DNA constructs expressing long-hairpin RNA (lhRNA) protect Penaeus monodon against White Spot Syndrome Virus

The use of stable and cost-effective DNA vaccines for silencing genes of White Spot Syndrome Virus (WSSV) in Penaeus monodon through RNA interference has been tested. DNA constructs that express long-hairpin RNA (lhRNA) constitutively in vivo against two WSSV envelop genes vp19 and vp28 (pCMV-VP19-LH and pCMV-VP28-LH) were used to confer protection against the pathogen. A construct expressing lhRNA directed against gfp gene (pCMV-GFP-LH) was used to estimate the non-specific protection and to show that on intramuscular administration the plasmid spreads all across the shrimp body and persists for at least 30 days. Shrimp injected with 10 μg lhRNA expressing constructs were challenged with purified WSSV after 24 h and pCMV-VP28-LH provided best protection as evidenced by higher survival, lower viral load and silencing of the target viral gene. At an increased dose (35 μg), this construct showed better protection with 75% survival and 81% silencing of the target vp28 mRNA. The construct could actually reduce the viral copy number from the initial 10³ to 10⁵ copies to 10–100 copies. The non-specific pCMV-GFP-LH also showed improved survival and silencing of viral genes, although its effect was less than one third of pCMV-VP28-LH. Silencing constructs can be a good prophylactic approach in commercial shrimp hatcheries to protect high value brooders and to check the vertical transmission of virus, which is a major route of viral entry. Silencing by lhRNA expressed in vivo, confirms the presence of a functional microRNA pathway in shrimp.     

A Cultural Competency Course for Pharmacy Students

Objective

To design, implement, and evaluate a course on health promotion and literacy.

Design

Course objectives such as the development of cultural competency skills, awareness of personal biases, and appreciation of differences in health beliefs among sociocultural groups were addressed using a team-based learning instructional strategy. Student learning outcomes were enhanced using readiness assessment tests (RATs), group presentations, portfolio reflections, and panel discussions.

Assessment

Comparing precourse and postcourse Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals (IAPCC-R) scores and portfolio responses indicated enhanced progress toward cultural competency. The Student Evaluation of Teaching (SET) provided suggestions for course enhancements.

Conclusions

Evidence supporting enhanced cultural competency after completing the course affirms its value as we prepare pharmacy students to provide patient-centered care in a culturally diverse world.     

Percutaneous Retrieval of Misplaced Intravascular Foreign Objects with the Dormia Basket: An Effective Solution

Purpose We report our experience of the retrieval of intravascular foreign body objects by the percutaneous use of the Gemini Dormia basket. Methods Over a period of 2 years we attempted the percutaneous removal of intravascular foreign bodies in 26 patients. Twenty-six foreign bodies were removed: 8 intravascular stents, 4 embolization coils, 9 guidewires, 1 pacemaker lead, and 4 catheter fragments. The percutaneous retrieval was achieved with a combination of guide catheters and the Gemini Dormia basket. Results Percutaneous retrieval was successful in 25 of 26 patients (96.2%). It was possible to remove all the intravascular foreign bodies with a combination of guide catheters and the Dormia basket. No complication occurred during the procedure, and no long-term complications were registered during the follow-up period, which ranged from 6 months to 32 months (mean 22.4 months overall). Conclusion Percutaneous retrieval is an effective and safe technique that should be the first choice for removal of an intravascular foreign body.     

Depressive Symptoms in Patients with Type 2 Diabetes Mellitus: Do Stress and Coping Matter?

This article examines the relationship among diabetes-related stress, appraisal, coping and depressive symptoms in patients with type 2 diabetes mellitus (T2DM) using the transactional model of stress and coping (TMSC) as the theoretical framework. In this cross-sectional study, a convenience sample of 201 patients with T2DM was recruited from three outpatient clinics. Patients with depressive symptoms reported significantly more diabetes-related stress than patients without depressive symptoms. The results of path analysis suggest that patients who experience greater diabetes-related stress or greater depressive symptoms have a negative appraisal of their diabetes. Negative appraisal is, in turn, associated with greater use of avoidance, passive resignation and diabetes integration coping and lesser use of problem-focused coping. Avoidance, passive resignation and diabetes integration coping are, in turn, related to greater depressive symptoms or greater diabetes-related stress. Overall, the results of this study support the TMSC as a framework to elucidate the relationships among diabetes-related stress, appraisal, coping and depressive symptoms in patients with T2DM. However, given the cross-sectional nature of the study, we are unable to elucidate the directionality of the relationship between stress and depressive symptoms. Implications of the findings and the need for longitudinal studies to evaluate these relationships are discussed.     

Studies on the bioavailability of the provitamin A carotenoid, beta-carotene, using human exfoliated colonic epithelial cells

The possibility of using exfoliated colonic epithelial cells for assessing the bioavailability of beta-carotene was examined. Analysis of exfoliated colonic epithelial cells showed the presence of beta-carotene and vitamin A. The beta-carotene content was significantly lower in cells from stool samples of subjects on a beta-carotene-poor diet than those receiving a single dose of a beta-carotene supplement. Colonic epithelial cells isolated from stool samples collected daily during a wash-out period while the subjects were on a beta-carotene-poor diet showed a steady decrease in beta-carotene content, reaching the lowest value on day 7. Kinetic analysis showed that a single dose of a beta-carotene supplement in the form of spirulina (Spirulina platensis) or agathi (Sesbania grandiflora) after the wash-out period caused an increase in the beta-carotene content after a lag period of 5-7 d, but the vitamin A levels during these periods were not significantly affected. Analysis of plasma beta-carotene concentration also showed similar changes, which correlated with those of exfoliated colonic cells. A relationship between the beta-carotene content of the diet and that of the colonic epithelial cells suggests that analysis of the beta-carotene content in exfoliated human colonic epithelial cells is a useful non-invasive method to assess the bioavailability of provitamin A beta-carotene.     

