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We present a differential equation model of the innate immune response to SARS-CoV-2 within the alveolar epithelium. Critical determinants of the viral dynamics and host response, including type I and type II alveolar epithelial cells, interferons, chemokines, toxins and innate immune cells, are included. We estimate model parameters, compute the within-host basic reproductive number, and study the impacts of therapies, prophylactics, and host/pathogen variability on the course of the infection. Model simulations indicate that the innate immune response suppresses the infection and enables the alveolar epithelium to partially recover. While very robust antiviral therapy controls the infection and enables the epithelium to heal, moderate therapy is of limited benefit. Meanwhile interferon therapy is predicted to reduce viral load but exacerbate tissue damage. The deleterious effects of interferon therapy are especially apparent late in the infection. Individual variation in ACE2 expression, epithelial cell interferon production, and SARS-CoV-2 spike protein binding affinity are predicted to significantly impact prognosis.
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Anecdotal reports in the press and epidemiological studies suggest that deployment to Iraq and Afghanistan may be associated with respiratory diseases and symptoms in U.S. military personnel and veterans. Exposures during military operations were complex, but virtually all service members were exposed to high levels of respirable, geogenic dust. Inhalation of other dusts has been shown to be associated with adverse health effects, but the pulmonary toxicity of ambient dust from Iraq has not been previously studied. The relative toxicity of Camp Victory dust was evaluated by comparing it to particulate matter from northern Kuwait, a standard U.S. urban dust, and crystalline silica using a single intratracheal instillation in rats. Lung histology, protein levels, and cell counts were evaluated in the bronchoalveolar lavage fluid 1-150 d later. The Iraq dust provoked an early significant, acute inflammatory response. However, the level of inflammation in response to the Iraq dust, U.S. urban dust, and Kuwait dust rapidly declined and was nearly at control levels by the end of the study At later times, animals exposed to the Iraq, U.S. urban, or Kuwait dusts showed increased small airway remodeling and emphysema compared to silica-exposed and control animals without evidence of fibrosis or premalignant changes. The severity and persistence of pulmonary toxicity of these three dusts from the Middle East resemble those of a U.S. urban dust and are less than those of silica. Therefore, Iraq dust exposure is not highly toxic, but similar to other poorly soluble low-toxicity dusts.
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Contaminantes Atmosféricos/toxicidad , Líquido del Lavado Bronquioalveolar/química , Exposición por Inhalación , Pulmón/efectos de los fármacos , Material Particulado/toxicidad , Animales , Polvo/análisis , Irak , Pulmón/patología , Masculino , Ratas , Ratas Sprague-Dawley , Estaciones del Año , Factores de TiempoRESUMEN
Muscle strength and proprioception deficits have been recognized in knee OA. Pain is the symptomatic hallmark of knee OA. Indirect evidence suggests that muscle strength and proprioception deficits may be interrelated and that pain may have a confounding influence on the measurement of these factors in knee OA. However, these relationships have never been clearly evaluated. Therefore, the purpose of this investigation was to investigate relationships between pain, muscle strength, and proprioception in subjects with knee OA before and after an 8-week home exercise program. This study evaluated thirty-eight subjects with knee OA. Subjects were taught standard quadriceps strengthening exercises that were to be performed daily at home. Pain, muscle strength, and proprioceptive function were measured at baseline and after 8 weeks of therapy. Significant improvements in pain (42%, p<0.001) and quadriceps muscle strength (30%, p<0.001) were noted. Significant indirect associations were observed between pain and both muscle strength (rho=-0.39, p=0.01) and proprioceptive acuity (rho=-0.35, p=0.03) at baseline. Changes in pain were directly associated with changes in muscle strength (rho=0.45, p=0.005) and proprioceptive acuity (rho=0.41, p=0.01) with exercise. The association of pain with both muscle strength and proprioception should prompt future studies to consider and adjust for the influence of pain on neuromuscular factors in knee OA.
