Case management: a method of addressing subject selection and recruitment issues.
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Adult↗
Biomedical subjects
T Hall
Publications and source records attributed to T Hall.
Comparison of sampling anopheline mosquitoes by light-trap and human-bait collections indoors at Bagamoyo, Tanzania.
The mosquito sampling efficiency of CDC miniature light-traps, relative to night-biting collections, was evaluated indoors at two sites in coastal Tanzania. We found that the total number of anophelines captured overnight by light-traps (hung beside a bednet in use) was 1.23 times the number of anophelines captured by human-bait collections. This relationship was not affected significantly by changes in the mosquito density, order of trapping method, date of sampling, or number of household occupants. Malaria sporozoite rates were twice as high among mosquitoes captured by light-trap as compared to those captured by night-biting collection. This was attributed to the tendency of light-traps to capture a larger proportion of gravid mosquitoes, which also had high sporozoite rates. The differences in sporozoites rates according to abdominal stage indicates that unfed mosquitoes captured by light-traps may define more precisely the human-biting activity and sporozoite rates as seen by night-biting collections. Our study shows that light-traps, when used in combination with night-biting collections, can be an effective and sensitive means for measuring human-biting activity and the sporozoite rate.
Animals↗
Malaria infection potential of anopheline mosquitoes sampled by light trapping indoors in coastal Tanzanian villages.
Anopheline mosquito populations were studied during 1992 in seven villages south of Bagamoyo, coastal Tanzania, prior to malaria control intervention using insecticide treated bednets. To collect mosquitoes, CDC light traps were used in ten houses per village fortnightly for 12 months. Anopheles females were identified and checked by ELISA for the presence of malaria sporozoite antigen and source of bloodmeal. An.funestus peaked in June-July after the long rains. Three members of the An.gambiae complex had different seasonality: An.arabiensis, An.gambiae and small numbers of An.merus were collected. In most villages transmission was extremely high and perennial with the entomological inoculation rate reaching three to eleven infective bites per person per night in July and persisting at around 0.1 and 1 for most of the remainder of the year. Sporozoite infection rates within the An.gambiae complex ranged from 2% to 25%, with the peaks in January and July following the two rainy periods. An.funestus showed a similar pattern. The light traps were reliable, simple to operate, and proved to be satisfactory to study the mosquito vector population.
Animals↗
Azithromycin prophylaxis against a chloroquine-resistant strain of Plasmodium falciparum.
Azithromycin has antimalarial activity and favourable pharmacokinetic properties for a prophylactic antimalarial agent. We investigated the ability of azithromycin to prevent malaria in volunteers infected with a chloroquine-resistant strain of Plasmodium falciparum. 4 volunteers received oral azithromycin 500 mg followed by 250 mg daily for 7 further days. Subjects were infected on the third day of azithromycin. 3 subjects were protected compared with none of 15 controls. The volunteer not protected by azithromycin had unquantifiable plasma levels of azithromycin, probably because of poor absorption. Azithromycin could be a promising prophylactic agent for P falciparum malaria.
Administration, Oral↗
A strand bias occurs in point mutations associated with variant surface glycoprotein gene conversion in Trypanosoma rhodesiense.
We previously described a bloodstream Trypansoma rhodesiense clone, MVAT5-Rx2, whose isolation was based on its cross-reactivity with a monoclonal antibody (MAb) directed against a metacyclic variant surface glycoprotein (VSG). When the duplicated, expressed VSG gene in MVAT5-Rx2 was compared with its donor (basic copy) gene, 11 nucleotide differences were found in the respective 1.5-kb coding regions (Y. Lu, T. Hall, L. S. Gay, and J. E. Donelson, Cell 72:397-406, 1993). Here we describe a characterization of two additional bloodstream trypanosome clones, MVAT5-Rx1 and MVAT5-Rx3, whose VSGs are expressed from duplicated copies of the same donor VSG gene. The three trypanosome clones each react with the MVAT5-specific MAb, but they have different cross-reactivities with a panel of other MAbs, suggesting that their surface epitopes are similar but nonidentical. Each of the three gene duplication events occurs at a different 5' crossover site within a 76-bp repeat and is associated with a different set of point mutations. The 35, 11, and 28 point mutations in the duplicated VSG coding regions of Rx1, Rx2, and Rx3, respectively, exhibit a strand bias. In the sense strand, of the 74 total mutations generated in the three duplications, 54% are A-to-G or G-to-A (A:G) transitions and 7% are C:T transitions, while 26% are C:A transversions and 13% are C:G transversions. No T:G or T:A transversions occurred. Possible models for the generation of these point mutations are discussed.
