Roth\u27s Contribution to the Narrativization of Illness

In her article Roth\u27s Contribution to the Narrativization of Illness Miriam Jaffe-Foger argues that Philipp Roth\u27s fiction represents him as an empath, a writer who prescribes for modern medicine a dose of humanity in listening to the pain of others. Using Roth\u27s The Anatomy Lesson, The Dying Animal, and Exit Ghost as primary source material in combination with theories from medical anthropology, Jaffe-Foger suggests that Roth is an inspiration for the field of narrative medicine. Jaffe-Foger examines the art in organizing narratives to tell these stories. Jaffe-Foger also argues against misogynist views of Roth as he represents woman\u27s bodies, offering a modern reading of the relationship between illness and sexuality

Results of pancreas transplantation after steroid withdrawal under tacrolimus immunosuppression

Purpose. The results of steroid withdrawal in pancreas transplant recipients under tacrolimus immunosuppression were analyzed. Methods. From July 4, 1994 until April 30, 1998, 147 pancreas transplantations were performed in 141 patients, including 126 simultaneous pancreas-kidney transplantations, 13 pancreas after kidney transplantation, and 8 pancreas transplantations alone. Baseline immunosuppression consisted of tacrolimus and steroids without antilymphocyte induction. Twenty-three patients were excluded from analysis because of early graft loss in 17 cases, retransplantation in 5 cases, and simultaneous pancreas-kidney transplantation after heart transplantation in 1 patient. Results. With a mean follow-up of 2.8±1.1 years (range 1.0 to 4.8 years), complete steroid withdrawal was achieved in 58 (47%) patients with a mean time to steroid withdrawal of 15.2±8 months (range 4 to 40 months after transplantation). Of the entire cohort of 141 patients, overall 1-, 2-, and 4-year patient survival rates were 98%, 95.5%, and 86%, respectively. Overall 1-, 2-, and 4- year graft survival rates were 83%, 80%, and 71% (pancreas) and 95%, 91%, and 84% (kidney), respectively. Of the 124 patients analyzed for steroid withdrawal, 1-, 2-, and 4-year patient survival rates were 98%, 97%, and 92%, respectively. Overall 1-, 2-, and 4-year graft survival rates were 98%, 91.5%, 83% (pancreas) and 97%, 95%, and 91% (kidney). Patient, pancreas, and kidney survival rates at 1 year were 100%, 100%, and 98% (off steroids) versus 97%, 91%, and 96% (on steroids, all NS) and at 4 years were 100%, 94%, and 95% (off steroids) versus 78%, 68%, and 85% (on steroids, P=0.01, 0.002, and NS, respectively). The cumulative risk of rejection at the time of follow-up was 76% for patients on steroids versus 74% for patients off steroids (P=NS). Seven patients originally tapered off steroids were treated for subsequent rejection episodes, which were all steroid sensitive, and two of these seven patients are currently off steroids. Thirteen patients received antilymphocyte therapy for steroid-resistant rejection, five of whom are now off steroids. Tacrolimus trough levels were 9.3±2.4 ng/ml (off steroids) and 9.7±4.3 (on steroids, P=NS). Mean fasting glucose levels were 98±34 mg/dl (off steroids) and 110±41 mg/dl (on steroids, P=NS). Mean glycosylated hemoglobin levels were 5.2±0.9% (off steroids) and 6.2±2.1% (on steroids, P=0.02), and mean serum creatinine levels were 1.4±0.8 mg/dl (off steroids) and 1.7±1.0 mg/dl (on steroids, P=0.02). Conclusion. These data show for the first time that steroid withdrawal can be safely accomplished in pancreas transplant recipients maintained on tacrolimus-based immunosuppression. Steroid withdrawal is associated with excellent patient and graft survival with no increase in the cumulative risk of rejection

Zebrafish homologs of 16p11.2, a genomic region associated with brain disorders, are active during brain development, and include two deletion dosage sensor genes

