The role of thyroid and steroid hormones in maturation of the adreline-sensitive reabsorptive mechanism of the fetal lung

Around the time of birth, the lung switches from a secretory- to a liquid absorptive organ to enable the fetus to transit from an intra-uterine to an air-breathing environment. This study concerns hormonal control of the liquid reabsorptive mechanism in the fetal lung which allows this transition to take place. Thyroidectomy in the fetal sheep at 118 days gestation (term = 147 days) prevented the development of adrenaline- or cyclic AMP-sensitivity which, in euthyroid fetuses, resulted in the capacity to absorb lung liquid from 130 days onwards. Studies in which T₃ and T₄ were infused to thyroidectornized fetal sheep showed that T₃ was required for the normal evolution of the reabsorptive response. However, infusion of this hormone to immature fetuses (110 days) did not advance the gestation at which adrenaline-sensitive absorption is first seen. Co-infusion of T₃ and hydrocortisone showed that these 2 hormones have a powerful synergistic effect on the absorption mechanism. Within a few hours of infusion of these 2 hormones to immature fetuses, a reabsorptive response to adrenaline similar to that normally seen in mature fetuses was observed. This response was fully reversible on withdrawal of T₃ and hydrocortisone infusion, and the hormonal effect was blocked by the protein synthesis inhibitor, cyclohexirnide. These findings suggest that the normal rise in T₃ and cortisol seen in the fetus in late gestation is responsible for maturation of the liquid absorption mechanism which allows the fetus to make a transition to an independent air-breathing existence. These observations may be of significance in the clinical management of infants born prematurely, who may have had insufficient pre-natal exposure to T₃ and cortisol

Managing HIV as a chronic disease: Using interactive data collection to improve clinical care

As South Africa and the rest of the developing world respond to the AIDS crisis, a critical task will be to develop scalable systems for sustainable and effective delivery of antiretroviral (ARV) drugs in a variety of resource-restricted settings. With the emergence, from national governments, the World Health Organization (WHO) and major international donors, of the political will and funding to support treatment programmes, it has become urgent that we consider how ARVs will be delivered. In this review, we consider how ARVs allow us to manage HIV/AIDS as a chronic disease, and the data systems that are required to support this approach to therapy. Southern African Journal of HIV Medicine Vol. 5(4) 2004: 7-1

Quality improvement in emergency obstetric referrals: qualitative study of provider perspectives in Assin North district, Ghana

Objective: To describe healthcare worker (HCW)-identified system-based bottlenecks and the value of local engagement in designing strategies to improve referral processes related to emergency obstetric care in rural Ghana. Design: Qualitative study using semistructured interviews of participants to obtain provider narratives. Setting: Referral systems in obstetrics in Assin North Municipal Assembly, a rural district in Ghana. This included one district hospital, six health centres and four local health posts. This work was embedded in an ongoing quality improvement project in the district addressing barriers to existing referral protocols to lessen delays. Participants: 18 HCWs (8 midwives, 4 community health officers, 3 medical assistants, 2 emergency room nurses, 1 doctor) at different facility levels within the district. Results: We identified important gaps in referral processes in Assin North, with the most commonly noted including recognising danger signs, alerting receiving units, accompanying critically ill patients, documenting referral cases and giving and obtaining feedback on referred cases. Main root causes identified by providers were in four domains: (1) transportation, (2) communication, (3) clinical skills and management and (4) standards of care and monitoring, and suggested interventions that target these barriers. Mapping these challenges allowed for better understanding of next steps for developing comprehensive, evidence-based solutions to identified referral gaps within the district. Conclusions: Providers are an important source of information on local referral delays and in the development of approaches to improvement responsive to these gaps. Better engagement of HCWs can help to identify and evaluate high-impact holistic interventions to address faulty referral systems which result in poor maternal outcomes in resource-poor settings. These perspectives need to be integrated with patient and community perspectives

Integrating microRNA and mRNA expression profiles of neuronal progenitors to identify regulatory networks underlying the onset of cortical neurogenesis

