Reaching rural veterans: a new mechanism to connect rural, low-income US Veterans with resources and improve food security.

BACKGROUND: Rural, low-income US veterans face additional barriers to accessing food and resources compared to urban veterans. Based on both social-ecological and cultural competence approaches, the Reaching Rural Veterans (RRV) pilot intervention built on the existing infrastructure of food pantries to improve food security and connect rural, low-income veterans with resources. This article describes the process of implementing and evaluating RRV. METHODS: Five rural food pantries within each of two states, Indiana and Kentucky, received training in cultural competence and held monthly outreach events where food and services were offered to veterans. Veteran adult participants completed an assessment at baseline and 3-month follow-up that measured food security using the US Household Food Security Survey Module and self-reported resource enrollment. Repeated measures logistic regression models evaluated the odds of improving food security and resource enrollment from baseline to follow-up (significance P < 0.05). RESULTS: RRV recruited 234 participants; 53% completed the follow-up assessment. At follow-up, the odds of household (P = 0.009) and adult (P = 0.01) food security increased, as did enrollment in one or more of the following resources: Temporary Assistance for Needy Families, Supplemental Security Income, General Assistance or Assistance from the Township Trustee (P = 0.005). CONCLUSIONS: RRV yielded promising preliminary results of improved food security and resource use.

Ontogeny of prolactin secretion in the neonatal rat is regulated posttranscriptionally.

PRL-secreting cells first appear in appreciable numbers on day 4 of neonatal life in rats. In the present study, we attempted to ascertain whether the ontogenic appearance of PRL mRNA and hormone release were temporally coordinated or discordant. Our results show that the PRL gene is expressed at least 3 days before the onset of secretion in newborn rats. Moreover, steady state levels of PRL mRNA in neonates are at least as high as those found in 10-day-old rats, in which 15-17% of all pituitary cells secret the hormone. This apparent blockage of translation is attributable to a lack of association of PRL message with ribosomes in the neonate. Taken together, these data indicate that the ontogeny of PRL secretion in rats is regulated translationally as well as transcriptionally.

Liver tissue from lactating rats produces a factor that stimulates prolactin release and gene expression.

Liver tissue from nursing rats produces a substance, termed liver lactogenic factor (LLF), that potently stimulates casein release from isolated mammary cells. Inasmuch as the production of LLF is dependent on PRL, we decided to determine whether it could influence the release of the hormone by dissociated pituitary cells in culture. This was accomplished by measuring PRL release with a reverse hemolytic plaque assay and PRL gene expression with a DNA probe complementary to PRL mRNA. Treatment of pituitary cells from day 10 lactating rats with liver slice incubates from the same type of animal caused a 35.3 +/- 4.3% increase in PRL release during a 3-h incubation. Likewise, the same dose of LLF activity markedly increased (3.5-fold) the steady state levels of PRL mRNA. The responses were reasonably specific for PRL, since neither GH plaque development nor gene expression was affected by identical treatment. Taken together these results demonstrate that LLF can act directly at the pituitary level to exert positive feedback effects on both PRL release and gene expression.

Induction of an acute phase response in lambs causes an increase in plasma levels of GH and IGF-I.

GH and IGF-I plasma concentrations were measured in lambs during an acute phase response induced by an intrathoracic injection of yeast. The acute phase response was indicated by reduced feed intake, weight loss and an increase in plasma concentrations of the acute phase protein haptoglobin. Intensive blood sampling on day 1 revealed elevated basal concentrations of GH in the yeast-injected group compared with concentrations in pair weight and ad libitum fed control lambs. This suggests that at the beginning of an acute phase response there is an increase in either GH secretion or the half life of GH. No evidence of a specific GH-binding protein in sheep plasma could be detected. IGF-I concentrations in the yeast-injected group remained constant for 3 days then increased to a peak level at day 6. In contrast, plasma IGF-I concentrations were depressed from days 3 to 6 in the pair weight control group and they were unchanged in the ad libitum fed controls. When the IGF-I concentrations were elevated in the yeast-injected group, this group had a higher daily weight gain despite their lower feed intake compared with the ad libitum fed controls. These results suggest that IGF-I may be associated with the increase in weight in the late stage of an acute phase response during recovery from an infection or injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Dexamethasone recruits atrial natriuretic peptide secretory cells in the rat left atrium and apex of the ventricle.

