ABSTRACT
In this study, we aimed to validate existing plasma assays to measure biomarkers for maternal signalling in milk and saliva of lactating sows. These biological samples are minimally invasive to the animal and could give a physiological profile of maternal qualities available to their piglets. Sows were farrowed in a zero-confinement system, and their colostrum and milk samples were manually collected during naturally occurring let-downs (i.e. not induced) over the lactation period. Saliva sampling involved sows voluntarily accepting cotton buds to chew without restraint. Commercial kits designed for blood plasma were tested, and any modifications and results are given. We successfully measured total protein, cortisol, tumour necrosis factor-α (TNF-α) and oxytocin in pig milk and saliva and immunoglobulin G (IgG) in pig milk samples. We were unsuccessful at measuring relaxin and serotonin in these biological samples. We observed higher levels of biomarkers in milk than in saliva. The measurement of TNF-α in pig milk for the first time revealed increased levels with larger litters. This development will allow more detailed understanding of biomarkers in milk. There was also evidence that the minimally invasive technique of using saliva sampling did not interrupt natural oxytocin production around parturition.
Subject(s)
Lactation , Milk , Animals , Biomarkers , Colostrum , Diet , Female , Immunoglobulin G , Pregnancy , Saliva , SwineABSTRACT
BACKGROUND: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR. METHODS: The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy. RESULTS: A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21·0 per cent; mastectomy: 570, 37·2 per cent; mastectomy and IBR: 359, 35·6 per cent; P < 0·001). Breast conservation was possible in 87·0 per cent of patients who had TM, and TM did not delay adjuvant treatment. CONCLUSION: TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety.
ANTECEDENTES: La mamoplastia terapéutica (therapeutic mammaplasty, TM) puede ser una alternativa a la mastectomía, pero hay pocos estudios bien diseñados que hayan evaluado el éxito de esta estrategia o hayan comparado los resultados a corto plazo de la TM con la mastectomía con o sin (+/-) reconstrucción mamaria inmediata (immediate breast reconstruction, IBR). Para comparar la seguridad y los resultados a corto plazo de la TM y la mastectomía +/- IBR se combinaron los datos de los estudios nacionales iBRA-2 y TeaM. MÉTODOS: En el estudio TeaM se identificó el subgrupo de pacientes al que se realizó una TM para evitar la mastectomía y se compararon los datos demográficos, las complicaciones, los resultados oncológicos y el tratamiento adyuvante con las pacientes sometidas a mastectomía +/- IBR del estudio iBRA-2. La variable principal fue el porcentaje de éxito de la cirugía conservadora de mama en el grupo TM. Las variables secundarias fueron las complicaciones postoperatorias y el intervalo de tiempo hasta el inicio del tratamiento adyuvante. RESULTADOS: Se incluyeron en el análisis 2.916 pacientes (TM n = 376; mastectomía n = 1.532; IBR n = 1.008). La TM era más frecuente en pacientes obesas o en las sometidas a cirugía bilateral en comparación con las pacientes con IBR. Sin embargo, las pacientes sometidas a una mastectomía +/- IBR tenían más probabilidades de desarrollar complicaciones que las del grupo TM (TM n = 79, 21,0%; mastectomía n = 570, 37,2%; mastectomía y IBR n = 359, 35,6%; P < 0,001). La conservación de la mama fue posible en el 87% de las pacientes con TM y el procedimiento no retrasó el inicio del tratamiento adyuvante. CONCLUSIÓN: La TM puede permitir que pacientes de alto riesgo que no serían candidatas a IBR eviten la mastectomía de una forma segura. Se necesitan más trabajos para comparar los resultados percibidos por las pacientes y los estéticos de las diferentes estrategias terapéuticas y establecer la seguridad oncológica a largo plazo.
