Molecular Epidemiology of Multidrug-Resistant Tuberculosis, New York City, 1995–1997

From January 1, 1995, to December 31, 1997, we reviewed records of all New York City patients who had multidrug-resistant tuberculosis (MDRTB); we performed insertion sequence (IS) 6110-based DNA genotyping on the isolates. Secondary genotyping was performed for low IS6110 copy band strains. Patients with identical DNA pattern strains were considered clustered. From 1995 through 1997, MDRTB was diagnosed in 241 patients; 217 (90%) had no prior treatment history, and 166 (68.9%) were born in the United States or Puerto Rico. Compared with non-MDRTB patients, MDRTB patients were more likely to be born in the United States, have HIV infection, and work in health care. Genotyping results were available for 234 patients; 153 (65.4%) were clustered, 126 (82.3%) of them in eight clusters of >4 patients. Epidemiologic links were identified for 30 (12.8%) patients; most had been exposed to patients diagnosed before the study period. These strains were likely transmitted in the early 1990s when MDRTB outbreaks and tuberculosis transmission were widespread in New York

A guide for the re-entry student

Includes bibliographical references (pages 74-75)This project consisted of the development of a guide for the\ud re-entry student in the form of a pamphlet. The information included\ud is based on a review of the literature pertaining to trends in higher\ud education, adult learning, and services and programs related to reentry\ud students. The author's experience in working with adult students\ud also serves as a basis for the material covered. The pamphlet\ud is designed to be an easy-to-read, informative manual for the adult\ud re-entry student. It covers many phases of the adjustment to college\ud such as learning basic skills, using various campus services, and the\ud problems of balancing one's personal life with being a student.\ud Attention is given to the special problems faced by older students\ud who have been away from school for many years and face additional\ud stress and fears due to the gap in their formal education. A suggested reading list is provided for the student to use in acquiring further and more detailed information about the topics covered. The pamphlet is intended for use as an information source for\ud re-entry students and could be given out during orientation, as well\ud as being available at counseling and re-entry centers. Since many\ud returning students are on campus-part time and are not able to attend\ud workshops or seminars, a pamphlet such as this might bridge the gap\ud in getting information to them

Bi-specific molecule against EGFR and death receptors simultaneously targets proliferation and death pathways in tumors

Developing therapeutics that target multiple receptor signaling pathways in tumors is critical as therapies targeting single specific biomarker/pathway have shown limited efficacy in patients with cancer. In this study, we extensively characterized a bi-functional molecule comprising of epidermal growth factor receptor (EGFR) targeted nanobody (ENb) and death receptor (DR) targeted ligand TRAIL (ENb-TRAIL). We show that ENb-TRAIL has therapeutic efficacy in tumor cells from different cancer types which do not respond to either EGFR antagonist or DR agonist monotherapies. Utilizing pharmacological inhibition, genetic loss of function and FRET studies, we show that ENb-TRAIL blocks EGFR signalling via the binding of ENb to EGFR which in turn induces DR5 clustering at the plasma membrane and thereby primes tumor cells to caspase-mediated apoptosis. In vivo, using a clinically relevant orthotopic resection model of primary glioblastoma and engineered stem cells (SC) expressing ENb-TRAIL, we show that the treatment with synthetic extracellular matrix (sECM) encapsulated SC-ENb-TRAIL alleviates tumor burden and significantly increases survival. This study is the first to report novel mechanistic insights into simultaneous targeting of receptor-mediated proliferation and cell death signaling pathways in different tumor types and presents a promising approach for translation into the clinical setting