ABSTRACT
En la medicina evaluadora, al estar en juego unos intereses (principalmente económicos u otro tipo de prestaciones sociales) muy distintos a los de la medicina asistencial (la curación de la enfermedad), no es infrecuente que el paciente o sujeto objeto de la valoración intente obtener el mayor beneficio posible de su situación, incluso utilizando todo tipo de artimañas (exageración, simulación, etc., y disimulación también, aunque en el sentido contrario) para intentar engañar al médico evaluador sobre la gravedad o afectación funcional que le produce la patología que presenta o alega. Esto, que en principio puede parecer algo novedoso, ya está recogido a lo largo de la Historia, tanto religiosa (Biblia, por ejemplo) como civil (libros de historia griegos, literatura, etc.) y médica (Hipócrates, Galeno, etc.) y, aunque la finalidad es la misma, y algunos métodos también, se han ido desarrollando diversas técnicas para conseguirla y, cómo no, también para detectarla. Diversos autores médicos han intentado describir los indicadores que pueden orientar hacia la existencia de algún tipo de simulación, han establecido técnicas para intentar llegar a su diagnóstico y diferenciación de la afectación real, y han descrito las distintas formas o modalidades en que se puede presentar. Con estas reflexiones no se pretende realizar un tratado o un estudio profundo sobre el tema de la simulación en medicina valoradora, sino que lo que se intenta es despertar en la conciencia del médico valorador la bombilla que le haga pensar en su existencia y señalarle algunas herramientas que le pueden ser útiles en su quehacer diario
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Subject(s)
Humans , Malingering/diagnosis , Disability Evaluation , Insurance Claim Review , Insurance, DisabilityABSTRACT
The nucleotide and deduced amino acid sequence of a serine protease (AgSp24D) from the human malaria vector, Anopheles gambiae, is presented. The gene product is a 271 amino acid protein that contains the conserved serine, histidine and aspartic acid residues found in serine proteases, and has the highest identity to a serine protease of unknown function from Drosophila melanogaster. In situ hybridization to the polytene chromosomes detects a single band at 24D. Northern analysis reveals only low levels of transcripts in larvae and pupae, but more abundant transcription products occur in adults. Interestingly, this analysis also shows that adult males express much higher levels of AgSp24D mRNA than females. In addition, Plasmodium-refractory mosquitoes express higher levels of AgSp24D mRNA than susceptible mosquitoes although the biological significance of this remains to be examined. The thorax is the primary site for expression in the adults. The lack of a dramatic increase in AgSp24D mRNA levels following blood feeding suggests that this protease is not involved in digestive processes. Transcriptional induction does not follow cold shock, septic wounding, bacterial injection, laminarin injection or CM-Sephadex bead injection.
Subject(s)
Anopheles/genetics , Gene Expression Regulation, Developmental/physiology , Insect Vectors/genetics , Serine Endopeptidases/genetics , Amino Acid Sequence , Animals , Anopheles/physiology , Base Sequence , Chromosome Mapping , Cloning, Molecular , Female , Gene Dosage , Genes, Insect/genetics , Humans , Malaria/transmission , Male , Molecular Sequence Data , Organ Specificity , Plasmodium , RNA, Messenger/analysis , Sequence Analysis, DNA , Sequence Homology, Amino AcidABSTRACT
New P element plasmids containing the organophosphate-degrading gene opd as a dominant selectable marker were tested as transformation vectors in Drosophila melanogaster. One of these vectors was modified by the addition of the D. melanogaster mini-white gene as a comarker. When transformed individuals were identified using paraoxon selection for opd alone, results were similar to those obtained with mini-white. No false positives were recovered, however one strain contained the mini-white gene but inadequate resistance to survive our screening regimen due to a defective Hsp70-opd gene. Results suggest that Hsp70-opd is similar to mini-white for distinguishing transformed individuals but does not require time-consuming individual examination. Due to the mode of action of organophosphorus nerve agents, Hsp70-opd has potential as a selectable marker in numerous animals beside fruit flies.
Subject(s)
Drosophila melanogaster/genetics , Genetic Markers , HSP70 Heat-Shock Proteins/genetics , Transformation, Genetic , Animals , Insecticide Resistance/genetics , Insecticides , Paraoxon , Phosphoric Monoester Hydrolases/genetics , Phosphoric Monoester Hydrolases/metabolism , PlasmidsABSTRACT
Five actin genes have been identified in the mosquito Anopheles gambiae, and a constitutively expressed actin gene has been chosen for detailed analysis. We have physically mapped and sequenced this gene and six associated cDNAs, including translated coding regions, as well as the 5' and 3' flanking sequences. Analysis of stage-specific RNA shows this gene to be present in all stages of mosquito development and in an established A. gambiae cell line, thus indicating a cytoskeletal actin. In the sequence of the translated coding region and in pattern of expression, this gene is very similar to the cytoskeletal actin genes of Drosophila melanogaster, and in sequence, equally similar to the Artemia cytoskeletal actin gene 403 (99.2% identity among the three amino acid sequences). Sequencing of this A. gambiae actin gene (designated act1D for its location in chromosome division 1D) and selected cDNAs shows that it possesses three alternative leader sequences; thus the gene appears to have three alternative promoters. These promoters should ultimately prove useful in the production of transgenic constructs for constitutive expression.