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Terapia por Ejercicio , Fuerza Muscular/fisiología , Osteoartritis de la Rodilla/terapia , Manejo del Dolor , Propiocepción/fisiología , Anciano , Femenino , Humanos , Articulación de la Rodilla/fisiología , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/fisiopatología , Dolor/fisiopatología , Proyectos PilotoRESUMEN
The aim of our study was to investigate the combination of Chlamydophila pneumoniae and human cytomegalovirus (HCMV) as a pathogenic factor in atherosclerosis. Accordingly, we tested by means of PCR and immunohistochemistry the presence of these pathogens in the same atherosclerotic carotid specimen. The histology of the samples and the patients' antibodies against these pathogens were evaluated. Further, we examined the impact of C. pneumoniae and HCMV infection on the gene expression of the human monocytic cell line U937. Six of the 22 samples contained only C. pneumoniae, 4 contained only HCMV, 7 contained both C. pneumoniae DNA and/or antigens of both pathogens, and 5 samples were negative. No correlation was found between the presence of these microbes and either the cellular structure of the plaques, or the serostatus of the patients. The infection of U937 cells with HCMV and especially C. pneumoniae induced inflammation and atherosclerosis-related genes. Furthermore, the doubly-infected cells produced higher levels of the mRNA of pro-platelet basic protein and fatty acid binding protein 4. In conclusion, C. pneumoniae is often present in combination with HCMV in atherosclerotic carotid lesions. The in vitro coinfection model reveals that the doubly-infected monocytes are potent expressors of proatherosclerotic genes, suggesting that this coinfected population may accelerate the process of atherosclerosis.
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Estenosis Carotídea/etiología , Infecciones por Chlamydophila/complicaciones , Chlamydophila pneumoniae/aislamiento & purificación , Enfermedad de la Arteria Coronaria/etiología , Vasos Coronarios/microbiología , Infecciones por Citomegalovirus/complicaciones , Citomegalovirus/aislamiento & purificación , Anciano , Antígenos Bacterianos/aislamiento & purificación , Antígenos Bacterianos/metabolismo , Antígenos Virales/aislamiento & purificación , Antígenos Virales/metabolismo , Estenosis Carotídea/microbiología , Estenosis Carotídea/patología , Estenosis Carotídea/cirugía , Línea Celular , Infecciones por Chlamydophila/diagnóstico , Chlamydophila pneumoniae/genética , Chlamydophila pneumoniae/inmunología , Enfermedad de la Arteria Coronaria/microbiología , Enfermedad de la Arteria Coronaria/patología , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/patología , Vasos Coronarios/cirugía , Citomegalovirus/genética , Citomegalovirus/inmunología , Infecciones por Citomegalovirus/diagnóstico , ADN Bacteriano/genética , ADN Viral/genética , Endarterectomía Carotidea , Femenino , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Monocitos/metabolismo , Monocitos/microbiología , Monocitos/virología , Reacción en Cadena de la Polimerasa , ARN Mensajero/análisis , ARN Mensajero/biosíntesis , beta-Tromboglobulina/genética , beta-Tromboglobulina/metabolismoRESUMEN
Oscillations in second-messenger signalling (e.g. calcium) have previously been shown to be important in the control of transcription. More recently, oscillations in localization and absolute levels of transcription factors and their regulators have been identified. Here we discuss the role of network motifs such as the negative feedback loop and their role in oscillatory signalling, and how oscillations in components of the nuclear factor kappaB signalling pathway are important to the dynamic control of transcription in response to a cytokine stimulus.
