RESUMO
The early years life-stage (1 year either side of childbirth) is an important period for preventive action focusing on optimizing nutritional health for mothers and babies. Community pharmacy is a much utilized, easily accessed setting for health promotion and exposure to the primary health care system. The literature suggests that there has been limited exploration of pharmacy utilization by mothers, particularly in the context of nutrition focused health promotion. This study aimed to explore mothers' expectations and experiences of pharmacy based health care and to explore mothers' attitudes and opinions regarding opportunities and scope for nutrition-related health promotion in pharmacy. Qualitative semi-structured telephone interviews were conducted amongst a purposive sample of 28 mothers from across Queensland, Australia. Interviews were transcribed and analysed thematically using an iterative approach. Participants as relatively frequent users of pharmacy services accessed pharmacy for medicines or product related concerns but expected information and health advice to be available. Opportunities for nutrition promotion in pharmacy, identified by participants, related primarily to addressing their personal needs for information, advice and support during this life-stage. Improving and reorienting pharmacy staff practices may contribute to more supportive guidance being provided to mothers in this setting.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Serviços Comunitários de Farmácia/estatística & dados numéricos , Educação em Saúde/métodos , Promoção da Saúde/métodos , Fenômenos Fisiológicos da Nutrição Materna , Mães/psicologia , Adulto , Criança , Pré-Escolar , Escolaridade , Emprego/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , QueenslandRESUMO
Using sialyl Lewisx (SLX) oligosaccharides derived from fucosyl transferase-expressing cells or generated synthetically, the ability of these compounds to protect against acute lung damage after deposition of immunoglobulin (Ig)G or IgA immune complexes has been determined. The synthetic compounds were tetra- and pentasaccharide derivates of SLX as well as the nonfucosylated forms of SLX as controls. In the IgG immune complex model of lung injury, which is E-selectin dependent, SLX preparations provided dose-dependent protective effects, as assessed by changes in lung vascular permeability and hemorrhage. Protective effects were associated with diminished tissue accumulation of neutrophils in lungs (as assessed by myeloperoxidase). Morphological assessment revealed reduced physical contact of neutrophils with the pulmonary vascular endothelium and reduced tissue accumulation of neutrophils. In the model of IgA immune complex-induced lung injury, which does not involve participation of neutrophils and is independent of the requirement for E-selectin, SLX preparations were not protective. These data suggest that, in neutrophil-mediated and E-selectin-dependent lung injury, SLX preparations provide significant, protective effects against inflammatory vascular injury. The ability to achieve antiinflammatory outcomes in vivo with appropriate oligosaccharides suggests a new approach to the blocking of acute inflammatory responses.
Assuntos
Doenças do Complexo Imune/prevenção & controle , Oligossacarídeos/uso terapêutico , Pneumonia/prevenção & controle , Ácidos Siálicos/uso terapêutico , Doença Aguda , Animais , Células CHO , Sequência de Carboidratos , Moléculas de Adesão Celular/metabolismo , Cricetinae , Selectina E , Doenças do Complexo Imune/imunologia , Imunoglobulina A , Imunoglobulina G , Masculino , Dados de Sequência Molecular , Oligossacarídeos/biossíntese , Oligossacarídeos/química , Pneumonia/imunologia , Ratos , Receptores Imunológicos/metabolismo , Ácidos Siálicos/químicaRESUMO
To determine how the alpha(1,3)fucosyltransferases Fuc-TIV and Fuc-TVII, and the selectin ligands they control may contribute to the adaptive immune response, contact hypersensitivity (CHS) was characterized in mice deficient in either or both enzymes. We find a substantial CHS deficiency in Fuc-TVII(-/-) mice, and a complete deficiency in Fuc-TIV(-/-)/Fuc-TVII(-/-) mice. These defects are not accounted for by alterations in the number or function of epidermal Langerhans cells required for cutaneous antigen processing and presentation. By contrast, defective CHS in Fuc-TVII(-/-) mice or Fuc-TIV(-/-)/Fuc-TVII(-/-) mice is attributed in part to prominent, or nearly complete deficiencies, respectively, in the complement of naive T lymphocytes available in lymph nodes for antigen-dependent activation, expansion, differentiation, and dissemination. Fuc-TVII deficiency also deletes expression of E- and P-selectin ligands by Th1 and T cytotoxic 1 (Tc1) lymphocytes, annuls T cell trafficking to inflamed cutaneous sites in vivo, and thereby controls an essential component of the efferent phase of the cutaneous immune response. These observations indicate that collaborative contributions of Fuc-TIV and Fuc-TVII to L-selectin ligand synthesis, and to lymphocyte recruitment, are requisite components of the primary cellular immune response, and assign an essential role to Fuc-TVII in control of E- and P-selectin ligand expression by Th1 and Tc1 lymphocytes.
