Quantitative neonatal glucose-6-phosphate dehydrogenase screening: distribution, reference values, and classification by phenotype.

OBJECTIVE: To determine enzyme assay reference values for newborns in a Sephardic Jewish population at high risk for glucose-6-phosphate dehydrogenase (G6PD) deficiency. STUDY DESIGN: Quantitative G6PD testing was performed on umbilical cord blood. The reduction of nicotinamide adenine dinucleotide phosphate to nicotinamide adenine dinucleotide phosphate-oxidase, reflecting G6PD activity, was measured spectrophotometrically. Hemoglobin (Hb) was measured on the same sample. G6PD activity was recorded as U/g Hb. RESULTS: Males (N = 1502) were separated into 2 distinct groups: those <7 U/g Hb (n = 243 [16.2%], median 0.28 U/g Hb), designated G6PD deficient, presumably hemizygotes; and those ≥ 9 U/g Hb (n = 1256 [83.8%], 18.76 U/g Hb), designated G6PD normal, presumably hemizygotes. Female (n = 1298) values were a continuum and were categorized based on the male distribution: those <7 U/g Hb (n = 81 [6.2%], 4.84 U/g Hb), G6PD deficient, probably homozogytes; those ≥ 9.5 U/g Hb, equivalent to 50% of the male normal value, (n = 1153 (88.8%), 18.36 U/g Hb), G6PD normal, probably homozygotes; and those with intermediate values (n = 64 [4.9%], 8.61 U/g Hb), probable heterozygotes. CONCLUSIONS: Accurate identification of the male G6PD-deficient state was possible despite high normal neonatal G6PD values. Female values were presented as a continuum preventing accurate classification but were classified based on male phenotype for practical use.

Effectiveness of home rehabilitation after stroke in Israel.

On discharge from an acute general hospital after a stroke, 191 patients were in need of, and were appropriate for, multidisciplinary rehabilitation. One-hundred-and-one patients (52.4%) received it in a rehabilitation institution as inpatients (the institutional rehabilitation group (IR) group) and 91 patients received it at home (the home rehabilitation (HR) group). Patients in the HR group had their mobility, activities of daily living (ADL), range of movements, tonus, coordination and sensation determined on admission to home rehabilitation and on discharge from it, 6 weeks to 2 months later. This group contained more women and more patients able to walk with devices and who were partially independent in ADL. The IR group consisted of more men and more patients with diabetes and marked difficulties in ADL and ambulation. In both groups the Barthel index and the Frenchay activities index were determined 1 year after the stroke by way of a telephone interview and no meaningful differences were found between the two groups. IR was considerably more expensive than HR. In Israel there exists a subpopulation of acute stroke survivors in need of, and appropriate for, multidisciplinary rehabilitation that can be provided at home; such rehabilitation was found to be effective in the short and long term, as well as cost effective.

Nucleoid restructuring in stationary-state bacteria.

The textbook view of the bacterial cytoplasm as an unstructured environment has been overturned recently by studies that highlighted the extent to which non-random organization and coherent motion of intracellular components are central for bacterial life-sustaining activities. Because such a dynamic order critically depends on continuous consumption of energy, it cannot be perpetuated in starved, and hence energy-depleted, stationary-state bacteria. Here, we show that, at the onset of the stationary state, bacterial chromatin undergoes a massive reorganization into ordered toroidal structures through a process that is dictated by the intrinsic properties of DNA and by the ubiquitous starvation-induced DNA-binding protein Dps. As starvation proceeds, the toroidal morphology acts as a structural template that promotes the formation of DNA-Dps crystalline assemblies through epitaxial growth. Within the resulting condensed assemblies, DNA is effectively protected by means of structural sequestration. We thus conclude that the transition from bacterial active growth to stationary phase entails a co-ordinated process, in which the energy-dependent dynamic order of the chromatin is sequentially substituted with an equilibrium crystalline order.