Does activated protein C resistance increase the risk of systematic embolism in non rheumatic atrial fibrillation?
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Biomedical subjects
Publications and source records attributed to R Baker.
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There are numerous reports of the effect of ethanol on protein kinase C (PKC) in animals or with in vitro systems. However, the effect of ethanol on PKC in humans has not been extensively investigated despite the large number of studies involving PKC and human platelets. In this study, we administered ethanol to human volunteers and determined the level of PKC before and after a 0.4 g/kg dose of ethanol. We studied Native Americans and Caucasians of both sexes. There was an increases in PKC activity 60 min after ethanol administration. There were no ethnic, age, nor gender differences detected, nor was there any correlation between family history of alcoholism and the basal or stimulated platelet PKC levels. Neither was there any correlation of basal or stimulated PKC activity with the genotypes for ADH2, ADH3, ALDH2, CYP2E1, and CYP1A2.
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The Notch (N) gene encodes a cell signaling protein that mediates neuronal and epidermal determination in Drosophila embryos. N also regulates several aspects of myogenic development; embryos lacking N function have too many muscle founder cells and fail to properly differentiate somatic muscle. To identify cell-autonomous requirements for Notch function during muscle development, we expressed a Notch minigene in the mesoderm, but not in the ectoderm, of amorphic N-embryos. In these embryos, muscle founder hypertrophy is rescued, indicating that Notch is autonomously required by mesoderm cells to regulate the proper number of muscle founders. However, somatic muscle differentiation is only partially normalized, suggesting that Notch is also required in the ectoderm for proper muscle development. Additionally, mesodermal expression of Notch partially rescues epidermal development in overlying neurogenic ectoderm. This is unexpected, since previous studies suggest that Notch is autonomously required by proneural ectoderm cells for epidermal development. Mesodermal expression of a truncated Notch protein lacking the extracellular domain does not rescue ventral epidermis, suggesting that the extra-cellular domain of Notch can non-autonomously rescue epidermal development across germ layers.
Our understanding of insect development and evolution has increased greatly due to recent advances in the comparative developmental approach. Modern developmental biology techniques such as in situ hybridization and molecular analysis of developmentally important genes and gene families have greatly facilitated these advances. The role of the comparative developmental approach in insect systematics is explored in this paper and we suggest two important applications of the approach to insect systematics--character dissection and morphological landmarking. Existing morphological characters can be dissected into their genetic and molecular components in some cases and this will lead to more and richer character information in systematic studies. Character landmarking will he essential to systematic studies for clarifying structures such as shapes or convergences, which are previously hard to analyze anatomical regions. Both approaches will aid greatly in expanding our understanding of homology in particular, and insect development in general.
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BACKGROUND: Despite interest in the relationship between patient satisfaction and consultation performance, there is little information about how other characteristics of general practitioners, practices and patients influence satisfaction with consultations. AIM: To identify characteristics of patients, practices and general practitioners that influence satisfaction with consultations. METHOD: In 1991-92, a consultation satisfaction questionnaire (CSQ) was administered to 75 patients attending each of the 126 general practitioners in 39 practices. Further questionnaires were used to collect information about the practice (such as total list size, training status, fundholding status and presence of a personal list system) and about the general practitioners (age, sex, whether vocationally trained, a trainer or a trainee, and the number of patients booked in the appointment system per hour). Stepwise multiple regression was undertaken to identify characteristics of patients, practices or general practitioners that influenced satisfaction. RESULTS: The mean of the response rates to the patient questionnaire for each general practitioner was 76.6%, with a standard deviation (SD) of 17.8. Practice characteristics associated with falls in satisfaction were an increasing total list size, the absence of a personal list system and its being a training practice. If more patients were booked in the appointment system per hour, satisfaction with the perceived length of consultations fell. Patient characteristics associated with falls in satisfaction were increased age and an increased proportion of male patients. The only characteristic of general practitioners associated with lower levels of satisfaction was increasing age. The sex of general practitioners did not influence satisfaction. CONCLUSIONS: The findings of this study give further support to the importance of a personal service in determining patient satisfaction in general practice. General Practitioners need to review the organization of practices to ensure an acceptable balance between the requirements of modern clinical care and the wishes of patients. Future studies should take account of the many variables that can influence patient satisfaction.
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Review criteria are designed to enable clinicians and others to assess care. However, there is no established method for developing criteria, and they are often confused with guidelines. Criteria should comprise measurable activities that are appropriate for the setting in which they are to be used. They should also be based on research evidence and prioritised according to the strength of that evidence and effect on outcome. Good criteria can be used to aid implementation of guidelines by providing a standard against which to monitor performance and enabling clinical audit.