Assuntos
Fucosiltransferases/metabolismo , Linfonodos/imunologia , Selectinas/metabolismo , Linfócitos T Citotóxicos/imunologia , Linfócitos T/imunologia , Células Th1/imunologia , Animais , Diferenciação Celular , Polaridade Celular , Selectina E/metabolismo , Citometria de Fluxo , Fucosiltransferases/deficiência , Fucosiltransferases/genética , Inflamação/genética , Inflamação/fisiopatologia , Células de Langerhans/citologia , Células de Langerhans/fisiologia , Ligantes , Ativação Linfocitária , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Selectina-P/metabolismo , Linfócitos T/citologia , Linfócitos T Citotóxicos/citologia , Células Th1/citologiaRESUMO
Interaction of leukocytes in flow with adherent leukocytes may contribute to their accumulation at sites of inflammation. Using L-selectin immobilized in a flow chamber, a model system that mimics presentation of L-selectin by adherent leukocytes, we characterize ligands for L-selectin on leukocytes and show that they mediate tethering and rolling in shear flow. We demonstrate the presence of L-selectin ligands on granulocytes, monocytes, and myeloid and lymphoid cell lines, and not on peripheral blood T lymphocytes. These ligands are calcium dependent, sensitive to protease and neuraminidase, and structurally distinct from previously described ligands for L-selectin on high endothelial venules (HEV). Differential sensitivity to O-sialo-glycoprotease provides evidence for ligand activity on both mucin-like and nonmucin-like structures. Transfection with fucosyltransferase induces expression of functional L-selectin ligands on both a lymphoid cell line and a nonhematopoietic cell line. L-selectin presented on adherent cells is also capable of supporting tethering and rolling interactions in physiologic shear flow. L-selectin ligands on leukocytes may be important in promoting leukocyte-leukocyte and subsequent leukocyte endothelial interactions in vivo, thereby enhancing leukocyte localization at sites of inflammation.
Assuntos
Adesão Celular/fisiologia , Movimento Celular/fisiologia , Selectina L/metabolismo , Leucócitos/citologia , Glicoproteínas de Membrana/metabolismo , Animais , Cálcio/fisiologia , Linhagem Celular , Quelantes/farmacologia , Ácido Edético/farmacologia , Endopeptidases , Epitopos/análise , Fucosiltransferases/genética , Humanos , Ligantes , Metaloendopeptidases , Camundongos , N-Formilmetionina Leucil-Fenilalanina/farmacologia , Neuraminidase , Ativação de Neutrófilo , Polissacarídeos/farmacologiaRESUMO
Selectin-ligands on T cells contribute to the recruitment of circulating cells into chronic inflammatory lesions in the skin and elsewhere. This report provides the first evidence that a single fucosyltransferase, termed FucT-VII, controls the synthesis of E-selectin ligands in human T-lymphoblasts. The FucT-IV transferase (the ELFT enzyme), in contrast constructs lower avidity E-selectin ligands and requires enzyme levels found only in myeloid cells. Treatment of Jurkat cells with phorbol myristate acetate increased the expression of sialylated Lewis(x)-related sLe(x)related epitopes and induced the synthesis of E-selectin ligands functional at physiologic levels of linear shear-stress. Northern analysis revealed a parallel increase in the steady-state levels FucT-VII mRNA, but there were no increases in the two other leukocyte-associated fucosyltransferases (FucT-IV and VI). The stable transfection of the FucT-VII gene into Jurkat cells induced high levels of the sLe(x)-related epitopes and the synthesis of E-selectin ligands which equal or exceeded the avidity of those on circulating lymphocytes. The growth of T-lymphoblasts under conditions which induced expression of the sLe(x,a) epitopes increased the level of FucT-VII mRNA, the synthesis of sialylated-Lewis(x) structures by cell-free extracts and the synthesis of E-selectin ligands equal in avidity to those on FucT-VII transfectants. In contrast, neither the mRNA levels nor activities of the FucT-IV and VI enzymes increased in association with E-selectin ligand synthesis in T-lymphoblasts. Myeloid cell lines, unlike lymphoblasts, expressed high levels of both the FucT-VII and IV enzymes in conjunction with E-selectin ligands raising the possibility that both enzymes contributed to ligand synthesis. FucT-IV transfected Jurkat cells synthesized low avidity ligands for E-selectin but only in association with CDw65 (VIM-2) carbohydrate epitope. Only blood neutrophils and myeloid cell lines expressed this epitope at the levels associated with E-ligand synthesis in the transfectants. In contrast, native Jurkat cells, blood monocytes, blood lymphocytes, and cultured T-lymphoblasts expressed low levels or none. We conclude that FucT-VII is a principal regulator of E-selectin ligand synthesis in human T-lymphoblasts while both FucT-VII and FucT-IV may direct ligand synthesis in some myeloid cells.