Subject(s)
Mammaplasty , Mastectomy , Adult , Aged , Aged, 80 and over , Female , Humans , Kaplan-Meier Estimate , Logistic Models , Mammaplasty/adverse effects , Mammaplasty/methods , Mastectomy/adverse effects , Mastectomy/methods , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Proportional Hazards Models , Treatment Outcome , Young AdultABSTRACT
Group A Streptococcus (GAS) is a globally important human pathogen that causes a broad spectrum of disease ranging from mild superficial infections to severe invasive diseases with high morbidity and mortality. Currently, there is no vaccine available for human use. GAS produces a vast array of virulence factors including multiple adhesin molecules. These mediate binding of the bacteria to host tissues and are essential in the initial phases of infection. Prophylactic vaccination with adhesins is a promising vaccine strategy and many GAS adhesins are currently in development as vaccine candidates. The most advanced candidates, having entered clinical trials, are based on the M protein, while components of the pilus and a number of fibronectin-binding proteins are in pre-clinical development. Adhesin-based vaccines aim to induce protective immunity via two main mechanisms: neutralisation where adhesin-specific antibodies block the ability of the adhesin to bind to host tissue and opsonisation in which adhesin-specific antibodies tag the GAS bacteria for phagocytosis. This review summarises our current knowledge of GAS adhesins and their structural features in the context of vaccine development.
Subject(s)
Adhesins, Bacterial/immunology , Bacterial Proteins/immunology , Streptococcal Infections/prevention & control , Streptococcal Vaccines/immunology , Streptococcal Vaccines/isolation & purification , Streptococcus pyogenes/immunology , Animals , Antibodies, Neutralizing/blood , Clinical Trials as Topic , Drug Discovery/trends , Drug Evaluation, Preclinical , Humans , Opsonin Proteins/bloodABSTRACT
BACKGROUND AND PURPOSE: Infantile neuronal ceroid lipofuscinosis is a devastating neurodegenerative storage disease caused by palmitoyl-protein thioesterase 1 deficiency, which impairs degradation of palmitoylated proteins (constituents of ceroid) by lysosomal hydrolases. Consequent lysosomal ceroid accumulation leads to neuronal injury, resulting in rapid neurodegeneration and childhood death. As part of a project studying the treatment benefits of a combination of cysteamine bitartrate and N-acetyl cysteine, we made serial measurements of patients' brain volumes with MR imaging. MATERIALS AND METHODS: Ten patients with infantile neuronal ceroid lipofuscinosis participating in a treatment/follow-up study underwent brain MR imaging that included high-resolution T1-weighted images. After manual placement of a mask delineating the surface of the brain, a maximum-likelihood classifier was applied to determine total brain volume, further subdivided as cerebrum, cerebellum, brain stem, and thalamus. Patients' brain volumes were compared with those of a healthy population. RESULTS: Major subdivisions of the brain followed similar trajectories with different timing. The cerebrum demonstrated early, rapid volume loss and may never have been normal postnatally. The thalamus dropped out of the normal range around 6 months of age; the cerebellum, around 2 years of age; and the brain stem, around 3 years of age. CONCLUSIONS: Rapid cerebral volume loss was expected on the basis of previous qualitative reports. Because our study did not include a nontreatment arm and because progression of brain volumes in infantile neuronal ceroid lipofuscinosis has not been previously quantified, we could not determine whether our intervention had a beneficial effect on brain volumes. However, the level of quantitative detail in this study allows it to serve as a reference for evaluation of future therapeutic interventions.
Subject(s)
Brain/diagnostic imaging , Magnetic Resonance Imaging/methods , Neuronal Ceroid-Lipofuscinoses/diagnostic imaging , Acetylcysteine/therapeutic use , Aging/pathology , Brain Stem/diagnostic imaging , Cerebellum/diagnostic imaging , Cerebrum/diagnostic imaging , Child , Child, Preschool , Cysteamine/therapeutic use , Electroencephalography , Female , Follow-Up Studies , Humans , Infant , Male , Neuronal Ceroid-Lipofuscinoses/drug therapy , Thalamus/diagnostic imagingABSTRACT
AIM: To assess the effect of several commercial essential oils samples Australian lemon myrtle (Backhousia citriodora), cinnamon bark (Cinnamomum zeylanicum), oregano (Origanum vulgare), thyme oil (Thymus vulgaris), clove bud (Eugenia caryophyllata), valerian (Valeriana officinalis) and Australian tea tree oil (Melaleuca alternifolia) on mycelium growth and spore germination of Monilinia fructicola. The effectiveness of lemon myrtle essential oil as a fumigant for the control of brown rot in nectarines was evaluated. METHODS AND RESULTS: Monilinia fructicola exhibited a different level of sensitivity to each tested essential oil with results suggesting that the essential oils provide excellent control of the pathogen with respect to mycelium growth and spore germination at very low concentrations, whereas for others higher concentrations are needed to reduce significant fungal growth. In vivo application of lemon myrtle essential oil effectively reduced the incidence of M. fructicola on noninoculated fruit. Fumigation of nectarines following inoculation did not reduce the incidence of brown rot in comparison with the inoculated control treatment. No evidence of phytotoxicity on the fruit was recorded. CONCLUSIONS: Lemon myrtle essential oil exhibited the strongest antifungal activity against M. fructicola, in vitro and to a lesser extent, under in vivo conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: The results demonstrate that lemon myrtle essential oil, in particular, has potential as an antifungal agent to control M. fructicola.
