Prostacyclin receptor regulation--from transcription to trafficking.

The prostacyclin receptor (IP--International Union of Pharmacology nomenclature) is a member of the seven transmembrane G-protein coupled receptor (GPCR) superfamily. Recent concerns with selective and non-selective COX-1/COX-2 inhibition have exposed an important cardioprotective role for IP in preventing atherothrombosis. Receptor dysfunction (genetic variants) or reduced signaling (COX-2 inhibition) in high cardiovascular risk patients leads to increased cardiovascular events. These clinical observations have also been confirmed genetically by mouse knockout studies. Thus, receptor regulation is paramount in ensuring correct function in the prevention of atherothrombosis. This review summarizes recent literature on how this important receptor is regulated, from transcription to transport (to and from the membrane surface). These regulatory processes are critical in ensuring that IP receptors are adequately expressed and functional on the cell surface.

Clinical course correlates poorly with muscle pathology in nemaline myopathy.

OBJECTIVE: To report pathologic findings in 124 Australian and North American cases of primary nemaline myopathy. METHODS: Results of 164 muscle biopsies from 124 Australian and North American patients with primary nemaline myopathy were reviewed, including biopsies from 19 patients with nemaline myopathy due to alpha-actin (ACTA1) mutations and three with mutations in alpha-tropomyosin(SLOW) (TPM3). For each biopsy rod number per fiber, percentage of fibers with rods, fiber-type distribution of rods, and presence or absence of intranuclear rods were documented. RESULTS: Rods were present in all skeletal muscles and diagnosis was possible at all ages. Most biopsies contained nemaline bodies in more than 50% of fibers, although rods were seen only on electron microscopy in 10 patients. Rod numbers and localization correlated poorly with clinical severity. Frequent findings included internal nuclei and increased fiber size variation, type 1 fiber predominance and atrophy, and altered expression of fiber type specific proteins. Marked sarcomeric disruption, increased glycogen deposition, and intranuclear rods were associated with more severe clinical phenotypes. Serial biopsies showed progressive fiber size variation and increasing numbers of rods with time. Pathologic findings varied widely in families with multiple affected members. CONCLUSIONS: Very numerous nemaline bodies, glycogen accumulation, and marked sarcomeric disruption were common in nemaline myopathy associated with mutations in skeletal alpha-actin. Nemaline myopathy due to mutations in alpha-tropomyosin(SLOW) was characterized by preferential rod formation in, and atrophy of, type 1 fibers. Light microscopic features of nemaline myopathy correlate poorly with disease course. Electron microscopy may correlate better with disease severity and genotype.

Don't run with scissors: young children's knowledge of home safety rules.

OBJECTIVE: To examine 4- to 6-year-old children's knowledge of their parents' home safety rules and to identify predictors of children's home injuries. METHODS: Within the context of an interview, parents completed a home safety questionnaire in which they specified home safety rules, rated their child's compliance with each rule, explained not having rules, reported on maternal supervision, and reported on the frequency of their child's injuries. We evaluated children's knowledge of home safety rules by having them play a home safety game designed for this study. RESULTS: Children spontaneously recalled only about half of their parents' home safety rules. Prompting resulted in their recognition of about 40% more rules. However, children's knowledge scores did not predict the frequency of their injuries. The best predictors of children's injuries were children's compliance with home safety rules and extent of parental supervision. CONCLUSIONS: These findings suggest that interventions to promote young children's safety knowledge will not likely reduce childhood injuries unless children consistently comply with these rules or parents supervise children to ensure compliance.

Eating and smoking behaviours of school children in southwestern Ontario and Charlottetown, PEI.

We conducted in-class written surveys of fourth to eighth grade children's eating and smoking behaviours in southwestern Ontario (n = 870) and Charlottetown (n = 423) in order to facilitate local school boards' and health units' planning of health education initiatives. Using chi-square analysis, we examined sex, grade, provincial and rural-urban differences in behaviours. No rural-urban differences emerged. While students reported few gender differences in food group consumption, more PEI students consumed French fries, snack foods, cakes and cookies, and regular soft drinks daily. Only 60.1% (379/630) of girls and 70.0% (462/660) of boys (chi 2 = 13.8; p < 0.001) ate breakfast every day, falling to 53.2% (115/216) among eighth grade girls, and 32.9% (25/76) among students who smoked. The prevalence of smoking was 4.8% (n = 40) in Ontario and 8.5% (n = 36) in PEI (chi 2 = 6.8; p < 0.01). Compared to non-smokers, a higher proportion of students who smoked consumed snack foods and regular soft drinks daily. The results emphasize the need to promote healthy eating behaviours and anti-smoking messages among school children.

Heart health Hamilton-Wentworth survey: programming implications.

This telephone survey (n = 601) provided baseline data for the development and evaluation of cardiovascular disease (CVD) prevention programming in the City of Hamilton. Questions covered health history, awareness of CVD risk factors, hypertension control, smoking, dietary fat knowledge, physical activity, and preferred sources of health promotion information. Body mass index values over 25 kg/m2 were calculated for 55.2% of respondents (n = 439). Smoking and poor diet were the most frequently reported CVD risk factors. Lack of time was the main barrier to increased physical activity for nearly 54% of respondents. Print media (55%) and physicians (36%) were preferred sources of healthy eating information, while physical activity information was most likely to be sought from recreation centres (37%) and print media (34%). Smokers who wished to quit would consult a physician. In the City of Hamilton, CVD prevention programming should support healthy body weights through promotion of active lifestyles and healthy eating.

Gender biases in children's appraisals of injury risk and other children's risk-taking behaviors.

Children ages 6, 8, and 10 years were given tasks designed to assess their beliefs about risk of injury from activities. Children were asked to appraise the risk of injury for boys and girls engaging in various play behaviors and to judge the sex of the character in stories about children engaging in activities that result in injuries. Results revealed gender biases in children's appraisals of injury risk: Both boys and girls rated boys as having a lower likelihood of injury than girls even though the boys and girls were engaging in the exact same activities. Children also showed higher accuracy in identifying the sex of the character in stories of boys' injuries than girls' injuries, and accuracy improved with the participant's age. Overall, the results indicate that by the age of 6 years children already have differential beliefs about injury vulnerability for boys and girls. Although boys routinely experience more injuries than girls, children rate girls as having a greater risk of injury than boys. With increasing age, school-age children develop a greater awareness of the ways in which boys and girls differ in risk-taking activities that lead to injury outcomes.

Changing health care, one phone call at a time.

Demand management is an approach to providing health care benefits that is designed to help beneficiaries receive the appropriate level of care at the appropriate time. When this is accomplished, health care expenditures are reduced. This case study shows how a large union health plan implemented a demand management program that has been well received by its members and has been effective in helping to control plan costs.