmann (Hoffmann-La Roche, Basel, Switzerland). 2D2 mice (CD45.2+) expressing transgenic TCRs specific for

the MOG35–55 peptide (MEVGWYRSPFSRVVHLYRNGK) presented by IAb were obtained from Harvard Medical School (Boston, MA, USA) and derived as described [21] All mice were maintained at the Biomedical Research Unit, Malaghan Institute of Medical Research, Wellington, New Zealand. Experimental Sirolimus protocols were approved by the Victoria University of Wellington Animal Ethics Committee and performed according to their guidelines. Sex- and age-matched mice were used between 8 and 12 weeks of age for all experiments. Immunizations and treatment.  Experimental autoimmune encephalomyelitis was induced by subcutaneous immunization with 50-μg MOG35–55 (synthesized by Mimotopes, Clayton, Vic., Australia) emulsified in complete Freund’s adjuvant (CFA) containing 500 μg heat-killed Mycobacterium tuberculosis, followed by intraperitoneal injections of 250-ng pertussis toxin 1 day after immunizations. Mice were treated with GA simultaneously for EAE induction according to Gilgun-Sherki et al. [22], by immunization with a single emulsion containing both MOG35–55 and 500 μg GA (Teva Pharmaceutical, Petach Tikva, Israel).

Cells were maintained in culture for 6 days before their use. After 6 days, human macrophages (hMDMs) were detached by incubation with Accutase (Sigma Aldrich) for 30 min at 37°C and then plated on fibronectin- or Gelatin-FITC-coated coverslips for 24 h in the above medium with a FCS concentration of 1%. Mouse wild-type fibroblasts were isolated from 15–18 days embryos

by standard procedures and SYF (src–/–yes–/–fyn–/–) fibroblasts were Alectinib molecular weight obtained from ATCC. Fibroblasts were cultured in DMEM supplemented with 10% FCS, 100 U/mL penicillin, and 100 μg/mL streptomycin. For immunofluorescence experiments, cells were detached with trypsin and then plated for 24 h on fibronectin-coated coverslips in the above medium with a FCS concentration of 1%. Transfection of BMDMs was carried out by electroporation

using the NucleofectorTM technology of Amaxa (Koel, Germany) according to proposed protocols. Cells were transfected with control nonsilencing siRNA pool or mouse-specific ON-TARGET plus siRNA Reagents targeting Abl or Arg (Dharmacon, Lafayette, CO). For fluorescence Birinapant supplier microscopy (confocal analysis of podosome formation) and assays of gelatin degradation, matrigel migration, and trans-endothelial migration, cells were detached after 48 h from transfection and plated on fibronectin- or gelatin-coated coverlips for further 24 h. For assays of migration in 2D and immunoblotting, cells were assayed after 72 h of culture as above described. An aliquot of BMDMs used for the different assays was lysed to control for

the efficacy of Abl silencing by the siRNA-specific reagent. Mean per cent of Abl expression in BMDM Bay 11-7085 treated with siRNA targeting Abl was 37.8% ± 11 compared to control siRNA-treated ones. Cells were fixed with 4% (w/v) paraformaldehyde (PFA) for 30 min. PFA was quenched with 50 mM NH4Cl. Cells were then permeabilized with PBS-0.1% Triton X-100, blocked with 1% BSA for 30 min and stained with primary Ab for 1 h. Cells were stained with secondary Ab and rhodamine-phalloidin for 30 min, followed by DAPI (Sigma Aldrich) for 10 min. Images were collected using the SP5 confocal microscope from Leica Microsystems (Wetzlar, Germany) with a 63× objective. Images were processed for brightness and contrast with Adobe Photoshop. Controls were done by staining cells with secondary Abs only or, in the case of Abl, by staining BMDMs in which Abl was silenced with anti-Abl and secondary Abs. In either cases we did nondetect any signal. For gelatin degradation assays, coverslips were incubated with poly-L-Lysine for 20 min, washed with PBS and then incubated with 0.5% glutaraldehyde for 15 min. After washing with PBS, coverslips were put on a drop of 0.2 mg/mL Gelatin-FITC in PBS/2% sucrose, left for 10 min and washed again with PBS. BMDMs and hMDMs were plated for 24 h on gelatin-FITC-coated coverslips.

That faith may inform or determine medical decision-making. In the context of ESKD faith may enter deliberations on withholding or withdrawing from dialysis, the pursuit of interventions

and discussions around mortality and bereavement. Australia and New Zealand are multicultural and multireligious societies. In terms of the cultural and religious perspectives Selleck AZD1208 on serious illness such as ESKD, dialysis and death several points are fundamental: In modern societies patients may or may not have a religious faith. All patients have spirituality. It is important to avoid two approaches: Ignoring all cultural/religious diversity and applying one approach to all patients. Assuming that all patients from an ethnic background or religious faith will act or believe identically. An example would be thinking ‘All Chinese patients believe this …’. Cultural and religious beliefs may enter discussions at critical times in the trajectory of chronic kidney disease including pre-dialysis discussions, during dialysis, discussions around withdrawing from dialysis and the care of Transferase inhibitor the dying patient. It is important to enquire whether the medical decision-making is influenced partly or completely by religious beliefs as they need to be clarified and

examined. An example is where there is concern that withdrawing from dialysis constitutes suicide or be a serious affront to a deity. It is appropriate to encourage the patient or their family to seek the guidance of religious clerics or advisers within their faith. A short summary of the perspectives of the major world religions on serious illness and death follows. It is not possible to refer to all religions. In a clinical context, it is important to seek the perspective Loperamide of the individual patient and family as, even within the one body of faith, there may be divergent views. As there are a large number of denominations within the Christian faith, generalizations are difficult to make. Nevertheless, there is a common belief that Jesus Christ is the Son of God, that He rose from the dead and that

there is life after death. Attitudes to serious illness and death vary from acceptance to distress. Withdrawal from treatment, including dialysis is acceptable in Christian ethics. It is not seen as sinful or constituting suicide. Intentionally causing a patient to die is forbidden. The Jewish faith believes in one God and that the human body belongs to God. With that belief comes an obligation to heal. Jewish law is binding and Jews may wish to consult a Rabbi before making serious medical decisions. Withdrawal from treatment, including dialysis is acceptable in Jewish law and ethics if it is in the patient’s best interests. Suicide and euthanasia are against Jewish law. Islam’ means submitting to the will of God. Muslims, the followers of Islam, believe in one God. Prophets guide the faithful and the most influential was Muhammad. They believe that God spoke through Muhammad in the Qur’an.