Subject(s)
Ascomycota/drug effects , Fungicides, Industrial/pharmacology , Oils, Volatile/pharmacology , Plant Oils/pharmacology , Ascomycota/growth & development , Australia , Cinnamomum zeylanicum/chemistry , Citrus/microbiology , Fruit/microbiology , Fumigation , Mycelium/drug effects , Mycelium/growth & development , Origanum/chemistry , Spores, Fungal/drug effects , Spores, Fungal/growth & development , Syzygium/chemistry , Thymus Plant/chemistryABSTRACT
BACKGROUND: Autosomal dominant partial epilepsy with auditory features (ADPEAF) is an idiopathic focal epilepsy syndrome with auditory symptoms or receptive aphasia as major ictal manifestations, frequently associated with mutations in the leucine-rich, glioma inactivated 1 (LGI1) gene. Although affected subjects do not have structural abnormalities detected on routine MRI, a lateral temporal malformation was identified through high resolution MRI in one family. We attempted to replicate this finding and to assess auditory and language processing in ADPEAF using fMRI and magnetoencephalography (MEG). METHODS: We studied 17 subjects (10 affected mutation carriers, 3 unaffected carriers, 4 noncarriers) in 7 ADPEAF families, each of which had a different LGI1 mutation. Subjects underwent high-resolution structural MRI, fMRI with an auditory description decision task (ADDT) and a tone discrimination task, and MEG. A control group comprising 26 volunteers was also included. RESULTS: We found no evidence of structural abnormalities in any of the 17 subjects. On fMRI with ADDT, subjects with epilepsy had significantly less activation than controls. On MEG with auditory stimuli, peak 2 auditory evoked field latency was significantly delayed in affected individuals compared to controls. CONCLUSIONS: These findings do not support the previous report of a lateral temporal malformation in autosomal dominant partial epilepsy with auditory features (ADPEAF). However, our fMRI and magnetoencephalography data suggest that individuals with ADPEAF have functional impairment in language processing.
Subject(s)
Auditory Cortex/physiopathology , Auditory Perception/genetics , Epilepsies, Partial/complications , Language Disorders/physiopathology , Speech Perception/genetics , Acoustic Stimulation , Adult , Auditory Cortex/pathology , Brain Mapping , Chromosome Disorders/complications , Chromosome Disorders/genetics , Epilepsies, Partial/genetics , Female , Functional Laterality/genetics , Genes, Dominant/genetics , Humans , Intracellular Signaling Peptides and Proteins , Language Disorders/genetics , Language Disorders/pathology , Language Tests , Magnetic Resonance Imaging , Magnetoencephalography , Male , Mutation/genetics , Proteins/genetics , Reaction Time/geneticsABSTRACT
Tuberculosis (TB) infects one-third of the world population. Despite 50 years of available drug treatments, TB continues to increase at a significant rate. The failure to control TB stems in part from the expense of delivering treatment to infected individuals and from complex treatment regimens. Incomplete treatment has fueled the emergence of multi-drug resistant (MDR) strains of Mycobacterium tuberculosis (Mtb). Reducing non-compliance by reducing the duration of chemotherapy will have a great impact on TB control. The development of new drugs that either kill persisting organisms, inhibit bacilli from entering the persistent phase, or convert the persistent bacilli into actively growing cells susceptible to our current drugs will have a positive effect. We are taking a multidisciplinary approach that will identify and characterize new drug targets that are essential for persistent Mtb. Targets are exposed to a battery of analyses including microarray experiments, bioinformatics, and genetic techniques to prioritize potential drug targets from Mtb for structural analysis. Our core structural genomics pipeline works with the individual laboratories to produce diffraction quality crystals of targeted proteins, and structural analysis will be completed by the individual laboratories. We also have capabilities for functional analysis and the virtual ligand screening to identify novel inhibitors for target validation. Our overarching goals are to increase the knowledge of Mtb pathogenesis using the TB research community to drive structural genomics, particularly related to persistence, develop a central repository for TB research reagents, and discover chemical inhibitors of drug targets for future development of lead compounds.
