The BH4 domain of Bcl-2 inhibits ER calcium release and apoptosis by binding the regulatory and coupling domain of the IP3 receptor

Although the presence of a BH4 domain distinguishes the antiapoptotic protein Bcl-2 from its proapoptotic relatives, little is known about its function. BH4 deletion converts Bcl-2 into a proapoptotic protein, whereas a TAT-BH4 fusion peptide inhibits apoptosis and improves survival in models of disease due to accelerated apoptosis. Thus, the BH4 domain has antiapoptotic activity independent of full-length Bcl-2. Here we report that the BH4 domain mediates interaction of Bcl-2 with the inositol 1,4,5-trisphosphate (IP3) receptor, an IP3-gated Ca²⁺ channel on the endoplasmic reticulum (ER). BH4 peptide binds to the regulatory and coupling domain of the IP3 receptor and inhibits IP3-dependent channel opening, Ca²⁺ release from the ER, and Ca²⁺-mediated apoptosis. A peptide inhibitor of Bcl-2-IP3 receptor interaction prevents these BH4-mediated effects. By inhibiting proapoptotic Ca²⁺ signals at their point of origin, the Bcl-2 BH4 domain has the facility to block diverse pathways through which Ca²⁺ induces apoptosis.     

The association of psychological stress and health related quality of life among patients with stroke and hypertension in Gaza Strip

Background  

The study was performed to investigate the association of psychological stress and quality of life (QOL) among patients with the cardiovascular disease (CVD) of hypertension plus stroke or hypertension only.     

THROAT SWABS IN CHRONIC TONSILLITIS: A TIME-HONOURED PRACTICE BEST FORGOTTEN

We have estimated that in 1995 more than £2 million was spent by the National Health Service on throat swabs used to investigate chronic tonsillitis in the UK. This study was devised to assess the value of this investigation. The surface microflora, obtained using a throat swab, was compared with the microflora of the deep tonsil in 30 cases of chronic tonsillitis. None of the throat swabs grew pathogenic organisms, while in 16 cases, heavy growths of recognised pathogens were grown from the tonsillar tissue. This paper demonstrates that throat swabs have little value in the management of chronic tonsillitis, and if the investigation was omitted in this condition, a substantial saving could be made.     

Dental hygiene students’ part‐time jobs in dental practices in the Netherlands

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00415.x
Poorterman JHG, Dikkes BT, Brand HS. Dental hygiene students’ part‐time jobs in dental practices in the Netherlands. Abstract: Objective: Many students have paid employment while studying. In the Netherlands, the Individual Health Care Professions Act (IHCP Act) allows dental hygiene students to work under certain conditions in a dental practice. The aim of the study was to determine how many dental hygiene students have part‐time job employment in dental practice and which professional tasks they carry out. We also asked the dental hygiene students their opinion of the IHCP Act. Methods: All the enrolled dental hygiene students (n = 341) at a School of Health in the Netherlands received a questionnaire by email. Results: The response was 52% (176 students). Of the responding students, 75% had paid employment in addition to their study. A proportion of the students (35%) worked in a dental practice. The median number of hours worked per week was eight. Study year, age and prior education were positively related to working part‐time in dental practice. Activities frequently performed were giving oral hygiene instruction, fluoride applications, scaling and root planning, providing chair side assistance and giving local anaesthesia. Although the self‐reported knowledge about the IHCP Act was high, almost half of the students expressed the need for more detailed legal information. Conclusions: Many dental hygiene students work in a dental practice, taking over a number of tasks usually performed by the dentist. More information in the dental hygiene curriculum about the requirements of the IHCP Act seems desirable.     

