[Meningoencephalitis caused by Bacillus cereus].
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Adult↗
Biomedical subjects
R Gross
Publications and source records attributed to R Gross.
Effective community intervention to improve hemoglobin status in preschoolers receiving once-weekly iron supplementation.
The effect of weekly iron supplementation with and without deworming on hemoglobin was investigated in a double-masked, placebo-controlled field trial. Subjects were 289 preschoolers who were randomly divided into three groups. Groups 1 and 2 received 30 mg Fe once weekly and group 3 received a placebo. Group 1 additionally received anthelminthic treatment. Supplements were administered by the mothers, who were educated about iron deficiency beforehand. In the iron-supplemented groups prevalence of anemia decreased from 37.2% to 16.2% (P < 0.001). Hemoglobin increased by an average of 6.9 +/- 9.8 g/L in the two iron-supplemented groups (n = 191), which was greater (P < 0.001) than the increase of 1.9 +/- 8.0 g/L in the placebo group. None of the subjects had hookworm, and anthelminthic treatment did not have an additional effect. Iron supplements administered once weekly by mothers reduced anemia without major involvement of health staff.
Anemia↗
Weekly micronutrient supplementation to build iron stores in female Indonesian adolescents.
Different supplementation schemes to build iron stores in female Indonesian adolescents were investigated. Subjects were 273 high-school girls allocated randomly to four treatment groups. During a 3-mo period one group received 60 mg Fe, 750 micrograms retinol, 250 micrograms folic acid, and 60 mg vitamin C per day; a second group received 60 mg Fe, 6000 micrograms retinol, 500 mg folic acid, and 60 mg vitamin C once a week; a third group received 120 mg Fe and the same amount of the other three micronutrients as the second group once a week; and a fourth group received only placebos. All subjects were dewormed and supplement allocation was double blind. Blood samples were collected at baseline, after 2 and 3 mo of supplementation, and 6 mo after the last supplement. After 2 mo of supplementation, groups supplemented weekly and daily showed similar significant improvements (P < 0.001) in hemoglobin and retinol concentrations, and supplementation for 3 instead of 2 mo did not significantly increase these two indicators. After 3 mo, the increase in ferritin was approximately equal to 27 micrograms/L in the daily and 14-15 micrograms/L in the weekly groups (P < 0.001), the latter having a final concentration of 42-45 micrograms/L. At 6 mo postsupplementation there were no significant differences among daily and weekly groups, but the ferritin concentration was still approximately equal to 10-12-micrograms/L higher (P < 0.001) than in the placebo group. The group supplemented weekly with 60 mg Fe complained less about side effects than the other supplemented groups (P < 0.05). Weekly supplementation with 60 mg Fe and 6000 micrograms retinol for 3 mo was optimal for improving the iron status of the adolescents for approximately equal to 9 mo.
Adolescent↗
Challenges in implementing a budget-holding programme for primary care clinics.
In 1990, Kupat Holim Clalit (KHC), Israel's largest sick fund, initiated a demonstration programme for transforming a number of primary care clinics in the Negev district of southern Israel into autonomous budget-holding units. Four programme components were implemented in the nine participating clinics: allocation of a fixed budget; expansion of day-to-day decision-making authority; establishment of a computerized information system to produce monthly reports on expenditure; and provision of incentives for budgetary control. The research findings are based on a four-year evaluation of the programme, which involved a longitudinal case study conducted with multiple research tools: in-depth interviews, a staff survey, and analysis of relevant documents. This article analyzes the challenges involved in implementing the demonstration programme. It examines clinic staff evaluation of the implementation process (e.g. overall staff had a positive attitude toward it); assesses staff satisfaction with clinic participation in the programme (while only 33% were satisfied, only 21% said they would like the clinic to revert to the pre-programme model) and factors influencing this satisfaction (among them intrinsic benefits, perception of the programme as fair and age); and discusses the lessons to be learnt from the programme regarding effective implementation of organizational change. The main lessons indicate the importance of certain factors in implementing such programmes: (a) long-term management commitment to the programme; (b) appointment of agents of change/programme administrators; (c) establishment of a formal agreement between the parties involved; (d) establishment of communication channels between the parties involved; (e) intrinsic benefits for staff, perceived as incentives to economize; (f) reliable data, perceived to be reliable by the parties involved; (g) staff participation in the process of change; and (h) involvement of the participating unit as a single entity.