The response of the atrial natriuretic peptide (ANP) secreting cells from both rat atria and the apex of the ventricles to dexamethasone (DEX) was analyzed by the plaque assay. In right atrial cardiocytes, 25% of the cells secreted ANP basally; DEX treatment did not alter this percentage. However, in the left atrial secretory population, a discordance between the basal (15%) and DEX stimulated (25%) percent plaque formation was found. ANP secreting cells from the ventricular apex responded similarly to DEX exposure (26%), with 8% of the cells basally releasing the hormone. These data suggest that in both the left atria and apex of the rat ventricles, exposure to DEX recruits ANP secretory cells from a non-secreting population. Consequently, the release of ANP from these tissues would increase after glucocorticoid stimulation.

Attenuation of growth hormone gene expression in desensitized somatotropes.

The effects of GRF-induced desensitization of somatotropes on GH gene expression were investigated on pituitary cells derived from male rats. Pretreatment of monodispersed cells for 18 hr with GRF abolished both the acute release of GH and the stimulation of GH gene expression in response to a subsequent 4 hr challenge with GRF. Concomitant preincubation with GRF and SS resulted in restoration of the ability of GRF to stimulate release of GH but not to augment GH gene expression. These results demonstrate that desensitization by GRF affects both the release of GH and GH gene expression, whereas the resensitizing effects of SS appear to be directed exclusively at the release mechanism.

The late nonfunctioning duodenal atresia repair--a second look.

BACKGROUND/PURPOSE: In 1986, the authors reported on 3 newborns who had repair of their duodenal atresia, and between 6 and 18 months postoperatively an anastomotic obstruction developed in each suddenly. After prolonged medical and surgical treatments it became apparent that the duodenal atresia repair was functionally obstructed and plication of the dilated atonic proximal duodenum was curative. Since then, 2 more patients became so obstructed at 5 and 24 years postoperatively. The aim of this study was to report the very late occurrence of a functional obstruction of a newborn duodenal atresia repair. METHODS: The 2 additional histories and surgical repairs were reviewed. RESULTS: The 5-year old boy was cured immediately with plication only of his dilated proximal duodenum. The 24-year-old nurse had a very stormy 2-year course with several bypass operations, which did not relieve her abdominal pain and bile vomiting until they were taken down and her dilated proximal duodenum was plicated, after which she made a good recovery. Both remain well. CONCLUSION: An uncommon, very late, sudden, apparently anastomotic, postoperative, newborn, duodenal atresia repair obstruction caused by proximal, dilated, duodenal atony, and dysfunction can occur many years later and responds to duodenal plication alone.

Investigation of the nature and specificity of antinuclear antibody in dogs.

A liquid phase radioimmunoassay was used to test sera from 34 dogs in 3 categories, determined by presence of antinuclear antibody (ANA) and disease, for antibodies against native canine DNA and dAdT, a synthetic double-stranded DNA analog. Antibodies to dAdT were absent in healthy dogs which, as a group, had levels of DNA antibodies consistent with those reported for healthy persons. Canine patients with a variety of illnesses, but which remained ANA negative, had slightly increased levels of binding of DNA and dAdT. As a group, ANA-positive dogs had significantly increased binding of dAdT and native DNA, which was shown to be mainly, but not entirely, double stranded. In the ANA-positive group, no correlation was found among ANA titer, % DNA binding, and % dAdT binding, indicating that these 3 procedures detect antibodies with differing specificities. In dogs, ANA are heterogeneous in antigenic specificity. Antibodies to double-stranded nucleic acid in dogs do not appear to be as specific for systemic lupus erythematosus as they are reported to be in persons with autoimmune disease.

[Migraine and MIDAS (MIDASELA) in Colombian hospital workers]. / Migraña y MIDAS (MIDASELA) en trabajadores hospitalarios colombianos.