Deletion or duplication of one copy of the human 16p11.2 interval is tightly associated with impaired brain function, including autism spectrum disorders (ASDs), intellectual disability disorder (IDD) and other phenotypes, indicating the importance of gene dosage in this copy number variant region (CNV). The core of this CNV includes 25 genes; however, the number of genes that contribute to these phenotypes is not known. Furthermore, genes whose functional levels change with deletion or duplication (termed 'dosage sensors'), which can associate the CNV with pathologies, have not been identified in this region. Using the zebrafish as a tool, a set of 16p11.2 homologs was identified, primarily on chromosomes 3 and 12. Use of 11 phenotypic assays, spanning the first 5 days of development, demonstrated that this set of genes is highly active, such that 21 out of the 22 homologs tested showed loss-of-function phenotypes. Most genes in this region were required for nervous system development - impacting brain morphology, eye development, axonal density or organization, and motor response. In general, human genes were able to substitute for the fish homolog, demonstrating orthology and suggesting conserved molecular pathways. In a screen for 16p11.2 genes whose function is sensitive to hemizygosity, the aldolase a (aldoaa) and kinesin family member 22 (kif22) genes were identified as giving clear phenotypes when RNA levels were reduced by ~50%, suggesting that these genes are deletion dosage sensors. This study leads to two major findings. The first is that the 16p11.2 region comprises a highly active set of genes, which could present a large genetic target and might explain why multiple brain function, and other, phenotypes are associated with this interval. The second major finding is that there are (at least) two genes with deletion dosage sensor properties among the 16p11.2 set, and these could link this CNV to brain disorders such as ASD and IDD.Simons Foundation (Grant Number 95091

University Mentors: Integrating Former and Current Student-Athletes into Communities

Two model programs to assimilate minority student-athletes in a predominantly white community provide examples of meaningful approaches to appreciating the variety of backgrounds, personal skills, and individual strengths of student-athletes

Impact of temporomandibular disorders on quality of life

Introduction: Temporomandibular dysfunction (TMD) may have a major impact on quality of life. Objective: Thus, this integrative review assessed the impact of TMD on quality of life. Method: An electronic and manual search was conducted to identify studies that evaluated the impact of TMD on an individual’s quality of life. After the inclusion and exclusion criteria were met, seven articles were included and evaluated according to the quality of evidence using the Newcastle-Ottawa assessment. Results: The selected studies used different instruments to diagnose temporomandibular joint disorders and measure the quality of life. Only three studies used the RDC/TMD. As for quality of life, the most used instrument was the SF-36, followed by Br-MPQ and WHOQOL-Bref. Conclusion: The findings show that there is a negative impact of temporomandibular dysfunction on quality of life, especially regarding its severity. However, further studies are needed to confirm these results

Frailty and oral health-related quality of life in community-dwelling older adults: a cross-sectional study

publishedVersio

Frequency of functional and muscular changes after head and neck radiation therapy. A cross-sectional study / Frequência de alterações funcionais e musculares após radioterapia de cabeça e pescoço. Um estudo transversal

Head and neck cancer is considered a mutilating disease, the therapeutic modalities for treatment include surgical, radiotherapeutic and chemotherapeutic procedures. The aim was to evaluate functional and muscular alterations in the head, neck, scapular girdle and upper extremities of individuals with head and neck cancer after radiotherapy. Cross-sectional study with retrospective data. Seventy-one medical charts were selected, analyzing in each of them the routine of the physiotherapeutic diagnosis of patients that includes information about the disease, physical examination and diagnosis of pain and limitation of movement. The results showed muscular alterations in all patients, most of the changes occurred in the area close to the irradiated site, such as the trapezius (90.1%) and pectoral (80.3%) muscles. All patients underwent radiotherapy, 29 (40.8%) used conventional cobalt therapy and 42 (59.2%) intensity-modulated radiation therapy (IMRT). The most used dose among the patients was 6,300 cGy. The Bisserial Correlation Test showed a correlation between the dose of radiotherapy and the segments: temporomandibular dysfunction, sternocleidomastoid, trapezius, pectoralis, cervical, shoulder, winged scapula, and sensory alterations. Radiation therapy in head and neck cancer causes functional and muscular changes in the irradiated regions. The present study showed that areas that were not directly irradiated should be better studied