Ureteric embolization: an alternative treatment strategy for urinary fistulae complicating advanced pelvic malignancy

OBJECTIVE: To report experience with a minimally invasive technique for palliation of urinary fistula/incontinence complicating advanced pelvic malignancy or its treatment. PATIENTS AND METHODS: We used ureteric embolization with permanent nephrostomy drainage in eight renal units in five patients for palliation of symptoms. All procedures were done under local anaesthesia as day-case procedures. Nephrostomy tubes were changed at regular intervals on an outpatient basis. Embolization was repeated when required. RESULTS: The follow-up was 2-84 months; four patients died from the underlying malignancy during the follow-up. All patients were continent and had effective palliation of their symptoms. Two patients required repeat embolization. There were no embolization-related complications. CONCLUSIONS: Ureteric embolization is a safe and effective minimally invasive palliative treatment option in urinary fistulae or incontinence complicating advanced pelvic malignancy.     

Evaluation of quantitative methods for the determination of polyphenols in algal extracts

Marine brown algae such as Ascophyllum nodosum and Fucus vesiculosus accumulate polyphenols composed of phloroglucinol units. These compounds are of ecological importance and, due to their antioxidative activity, of pharmacological value as well. In this study four methods for the quantitative determination of phlorotannins are compared: spectrophotometric determinations using Folin-Ciocalteu's phenol reagent or 2,4-dimethoxybenzaldehyde (DMBA), quantitative (1)H NMR spectroscopy (qHNMR), and gravimetrical measurements. On the basis of the relative standard deviation and the F-test, the determination using Folin-Ciocalteu's phenol reagent and qHNMR proved to be the most reliable and precise methods.     

‘Nephrostomy-Free’ Percutaneous Nephrolithotomy: Experience in a UK District General Hospital

INTRODUCTION

Percutaneous nephrolithotomy (PCNL) is the first-line treatment for large and complex renal calculi. Accepted UK practice is to insert a nephrostomy tube at the end of the procedure to drain the kidney and reduce potential complications. ‘Tubeless’ or ‘nephrostomy-free’ PCNL has been advocated in selected patients as it is thought to reduce length of hospital stay, analgesia requirements and pain experienced. We present our outcomes of a consecutive series (n = 101) of ‘nephrostomy-free’ PCNLs compared to standard PCNL over a 4-year period.

PATIENTS AND METHODS

Between January 2004 and October 2006, we performed 55 standard (with nephrostomy tube) PCNLs (Group 1). From October 2006 onwards, we changed our technique and have performed 46 consecutive ‘nephrostomy-free’ PCNLs (JJ stent inserted), independent of patient and stone factors (Group 2). We have compared the two groups in terms of length of hospital stay (LOS), analgesia requirements, transfusion rates, haemoglobin (Hb) decrease and immediate, early and late complications.

RESULTS

‘Nephrostomy-free’ PCNL significantly reduced the length of hospital stay (2.8 vs 5.1 days; P < 0.001), morphine-based analgesia requirements (23% no morphine required vs 2.8%; P < 0.001), transfusion rate (2.5% vs 7%; P < 0.01) and mean Hb decrease (1.89 g/dl vs 2.25 g/dl; P > 0.05). Overall, no patient experienced a serious complication. All attempted ‘nephrostomy-free’ PCNLs were completed (stone clearance 95%) and no patient needed an unplanned nephrostomy. Only 5% in Group 2 needed their ureteric JJ stent removing earlier than planned secondary to pain. Both groups were comparable in terms of immediate, early and late complications, though three patients in Group 1 developed chronic loin pain and one patient in the ‘nephrostomy-free’ group developed a delayed perirenal haematoma.

CONCLUSIONS

‘Nephrostomy-free’ percutaneous nephrolithotomy is a safe, effective and feasible procedure independent of patient and stone factors. It decreases the length of hospital stay, the pain experienced and the need for morphine-based analgesia; we feel it should be the standard of care for patients undergoing a PCNL.     

Cemented versus non-cemented hemiarthroplasty of the hip as a treatment for a displaced femoral neck fracture: design of a randomised controlled trial

Background  

A discussion is ongoing whether displaced femoral neck fractures in elderly patients should be treated with a non-cemented or a cemented hemiarthroplasty. A recent Cochrane analysis stresses the importance of further research into the relative merits of these techniques. We hypothesise that non-cemented hemiarthroplasty will result in at least the same technical-functional outcome and complication rate, with a shorter operation time.