Assuntos
Selectina E/metabolismo , Fucosiltransferases/fisiologia , Glicoproteínas de Membrana/biossíntese , Linfócitos T/metabolismo , Antígenos CD , Antígenos CD4/imunologia , Antígenos CD8/imunologia , Fucosiltransferases/genética , Humanos , Ligantes , Oligossacarídeos/metabolismo , Antígeno Sialil Lewis X , Linfócitos T/citologia , Linfócitos T/efeitos dos fármacos , Acetato de Tetradecanoilforbol/farmacologia , Células Tumorais CultivadasRESUMO
The fucose alpha(1-->2) galactose beta structure is expressed by uterine epithelial cells in the mouse and has been implicated in blastocyst adhesion events thought to be required for murine implantation. Fucalpha(1-->2)Galbeta moieties and cognate fucosyltransferases are also expressed by epithelial cells of the male reproductive tract and have been implicated in sperm maturation events that may contribute to fertilization. To determine directly if Fucalpha(1-->2)Galbeta moieties are required for fertility, we have generated strains of mice that are deficient in genes encoding FUT1 and FUT2, a pair of GDP-L-fucose:beta(1-->4)-D-galactosyl-R 2-alpha-L-fucosyltransferase enzymes (EC 2.4.1.69) responsible for Fucalpha(1-->2)Galbeta synthesis and expression. FUT1 null mice and FUT2 null mice develop normally and exhibit no gross phenotypic abnormalities. The Fucalpha(1-->2)Galbeta epitope is absent from the uterine epithelia of FUT2 null mice and from the epithelia of the epididymis of FUT1 null mice. Fully normal fertility is observed in FUT1 null intercrosses and in FUT2 null intercrosses. These observations indicate that Fucalpha(1-->2)Galbeta moieties are not essential to blastocyst-uterine epithelial cell interactions required for implantation and are not required for sperm maturation events that permit fertilization and that neither the FUT loci nor their cognate fucosylated glycans are essential to normal development.
Assuntos
Fertilidade/genética , Fucosiltransferases/genética , Polissacarídeos/biossíntese , Alelos , Animais , Blastocisto/metabolismo , Southern Blotting , Embrião de Mamíferos/citologia , Epididimo/metabolismo , Células Epiteliais/metabolismo , Feminino , Fertilidade/fisiologia , Fucosiltransferases/fisiologia , Genótipo , Heterozigoto , Homozigoto , Humanos , Imuno-Histoquímica , Lectinas/metabolismo , Masculino , Camundongos , Modelos Genéticos , Mutação , Fases de Leitura Aberta , Fenótipo , Reação em Cadeia da Polimerase , Células-Tronco/metabolismo , Útero/metabolismo , Galactosídeo 2-alfa-L-FucosiltransferaseRESUMO
BACKGROUND/OBJECTIVES: Nutrient profiling models classify the healthiness of foods based on their nutritional composition and provide the science that underlies nutrition signposting schemes. The two objectives were to examine the construct validity of the Health Star Rating (HSR) system by determining its diagnostic accuracy and to detect the optimal HSR cutoff points to define healthiness in packaged dairy foods. We hypothesised that ultra-processed dairy, defined by NOVA, would have less stars (less healthy) and non-ultra-processed dairy would have more stars (more healthy). SUBJECTS/METHODS: The diagnostic accuracy of the HSR system used for 621 dairy foods for sale in an Australian regional supermarket was investigated. The healthiness of packaged dairy was measured using the NOVA food classification system. RESULTS: The dairy beverages model was found to discriminate between healthy and less healthy dairy beverages as classified by NOVA (AUC: 0.653; 95% CI: 0.556-0.750; P=0.005). A receiver operating characteristic curve analysis for dairy beverages demonstrated that the optimal cutoff point corresponded to a rating of four stars. There was no discrimination power when using the HSR for predicting the health value of yoghurt and other dairy, or cheeses. CONCLUSIONS: At the optimal cutoff point of four stars the HSR has a high sensitivity but a low specificity to correctly classify healthy packaged dairy beverages, as defined by NOVA. We provide evidence to support the construct validity of the HSR model for dairy beverages, but not for the models used for yoghurts and other dairy products, or cheeses.
