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Both maternal 25-hydroxyvitamin D (25(OH)D) concentrations during pregnancy and
placental amino acid transporter gene expression have been associated with
development of the offspring in terms of body composition and bone structure.
Several amino acid transporter genes have vitamin D response elements in their
promoters suggesting the possible linkage of these two mechanisms. We aimed to
establish whether maternal 25(OH)D and vitamin D-binding protein (VDBP) levels
relate to expression of placental amino acid transporters. RNA was extracted
from 102 placental samples collected in the Southampton Women's Survey,
and gene expression was analysed using quantitative real-time PCR. Gene
expression data were normalised to the geometric mean of three housekeeping
genes, and related to maternal factors and childhood body composition. Maternal
serum 25(OH)D and VDBP levels were measured by radioimmunoassay. Maternal
25(OH)D and VDBP levels were positively associated with placental expression of
specific genes involved in amino acid transport. Maternal 25(OH)D and VDBP
concentrations were correlated with the expression of specific placental amino
acid transporters, and thus may be involved in the regulation of amino acid
transfer to the fetus. The positive correlation of VDBP levels and placental
transporter expression suggests that delivery of vitamin D to the placenta may
be important. This exploratory study identifies placental amino acid
transporters which may be altered in response to modifiable maternal factors and
provides a basis for further studies.
To determine how inaccurate communication of patient data by clinicians in telephone calls to the prior-approval antimicrobial stewardship program (ASP) staff affects the incidence of inappropriate antimicrobial recommendations made by ASP practitioners.
A retrospective cohort design was used. The accuracy of the patient data communicated was evaluated against patients' medical records to identify predetermined, clinically significant inaccuracies. Inappropriate antimicrobial recommendations were defined having been made if an expert panel unanimously rated the actual recommendations as inappropriate after reviewing vignettes derived from inpatients' medical records.
The setting was an academic medical center with a prior-approval ASP.
All inpatient subjects of ASP prior-approval calls were eligible for inclusion.
Of 200 ASP telephone calls, the panel agreed about whether or not antimicrobial recommendations were inappropriate for 163 calls (82%); these 163 calls were then used as the basis for further analyses. After controlling for confbunders, inaccurate communication was found to be associated with inappropriate antimicrobial recommendations (odds ratio [OR], of 2.2; P = .03). In secondary analyses of specific data types, only inaccuracies in microbiological data were associated with the study outcome (OR, 7.5; P = .002). The most common reason panelists gave for rating a recommendation as inappropriate was that antimicrobial therapy was not indicated.
Inaccurate communication of patient data, particularly microbiological data, during prior-approval calls is associated with an increased risk of inappropriate antimicrobial recommendations from the ASP. Clinicians and ASP practitioners should work to confirm that critical data has been communicated accurately prior to use of that data in prescribing decisions.
Objectives: The objectives were to
ascertain the value of a range of methods—including clinical
features, resting and exercise electrocardiography, and rapid access
chest pain clinics (RACPCs)—used in the diagnosis and early
management of acute coronary syndrome (ACS), suspected acute myocardial
infarction (MI), and exertional angina.
THE INHIBITORS OF NF-κB (IκBs) play an important role in the regulation of the NF-κB pathway.
IκBR (for IκB-Related) is proposed to be a novel member of this family. We report the cloning and
characterization of the region of the human gene encoding the previously reported mRNA. This
region contains 13 exons, spread over 6550 bp of genomic sequence. The coding sequence is only
weakly similar to other IκBs and the exons display a more complicated structure than has been found
in other members of the IκB gene family. Moreover, the positions of intron-exon junctions are
different from those found in other IκB genes, even within the otherwise conserved ankyrin-like
repeat region, suggesting that the IκBR gene is not a member of this extended gene family. We
report a revised mRNA and protein sequence for IκBR, which predicts that the protein is larger than
originally described. We also report the chromosomal localisation of the human IκBR gene
(approved gene symbol NFKBIL2) to 8q24.3 using PCR-based somatic cell hybrid panel analysis and
fluorescence in situ hybridization (FISH) mapping.
We have localized the gene encoding the fast skeletal muscle
isoform of troponin I (TNNI2) to
11p15.5 by PCR-based analysis of somatic cell hybrid panels: based on the
hybrid panel, TNNI2 is coincident with the marker D11S922. The gene encoding
the fast skeletal
muscle troponin T gene (TNNT3) has been previously assigned to 11p15.5
suggesting that TNNI2
and TNNT3 may be closely linked. The overall location of genes encoding
troponin I and T isoforms
now reveals that they are organized at three loci each containing a
troponin I/troponin T gene pair.
This organization contrasts with all other sarcomeric protein genes and
has implications for the
evolution of these two gene families, for their regulation and for the
analysis of mutations suspected to result in cardiomyopathy.
The chromosomal location of the human fast skeletal muscle troponin
(TNNC2) gene was determined using somatic cell hybrids. PCR-based analysis
‘monochromosomal’ hybrid panel
identified the presence of the TNNC2 gene on human chromosome 20 and subsequent
analysis of the Genebridge4 radiation hybrid panel located the gene between
D20S721 and GCT10F11 with a lod score of >3.
We have determined the chromosomal location of the human
cardiac/slow skeleletal muscle
troponin C gene (TNNC1) to the short arm of chromosome 3 using somatic
analysis of a ‘monochromosomal’ hybrid panel identified
the presence of the TNNC1 gene on human
chromosome 3 and subsequent analysis of the Genebridge4 radiation
hybrid panel located the gene
between D3S3118 (7·3cR) and GCT4B10 (4·2cR) with a lod score
We describe the case of a 50-year-old previously well female, who presented with a slowly growing mass in the right submandibular region. Imaging confirmed the absence of a normally placed thyroid and the presence of a lingual thyroid. The submandibular mass was excised and histological examination confirmed ectopic thyroid tissue. The embryological descent of the thyroid and the Sistrunk procedure are discussed as well as the importance of thyroid scanning in neck lumps.
The term ‘tumefactive fibroinflammatory lesion’ has been usedto describe a fibrosclerosing disorder which has a locally destructive nature but is characterized by a benign histological appearance. We report five patients, over a five year period, with such a lesion.
The clinical behaviour and surgical findings suggest the lesion to be an invasive malignancy. However, the histological appearance of an admixtureof chronic inflammatory cells and fibrosis is consistent with a benign condition.
We recommend surgical excision of the lesion as the mainstay of treatment; other studies report the use of steroids and radiotherapy.
Carcinoid tumour is one of the rarest middle-ear neoplasms. We describe here a case of carcinoid tumour of the middle-ear cleft that presented with aural as well as systemic symptoms. Diagnostic difficulty was encountered using light microscopy, but electron microscopy revealed the neurosecretory granules.