Is There Extra Cost of Institutional Care for MS Patients?

Throughout life, patients with multiple sclerosis (MS) require increasing levels of support, rehabilitative services, and eventual skilled nursing facility (SNF) care. There are concerns that access to SNF care for MS patients is limited because of perceived higher costs of their care. This study compares costs of caring for an MS patient versus those of a typical SNF patient. We merged SNF cost report data with the 2001-2006 Nursing Home Minimum Data Set (MDS) to calculate percentage of MS residents-days and facility case-mix indices (CMIs). We estimated the average facility daily cost using hybrid cost functions, adjusted for facility ownership, average facility wages, CMI-adjusted number of SNF days, and percentage of MS residents-days. We describe specific characteristics of SNF with high and low MS volumes and examine any sources of variation in cost. MS patients were no longer more costly than typical SNF patients. A greater proportion of MS patients had no significant effect on facility daily costs (P = 0.26). MS patients were more likely to receive care in government-owned facilities (OR = 1.904) located in the Western (OR = 2.133) and Midwestern (OR = 1.3) parts of the USA (P < 0.05). Cost of SNF care is not a likely explanation for the perceived access barriers that MS patients face

Chemical Evolution of the Galactic Bulge as Derived from High-Resolution Infrared Spectroscopy of K and M Red Giants

We present chemical abundances in K and M red-giant members of the Galactic bulge derived from high-resolution infrared spectra obtained with the Phoenix spectrograph on Gemini-South. The elements studied are carbon, nitrogen, oxygen, sodium, titanium, and iron. The evolution of C and N abundances in the studied red-giants show that their oxygen abundances represent the original values with which the stars were born. Oxygen is a superior element for probing the timescale of bulge chemical enrichment via [O/Fe] versus [Fe/H]. The [O/Fe]-[Fe/H] relation in the bulge does not follow the disk relation, with [O/Fe] values falling above those of the disk. Titanium also behaves similarly to oxygen with respect to iron. Based on these elevated values of [O/Fe] and [Ti/Fe] extending to large Fe abundances, it is suggested that the bulge underwent a more rapid chemical enrichment than the halo. In addition, there are declines in both [O/Fe] and [Ti/Fe] in those bulge targets with the largest Fe abundances, signifying another source affecting chemical evolution: perhaps Supernovae of Type Ia. Sodium abundances increase dramatically in the bulge with increasing metallicity, possibly reflecting the metallicity dependant yields from supernovae of Type II, although Na contamination from H-burning in intermediate mass stars cannot be ruled out.Comment: ApJ in pres

The Stellar Parameters and Evolutionary State of the Primary in the d'-Symbiotic System StH\alpha190

We report on a high-resolution, spectroscopic stellar parameter and abundance analysis of a d' symbiotic star: the yellow component of StH\alpha190. This star has recently been discovered, and confirmed here, to be a rapidly rotating (vsini=100 km/s) subgiant, or giant, that exhibits radial-velocity variations of probably at least 40 km/s, indicating the presence of a companion (a white dwarf star). It is found that the cool stellar component has Teff=5300K and log g=3.0. The iron and calcium abundances are close to solar, however, barium is overabundant, relative to Fe and Ca, by about +0.5 dex. The barium enhancement reflects mass-transfer of s-process enriched material when the current white dwarf was an asymptotic giant branch (AGB) star. The past and future evolution of this binary system depends critically on its current orbital period, which is not yet known. Concerted and frequent radial-velocity measurements are needed to provide crucial physical constraints to this d' symbiotic system.Comment: 9 pages, 1 table, 3 figures. In press to Astrophysical Journal Letter

Evidence for a GABAergic system in rodent and human testis: Local GABA production and GABA receptors