Assuntos
Laticínios , Rotulagem de Alimentos , Valor Nutritivo , Austrália , Humanos , Modelos Teóricos , Reprodutibilidade dos TestesRESUMO
Transcripts of alpha-(1,3)-fucosyltransferases in human epithelial cancer and leukemia cell lines were analyzed by Northern blotting and reverse transcriptase mediated-polymerase chain reaction using specific probes and primers which can discriminate between the transcripts derived from the four alpha-(1,3)-fucosyltransferase genes Fuc-TIII, IV, V, and VI. Flow cytometric analysis of the sialyl Le(x) and sialyl Le(a) antigens was also performed on the same cell lines. The sialyl Le(x) antigen was expressed on 14 of 15 epithelial cancer cell lines, and the sialyl Le(a) antigen was detected on 8 of them. The message of Fuc-TIII was detected in most of the epithelial cancer cell lines (14 of 15), which correlated with the surface expression of these carbohydrate determinants. In addition, the messages of Fuc-TIV and Fuc-TVI were detected in most epithelial cancer cell lines, while the message of Fuc-TV was undetectable in most of them. On the other hand, all leukemia cell lines were positively stained for sialyl Le(x), but none of them was stained for sialyl Le(a) in flow cytometry. The messages of Fuc-TIV++ were detected in all leukemia cell lines tested. Small quantities of Fuc-TIII, V, and/or VI messages were also detected in some leukemia cell lines in reverse transcriptase mediated-polymerase chain reaction analysis. These studies indicate that alpha-(1,3)-fucosyltransferase activities in epithelial cancer and leukemia cell lines are mixtures of multiple molecular species of alpha-(1,3)-fucosyltransferases. It is natural that epithelial cancer cells contain a significant amount of Fuc-TIII mRNA and leukemia cell lines contain Fuc-TIV mRNA, since their normal counterparts, normal epithelial cells and leukocytes, respectively, are known to contain these fucosyltransferases. The unexpectedly frequent occurrence of Fuc-TIV mRNA in epithelial cancer cell lines may be related to their retro-differentiation associated with tumorigenesis. Another unexpected finding was a weak but significant expression of the alpha-(1,3)-fucosyltransferases Fuc-TIII, V, and/or VI in leukemia cell lines detected by reverse transcriptase mediated-polymerase chain reaction analysis. Since these enzymes are known to be capable of synthesizing the sialyl Le(x) determinant, this finding implies a possibility that some of them may be involved in the synthesis of sialyl Le(x) in leukemia cells.
Assuntos
Biomarcadores Tumorais/análise , Fucosiltransferases/análise , Gangliosídeos/análise , Neoplasias/enzimologia , Adenocarcinoma/enzimologia , Sequência de Bases , Northern Blotting , Carcinoma de Células Escamosas/enzimologia , Moléculas de Adesão Celular , Selectina E , Citometria de Fluxo , Hepatoblastoma/enzimologia , Humanos , Leucemia/enzimologia , Dados de Sequência Molecular , Selectina-P , Glicoproteínas da Membrana de Plaquetas , Reação em Cadeia da Polimerase , RNA Mensageiro/análise , Células Tumorais CultivadasRESUMO
Leukocyte adhesion deficiency type II (LAD II) is a rare disorder characterized by recurrent infections, persistent leukocytosis, and severe mental and growth retardation. LAD II neutrophils are deficient in expression of selectin ligand activity, and exhibit a correspondingly diminished ability to roll on endothelium and to traffic to inflammatory sites in vivo. LAD II patients exhibit a deficiency in the expression of cell surface fucosylated glycan structures that include the H and Lewis blood group determinants and the sialyl Lewis x epitope, yet the corresponding fucosyltransferase activities responsible for synthesis of these structures are expressed at normal levels. The molecular defect in LAD II has been localized to the pathway that synthesizes GDP-fucose from GDP-mannose. However, the two known component enzymes in this GDP-fucose biosynthetic pathway are normal in sequence and in expression levels in LAD II cells. The genetic lesion in LAD II that accounts for the generalized fucosylation defect in LAD II patients remains to be determined.