Subject(s)
Antitubercular Agents/pharmacology , Crystallography , Drug Design , Mycobacterium tuberculosis/drug effects , Arginine/metabolism , Bacterial Proteins/antagonists & inhibitors , Bacterial Proteins/chemistry , Drug Evaluation, Preclinical , Iron/metabolism , Malate Synthase/antagonists & inhibitors , Malate Synthase/chemistry , Microfluidic Analytical Techniques , Monosaccharide Transport Proteins/antagonists & inhibitors , Monosaccharide Transport Proteins/chemistry , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/metabolism , Mycolic Acids/antagonists & inhibitors , Peptide Synthases/antagonists & inhibitors , Peptide Synthases/chemistry , X-Ray DiffractionABSTRACT
BACKGROUND: Several studies in isolated cells have reported that intracellular pH (pHi) in individuals with essential hypertension may be relatively alkaline compared to normotensive individuals. Such an abnormality of pHi in hypertension would be consistent with enhanced sodium-hydrogen exchanger activity and may provide potential mechanisms by which hypertension and its complications could develop. OBJECTIVES: To determine in-vivo intracellular pH of skeletal muscle at rest and during recovery from exercise-induced acidosis in hypertensive and normotensive subjects. METHODS: Using 31-phosphorus magnetic resonance spectroscopy, pHi of the dominant flexor digitorum superficialis was measured in 20 Caucasian subjects (14 male) with essential hypertension and 20 normotensive controls matched for gender, age, race and body mass index. Measurements were made at rest and during the exercise and recovery periods of a stepped incremental maximal exercise protocol. The rate of pHi recovery from exercise-induced acidosis was calculated by linear regression over the first 210 s of recovery from the pHi time plots of respective subjects. RESULTS: Mean resting pHi in the hypertensive (7.05 +/- 0.04) and normotensive groups (7.06 +/- 0.04) were not significantly different. There was a significant effect of gender on pHi: mean pHi was 7.07 +/- 0.03 in males and 7.02 +/- 0.03 in females, respectively (P < 0.0005). The mean intracellular pH achieved by exercise was 6.74 +/- 0.31 in hypertensive individuals and not significantly different in normotensive individuals (6.68 +/- 0.19; P = 0.4). The mean rate of pHi recovery in the hypertensives was 0.08 +/- 0.03 pH units/min and not significantly different in normotensives (0.08 +/- 0.02; P = 0.4). CONCLUSIONS: These results contrast with previously documented abnormalities in the control of pHi in hypertension and demonstrate the absence of major in-vivo disturbances of pHi in skeletal muscle, both at rest and during recovery from exercise-induced acidosis, in essential hypertension. Therefore, it is possible that previously documented abnormalities of pHi and activity of the exchanger may be either specific to cell type or not present under in-vivo conditions.