<p>Abstract</p> <p>Background</p> <p>Cortical development is a complex process that includes sequential generation of neuronal progenitors, which proliferate and migrate to form the stratified layers of the developing cortex. To identify the individual microRNAs (miRNAs) and mRNAs that may regulate the genetic network guiding the earliest phase of cortical development, the expression profiles of rat neuronal progenitors obtained at embryonic day 11 (E11), E12 and E13 were analyzed.</p> <p>Results</p> <p>Neuronal progenitors were purified from telencephalic dissociates by a positive-selection strategy featuring surface labeling with tetanus-toxin and cholera-toxin followed by fluorescence-activated cell sorting. Microarray analyses revealed the fractions of miRNAs and mRNAs that were up-regulated or down-regulated in these neuronal progenitors at the beginning of cortical development. Nearly half of the dynamically expressed miRNAs were negatively correlated with the expression of their predicted target mRNAs.</p> <p>Conclusion</p> <p>These data support a regulatory role for miRNAs during the transition from neuronal progenitors into the earliest differentiating cortical neurons. In addition, by supplying a robust data set in which miRNA and mRNA profiles originate from the same purified cell type, this empirical study may facilitate the development of new algorithms to integrate various "-omics" data sets.</p

The Canadian Cooperative Wildlife Health Centre and Surveillance of Wild Animal Diseases in Canada, Volume 38, May 1997

The Canadian Cooperative Wildlife Health Centre (CCWHC) was established in 1992 as an organization among Canada\u27s 4 veterinary colleges, with a mandate to apply veterinary medicine to wildlife management and conservation in Canada. A major function of the CCWHC is nation-wide surveillance of wild animal diseases. Disease surveillance is conceived as consisting of 4 different activities: detection, diagnosis, information management, and use of information. In the CCWHC surveillance program, detection of disease is carried out by a wide range of professional and avocational field personnel, and much effort is expended to stimulate and support this activity. Diagnosis is done by personnel of provincial and federal veterinary laboratories and the CCWHC. Information management is achieved through a national database of wildlife disease incidents developed and maintained by the CCWHC. Use of information is enabled through established channels for distribution of information derived from the surveillance program to persons responsible for wildlife programs and policies, and to the public. There has been a high demand for the services of the CCWHC since its establishment. The CCWHC responds to approximately 2000 requests for information annually, distributes its newsletter to over 1700 recipients, examines approximately 1200 wild animal submissions each year, and has accumulated records of over 5000 disease incidents in its database. Technical information from the CCWHC has benefited federal, provincial/territorial, and non-government wildlife agencies; endangered species recovery programs; federal and provincial veterinary services; and federal and provincial public health programs

The Canadian Cooperative Wildlife Health Centre and Surveillance of Wild Animal Diseases in Canada, Volume 38, May 1997

The Canadian Cooperative Wildlife Health Centre (CCWHC) was established in 1992 as an organization among Canada\u27s 4 veterinary colleges, with a mandate to apply veterinary medicine to wildlife management and conservation in Canada. A major function of the CCWHC is nation-wide surveillance of wild animal diseases. Disease surveillance is conceived as consisting of 4 different activities: detection, diagnosis, information management, and use of information. In the CCWHC surveillance program, detection of disease is carried out by a wide range of professional and avocational field personnel, and much effort is expended to stimulate and support this activity. Diagnosis is done by personnel of provincial and federal veterinary laboratories and the CCWHC. Information management is achieved through a national database of wildlife disease incidents developed and maintained by the CCWHC. Use of information is enabled through established channels for distribution of information derived from the surveillance program to persons responsible for wildlife programs and policies, and to the public. There has been a high demand for the services of the CCWHC since its establishment. The CCWHC responds to approximately 2000 requests for information annually, distributes its newsletter to over 1700 recipients, examines approximately 1200 wild animal submissions each year, and has accumulated records of over 5000 disease incidents in its database. Technical information from the CCWHC has benefited federal, provincial/territorial, and non-government wildlife agencies; endangered species recovery programs; federal and provincial veterinary services; and federal and provincial public health programs