Assuntos
Síndrome da Aderência Leucocítica Deficitária/genética , Sistema ABO de Grupos Sanguíneos/química , Sistema ABO de Grupos Sanguíneos/imunologia , Animais , Moléculas de Adesão Celular/imunologia , Linhagem Celular , Movimento Celular , Fucose/metabolismo , Fucosiltransferases/metabolismo , Guanosina Difosfato Fucose/biossíntese , Guanosina Difosfato Manose/metabolismo , Humanos , Hidroliases/antagonistas & inibidores , Hidroliases/metabolismo , Síndrome da Aderência Leucocítica Deficitária/imunologia , Síndrome da Aderência Leucocítica Deficitária/metabolismo , Leucócitos/imunologia , Antígenos do Grupo Sanguíneo de Lewis/química , Antígenos do Grupo Sanguíneo de Lewis/imunologia , Linfócitos/imunologia , Neutrófilos/imunologia , Fenótipo , Selectinas/metabolismoRESUMO
The bacterial transposon Tn5 possesses a regulatory mechanism that allows it to move with higher efficiency when it is first introduced into a cell than after it is established. Tn5 is a composite transposable element containing inverted repeats of two nearly identical elements, IS50R, which encodes the transposase protein necessary for Tn5 movement, and IS50L which contains an ochre mutant allele of the transposase gene. Data presented here show that Tn5 transposition is inhibited about 50-fold in cells of Escherichia coli which already carry IS50R in the multicopy plasmid pBR322. If the cells contain a plasmid carrying either IS50L instead of IS50R, or derivatives of IS50R in which the transposase gene has been mutated, little if any inhibition of Tn5 transposition is found. Although inhibition had previously been hypothesized to require interaction between the products of IS50L and IS50R, our results show that IS50R alone is sufficient to mediate inhibition and suggest that the inhibitor is a product of the transposase gene itself.
Assuntos
Elementos de DNA Transponíveis , Escherichia coli/genética , Genes Bacterianos , Bacteriófago lambda/genética , Vetores Genéticos , PlasmídeosRESUMO
Genetic mapping studies had shown that the bacterial transposon Tn5 can insert into many sites in a gene, but that some sites are preferred. To begin understanding Tn5's insertion specificity at the molecular level, we selected transpositions of Tn5 from the Escherichia coli chromosome to the plasmid pBR322 and analyzed the resultant pBR322::Tn5 plasmids by restriction endonuclease digestion and DNA sequencing. Seventy-five insertions in the tet gene were found at 28 sites including one major hotspot (with 21 insertions) and four lesser hotspots (with four to ten insertions each). All five hotspots are within the first 300 of the 1250-base pair (bp) tet gene. In contrast, 31 independent insertions in the amp gene were found in at least 27 distinct sites.--Tn5 generates 9 bp target sequence duplications when it transposes. Such transposon-induced duplications are generally taken to indicate that cleavages of complementary target DNA strands are made 9 bp apart during transposition. DNA sequence analysis indicated that GC base pairs occupy positions 1 and 9 in the duplications at each of the five hotspots examined, suggesting a GC-cutting preference during Tn5 transposition.