Subject(s)
Exercise/physiology , Hydrogen/metabolism , Hypertension/metabolism , Intracellular Membranes/metabolism , Muscle, Skeletal/metabolism , Female , Humans , Hydrogen-Ion Concentration , Magnetic Resonance Spectroscopy , Male , Middle Aged , Phosphorus , Reference Values , Rest , Sex CharacteristicsABSTRACT
OBJECTIVES: To investigate short-term effects of Multi-Sensory Stimulation (MSS) on behaviour, mood and cognition of older adults with dementia, the generalization of effects to day hospital and home environments and the endurance of any effects over time. DESIGN: A randomized controlled trial comparing MSS with a credible control of one-to-one activities. METHODS: Fifty patients with diagnoses of moderate to severe dementia were randomized to either MSS or Activity groups. Patients participated in eight 30-minute sessions over a 4-week period. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre, mid, post-trial, and follow-up assessments were taken to investigate any generalization of effects on cognition, behaviour at the day hospital and behaviour and mood at home and endurance of effects once sessions had ceased. RESULTS: Immediately after MSS and Activity sessions patients talked more spontaneously, related better to others, did more from their own initiative, were less bored/inactive, and were more happy, active or alert. Both groups were more attentive to their environment than before, with a significantly greater improvement from the MSS group. At the day hospital, patients in the Activity group improved on their 'speech skills' (amount of speech; initiation of speech), whereas the MSS group remained unchanged during the trial. The MSS group showed a significant improvement in mood and behaviour at home compared to the Activity group whose behaviour deteriorated. No longer-term benefits were shown; indeed, behaviour declined sharply during the month follow-up period. CONCLUSIONS: Both MSS and Activity sessions appear to be effective and appropriate therapies for people with dementia.
Subject(s)
Acoustic Stimulation/methods , Alzheimer Disease/therapy , Photic Stimulation/methods , Affect , Aged , Alzheimer Disease/psychology , Cognitive Behavioral Therapy , Communication , Environment , Female , Generalization, Psychological , Humans , Male , Mental Disorders/psychology , Mental Disorders/rehabilitation , Relaxation TherapyABSTRACT
OBJECTIVE: To determine if long-term, high-vitamin supplementation could reverse cognitive malfunction in old people. METHODS: We performed a longitudinal study relating the 12-month outcome to baseline values. Twenty non-vitamin-deficient elderly females with a Folstein mini mental state examination score indicating cognitive malfunctions were recruited to ascertain if feeding a high-dose vitamin-mineral supplement for 1 year could, by mass vitamin action, reverse some existing cognitive malfunctions. Ten females were fed a high-dose vitamin-mineral supplement pill with each of three daily meals for 1 year; the other 10 did not receive this supplementation. Twelve blood vitamin analyses and a Folstein mini mental state examination were performed for each of the 20 subjects before and after 1 year; each subject served as its own control. RESULTS: No improvement in cognitive malfunction was noted despite elevation of blood vitamins. CONCLUSION: Feeding of a high-dose vitamin and mineral supplement for 1 year did not improve cognitive malfunction in non-vitamin-deficient elderly in this study.
Subject(s)
Aging , Cognition Disorders/drug therapy , Minerals/administration & dosage , Vitamins/administration & dosage , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Mental Status Schedule , Minerals/blood , Treatment Failure , Vitamins/bloodABSTRACT
The neuropeptide galanin mediates a diverse spectrum of biological activities by interacting with specific G protein-coupled receptors. We have used homology genomic library screening and polymerase chain reaction (PCR) techniques to isolate both genomic and cDNA clones encoding the human homolog of the recently cloned rat GALR2 galanin receptor. By fluorescence in situ hybridization, the gene encoding human GALR2 (GALNR2) has been localized to chromosome 17q25.3. The two coding exons of the human GALNR2 gene, interrupted by an intron positioned at the end of transmembrane domain III, encode a 387 amino acid G protein-coupled receptor with 87% overall amino acid identity with rat GALR2. In HEK-293 cells stably expressing human GALR2, binding of [125I]porcine galanin is saturable and can be displaced by galanin, amino-terminal galanin fragments and chimeric galanin peptides but not by carboxy-terminal galanin fragments. In HEK-293 cells, human GALR2 couples both to Galphaq/11 to stimulate phospholipase C and increase intracellular calcium levels and to Galphai/o to inhibit forskolin-stimulated intracellular cAMP accumulation. A wide tissue distribution is observed by reverse transcriptase (RT)-PCR analysis, with human GALR2 mRNA being detected in many areas of the human central nervous system as well as in peripheral tissues.
