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Engagement of African American families in research on chronic illness: a multisystem recruitment approach.

Our multisystem approach addressed the recruitment of African American families with a chronically, physically ill member. The approach focused on the social transactions between the family, the healthcare team, and the research staff, and the influence of these transactions on family recruitment. This multisystem approach included three core strategies: defining the membership of families in a culturally appropriate fashion and engaging those members; engaging the healthcare team; and building and maintaining the skills and morale of the research staff. A description of a longitudinal family health study and potential sources of recruitment biases is provided. Descriptive and bivariate analyses examined the effectiveness of the recruitment approach. A focus groups explored the reciprocal process of family protectiveness that both facilitated and hindered family recruitment and the research staff's alliance with families and the dialysis staff. Discussion focuses on the family health study's recruitment rate, sampling biases, and methods for improving the effectiveness of the multisystem recruitment approach.

Adaptation, Psychological↗

Detection of visible and latent fingerprints using micro-X-ray fluorescence elemental imaging.

Using micro-X-ray fluorescence (MXRF), a novel means of detecting fingerprints was examined in which the prints were imaged based on their elemental composition. MXRF is a nondestructive technique. Although this method requires a priori knowledge about the approximate location of a print, it offers a new and complementary means for detecting fingerprints that are also left pristine for further analysis (including potential DNA extraction) or archiving purposes. Sebaceous fingerprints and those made after perspiring were detected based on elements such as potassium and chlorine present in the print residue. Unique prints were also detected including those containing lotion, saliva, banana, or sunscreen. This proof-of-concept study demonstrates the potential for visualizing fingerprints by MXRF on surfaces that can be problematic using current methods.

Chlorine↗

Colour Doppler examination of early and late orbital haemodynamic changes in eyes with eyelid oedema due to blunt trauma.

PURPOSE: To evaluate the early and late alterations in orbital blood flow parameters in eyes with severe eyelid swelling due to blunt trauma by using colour Doppler ultrasonography (CDU). METHODS: Blood flow parameters in the ophthalmic artery (OA), central retinal artery (CRA), short posterior ciliary arteries (SPCAs) and central retinal vein (CRV) were examined by CDU in 62 eyes of 31 patients with unilateral blunt trauma and in 32 eyes of 32 normal subjects. Patients were examined within the first 5 days and at least 1 month after trauma. The traumatized eyes of patients were designated 'trauma eyes', non-traumatized fellow eyes were designated 'fellow eyes', and randomly chosen eyes of control subjects 'control eyes'. RESULTS: In the early phase, peak systolic velocity (PSV) and end diastolic velocity (EDV) in the OA in trauma eyes were statistically significantly higher than in both fellow eyes and control eyes: the p-values for the differences in PSV and EDV between trauma eyes and fellow eyes were p < 0.001 and p = 0.001, respectively, while the p-values for the differences in PSV and EDV between trauma eyes and control eyes were p = 0.002 and p = 0.019, respectively). No other blood flow parameters obtained at the first examination in all groups were statistically different. In the late phase, PSV in the OA in trauma eyes was found to be higher than that in both fellow eyes and control eyes, but the difference was significant only between trauma eyes and fellow eyes (p = 0.028). End diastolic velocity in the CRA was statistically significantly lower in fellow eyes than in control eyes (p = 0.046). No other blood flow parameters in any vessels examined in fellow eyes and control eyes were statistically significantly different during the study period. CONCLUSION: Blood flow velocities detected by CDU are increased in the OA in eyes with eyelid oedema due to blunt trauma and some of these changes may persist for up to 1 month. This effect seems to be a consequence of trauma-induced hyperaemia in the orbital soft tissues rather than an expression of traumatic choroidal vasculopathy.

Adult↗

Adverse effects of fluorescein angiography in hypertensive and elderly patients.

PURPOSE: To evaluate adverse effects in patients undergoing fundus fluorescein angiography (FA), and to assess the level of these adverse effects in hypertensive and elderly patients. METHOD: We carried out a retrospective study of 358 patients undergoing FA. They were assessed for adverse effects and their relationship to medical history, pre- and post-FA blood pressure and age. RESULTS: The overall adverse reaction rate (AR) was 11.2%, the majority (80%) of which involved nausea. There were no mortalities and no cases of anaphylaxis or cardiac arrest. Hypertension (systolic or diastolic) did not increase the AR. Interestingly, raised initial systolic blood pressure (BP) > or = 160 showed a statistically significant decreased AR compared with that for BP < 160 (7% versus 15%, respectively; p = 0.04). There was no statistical correlation between AR and age. CONCLUSIONS: FA is a relatively safe procedure, but serious side-effects have been reported in the past and therefore adequate measures need to be in place to cope with such emergencies. In our study, there was no increase in the incidence of adverse effects in patients who were hypertensive or elderly. Therefore, these patients should not be denied an important diagnostic procedure that may improve their quality of life purely because of hypertension or age.

Adult↗

Effects of amifostine on glycerol-pretreated rabbit kidneys.