Budgets↗
Medical therapy for inflammatory bowel disease.
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Humans↗
Phase variation affects long-term survival of Bordetella bronchiseptica in professional phagocytes.
Several Bordetella bronchiseptica isolates were investigated for intracellular survival in macrophages. A significant number of viable bacteria of all strains could be recovered even after 96 h postinfection. In all cases bvg mutants of the B. bronchiseptica strains showed a significant survival advantage over the respective wild-type strains. The bacteria were already located in phagolysosomes early after uptake. Neither opsonization of the bacteria nor activation of the macrophages with gamma interferon or lipopolysaccharide prior to infection affected uptake and survival of the bacteria.
Animals↗
Cloning and characterization of an Mn-containing superoxide dismutase (SodA) of Bordetella pertussis.
The Fur titration assay (FURTA) recently developed by I. Stojiljkovic and coworkers (J. Mol. Biol. 236:531-545, 1994) was applied to clone iron-regulated genes of Bordetella pertussis. After sequence analysis, one of the clones obtained by this selection procedure was shown to contain an open reading frame with significant sequence similarities to Mn-containing superoxide dismutases (SodA). The open reading frame was preceded by a Fur consensus binding site, which according to primer extension analysis overlaps the -10 region of the sodA promoter. Southern blot analysis also revealed the presence of sodA homologous sequences in Bordetella bronchiseptica. On the transcriptional level, sodA expression is strictly iron regulated in both organisms and also in the heterologous host Escherichia coli harboring a plasmid with the sodA gene. Accordingly, SodA-mediated superoxide dismutase activity in Bordetella lysates was detected only after cultivation of the bacteria in iron-restricted media. A B. bronchiseptica fur mutant constitutively expressed SodA, thereby confirming the functional similarity of the iron regulatory systems in the two genera. Apart from iron regulation, sodA expression was affected by changes in DNA topology induced by coumermycin A but not by the global virulence regulatory Bvg system. B. pertussis and B. bronchiseptica sodA deletion mutants did not show significant changes in their growth properties. In contrast, mutation of the previously described Fe-containing SodB enzyme resulted in clones strongly impaired in viability. No direct involvement of SodA in bacterial virulence could be revealed because deletion of the sodA gene affected survival of Bordetella species neither in cultured macrophages nor in a mouse respiratory infection model.
Amino Acid Sequence↗
Coexistence of eosinophilia and agranulocytosis in a clozapine-treated patient.
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Adult↗
[Age determination by measurement of the ratio of D- and L- forms of aspartic acid. II. Chiral separation of amino acids from human dentin].
Estimation of relation of D,L-forms aspartic acid has been recently used for an evaluation of age. It represents a relatively new method based on analysis of hydrolyzed dentine. Its amino acids are derived and analyzed by gas chromatography or liquid chromatography on a chiral column.
Age Determination by Teeth↗
[Polychlorinated biphenyls in human subepicardial fat].
A considerable relation between myocardial fatty infiltration (lipomatosis) and ischemic lesion of myocardium was proved by authors else where. This time, polychlorinated biphenyls (PCB) wee studied in subepicardial fat as well as in subcutaneous fat in thorax and abdomen of deceased person after sudden and violent death. For the time being, most published results concerned the abdominal subcutaneous fat. All the published results showed high concentrations of PCB were proved in subcutaneous fat tissue from thorax and abdominal area and specially in subepicardial fat. Topical relation of PCB deposits and heart muscle was direct in all analyzed case because of fatty infiltration of myocardium. Obviously, a direct toxic effect of PCB on myocardium can take place in stress lypolysis e.g. associated with heart infarct (in some animals hydropericardium and impairment of parenchymatous organs were observed) and prognosis of patients with ischemic lesion can get worser.