Subject(s)
Chromosomes, Human, Pair 17 , GTP-Binding Proteins/metabolism , Receptors, Neuropeptide/genetics , Amino Acid Sequence , Animals , Base Sequence , Cell Line , Chromosome Mapping , Cloning, Organism , DNA, Complementary , Galanin/metabolism , Humans , In Situ Hybridization, Fluorescence , Kinetics , Molecular Sequence Data , Phosphatidylinositols/metabolism , Rats , Receptors, Galanin , Receptors, Neuropeptide/biosynthesis , Receptors, Neuropeptide/metabolism , Recombinant Proteins/biosynthesis , Recombinant Proteins/metabolism , Sequence Alignment , Sequence Homology, Amino Acid , Swine , TransfectionABSTRACT
PURPOSE: Interphotoreceptor retinoid-binding protein (IRBP), an extracellular protein believed to support the exchange of retinoids between the neural retina and retinal pigment epithelium (RPE) in the vertebrate eye, exhibits a modular, i.e., repeat, structure. The present study was undertaken to determine whether an individual module of IRBP has activity in retinoid transfer between the RPE and rod photoreceptors. METHODS: The retinoid transfer activity of a recombinant protein corresponding to the fourth module of Xenopus laevis IRBP (X4IRBP) was examined in two ways. First, X4IRBP was tested for its ability to support the regeneration of porphyropsin in detached/reattached Xenopus retina/RPE-eyecups. Following illumination and removal of native IRBP, Xenopus eyecups supplemented with 42 microM X4IRBP or (as a control) Ringer's solution were incubated in darkness and then analyzed for regenerated porphyropsin. Second, toad (Bufo marinus) RPE-eyecup preparations were used to evaluate X4IRBP's ability to promote the release of 11-cis retinal from the RPE. RESULTS: The regeneration of porphyropsin in X4IRBP-supplemented Xenopus retina/RPE-eyecups (0.45 +/- 0.04 nmol; mean +/- SEM, n = 11) exceeded that in controls (0.13 +/- 0.02 nmol, n = 11). For promoting the release of 11-cis retinal from the toad RPE, 42 microM X4IRBP was more effective than equimolar bovine serum albumin although considerably less than that of 26 microM native bovine IRBP. CONCLUSIONS: The results indicate a low but significant activity of IRBP's fourth module in reactions relevant to retinoid exchange.
Subject(s)
Eye Proteins/pharmacology , Pigment Epithelium of Eye/drug effects , Retinal Pigments/physiology , Retinal Rod Photoreceptor Cells/drug effects , Retinaldehyde/metabolism , Retinol-Binding Proteins/pharmacology , Animals , Bufo marinus , Cattle , Ligands , Microscopy, Immunoelectron , Pigment Epithelium of Eye/metabolism , Protein Conformation , Recombinant Proteins/pharmacology , Retinal Rod Photoreceptor Cells/metabolism , Retinal Rod Photoreceptor Cells/ultrastructure , Retinol-Binding Proteins/metabolism , Vision, Ocular , Xenopus laevisABSTRACT
Passage of the Occupational Safety and Health Act in 1971 represented a major milestone for occupational and environmental medicine. Creation of the Occupational Safety and Health Administration (OSHA) and the National Institute for Occupational Safety and Health (NIOSH) flowed directly from the legislation, and the specialty of occupational medicine entered a new era. As the 25th anniversaries of OSHA and NIOSH are celebrated, consideration of the future of the specialty of occupational and environmental medicine seems timely. In this lecture, an expanded role for the specialty is proposed, based on an analysis of the forces shaping the practice of public health and the opportunities that these forces present. This analysis suggests considering the concept of a "Chief Health Officer" serving the broad health needs of the workplace.
