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51.
Abstract Health care access was surveyed in a sample of 182 northern Texas individuals (57% Hispanic) who provided information on 658 family members in northern Texas. Barriers were evaluated using the Institute of Medicine (Millman, 1993) and the L.A. Aday and R. M. Anderson (1981) conceptual framework and a survey research design. Eighty-eight percent of the 182 respondents were 54 years old or younger, yet the majority reported fair health status with currently unmet needs and untreated health problems. Forty-nine percent used an emergency room within the last year. Forty-two percent of the respondents always worry about their future health and 40% perceived little or no influence over their family's future health status. Forty-one percent of the variance in chronic health problems was accounted for by barriers, mental health needs, educational needs, and use of social services. Seventeen percent of the variance in health status was explained by mutable barriers to access. Unmet needs negatively affected physical and mental health. This study demonstrated that this relatively young sample (77% <44 years old) was experiencing health care access needs. These data aid evaluation of the Healthy People 2000 goal of reducing disparities that exist among Americans in health promotion, protection and prevention. 相似文献
52.
Impact of Pre-ESRD Management on Dialysis Outcomes: A Review 总被引:7,自引:0,他引:7
53.
Nichols KE Haines K Myung PS Newbrough S Myers E Jumaa H Shedlock DJ Shen H Koretzky GA 《Journal of leukocyte biology》2004,75(3):541-552
The Src-homology 2 domain-containing, leukocyte-specific phosphoprotein of 76 kDa (SLP-76) is a hematopoietic adaptor that plays a central role during immunoreceptor-mediated activation of T lymphocytes and mast cells and collagen receptor-induced activation of platelets. Despite similar levels of expression in macrophages, SLP-76 is not required for Fc receptor for immunoglobulin G (IgG; FcgammaR)-mediated activation. We hypothesized that the related adaptor SLP-65, which is also expressed in macrophages, may compensate for the loss of SLP-76 during FcgammaR-mediated signaling and functional events. To address this hypothesis, we examined bone marrow-derived macrophages (BMM) from wild-type (WT) mice or mice lacking both of these adaptors. Contrary to our expectations, SLP-76(-/-) SLP-65(-/-) BMM demonstrated normal FcgammaR-mediated activation, including internalization of Ig-coated sheep red blood cells and production of reactive oxygen intermediates. FcgammaR-induced biochemical events were normal in SLP-76(-/-) SLP-65(-/-) BMM, including phosphorylation of phospholipase C and the extracellular signaling-regulated kinases 1 and 2. To determine whether macrophages functioned normally in vivo, we infected WT and SLP-76(-/-) SLP-65(-/-) mice with sublethal doses of Listeria monocytogenes (LM), a bacterium against which the initial host defense is provided by activated macrophages. WT and SLP-76(-/-) SLP-65(-/-) mice survived acute, low-dose infection and showed no difference in the number of liver or spleen LM colony-forming units, a measure of the total body burden of this organism. Taken together, these data suggest that neither SLP-76 nor SLP-65 is required during FcgammaR-dependent signaling and functional events in macrophages. 相似文献
54.
Boxall S Stanton T Hirai K Ward V Yasui T Tahara H Tamori A Nishiguchi S Shiomi S Ishiko O Inaba M Nishizawa Y Dawes R Bodmer W Beverley PC Tchilian EZ 《Human molecular genetics》2004,13(20):2377-2384
The CD45 antigen is a haemopoietic cell specific tyrosine phosphatase essential for antigen receptor mediated signalling in lymphocytes. Expression of different patterns of alternatively spliced CD45 isoforms is associated with distinct functions. We recently identified a polymorphism in exon 6 (A138G) of the gene encoding CD45 (PTPRC) that results in altered CD45 splicing. The 138G allele is present at a high frequency among Japanese (23.7%), with 5.1% individuals homozygous for the G allele. In this study we show that the A138G polymorphism is the cause of altered CD45 isoform expression, promoting splicing towards low molecular weight CD45 isoforms. We further report that the frequency of A138G heterozygotes is significantly reduced in number in cohorts of patients with autoimmune Graves' disease or hepatitis B infection, whereas G138G homozygotes are absent from a cohort of Hashimoto's thyroiditis patients. We also show that 138G individuals exhibit altered cytokine production in vitro and an increased proportion of memory T cells. These data suggest that the 138G variant allele strongly influences these diseases by modulation of immune mechanisms and may have achieved its high frequency as a result of a natural selection probably related to pathogen resistance. 相似文献
55.