Adipose Tissue↗
[Present possibilities of age determination in forensic medicine with emphasis on the importance of measurement of D- and L- forms of aspartic acid. I. An overview].
Evaluation of age of unknown deceased persons belongs to the most important ways to identification. For the time being, morphological methods are used, namely evaluation of age according to Gustafson's method from tooth grindings or by macroscopical estimation of abrasion, transparency of root dentine, alveolar atrophy and number of missing teeth. Evaluation of the data can be influenced by an individual failure and experience showed an age related decrease of precision. Recently, some papers occurred estimating a relation of D, L-forms of aspartic acid which depends on the age with a significant precision.
Age Determination by Teeth↗
Parasitological and nutritional situation of school children in the Sukaraja district, West Java, Indonesia.
A parasitological survey of children aged 8 to 10 years from ten schools located in the rural district Sukaraja, West Java, Indonesia was conducted in December 1995. A total of 348 fecal samples were examined by using modified Kato-Katz thick smear techniques, 365 blood samples for the measurement of hemoglobin concentration, and anthropometric data were obtained from 404 participants. Four nematode (hookworm taken as one species), two cestode and nine protozoan species were detected, but no trematode infection was observed. Among helminths, soil-transmitted nematode infections were predominant, Trichuris trichiura with a prevalence of 76% being the most common infection, followed by Ascaris lumbricoides (44%). Hookworm and Enterobius vermicularis were found in 9% and 3% of the children examined, respectively. Among protozoa, Blastocystis hominis was by far the most common species, detected in 60% of volunteers cases. For the helminths A. lumbricoides, T. trichiura and hookworm, school to school differences in parasite prevalence and infection intensity were observed; these were probably due to different socioeconomic and sanitary-environmental conditions. Intensity of Ascaris and hookworm infection tended to be highly over-dispersed; 85% of the worms identified were harbored by 15% and 7% of the children, respectively. Nutritional status was characterized by an average anemia rate of 13% and a prevalence of 51% stunting. All nutritional indicators differed significantly from school to school. Intensity of geohelminths infection could not be associated to the observed nutritional indicators. Thus, there must be additional factors contributing to the studied nutritional indicators of the school children which overlay a possible influence of moderate to heavy worm burden.
Anemia, Iron-Deficiency↗
The I.U.N.S. gains from participation with Brazilian colleagues' deepening interest in urban nutrition.
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Brazil↗
Micronutrient deficiency in urban Indonesia.
The economic situation of Indonesia is characterized by a large increase in the gross national product which has been on average 7% annually during the last ten years. This was accompanied by rapid urbanization. With the economic improvement, "First World" and "Third World" health and nutrition problems are coexisting in Indonesia. In 1992, the most common of death cause was cardiovascular disease whereas tuberculosis was the second ranking. About 40% of the preschool children are stunted. The main stable food and energy source is rice, although the urban population has a more diverse food pattern than the rural population. In Jakarta, many children receive too late colostrum feeding and mothers are not aware about the importance of correct breastfeeding practices after delivery. Three studies had shown that about one fifth of preschool children and one fourth of elderly take micronutrient supplements. Nevertheless, micronutrient deficiencies are prevalent in Jakarta. About one third of women suffer from moderate vitamin A deficiency (plasma retinol < 0.70 mmol/L) and 50% of pregnant women are anemic. More information is necessary on other micronutrient deficiencies. For example, a small study revealed that nearly two thirds of non-institutionalized elderly living in Jakarta experience thiamine deficiency. Appropriate interventions to reduce micronutrient deficiencies should sensitize the urban population to the fact that the government should restrict itself to use its resources to assist only the poorest individuals and groups, whereas it must be expected from the middle class to spend more time and money to solve their own problems.
Deficiency Diseases↗
Vanadyl sulphate differently influences insulin response to glucose in isolated pancreas of normal rats after in vivo or in vitro exposure.