Subject(s)
Environmental Medicine/trends , Occupational Health Services/organization & administration , Occupational Medicine/trends , Cost-Benefit Analysis , Education, Medical, Continuing , Environmental Medicine/education , Environmental Medicine/organization & administration , Humans , Information Systems , Leadership , Occupational Medicine/education , Occupational Medicine/organization & administration , Organizational Innovation , United StatesABSTRACT
There have been numerous calls in the literature for health educators to develop programs to improve access to and utilization of health and human services by traditionally underserved communities, including Latinos. While the literature suggests several principles that can guide the development of these programs, it is important to address the needs, and build on the strengths, of the specific community of interest. It is, therefore, important to use collaborative approaches in which community members take an active role in the initiation, design, implementation, and evaluation of program activities. Lay health advisor programs are particularly well suited to this approach as they are designed to build on the strength of already existing community relationships to improve community health. This article describes a collaborative, culturally appropriate, holistic, and ecological lay health advisor program--the Latino Health Advocacy Program. Lessons learned and implications for future program development are discussed.
Subject(s)
Community Health Services/organization & administration , Community Health Workers , Health Promotion , Health Services Accessibility , Hispanic or Latino , Health Services Needs and Demand , Humans , Interinstitutional Relations , Massachusetts , Pilot Projects , Program Development , Program Evaluation , Public Health , Social ChangeABSTRACT
The three-dimensional structures of two cytochromes c' have been determined in order to analyse the common features of proteins of this family and their relationship with other four-helix bundle structures. The structure of cytochrome c' from Alcaligenes sp was determined by molecular replacement supplemented with the iron anomalous scattering and the use of a single isomorphous heavy-atom derivative, and was refined using synchrotron data to 1.8 A resolution. The final model, comprising 956 protein atoms (one monomer) and 89 water molecules, has a final R value of 0.188 for all data in the range 20.0-1.8 A resolution (14 673 reflections). The structure of the cytochrome c' from Alcaligenes denitrificans is isomorphous and essentially identical (r.m.s. deviation for all atoms 0.36 A). Although its amino-acid sequence has not been determined chemically, only four differences from that of Alcaligenes sp cytochrome c' were identified by the X-ray analysis. The final model for Alcaligenes denitrificans cytochrome c', comprising 953 protein atoms and 75 water molecules, gave a final R factor of 0.167 for all data in the range 20.0-2.15 A (8220 reflections). The cytochrome c' monomer forms a classic four-helix bundle, determined by the packing of hydrophobic side chains around the enclosed haem group. There are very few cross-linking hydrogen bonds between the helices, the principal side-chain hydrogen bonding involving one of the haem propionates and a conserved Arg residue. The cytochrome c' dimer is created by a crystallographic twofold axis. Monomer-monomer contacts primarily involve the two A helices, with size complementarity of side chains in a central solvent-excluded portion of the interface and hydrogen bonding at the periphery. Both species have a pyroglutamic acid N-terminal residue. The haem iron is five-coordinate, 0.32 A out of the haem plane towards the fifth ligand, His120. The unusual magnetic properties of the Fe atom may be linked to a conserved basic residue, Arg124, adjacent to His120.
ABSTRACT
This review presents historical and cost-effectiveness perspectives of prevention in health care; discusses the nature, extent, and determinants of health system change, particularly the transition to managed care with large integrated health care corporations; and identifies implications for public health agencies and opportunities for prevention within the reforming health system.
Subject(s)
Health Care Reform/organization & administration , Preventive Health Services/organization & administration , Public Health Administration , Cause of Death , Cost-Benefit Analysis , Female , Humans , Male , Managed Care Programs/organization & administration , Medicaid , Organizational Innovation , United States/epidemiologyABSTRACT
The inhibitory glycine receptor (GlyR) is a pentameric receptor comprised of alpha and beta subunits, of which the beta subunit has not been characterised in humans. A 2106 bp cDNA, isolated from a human hippocampal cDNA library, contained an open reading frame of 497 amino acids which encodes the beta subunit of the human GlyR. The mature human GlyR beta polypeptide displays 99% amino acid identity with the rat GlyR beta subunit and 48% identity with the human GlyR alpha 1 subunit. Neither [3H]strychnine binding nor glycine-gated currents were detected when the human GlyR beta subunit cDNA was expressed in the human embryonic kidney 293 cell line. However, co-expression of the beta subunit cDNA with the alpha 1 subunit cDNA resulted in expression of functional GlyRs which showed a 4-fold reduction in the EC50 values when compared to alpha 1 homomeric GlyRs. Glycine-gated currents of alpha 1/beta GlyRs were 17-fold less sensitive than homomeric alpha 1 GlyRs to the antagonists picrotoxin, picrotoxinin and picrotin, providing clear evidence that heteromeric alpha 1/beta GlyRs were expressed. The beta subunit appears to play a structural rather than ligand binding role in GlyR function. Fluorescence in situ hybridisation was used to localise the gene encoding the human GlyR beta subunit (GLRB) to chromosome 4q32, a position syntenic with mouse chromosome 3. In situ hybridisation using the human GlyR beta subunit cDNA showed that the murine GlyR beta subunit gene (Glrb) maps to the spastic (spa) locus on mouse chromosome 3 at bands E3-F1. This is consistent with the recent finding that a mutation in the murine GlyR beta subunit causes the spa phenotype. It also raises the possibility that mutations in the human beta subunit gene may cause inherited disorders of the startle response.