Assuntos
Elementos de DNA Transponíveis , Escherichia coli/genética , Sequência de Bases , Mapeamento Cromossômico , DNA Bacteriano/genética , Amplificação de Genes , Genes Bacterianos , PlasmídeosRESUMO
The reversion of lac:: Tn5 insertion mutations was used to examine the control of excision of the kanamycin-resistance transposon Tn5 in Escherichia coli. Earlier work which showed that the fertility factor F enhances Tn5 excision had led another group to suggest that this is due to the product of a putative transposable element-specific "recombination" gene in the F factor which can act on Tn5 located anywhere in the genome. We show, however, that Tn5 is excised from sites in the lac operon of F'lac plasmids several orders of magnitude more efficiently than from the same sites in the chromosomes of F-, F+ or homozygous lac:: Tn5[F'lac:: Tn5] strains. Thus F enhances Tn5 excision, but only if F and Tn5 are in cis in the same DNA molecule. Bacterial crosses showed that transfer of F'lac:: Tn5 plasmids by conjugation stimulates Tn5 excision, and that transfer is frequent even within F' populations. These results suggest that the ability of F to enhance excision is the consequence of DNA transfer in conjugation.
Assuntos
Elementos de DNA Transponíveis , Escherichia coli/genética , Fator F , Conjugação Genética , DNA Bacteriano/genética , Genes Bacterianos , MutaçãoRESUMO
On hundred fifty-four patients who underwent open mitral valvotomy in the years of 1968 to 1976 were reviewed 1 to 112 months (mean 48) postoperatively. There was one hospital death and there were 14 late deaths (nine cardiac), and 16 patients required reoperation during the follow-up period. Preoperative factors were examined to assess their association with an unsatisfactory postoperative course. End points included unsatisfactory symptomatic status, the need for reoperation, and postoperative death. Maori race and atrial fibrillation (AF) were associated with all three end points. Other preoperative factors associated with at least one unfavorable end point were female sex, unfavorable preoperative symptomatic status, the presence of mild associated mitral incompetence (MI), a previous operation, and the presence of calcification in the mitral valve. The degree of subvalvular fusion and the adequacy of valvotomy assessed at operation were also related to outcome. A binary regression program was developed to assist in the prediction of outcome from an assessment of preoperative factors. Preoperative embolism occurred in 31 patients and postoperative embolism in 13. Postoperative embolism occurred in 35% of patients with a preoperative embolic episode and AF. Open mitral valvotomy carries a low operative risk, but unfavorable preoperative factors militate against a satisfactory long-term result and protection from recurrent embolism is only partial.
Assuntos
Fibrilação Atrial/complicações , Estenose da Valva Mitral/cirurgia , Adolescente , Adulto , Calcinose/complicações , Criança , Embolia/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/mortalidade , Nova Zelândia , Complicações Pós-Operatórias , Recidiva , Risco , Fatores Sexuais , População BrancaRESUMO
The operative technique and the immediate and long-term results are described in 49 patients who have undergone myectomy for IHSS. There was a 4 percent early and 12 percent late mortality rate and surviving patients have been followed for up to 13 years. The operation has resulted in a striking symptomatic improvement in most patients in association with relief of outflow obstruction and mitral regurgitation. Chronic atrial fibrillation was poorly tolerated but has not occurred as a late complication in any of the patients operated upon.
Assuntos
Aorta Torácica , Estenose Aórtica Subvalvar/cirurgia , Cardiomiopatia Hipertrófica/cirurgia , Ventrículos do Coração , Adolescente , Adulto , Idoso , Aorta Torácica/cirurgia , Estenose Aórtica Subvalvar/diagnóstico por imagem , Arritmias Cardíacas/mortalidade , Criança , Pré-Escolar , Eletrocardiografia , Feminino , Seguimentos , Insuficiência Cardíaca/mortalidade , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/cirurgia , Hemodinâmica , Humanos , Embolia e Trombose Intracraniana/mortalidade , Masculino , Métodos , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/diagnóstico por imagem , Infarto do Miocárdio/mortalidade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/mortalidade , RadiografiaRESUMO
Nationwide dissemination of efficacious and cost-effective smoking cessation methods during the 1990s represents an important part of the solution to reducing the low birthweight (LBW) rate and associated health care costs. A minimum of 250,000 LBW births must be prevented during the 1990s to achieve the year 2000 LBW rate objective of 5% of total births. Annually 1,500 to 6,000 LBW births might be prevented between 1991 and 2000, and cumulatively 29,000 to 44,000, by dissemination of tested smoking cessation methods. Twelve to eighteen percent of the objective might be accomplished by dissemination. LBW births attributable to smoking might be reduced from the current 20% to 26% rate to a rate of 9% to 12% if the overall maternal smoking prevalence rate is reduced to 10% as projected in the Year 2000 Objectives. Smoking-attributable health care cost savings from dissemination would range from $22 million to $59 million.