The major neurotransmitter of the central nervous system, gamma-aminobutyric acid (GABA), exerts its actions through GABA(A), GABA(B) and GABA(C) receptors. GABA and GABA receptors are, however, also present in several non-neural tissues, including the endocrine organs pituitary, pancreas and testis. In the case of the rat testis, GABA appears to be linked to the regulation of steroid synthesis by Leydig cells via GABA(A) receptors, but neither testicular sources of GABA, nor the precise nature of testicular GABA receptors are fully known. We examined these points in rat, mouse, hamster and human testicular samples. RT-PCR followed by sequencing showed that the GABA-synthesizing enzymes glutamate decarboxylase (GAD) 65 and/or GAD67, as well as the vesicular GABA transporter vesicular inhibitory amino acid transporter (VIAAT/VGAT) are expressed. Testicular GAD in the rat was shown to be functionally active by using a GAD assay, and Western blot analysis confirmed the presence of GAD65 and GAD67. Interstitial cells, most of which are Leydig cells according to their location and morphological characteristics, showed positive immunoreaction for GAD and VIAAT/VGAT proteins. In addition, several GABA(A) receptor subunits (alpha1-3, beta1-3, gamma1-3), as well as GABAB receptor subunits R1 and R2, were detected by RT-PCR. Western blot analysis confirmed the results for GABA(A) receptor subunits beta2/3 in the rat, and immunohistochemistry identified interstitial Leydig cells to possess immunoreactive GABA(A) receptor subunits beta2/3 and alpha1. The presence of GABA(A) receptor subunit alpha1 mRNA in interstitial cells of the rat testis was further shown after laser microdissection followed by RT-PCR analysis. In summary, these results describe molecular details of the components of an intratesticular GABAergic system expressed in the endocrine compartment of rodent and human testes. While the physiological significance of this peripheral neuroendocrine system conserved throughout species remains to be elucidated, its mere presence in humans suggests the possibility that clinically used drugs might be able to interfere with testicular function. Copyright (C) 2003 S. Karger AG, Basel

The Observed Trend of Boron and Oxygen in Field Stars of the Disk

Oxygen abundances are derived in a sample of 13 field F and G dwarfs and subgiants with metallicities in the range of -0.75 < [Fe/H] < +0.15. This is the same sample of stars for which boron abundances have been derived earlier from archived spectra obtained with the Hubble Space Telescope. In a log-log comparison of the B versus the O abundances, a slope of m(BO)=1.39 is found, indicating that in the disk, the abundance of B relative to O is intermediate between primary and secondary production (hybrid behavior). This relation of B versus O for disk stars is compared to the same relation for halo stars.Comment: 14 pages, 3 figures, 1 table. In press to The Astronomical Journal (July 2001

Fluorine Abundances in the Globular Cluster M 4

We present chemical abundances for the elements carbon, sodium, and fluorine in 15 red giants of the globular cluster M 4, as well as six red giants of the globular cluster $\omega$ Centauri. The chemical abundances were calculated in LTE via spectral synthesis. The spectra analyzed are high-resolution spectra obtained in the near-infrared region around $\lambda$2.3$\mu$m with the Phoenix spectrograph on the 8.1m Gemini South Telescope, the IGRINS spectrograph on the McDonald Observatory 2.7m Telescope, and the CRIRES spectrograph on the ESO 8.2m Very Large Telescope. The results indicate a significant reduction in the fluorine abundances when compared to previous values from the literature for M 4 and $\omega$ Centauri, due to a downward revision in the excitation potentials of the HF(1-0) R9 line used in the analysis. The fluorine abundances obtained for the M 4 red giants are found to be anti-correlated with those of Na, following the typical pattern of abundance variations seen in globular clusters between distinct stellar populations. In M 4, as the Na abundance increases by $\sim$+0.4 dex, the F abundance decreases by $\sim$-0.2 dex. A comparison with abundance predictions from two sets of stellar evolution models finds that the models predict somewhat less F depletion ($\sim$-0.1 dex) for the same increase of +0.4 dex in Na

Chronic Myeloid Leukemia: causes of treatment failure with imatinib

Imatinib is currently the treatment of choice of CML, but despite of the excellent results, it is not able to completely eradicate the disease and resistance may occur. The most studied mechanism is the presence of ABL kinase mutations that interfere with imatinib binding and action, gene amplification and clonal evolution. However, there are other mechanisms involved and less studied such as drug absorption and influx and efflux of imatinib. Besides the true causes of resistance, compliance is always a concern and also drug interaction should be checked. An understanding of these mechanisms will certainly contribute to develop new strategies for the treatment of resistant cases.O mesilato de imatinibe (MI) é atualmente o tratamento de escolha da Leucemoa Mielóide Crônica (LMC), mas, apesar dos excelentes resultados, não é capaz de erradicar completamente a doença, podendo ocorrer resistência ao tratamento. O mecanismo mais conhecido de resistência é o desenvolvimento de mutações do BCR-ABL, que impedem a ação ligação adequada do imatinibe à quinase, além de amplificação gênica e evolução clonal. No entanto, há uma série de outros mecanismos envolvidos e ainda pouco estudados, como alterações na absorção, efluxo e influxo de droga para o interior das células. Devem-se também considerar outros fatores, como aderência ao tratamento e uso de medicamentos concomitantes que podem interferir com imatinibe, diminuindo sua ação. O entendimento desses mecanismos poderá contribuir no desenvolvimento de novas estratégias para o tratamento dos casos resistentes.222

JUNB methylation and expression in chronic myeloid leukemia

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