Coronin 1C harbours a second actin-binding site that confers co-operative binding to F-actin

Dynamic rearrangement of actin filament networks is critical for cell motility, phagocytosis and endocytosis. Coronins facilitate these processes, in part, by their ability to bind F-actin (filamentous actin). We previously identified a conserved surface-exposed arginine (Arg30) in the β-propeller of Coronin 1B required for F-actin binding in vitro and in vivo. However, whether this finding translates to other coronins has not been well defined. Using quantitative actin-binding assays, we show that mutating the equivalent residue abolishes F-actin binding in Coronin 1A, but not Coronin 1C. By mutagenesis and biochemical competition, we have identified a second actin-binding site in the unique region of Coronin 1C. Interestingly, leading-edge localization of Coronin 1C in fibroblasts requires the conserved site in the β-propeller, but not the site in the unique region. Furthermore, in contrast with Coronin 1A and Coronin 1B, Coronin 1C displays highly co-operative binding to actin filaments. In the present study, we highlight a novel mode of coronin regulation, which has implications for how coronins orchestrate cytoskeletal dynamics

Educação sexual para pessoas com deficiência física

Pessoas com deficiência física são seres sexuados que necessitam receber esclarecimentos e educação sexual. Este trabalho descreve um programa de intervenção em educação sexual para pessoas com deficiência física que teve por objetivos: a) transmitir uma noção ampla e emancipatória de sexualidade, b) esclarecer e informar sobre a educação e repressão sexual, c) refletir sobre as mudanças na imagem corporal e autoestima da pessoa com deficiência física e suas implicações na sexualidade e d) discutir sobre a crença social de que a deficiência é impeditiva para a sexualidade. O programa foi realizado em dez encontros semanais de duas horas de duração e utilizou-se de recursos pedagógicos como dinâmicas grupais, vídeos e imagens. Os jovens participaram ativamente, discutindo e refletindo sobre as questões sociais da sexualidade. Conclui-se que a população estigmatizada pela deficiência carece de esclarecimentos e reflexões sobre a construção social da sexualidade e da deficiência e que oportunidades de reflexões grupais em processos de educação sexual para essa população são fundamentais na sociedade inclusiva

Red yeast rice for dyslipidaemias and cardiovascular risk reduction: A position paper of the International Lipid Expert Panel.

The risk of atherosclerotic cardiovascular disease (ASCVD) is strongly related to lifetime exposure to low-density lipoprotein (LDL)-cholesterol in longitudinal studies. Lipid-lowering therapy (using statins, ezetimibe and PCSK9 inhibitors) substantially ameliorates the risk and is associated with long-term reduction in cardiovascular (CV) events. The robust evidence supporting these therapies supports their continued (and expanding) role in risk reduction. In addition to these 'conventional' therapeutics, while waiting for other innovative therapies, growing evidence supports the use of a range of 'nutraceuticals' (constituents of food prepared as pharmaceutical formulations) including preparations of red yeast rice (RYR), the product of yeast (Monascus purpureus) grown on rice, which is a constituent of food and is used in traditional Chinese medicine. The major active ingredient, monacolin K, is chemically identical to lovastatin. RYR preparations have been demonstrated to be safe and effective in reducing LDL-C, and CV events. However, surprisingly, RYR has received relatively little attention in international guidelines - and conventional drugs with the strongest evidence for event reduction should always be preferred in clinical practice. Nevertheless, the absence of recommendations relating to RYR may preclude the use of a product which may have clinical utility in particular groups of patients (who may anyway self-prescribe this product), what in the consequence might help to reduce population CV risk. This Position Paper of the International Lipid Expert Panel (ILEP) will use the best available evidence to give advice on the use of red-yeast rice in clinical practice