Assuntos
Coeficiente de Natalidade/tendências , Recém-Nascido de Baixo Peso , Serviços de Informação , Abandono do Hábito de Fumar/métodos , Redução de Custos/tendências , Feminino , Custos de Cuidados de Saúde , Humanos , Recém-Nascido , Fumar/efeitos adversos , Abandono do Hábito de Fumar/economia , Estados UnidosRESUMO
INTRODUCTION: Australian national policies do not recommend skin cancer screening. We measured family physicians' beliefs, self-reported practices, and predictors of using clinical skin examination for skin cancer screening. METHOD: Random self-administered postal survey of 1271 Australian family physicians (FPs) performed during 1996, obtaining 855 completed questionnaires (67% response rate). RESULTS: Eighty-six percent of FPs surveyed indicated that they thought clinical skin examination was effective in reducing premature death from skin cancer; 72% indicated that they should be performed annually; and 60% indicated that all adults should be screened. Only 3% indicated correctly that screening has not been tested to determine its effectiveness. Although most FPs were unlikely to adopt an opportunistic approach to screening, 64% indicated that they would recommend clinical skin examination during a health check-up. FPs in northern (high incidence) latitudes were 3 to 4 times more likely to adopt opportunistic screening, and twice as likely to discuss clinical skin examination in a dedicated check-up. FPs were more likely to advocate screening in male rather than female patients. Half of respondents were unaware of relevant guidelines. CONCLUSION: Although Australian policies do not recommend clinical skin examination because of insufficient evidence as yet of effectiveness, FPs show considerable support for screening. Geographic location, patient gender, and physician beliefs predict the self-reported provision of clinical skin examination by family physicians, suggesting that factors other than published guidelines affect clinical practice.
Assuntos
Atitude do Pessoal de Saúde , Carcinoma/prevenção & controle , Medicina de Família e Comunidade/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Neoplasias Cutâneas/prevenção & controle , Adulto , Fatores Etários , Austrália , Intervalos de Confiança , Coleta de Dados , Medicina de Família e Comunidade/métodos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Área de Atuação Profissional , Inquéritos e QuestionáriosRESUMO
Recent prevalence rates show that by Year 10 (ages 14-16 years), 15% of students are smoking each day. As the majority of young people do not smoke, schools have traditionally provided an emphasis on prevention. However, the prevalence of daily smoking increases from 15 to 31% across the last 3 years of secondary school, suggesting a need for cessation programs. Therefore, a study of smoking cessation among students was conducted with 2877 Year 10 students in Queensland, Australia. Results of the survey showed that students (i) moderately under-estimated the number of smoking peers who had tried to stop smoking (perceived as 42%, reported as 55%), and (ii) over-estimated the success their smoking peers have (perceived as 29%, reported as 13.6%). The majority of adolescents (57.5%) reported that they had done something to influence a student not to smoke in the last 12 months, including 29% of the smokers. Among those who were current smokers, 64% wanted to stop smoking and 55% had tried to stop in the past year. Withdrawal symptoms were frequently reported among adolescent smokers and more males than females reported being stressed and depressed as a result of their efforts to quit. Intention to quit in the next year was associated with high confidence in ability to quit. These issues deserve attention in prevention programs and the development of age appropriate cessation material for adolescents should have high priority.
Assuntos
Abandono do Hábito de Fumar/estatística & dados numéricos , Fumar/epidemiologia , Adolescente , Estudos Transversais , Feminino , Educação em Saúde , Humanos , Incidência , Masculino , Nicotina/efeitos adversos , Grupo Associado , Queensland/epidemiologia , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Prevenção do Hábito de Fumar , Síndrome de Abstinência a Substâncias/epidemiologia , Síndrome de Abstinência a Substâncias/prevenção & controle , Síndrome de Abstinência a Substâncias/psicologiaRESUMO
Although the majority of adolescents in the 13-18 age range are at school, there is a need to target specific groups of young smokers such as unemployed youth. For those young people who are not at school, few directed programs are available in either prevention or cessation and information is needed about the design and delivery of appropriate programs for this population. This report presents the results from a survey of unemployed youth and students at vocational colleges about various aspects of smoking cessation. The majority of out-of-school youth smokers had not tried to quit, but 52% were contemplating action to quit. Only a quarter of the smokers had quit for more than a week. Few young smokers would use a recognised program though more females would change to a lower nicotine brand, quit with the help of a friend or participate in a group quit program. The method of quitting most would recommend to peers is 'use of will power'. Incentives to quit were attractive to only a third of the smokers, and many enhancing and inhibiting factors for participation in programs were identified. In particular, efforts to quit increased their confidence in quitting, supporting the need to assist those who are contemplating action to quit. Programs need to incorporate input from youth and be tailored for them but not necessarily for different groups such as non-secondary school students and unemployed youth.