Subject(s)
Chromosome Mapping , Chromosomes, Human, Pair 4 , Receptors, Glycine/genetics , Amino Acid Sequence , Animals , Base Sequence , Cell Line , Cloning, Molecular , DNA, Complementary , Gene Library , Glycine/metabolism , Hippocampus/metabolism , Humans , Kidney , Kinetics , Macromolecular Substances , Mice , Molecular Sequence Data , Mutation , Open Reading Frames , Rats , Receptors, Glycine/biosynthesis , Receptors, Glycine/metabolism , Recombinant Proteins/biosynthesis , Recombinant Proteins/metabolism , Strychnine/metabolismABSTRACT
Metallothioneins (MTs) are small cysteine-rich proteins that bind heavy metal ions such as zinc, cadmium and copper with high affinity, and have been functionally implicated in heavy metal detoxification and radical scavenging. Transcription of metallothioneins genes is induced by exposure of cells to heavy metals. This induction is mediated by metal-responsive promoter elements (MREs). We have previously cloned the cDNA of an MRE-binding transcription factor (MTF-1) from the mouse. Here we present the human cDNA equivalent of this metal-regulatory factor. Human MTF-1 is a protein of 753 amino acids with 93% amino acid sequence identity to mouse MTF-1 and has an extension of 78 amino acids at the C-terminus without counterpart in the mouse. The factors of both species have the same overall structure including six zinc fingers in the DNA binding domain. We have physically mapped the human MTF-1 gene to human chromosome 1 where it localizes to the short arm in the region 1p32-34, most likely 1p33. Both human and mouse MTF-1 when produced in transfected mammalian cells strongly bind to a consensus MRE of metallothionein promoters. However, human MTF-1 is more effective than the mouse MTF-1 clone in mediating zinc-induced transcription.
Subject(s)
Chromosome Mapping , Cloning, Molecular , Transcription Factors/genetics , Amino Acid Sequence , Animals , Base Sequence , Chromosomes, Human, Pair 1 , Consensus Sequence , DNA/metabolism , DNA, Complementary/chemistry , DNA-Binding Proteins , Humans , Mice , Molecular Sequence Data , Promoter Regions, Genetic , Recombinant Proteins/metabolism , Sequence Homology , Transcription Factors/chemistry , Transcription, Genetic/drug effects , Transfection , Zinc/pharmacology , Transcription Factor MTF-1ABSTRACT
The three-dimensional structures of various forms of lactoferrin, determined by high resolution crystallographic studies, have been compared in order to determine the relationship between structure and biological function. These comparisons include human apo and diferric lactoferrins, metal and anion substituted lactoferrins, the N-terminal half molecule of human lactoferrin, and bovine diferric lactoferrin. The structures themselves define the nature and location of the iron binding sites and allow anti-bacterial and putative receptor-binding regions to be mapped on to the molecular surface. The structural comparisons show that small internal adjustments can allow the accommodation of different metals and anions without altering the overall molecular structure, whereas large-scale conformational changes are associated with metal binding and release, and smaller, but significant, movements accompany species variations. The results also focus on differences in flexibility between the two lobes, and on the importance of interactions in the inter-lobe region in modulating iron release from the N-lobe and in possibly enabling binding at one site to be signalled to the other.