Opportunities for Supporting Latino Immigrants in Emergency and Ambulatory Care Settings

Journal of Community Health - Toughened immigration policies exacerbate barriers to public benefits and health care for immigrants. The objective of this study is to examine the impact of the...     

Microstructural development: Organizational differences of the fiber architecture between children and adults in dorsal and ventral visual streams

Visual perceptual skills are basically mature by the age of 7 years. White matter, however, continues to develop until late adolescence. Here, we examined children (aged 5–7 years) and adults (aged 20–30 years) using diffusion tensor imaging (DTI) fiber tracking to investigate the microstructural maturation of the visual system. We characterized the brain volumes, DTI indices, and architecture of visual fiber tracts passing through white matter structures adjacent to occipital and parietal cortex (dorsal stream), and to occipital and temporal cortex (ventral stream). Dorsal, but not ventral visual stream pathways were found to increase in volume during maturation. DTI indices revealed expected maturational differences, manifested as decreased mean and radial diffusivities and increased fractional anisotropy in both streams. Additionally, fractional anisotropy was increased and radial diffusivity was decreased in the adult dorsal stream, which can be explained by specific dorsal stream myelination or increasing fiber compaction. Adult dorsal stream architecture showed additional intra‐ and interhemispheric connections: Dorsal fibers penetrated into contralateral hemispheres via commissural structures and projection fibers extended to the superior temporal gyrus and ventral association pathways. Moreover, intra‐hemispheric connectivity was particularly strong in adult dorsal stream of the right hemisphere. Ventral stream architecture also differed between adults and children. Adults revealed additional connections to posterior lateral areas (occipital‐temporal gyrus), whereas children showed connections to posterior medial areas (posterior parahippocampal and lingual gyrus). Hence, in addition to dorsal stream myelination or fiber compaction, progressing maturation of intra‐ and interhemispheric connectivity may contribute to the development of the visual system. Hum Brain Mapp, 2011. © 2010 Wiley‐Liss, Inc.     

Metal ions activate vascular endothelial cells and increase lymphocyte chemotaxis and binding

Metal on metal articulations in hip arthroplasty offer advantages, including lower volumetric wear compared to conventional metalonpolyethylene bearings, and increased resistance to dislocation. Reports described early failures, with histologic features similar to a Type IV immune response. Mechanisms by which metal wear products cause this reaction are not completely understood. We hypothesized a mechanism through direct activation of endothelial cells (ECs) by metal ions, resulting in both vasculitis and accumulation of lymphocytes without prior immune sensitization. Effects of metal ions were evaluated using human ECs in culture. Alterations in chemotactic proteins IL8 and MCP1 were assessed, as was upregulation of the adhesion molecule ICAM‐1 and lymphocyte binding to ECs. Cobalt increased secretion of IL8 and MCP1 significantly, and upregulated the expression of ICAM‐1 in ECs compared to stimulation by chromium and controls. Binding of lymphocytes to ECs and transEC migration were both significantly increased by cobalt but not chromium. These findings suggest that cobalt contributes more to the activation of ECs and lymphocyte binding than chromium without an allergic response. Some of the adverse tissue reactions to implants with components made of cobalt–chromium–molybdenium alloys may be due in part to activation of the endothelium by metal ions. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31:1484–1491, 2013     

Profiling osteopathic practice in the UK using standardised data collection

BackgroundIncreasing interest is being shown in osteopathy on a national and international basis. Little prospective data are available concerning the day-to-day practice of the profession. To address this issue, a standardised data collection tool was developed for osteopathy.MethodsThe standardised data collection (SDC) tool underwent national piloting between April and July 2009 in United Kingdom private practices. Osteopaths volunteered to participate and recruited patients on whom to record data for a period of one month. This was followed by a follow-up period of two more months.ResultsA total of 1630 completed datasets from the SDC pilot were analysed by the project team. The SDC tool performed extremely well, and generated meaningful data. Lumbar symptoms were the most common (36%), followed by cervical spine (15%), sacroiliac/pelvic/groin (7.9%), head/facial area (7%), shoulder (6.8%), and thoracic spine (6%). Additional symptoms were recorded in 2.9% of patients. A total of 48.8% of patients reported co-morbidities, the most common being hypertension (11.7%), followed by asthma (6.6%), and arthritis (5.7%). Outcome data were collected looking at the patients' response to treatment, and any form of treatment reactions.ConclusionThe primary aim of the project was to create and test a standardised data collection tool for osteopathy. A small number of issues were highlighted during the project identifying where further refinement was required. The development of an electronic format, and a short form version for daily practitioner use would be welcome.