Assuntos
Abandono do Hábito de Fumar/psicologia , Fumar/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Projetos Piloto , Fumar/tendências , Abandono do Hábito de Fumar/métodos , Desemprego , Educação VocacionalRESUMO
Recent developments in recombinant DNA technology have made possible the production of gene probes consisting of cloned gene segments, cloned segments of DNA linked to genes, and synthetic gene fragments. Several methods have been developed by which these probes may be used for the diagnosis of human disease. This technology has been outstandingly successful for prenatal diagnosis and carrier detection in many genetic diseases. These methods have also been successfully applied to the analysis of human malignancies, by providing for the determination of cell lineage and clonality in lymphoid neoplasms. Finally, these methods have shown potential for rapid and sensitive diagnosis of some infectious diseases.
Assuntos
DNA Recombinante , Doenças Genéticas Inatas/diagnóstico , Infecções/diagnóstico , Leucemia Linfoide/diagnóstico , Linfócitos B , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/genética , Biotina , Clonagem Molecular , DNA/genética , Enzimas de Restrição do DNA , Desoxirribonucleotídeos/síntese química , Feminino , Triagem de Portadores Genéticos , Doenças Genéticas Inatas/genética , Genótipo , Hemofilia A/diagnóstico , Hemofilia A/genética , Humanos , Imunoglobulinas/genética , Infecções/genética , Leucemia Linfoide/genética , Leucócitos/análise , Masculino , Distrofias Musculares/diagnóstico , Distrofias Musculares/genética , Hibridização de Ácido Nucleico , Fenilcetonúrias/diagnóstico , Fenilcetonúrias/genética , Radioisótopos de Fósforo , Polimorfismo Genético , Gravidez , Diagnóstico Pré-Natal , RNA/genética , Receptores de Antígenos de Linfócitos T/genética , Linfócitos T , Viroses/diagnóstico , Viroses/genéticaRESUMO
The structures of intestinal and liver fatty acid binding proteins (FABPs) have been determined from an analysis of the nucleotide sequences of cloned cDNAs. The primary translation product of intestinal FABP mRNA contains 132 residues (Mr = 15 124). Liver FABP mRNA encodes a 127 amino acid polypeptide (Mr = 14 273). In vitro co-translational cleavage and translocation assays showed that neither sequence has a cleavable signal peptide or signal peptide equivalent - suggesting that the FABPs do not enter the secretory apparatus but rather are targeted to the cytoplasm. A variety of computational techniques were used to compare the two FABP sequences. The results indicate that liver and intestinal FABP are paralogous homologues. A superfamily of proteins was defined which includes the FABPs, the cellular retinol and retinoic acid binding proteins, the P2 protein of peripheral nerve myelin, and a polypeptide known as 422 whose synthesis is induced during differentiation of 3T3-L1 cells to adipocytes. No sequence homologies were noted between any of these small molecular weight cytosolic proteins and nonspecific lipid transfer protein (sterol carrier protein 2), phosphatidylcholine transfer protein, serum albumin or apolipoprotein AI. The FABPs may have structural features responsible for lipid-protein interactions that are not present in these non-homologous sequences. The distribution of intestinal and liver FABP mRNAs in adult rat tissues and the changes in FABP gene expression which occur during gastrointestinal development support the notion that these proteins are involved in fatty acid uptake, transport and/or compartmentalization. However, differences in tissue distribution and periods of non-coordinate expression during gastrointestinal ontogeny suggest that the two FABPs have distinct functions. The relationship between intestinal and liver FABPs and similar sized cytosolic FABPs isolated from brain, skeletal and cardiac muscle remains unclear. Recombinant DNA techniques combined with comparative sequence analyses offer a useful approach for defining unique as well as general structure-function relationships in this group of fatty acid binding proteins.