The effect of the antidiabetic agent vanadyl sulphate (VOSO4) on the endocrine pancreas function of normal rats was studied using the isolated pancreas preparation. A short-term (8 days) i.p. treatment (15 mg/kg per day) resulted in attenuation of high glucose-stimulated insulin release, at day 9 but also at days 19, i.e., after full recovery of appetite and weight, while blood and pancreas vanadium concentrations were still elevated. Six months of oral VOSO4 treatment (0.75 mg/ml in drinking water) resulted in elevated vanadium concentrations while glucose-stimulated insulin release was attenuated as compared to pair-fed animals. Conversely, when directly perfused in pancreas, VOSO4 potentiated glucose-stimulated insulin release. These apparently opposite effects may be related to the ability of VOSO4 to exert both peripheral insulinomimetic effects-leading to chronic reduction in insulin demand-, and a direct pancreatic insulinotropic activity.
Administration, Oral↗
Asymmetric response of superconducting niobium-tunnel-junction x-ray detectors.
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Journal Article↗
Conserved sequence motifs in the unorthodox BvgS two-component sensor protein of Bordetella pertussis.
The unorthodox two-component sensor protein BvgS of Bordetella pertussis contains several interesting sequence motifs of unknown functional relevance, such as a histidine motif in its output domain, which is conserved among several unorthodox sensor proteins, a putative nucleotide binding site [Walker box type A] in its linker region, and a region in its periplasmic domain with significant homology to the TonB protein of Escherichia coli. We investigated potential functions of these sequences by constructing B. pertussis strains that express mutant BvgS derivatives. The His1172 residue in the output domain was exchanged for Gln, and the Walker motif was mutated either by the replacement of Lys625 by Arg, or of Gly624 by Val and Lys625 by Leu. To analyse the TonB motif, the periplasmic domain of BvgS was replaced with the corresponding domain of EvgS, an E. coli sensor that is highly homologous to BvgS but lacks the similarity with TonB. All mutations except the conservative Lys/Arg exchange in the Walker box caused the inactivation of BvgS, indicating the functional importance of the conserved motifs. The activity of the mutant proteins could be restored by complementation in trans with various separately expressed, truncated parts of BvgS. Mutations in the BvgS receiver domain could be complemented not only by a construct expressing the wild-type receiver and output domains, but also by the derivative containing the His-Gln exchange. Therefore, the histidine motif, although important for BvgS function, is not essential for complementation of BvgS mutants. The mutations in the Walker box and in the periplasmic domain could be complemented by a truncated BvgS derivative lacking the receiver and output domains. The characterization of a spontaneous revertant of the strain expressing the originally inactive EvgS/BvgS hybrid protein revealed the presence of a mutation in the BvgS linker region, conferring constitutive activity on the protein. As TonB energizes transport processes across the outer membrane of E. coli, the strain expressing the constitutive EvgS/BvgS hybrid protein lacking the TonB motif was used in preliminary investigations of a possible direct involvement of BvgS in transport processes.
Amino Acid Sequence↗
Flavodoxin from Wolinella succinogenes.
A monomeric flavoprotein (18.8 kDa) was isolated from the soluble cell fraction of Wolinella succinogenes and was identified as a flavodoxin based on its N-terminal sequence, FMN content, and redox properties. The midpoint potentials of the flavodoxin (Fld) at pH 7. 5 were measured as -95 mV (Fldox/Flds) and -450 mV (Flds/Fldred) relative to the standard hydrogen electrode. The cellular flavodoxin content [0.3 micromol (g protein)-1] was the same in bacteria grown with fumarate or with polysulfide as the terminal acceptor of electron transport. The flavodoxin did not accept electrons from hydrogenase or formate dehydrogenase, the donor enzymes of electron transport to fumarate or polysulfide. Pyruvate:flavodoxin oxidoreductase activity [180 U (g cellular protein)-1] was detected in the soluble cell fraction of W. succinogenes grown with fumarate or polysulfide. The enzyme was equally active with Fldox or Flds at high concentrations. The Km for Flds (80 microM) was larger than that for Fldox and for the ferredoxin isolated from W. succinogenes (15 microM). We conclude that flavodoxin serves anabolic rather than catabolic functions in W. succinogenes.
Amino Acid Sequence↗