Alexander Yu Donald Turbiville Fangling Xu Joseph W. Ray Allison D. Britt Pamela J. Lupo Sunil K. Jain Karen E. Shattuck Sally S. Robinson Jianli Dong 《American journal of medical genetics. Part A》2019,179(11):2178-2189
Duplications in the 22q11.2 region can cause 22q11.2 duplication syndrome and encompass a variety of phenotypes including developmental delays, facial abnormalities, cardiovascular defects, central nervous system delays, and other congenital abnormalities. However, the contribution of these contiguous duplicated regions to the clinical phenotypes has not been fully elucidated. In this study, we identified nine patients carrying different 22q11.2 microduplications detected by chromosomal microarray. Of these patients, seven pediatric patients presented with various clinical features including two neonate cases died shortly after birth, and two healthy adults. We examined region specific genotype–phenotype associations and found unpredictability associated with 22q11.2 duplications in these nine patients. 相似文献
56.
57.
Youssef N Carbonell N Bonte H Serfaty L Poupon R Fléjou JF 《Annales de pathologie》2004,24(3):256-258
Dieulafoy's ulcer is a particular form of gastric ulcer confined to a persistent caliber artery and may lead to severe hemorrhage. We report a case of fatal gastric bleeding in a woman with benign biclonal gammapathy. Autopsy found a typical Dieulafoy's ulcer centered by a persistent caliber artery which wall was thickened by AL-amyloid deposits. Amyloidosis involved the gastric wall, but also middle caliber arteries of the liver, the lung, the pancreas, the kidney and the myocardium. AL-amyloidosis is a rare and late complication of monoclonal gammapathy and may be asymptomatic. Pathogenesis of Dieulafoy's ulcer remains unclear. In our case, local ischemia may have facilitated gastric ulceration, and amyloid deposits may have contributed to arterial rupture. 相似文献
58.
Transcytosis and catabolism of antibody 总被引:10,自引:0,他引:10
This review describes the evolution of our knowledge of the transmission of immunoglobulin G (IgG) from mother to infant and
the factors which regulate the persistence of IgG in the circulation. These apparently unrelated processes involve the same
Fc receptor, FcRn (n=neonatal). FcRn appears to carry out these diverse roles by binding to IgG and then either transporting
the bound IgG across cells (transcytosis) or recycling its cargo back to the cell surface (control of catabolism). IgG that
is taken up by cells in the absence of binding to FcRn undergoes degradation. Thus, FcRn is the “protective” receptor that
servesto maintain IgG homeostasis and deliver IgGs across cellular barriers. 相似文献
59.
Daniel L. Hamilos MD John J. Oppenheimer MD Harold S. Nelson MD Sally Wenzel MD Sue Driscoll RN Richard F. Lockey MD David B. K. Golden MD Leland Fan MD Ralph J. Sanks RPh S. Allen Bock MD John W. Yunginger MD Donald Stevenson MD Timothy Sullivan MD Thomas Corbridge MD 《The Journal of allergy and clinical immunology》1993,91(6)
These guidelines are intended to reduce the potential for serious or life-threatening reactions when clinical research is conducted. The following issues were addressed: identifying the risks involved in the research, providing adequate safeguards in the protocol design and during withholding of medication, anticipating risks, minimizing the chances for human error, providing resuscitative equipment sufficient to deal with the most serious anticipated life-threatening reactions, planning for medical support in case of a life-threatening emergency, and optimizing the use of medical personnel and expertise to handle emergency situations. The guidelines also discuss important general issues about protocol design and implementation and the human subject consent form, which should facilitate the approval of protocols by the governing institutional review board.The guidelines are not meant to be inflexible or applicable to all research situations. However, it is our hope that they will allow for clinical research to be conducted in a manner that affords the research subjects a high degree of protection from unnecessary and possibly fatal injuries. 相似文献
60.