Amino Acid Sequence↗
A monocistronic transcript for a trypanosome variant surface glycoprotein.
Many protein-encoding genes of African trypanosomes are transcribed as large polycistronic pre-mRNAs that are processed into individual mRNAs containing a 5' spliced leader and 3' poly(A). The 45- to 60-kb pre-mRNAs encoding some variant surface glycoproteins (VSGs) contain as many as eight unrelated coding regions. Here we identify the promoter for a metacyclic VSG gene that is expressed without duplication in a bloodstream trypanosome clone. This 70-bp promoter is located 2 kb upstream of the telomere-linked VSG gene and directs the synthesis of a monocistronic VSG pre-mRNA lacking the 5' spliced leader. Its sequence only slightly resembles those of other known trypanosome promoters, but it does cross-hybridize with several related sequences elsewhere in the genome. These results suggest that a new class of trypanosome promoters has been found, whose function is to initiate monocistronic transcription of those VSG genes normally expressed during the metacyclic stage.
Amino Acid Sequence↗
Making love: Australian adults' rating of its importance as a romantic act in a relationship.
A personal opinion survey was administered to 1207 adults assessing attitudes towards 13 romantic acts with regard to age and gender. The present study focused upon attitudes towards the perceived importance of making love as a romantic act in a relationship. The sample was divided into three age groups, 18 to 25 years, 26 to 35 years, and 36 to 45 years. Analysis showed that 600 men's mean rating on a 5-point scale for importance was higher than the 607 women's rating; however, no significant difference was found among age groups and the interaction of age and gender was nonsignificant.
Adolescent↗
Weak universality in two-dimensional transitions to chaos.
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Journal Article↗
Point mutations are associated with a gene duplication leading to the bloodstream reexpression of a trypanosome metacyclic VSG.
African trypanosomes evade the immune response of their hosts by sequentially expressing different variant surface glycoproteins (VSGs). We isolated a bloodstream trypanosome clone of Trypanosoma brucei rhodesiense that expresses a VSG normally present during the metacyclic stage of the parasite in the insect vector. Associated with the bloodstream reexpression of this metacyclic VSG is a gene conversion in which the duplicated, expressed gene of 1650 nt contains 11 scattered point mutations when compared with its donor gene. Analysis of an uncloned population of bloodstream trypanosomes revealed another VSG reexpressor of the same donor gene in which the coding region had undergone 24 point mutations. The mutations are unique to the duplicated gene and appear to be nontemplated. The generation of these mutations provides a way for the trypanosome to increase further its antigenic diversity.
Amino Acid Sequence↗
Development and evaluation of an enzyme-linked immunosorbent assay for Plasmodium vivax-VK247 sporozoites.
An enzyme-linked immunosorbent assay (ELISA) for the Plasmodium vivax-VK247 (variant) circumsporozoite (CS) protein was developed and evaluated using sporozoites produced by feeding mosquitoes on Thai patients with parasitologically confirmed P. vivax infections. The ELISA had a detection threshold of fewer than 50 sporozoites. Using this assay in conjunction with an ELISA for the VK210 polymorph, nearly 16% of the 235 P. vivax cases produced sporozoites positive only for the variant; 69% produced sporozoites positive only in the VK210 assay; and 15% were positive in both assays, indicating mixed infections. Twelve cases (5%) produced sporozoites negative in one assay and with unexpectedly low activity in the other ELISA, indicating the possibility of other CS protein polymorphs.
Amino Acid Sequence↗
Immunoenzymatic labeling of multiple plasmodial salivary gland sporozoites in a single test.
A direct, double- and triple-staining immunoenzymatic method detected and differentiated sporozoites by color in Anopheles stephensi salivary glands and in mixed sporozoite slide preparations. A double-staining method used beta-galactosidase- and alkaline phosphatase-labeled monoclonal antibodies to the circumsporozoite (CS) proteins of Plasmodium berghei and P. falciparum in mosquito salivary glands. The CS proteins were distinguished clearly by the blue-green and red substrate products of beta-galactosidase and alkaline phosphatase, respectively. A triple-staining method differentiated by color among a mixture of P. falciparum and two strains of P. vivax sporozoites. Monoclonal antibodies to the CS proteins conjugated to beta-galactosidase (P. falciparum), alkaline phosphatase (P. vivax variant), and horseradish peroxidase (P. vivax predominant) readily color differentiated sporozoites by the blue-green, purple-blue, and orange-brown substrate products, respectively. This assay may have potential use in malaria transmission studies, genetic crosses of variant strains of plasmodia to determine assortment of CS antigen alleles, and as a technique to determine the fate of the CS antigen in infected mosquitoes.