Chronic opioid antagonist treatment dose-dependently regulates mu-opioid receptors and trafficking proteins in vivo

Chronic opioid antagonist treatment increases the density of mu-opioid receptors (muOR) in many model systems. In previous studies, naltrexone treatment produced an increase in muOR density accompanied by decreases in GRK-2 and DYN-2 protein abundance. To examine the relationship between changes in receptor density and proteins involved in receptor trafficking, the dose-dependent effect of chronic naloxone infusion was determined. Dose-dependent antagonism of morphine analgesia was also examined. Mice were infused with naloxone (0.1, 1.0, 5.0 mg/kg/day sc) for 7 days via osmotic pump. Controls were treated with placebo pellets. On the 7th day, morphine dose-response studies were determined using the tail flick. Other mice were sacrificed at the end of the treatment and spinal cords were collected for determination of muOR density and GRK-2 and DYN-2 protein abundance. Naloxone infusion dose-dependently increased spinal muOR density with no change in affinity. The increases in mu-receptor density were proportional to dose-dependent decreases in GRK-2 and DYN-2 protein levels. Furthermore, naloxone dose-dependently antagonized morphine. These data suggest that opioid antagonist-induced muOR up-regulation in mouse spinal cord is associated with regulation of proteins involved in receptor trafficking and support suggestions that opioid antagonist-induced receptor up-regulation is due to reduced constitutive internalization of opioid receptors.     

Specific detection of avian pneumovirus (APV) US isolates by RT-PCR

Summary.  This report details the development of an RT-PCR assay for the specific detection of US isolates of avian pneumovirus (APV). Of the several primer pairs tested, two sets of primers derived from the matrix gene of APV were able to specifically detect the viral RNA of APV. The nucleotide sequence comparison of the PCR products of APV isolates from Minnesota suggested that these viruses were closely related to the Colorado strain of APV, but were distinct from subtypes A and B European isolates of turkey APV (turkey rhinotracheitis: TRT). This M gene-based PCR was found to be very specific and sensitive. APV as low as 8 × 10⁻⁵ TCID⁵⁰ (0.0323 μg/ml) could be detected using this assay. In addition, the two primers were able to differentiate isolates from turkeys in Minnesota. Received June 15, 1999 Accepted January 3, 2000     

Impact of pharmacists' directive guidance behaviors on patient satisfaction

OBJECTIVE: To determine the impact of directive guidance (DG) behaviors by pharmacists on patient satisfaction with pharmaceutical care services. DG behaviors are social support behaviors and include such activities as supplying information about medications and providing encouragement and feedback regarding drug therapy. DESIGN: Cross-sectional observational study using a self-administered survey. SETTING: Two university-affiliated ambulatory care clinics, two chain pharmacies, and one independent pharmacy. PATIENTS: One hundred sixty patients with a chronic disease (e.g., asthma, hypertension, diabetes). MAIN OUTCOME MEASURE: Patient satisfaction with pharmaceutical care services. RESULTS: A total of 160 completed questionnaires were collected from patients at 5 sites. Overall, patients patronizing ambulatory care clinics perceived higher rates of DG behaviors and were more satisfied with pharmaceutical care services, compared with patients in community pharmacies (P < .05). The hierarchical regression model was significant (F(13,112) = 4.9091, P < .001). DG behaviors explained 32.4% (P < .001) of the variance in patient satisfaction with pharmaceutical care services. CONCLUSION: Higher rates of DG behaviors by pharmacists are associated with greater patient satisfaction with pharmaceutical care services.     

Negative pressure wound therapy: current practice in India

Background

Negative pressure wound therapy (NPWT) is a therapeutic technique using a vacuum dressing to promote healing in acute or chronic wounds. This study aims to survey current opinion regarding negative pressure wound therapy (NPWT) among plastic surgeons in India.

Methods

Registered plastic surgeons currently practicing in India were identified from the Association of Plastic Surgeons in India database. A questionnaire was designed asking a set of question which included if they used NPWT in their plastic surgical practice, whether or not they considered themselves aware of the current evidence and applications of NPWT and how successful they felt that NPWT was in different clinical situations. The questionnaire was uploaded online and a link was e-mailed to them requesting for completion. Two e-mail reminders were sent to those who failed to respond.

Results

Of 388 plastic surgeons, 240 responded (62 %). The median response time was 18.2 days. Out of 240, 182 (76 %) plastic surgeons used NPWT in their clinical practice. The main adverse events when using NPWT appeared to be pain when changing the dressing (22 %), bleeding (18 %) and infection (12 %). NPWT was most commonly used for diabetic foot wounds post-debridement, pressure sores and arterial/venous ulcers. As per the respondents, use of NPWT reduced the time interval from admission to final procedure by almost 40 %.

Conclusions

Currently in India, NPWT is most commonly used for diabetic foot wounds post-debridement, pressure sores and arterial ulcers followed by venous ulcers, with perceived success correlating with this order of popularity. There is a need for surgeons in India to understand the controversies regarding NPWT and adopt it in their clinical practice wherever feasible. Level of Evidence: Level III, therapeutic study.