Glycerol-induced acute renal failure is an experimental model for myoglobinuric nephropathy. Amifostine is a cytoprotective agent which scavenges the free radicals. Since there is enhanced production of reactive oxygen metabolites in glycerol-induced acute renal failure, we wanted to examine whether amifostine has a protective role against vascular reactivity and histological changes in kidneys isolated from glycerol-pretreated rabbits. Perfusion pressure was recorded from kidneys obtained from rabbits injected with glycerol 3 hr before the experiments and from glycerol-pretreated and non-pretreated rabbits injected with amifostine 30 min. before the experiments. Acetylcholine-induced (10(-8)-10(-5) M) vasodilatation was tested following the construction of submaximal vasoconstriction by phenylephrine. Histological investigation was performed using light microscope. Acetylcholine-induced vasodilatation was found to be significantly decreased in glycerol, glycerol+amifostine and amifostine groups compared to controls at all concentrations. Reduction in acetylcholine-induced vasodilation was more prominent in amifostine group compared to amifostine+glycerol group. There was histological renal damage in all experimental groups and this damage was more pronounced in glycerol+amifostine group. In conclusion, contrary to expectation, amifostine per se led to histological damage and potentiated the histological damage caused by glycerol and produced a decrease in acetylcholine-induced vasodilatation. The mechanisms by which amifostine exerts its effects are not known.

Acetylcholine↗

Karat, pulque, and gac: three shining stars in the traditional food galaxy.

Karat banana, pulque prepared from Agave species, and gac fruit are three traditional local food items recently studied intensively for their nutrition potential among traditional and indigenous peoples, and are examples of how local food-based strategies can be used to ensure micronutrient nutrition. Successful health promotion and intervention programs emphasizing traditional food systems are few in the international literature, but offer promise in understanding the potential of food-based strategies. Traditional food strategies could be used not only for alleviating malnutrition, but also for developing locally relevant programs for stemming the nutrition transition and preventing chronic disease, particularly among indigenous and traditional peoples who retain knowledge of using food species in their local ecosystems.

Alcoholic Beverages↗

Amino terminal glutamate residues confer spermine sensitivity and affect voltage gating and channel conductance of rat connexin40 gap junctions.

Connexin40 (Cx40) contains a specific binding site for spermine (affinity approximately 100 microm) whereas connexin43 (Cx43) is unaffected by identical concentrations of intracellular spermine. Replacement of two unique glutamate residues, E9 and E13, from the cytoplasmic amino terminal domain of Cx40 with the corresponding lysine residues from Cx43 eliminated the block by 2 mm spermine, reduced the transjunctional voltage (V(j)) gating sensitivity, and reduced the unitary conductance of this Cx40E9,13K gap junction channel protein. The single point mutations, Cx40E9K and Cx40E13K, predominantly affected the residual conductance state (G(min)) and V(j) gating properties, respectively. Heterotypic pairing of Cx40E9,13K with wild-type Cx40 in murine neuro2A (N2A) cells produced a strongly rectifying gap junction reminiscent of the inward rectification properties of the Kir (e.g. Kir2.x) family of potassium channels. The reciprocal Cx43K9,13E mutant protein exhibited reduced V(j) sensitivity, but displayed much less rectification in heterotypic pairings with wtCx43, negligible changes in the unitary channel conductance, and remained insensitive to spermine block. These data indicate that the connexin40 amino terminus may form a critical cytoplasmic pore-forming domain that serves as the receptor for V(j)-dependent closure and block by intracellular polyamines. Functional reciprocity between Cx40 and Cx43 gap junctions involves other amino acid residues in addition to the E or K 9 and 13 loci located on the amino terminal domain of these two connexins.

Algorithms↗

Combination therapy counteracts the enhanced transmission of drug-resistant malaria parasites to mosquitoes.

Malaria parasites carrying genes conferring resistance to antimalarials are thought to have a selective advantage which leads to higher rates of transmissibility from the drug-treated host. This is a likely mechanism for the increasing prevalence of parasites with resistance to chloroquine (CQ) and sulfadoxine-pyrimethamine in sub-Saharan Africa. Combination therapy is the key strategy being implemented to reduce the impact of resistance, but its effect on the transmission of genetically resistant parasites from treated patients to mosquito vectors has not been measured directly. In a trial comparing CQ monotherapy to the combination CQ plus artesunate (AS) in Gambian children with uncomplicated falciparum malaria, we measured transmissibility by feeding Anopheles gambiae mosquitoes with blood from 43 gametocyte-positive patients through a membrane. In the CQ-treated group, gametocytes from patients carrying parasites with the CQ resistance-associated allele pfcrt-76T prior to treatment produced infected mosquitoes with 38 times higher Plasmodium falciparum oocyst burdens than mosquitoes fed on gametocytes from patients infected with sensitive parasites (P < 0.001). Gametocytes from parasites carrying the resistance-associated allele pfmdr1-86Y produced 14-fold higher oocyst burdens than gametocytes from patients infected with sensitive parasites (P = 0.011). However, parasites carrying either of these resistance-associated alleles pretreatment were not associated with higher mosquito oocyst burdens in the CQ-AS-treated group. Thus, combination therapy overcomes the transmission advantage enjoyed by drug-resistant parasites.

ATP-Binding Cassette Transporters↗

Thermophilic aerobacillus from banana puree.

Bacillus licheniformis was isolated from spoiled cans of banana purée. The isolate proved to be a thermophilic gas former which causes soft swell in cans of nonacidic food. Thermal resistance of the spores was examined. Heat treatment for at least 90 to 100 sec at 230 F was found necessary to assure commercial sterility of canned banana purée at pH 4.5.

Bacillus↗