Animals↗
The concentration and temporal relationships of acetaminophen-induced changes in intracellular and extracellular total glutathione in freshly isolated hepatocytes from untreated and 3-methylcholanthrene pretreated Sprague-Dawley and Fischer rats.
Fischer rats are more sensitive to acetaminophen-induced hepatotoxicity than Sprague-Dawley rats, however, the mechanisms for this enhanced sensitivity remain unclear. The susceptibility to hepatotoxicity is determined largely by the balance between acetaminophen toxification and detoxification. Since glutathione plays a critical role in the detoxification process, it would be of interest to compare the effects of acetaminophen on hepatic glutathione homeostasis in the Sprague-Dawley and Fischer rat, and relate these effects to cytotoxicity. To this end, we measured the sequential changes of intracellular and extracellular total glutathione in freshly isolated hepatocytes from untreated and 3-methylcholanthrene pretreated Fischer and Sprague-Dawley rats, both in the absence (basal) and presence of acetaminophen. In the basal state, the intracellular total glutathione content was significantly (P less than 0.01) increased in hepatocytes from untreated Fischer rats. Nevertheless, the sequential release of total glutathione into the medium and the sequential depletion of intracellular total glutathione were quantitatively similar in hepatocytes from untreated Fischer and Sprague-Dawley rats. Following exposure to acetaminophen, there was a striking dose and time associated depletion of intracellular total glutathione in untreated hepatocytes from both rat strains, and quantitatively the depletion was similar in untreated hepatocytes from both rat strains. This degree of depletion of intracellular total glutathione was not associated with acetaminophen-induced cytotoxicity in Sprague-Dawley hepatocytes, whereas significant (P less than 0.05) cytotoxicity was demonstrated in Fischer hepatocytes.(ABSTRACT TRUNCATED AT 250 WORDS)
Acetaminophen↗
Mechanisms of blood flow during pneumatic vest cardiopulmonary resuscitation.
Mechanisms of blood flow during cardiopulmonary resuscitation (CPR) were studied in a canine model with implanted mitral and aortic flow probes and by use of cineangiography. Intrathoracic pressure (ITP) fluctuations were induced by a circumferential pneumatic vest, with and without simultaneous ventilation, and by use of positive-pressure ventilation alone. Vascular volume and compression rate were altered with each CPR mode. Antegrade mitral flow was interpreted as left ventricular (LV) inflow, and antegrade aortic flow was interpreted as LV outflow. The pneumatic vest was expected to elevate ITP uniformly and thus produce simultaneous LV inflow and LV outflow throughout compression. This pattern, the passive conduit of "thoracic pump" physiology, was unequivocally demonstrated only during ITP elevation with positive-pressure ventilation alone at slow rates. During vest CPR, LV outflow started promptly with the onset of compression, whereas LV inflow was delayed. At compression rates of 50 times/min and normal vascular filling pressures, the delay was sufficiently long that all LV filling occurred with release of compression. This is the pattern that would be expected with direct LV compression or "cardiac pump" physiology. During the early part of the compression phase, catheter tip transducer LV and left atrial pressure measurements demonstrated gradients necessitating mitral valve closure, while cineangiography showed dye droplets moving from the large pulmonary veins retrograde to the small pulmonary veins. When the compression rate was reduced and/or when intravascular pressures were raised with volume infusion, LV inflow was observed at some point during the compressive phase. Thus, under these conditions, features of both thoracic pump and cardiac pump physiology occurred within the same compression. Our findings are not explained by the conventional conceptions of either thoracic pump or cardiac compression CPR mechanisms alone.
Animals↗
Sequences of three VSG mRNAs expressed in a mixed population of Trypanosoma brucei rhodesiense.