AIMS: The aim of this study was to determine the prevalence of migraine and its implications in the occupational and outside employment/daily activities of the workers at a regional hospital in the Cundiboyacense Plateau in Colombia. PATIENTS AND METHODS: The available members of the house staff at this institution were interviewed by applying the neuroepidemiological protocol drawn up by the World Health Organization (WHO); general doctors performed the initial screening and the determination of neurological disease was carried out by a clinical neurologist, both in patients who were positive and negative for neurological disease. Quality of life was evaluated by means of the MIDAS (Migraine Disability Assessment) survey, MIDASELA (in Spanish for Latin America); the analysis was performed using the EPI 6.04 software application. RESULTS: A total of 238 people were studied: 188 females and 50 males; the prevalence of migraine was 22.5% (15.5% by the WHO protocol and 7% false negatives), with predominance in females (OR: 5.49; p< 0.005). In the MIDASELA questionnaire, 47.2% of the patients had a 50% alteration in their productivity, with regard to their occupational and outside employment/daily activities. A minimum number of patients (3.8%) were unable to work because of migraine, as compared to the figures for outside employment/daily activities (29.7%) or those involving leisure/family (66.4%). The average work, outside employment/daily and family time lost per patient because of migraine was 0.3, 2 and 5.2 days, respectively. CONCLUSION: A sub register in the prevalence of migraine could be reported in places where the WHO protocol is used. This pathology will have to be taken well into account in Colombian hospital workers due to its individual, occupational, family, social and economic impact. It is necessary to introduce health policies and programmes aimed at evaluating, controlling and treating this type of pathology in an appropriate manner, in order to improve the quality of life of those whose job it is to look after and improve that of the other Colombians.

Partial tracheal obstruction due to chondromas in ball pythons (Python regius).

Over a 9-mo period, three adult ball pythons (Python regius) (one male, two females) were evaluated for severe dyspnea. Partial obstructions of the tracheal lumen were identified radiographically and/or visualized with a 3.0-mm rigid laparoscope inserted into the tracheal lumen in all three snakes. Administration of systemic antibiotics and nebulization resulted in partial improvement of the dyspnea. In two snakes, the tracheal lesions were removed with a rigid laparoscope and a flexible biopsy instrument inserted into the tracheal lumen. The other snake died and was necropsied. Histologically, the lesions from two snakes were determined to be benign chondromas. The chondromas were composed of a variably disorganized chondroid matrix populated by quiescent, normal-appearing chondrocytes within lacunae, although the chondrocytes were increased in density compared with normal hyaline cartilage and contained rare mitotic figures. The tracheal masses in one snake grew by expansion, not invasion, and were focally continuous with a mineralized cartilage tracheal ring, suggesting a benign nature. This is the second report of tracheal chondroma in ball pythons. Tracheal chondromas are exceedingly rare in humans and domesticated animals, suggesting a possible predisposition of ball pythons for this neoplasm.

Therapy for septic shock.

To adequately appraoch the therapeutics of such a diffuse disorder as sepsis, a firm grasp of the multiple pathophysiologic subsets is imperative. With this as a basis, therapy comes as close to applied physiology as is possible in medicine today.

PIP: Each year between 71,000 and 142,000 cases of septic shock are estimated to occur. Shock is a derangement in the homeostatic mechanisms of the body secondary to decreased tissue perfusion. The proper treatment of septic shock is based on complete understanding of the altered physiologic events, and, consequently, adequate therapy for shock should be approached from the standpoint of applied physiology in the clinical setting. Currently, sepsis is seen in the patients suffering multiple trauma or burns, undergoing immunosuppressive therapy for cancer or connective tissue disease, or who have undergone organ transplants. The initial therapy needs to consider carefully whether subtle clinical parameters are consistent with sepsis. Time and effort should be given to the prevention of septic shock. Good drainage procedures, proper nutritional therapy, and hydration needs to be maintained at all times. An early aggressive approach with regard to diagnosis can beneficially influence the outcome of infection by reducing the duration and complexity of therapy. Focus is on bacteriology and antimicrobial therapy, hemodynamic and fluid therapy, metabolic and nutritional aspects, complications, and steroids. 4 major complications of sepsis are abnormalities in the clotting pathway and changes in the renal, pulmonary, and cardiovascular systems. Steroids have been recommended for septic shock, for they are stabilizing to the lysosomal membranes in the splanchnic circulation. Experimentally, this has led to a decreased production of myocardial depressant factor. To use steroids properly large doses should be administered early in the shock state.

