RESUMEN
BACKGROUND: Case management (CM) coordinates care for persons with complex health care needs. It is not known whether CM is effective at improving biological outcomes among homeless and marginally housed persons with human immunodeficiency virus (HIV) infection. Our goal was to determine whether CM is associated with reduced acute medical care use and improved biological outcomes in homeless and marginally housed persons with HIV infection. METHODS: We conducted a prospective observational cohort study in a probability-based community sample of HIV-infected homeless and marginally housed adults in San Francisco, California. The primary independent variable was CM, defined as none or rare (any CM in
Asunto(s)
Manejo de Caso , Infecciones por VIH/inmunología , Infecciones por VIH/terapia , Personas con Mala Vivienda , Adulto , Antirretrovirales/uso terapéutico , Recuento de Linfocito CD4 , Atención a la Salud , Femenino , Infecciones por VIH/tratamiento farmacológico , Humanos , Masculino , Cooperación del Paciente , Estudios Prospectivos , Resultado del Tratamiento , Carga ViralRESUMEN
Female reproductive hormones control mammary gland morphogenesis. In the absence of the progesterone receptor (PR) from the mammary epithelium, ductal side-branching fails to occur. We can overcome this defect by ectopic expression of the protooncogene Wnt-1. Transplantation of mammary epithelia from Wnt-4(-)/(-) mice shows that Wnt-4 has an essential role in side-branching early in pregnancy. PR and Wnt-4 mRNAs colocalize to the luminal compartment of the ductal epithelium. Progesterone induces Wnt-4 in mammary epithelial cells and is required for increased Wnt-4 expression during pregnancy. Thus, Wnt signaling is essential in mediating progesterone function during mammary gland morphogenesis.