A cDNA library was constructed from a mixed population of bloodstream Trypanosoma brucei rhodesiense expressing at least three different VSGs, one of which is immunologically similar to a VSG present during the metacyclic stage. Complete sequence determinations of three full length VSG cDNAs showed that the 5' spliced leader sequence is located 20-26 nucleotides upstream of the start codons of each of the three VSG mRNAs. Two of the VSGs (472 and 487 aa) are members of one C-terminal isotype group while the other, metacyclic-like, VSG (517 aa) is a member of the other C-terminal group. Since VSGs of different sequences have similar three-dimensional structures, comparison of many different VSGs sequences should lead to a more detailed understanding of the relationship between primary and tertiary structures of proteins in general. GenBank accession numbers: M33823, M33824, and M33825.
Amino Acid Sequence↗
Dietary intake and changes in body weight in burned children.
Two groups of children were studied. In the first group serial measurements of body weight were made during the child's stay in hospital. In 11 patients, aged 7 months to 13 years, admitted with 10-58 per cent burns, the maximum weight loss was between 6 and 13 per cent of admission weight. Patients had not regained their admission weight at discharge (8-77 days after injury). In the youngest patients, the discharge weight corresponded with the maximum recorded weight loss. In five of the 11 patients dietary intake was calculated by weighing the foods in meals. This was done on average twice per week. Energy and protein intake was below that recommended for children with burns and often lower than that recommended for healthy children. In the second group of 10 patients, 6 months to 7 years had elapsed since the burn. These children were outpatients attending the Burns Aftercare Clinic. Six of the children were at a lower weight centile position when compared to the position at the time of the accident. The children had not 'caught up' to their original centile position.
Adolescent↗
Inverse relationship between total glutathione S-transferase content and bile acid release in isolated hepatocytes from untreated, phenobarbital pretreated and hypothyroid rats.
The role of cytosolic anion binding proteins (glutathione S-transferases) in the hepatic transport of bile acids remains controversial. To investigate whether increased levels of the hepatocyte total glutathione S-transferase content were associated with changes in the release of bile acids from the hepatocyte, we measured the rate of release of radioactive bile acids in isolated hepatocytes from thyroidectomized, phenobarbital pretreated and untreated rats. The isolated hepatocytes were preincubated with either 14C-cholic acid or 14C-taurocholic acid, and the release rate of radiolabeled bile acids was determined. Hepatocyte total glutathione S-transferase content was measured by rocket immunoelectrophoresis. The release rate of the radiolabeled bile acids was significantly (P less than 0.005) decreased in both hypothyroid and phenobarbital pretreated hepatocytes. The levels of total glutathione S-transferase content were significantly (P less than 0.001) increased in the hepatocytes from both hypothyroid and phenobarbital pretreated animals. Our findings reveal a striking inverse relationship between the total glutathione S-transferase content of the hepatocyte and the release rate of radiolabeled bile acids in isolated hepatocytes from two independent animal models. These observations support the hypothesis that cytosolic anion binding proteins (glutathione S-transferases) may influence the net flux across the hepatocyte plasma membrane largely by limiting efflux.
Animals↗
Case management in long-term care: new directions for professional nursing.
Case management can be a highly successful model to deal with issues of cost effectiveness, accountability, and quality care. Continuity of care is a guaranteed benefit of the case management model. Case management is a centralized or structured system whose standard is not set by those performing less effectively. Case management offers autonomy, empowerment, and positive patient care outcomes. These are magnet issues in the retention of staff nurses. The case management method of primary nursing allows for a reduction in the need for professional nurse staff.
Aged↗
The changing epidemiology of diabetes mellitus among Navajo Indians.
Although early descriptions of diabetes mellitus among Navajo Indians characterized the disease as an infrequent and "benign chemical abnormality," the prevalence of diabetes and its complications among Navajos appears to have increased substantially in this century. We reviewed recent Indian Health Service inpatient and ambulatory care data and compared these data with previous reports. Of the estimated Navajo population aged 45 years or older, 4,331 (16.9%) had an ambulatory care visit for diabetes between October 1, 1986, and September 30, 1987. Diabetes was coded for 1,041 (7.0%) of hospital admissions of persons aged 20 and older. Of 377 lower-extremity amputations done from 1978 to 1987, diabetes was involved in 245 (66%). The 1986 age-adjusted mortality rate from diabetes was 30.3 per 100,000, approximately twice that for the general US population. The explanation for the increased prevalence of diabetes mellitus among Navajos probably relates to an increasing prevalence of obesity.
Adult↗