Nanotechnology makes biomass electrolysis more energy efficient than water electrolysis.

The energetic convenience of electrolytic water splitting is limited by thermodynamics. Consequently, significant levels of hydrogen production can only be obtained with an electrical energy consumption exceeding 45 kWh kg(-1)H2. Electrochemical reforming allows the overcoming of such thermodynamic limitations by replacing oxygen evolution with the oxidation of biomass-derived alcohols. Here we show that the use of an original anode material consisting of palladium nanoparticles deposited on to a three-dimensional architecture of titania nanotubes allows electrical energy savings up to 26.5 kWh kg(-1)H2 as compared with proton electrolyte membrane water electrolysis. A net energy analysis shows that for bio-ethanol with energy return of the invested energy larger than 5.1 (for example, cellulose), the electrochemical reforming energy balance is advantageous over proton electrolyte membrane water electrolysis.

Dexamethasone stimulates release of an ANP-like substance from rainbow trout cardiocytes.

A substance that cross-reacts with antiserum to human atrial natriuretic peptide (ANP) is found in fish hearts. This ANP-like material increases sodium output from the gill and kidney while inhibiting sodium uptake in the gut. Mammalian ANP secretion is stimulated by glucocorticoids, and cortisol injection increases sodium output in salt-loaded fish. Therefore, we wanted to determine if the release of ANP in fish is sensitive to dexamethasone. Ventricle cardiocytes from the rainbow trout Oncorhynchus mykiss were treated with various doses of dexamethasone for 18 or 72 h. Single ventricle cells were then assayed for ANP release using a reverse hemolytic plaque assay and antiserum to human alpha-ANP. Incubation with 100 microM dexamethasone almost doubled the population of ventricle cells committed to ANP release (basal, 15.0 +/- 0.3% vs. Dexamethasone, 28.3 +/- 1.4%; values are percent plaque formation +/- SE). Stimulation of ANP secretion was dependent on dose and time of exposure to dexamethasone. These results suggest that ANP secretion in fish is regulated by glucocorticoids.

Release of atrial natriuretic peptide from individual rat cardiocytes.

Atrial natriuretic peptide (ANP) is released from the atria and acts to regulate blood volume and pressure. The release of ANP appears to be stimulated by atrial distension, initiated by stretch on the cardiocytes. The purpose of the present study was to develop an assay that would allow for the detection of ANP release from single, isolated cells in the absence of distension. Using the reverse hemolytic plaque assay and antibody raised against human-alpha ANP, the release of ANP was detected from trypsin dissociated rat atrial cells. The specificity of the assay was demonstrated by a 67% reduction in ANP plaque forming cells detected following preabsorption of the anti-sera with rat-alpha ANP. The assay also proved efficient in monitoring changes in ANP secreting cell populations, where an acute treatment with dexamethasone resulted in a doubling of the percentage of atrial cardiocytes detected within a 4 hour antibody incubation. Finally, the assay established that about 52% of the dispersed atrial cardiocytes release ANP. The establishment of a plaque assay for ANP release should assist in addressing questions concerning what hormones may regulate ANP secretion directly and also allow for the determination of ANP secreting cell population dynamics.

Management of late cases of esophageal disruption with intravenous hyperalimentation.

Among fourteen patients with disruption of the thoracic esophagus, the overall mortality rate was 36%. The mortality was greatly reduced in a group of five of these patients who were treated by closed-chest tube drainage and intravenous hyperalimentation. The cause of death in most cases was sepsis and malnutrition. Although the ideal treatment in early cases of eosphageal disruption is thoracotomy and direct suture, it is believed that in patients presenting late, in old and debilitated patients, and in cases of a leaking thoracic anastomosis, the mortality will be greatly improved by the use, primarily, of conservative measures,, with the addition of intravenous hyperlimentation.