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Regulación de la Expresión Génica/fisiología , Factores de Transcripción/metabolismo , Animales , Retroalimentación , Cinética , Modelos Genéticos , FN-kappa B/fisiología , OscilometríaRESUMEN
Signaling by the transcription factor nuclear factor kappa B (NF-kappaB) involves its release from inhibitor kappa B (IkappaB) in the cytosol, followed by translocation into the nucleus. NF-kappaB regulation of IkappaBalpha transcription represents a delayed negative feedback loop that drives oscillations in NF-kappaB translocation. Single-cell time-lapse imaging and computational modeling of NF-kappaB (RelA) localization showed asynchronous oscillations following cell stimulation that decreased in frequency with increased IkappaBalpha transcription. Transcription of target genes depended on oscillation persistence, involving cycles of RelA phosphorylation and dephosphorylation. The functional consequences of NF-kappaB signaling may thus depend on number, period, and amplitude of oscillations.
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Regulación de la Expresión Génica , FN-kappa B/metabolismo , Transducción de Señal , Transporte Activo de Núcleo Celular , Línea Celular Tumoral , Núcleo Celular/metabolismo , Simulación por Computador , Citoplasma/metabolismo , Etopósido/farmacología , Retroalimentación Fisiológica , Células HeLa , Humanos , Proteínas I-kappa B/genética , Proteínas I-kappa B/metabolismo , Modelos Biológicos , Inhibidor NF-kappaB alfa , Fosforilación , Proteínas Recombinantes de Fusión/metabolismo , Factor de Transcripción ReIA , Transcripción Genética , Transfección , Factor de Necrosis Tumoral alfa/farmacologíaRESUMEN
Inadequate antiprotease activity in the lungs due to alpha-1-antitrypsin (A1AT) deficiency is a factor of early-onset emphysema. We propose a new approach to gene therapy that involves the intratracheal delivery of macrophages expressing human A1AT (hA1AT). Recombinant adeno-associated virus (rAAV) plasmids encoding the hA1AT gene were packaged into virions using 293 cells, and transgenic progeny virus was purified from the cells. The murine macrophage cell line J774A.1 was infected in vitro with the recombinant hA1AT rAAV virus. The hA1AT-producing macrophages were delivered intratracheally into mechanically ventilated C57BL/6J mice, a strain with low endogenous levels of A1AT. Transcription of hA1AT mRNA was detected in the transfected cells by RT-PCR, and protein expression was verified by immunohistochemistry. Levels of hA1AT in the cell culture medium and in the bronchoalveolar lavage (BAL) were assayed by ELISA. The concentration of hA1AT in J774A.1 cell-conditioned medium increased from undetectable levels prior to transfection, to 60 mg/l at 24 h post-transfection. At 1, 3 and 7 days after intratracheal delivery of transfected macrophages, hA1AT protein in BAL from C57BL/6J mice increased from undetectable levels to 2.5+/-0.9, 2.6+/-1.1 and 2.2+/-0.8 mg/l, respectively. These results suggest that airway delivery of macrophages overexpressing hA1AT may be an effective approach to enhance alveolar protection in A1AT deficiency.
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Dependovirus/genética , Pulmón/metabolismo , Macrófagos Alveolares/virología , Transfección/métodos , Deficiencia de alfa 1-Antitripsina/terapia , alfa 1-Antitripsina/metabolismo , Administración por Inhalación , Animales , Líquido del Lavado Bronquioalveolar/citología , Ensayo de Inmunoadsorción Enzimática , Terapia Genética/métodos , Vectores Genéticos/administración & dosificación , Ratones , Ratones Endogámicos C57BL , Enfisema Pulmonar/terapia , alfa 1-Antitripsina/administración & dosificación , Deficiencia de alfa 1-Antitripsina/metabolismoRESUMEN
Previously, we constructed a set of mutants from which eight penicillin binding protein (PBP) genes were deleted in 192 combinations from Escherichia coli (S. A. Denome, P. K. Elf, T. A. Henderson, D. E. Nelson, and K. D. Young, J. Bacteriol. 181:3981-3993, 1999). Although these mutants were constructed correctly as determined by restriction mapping and the absence of relevant protein products, we recently discovered by PCR mapping that strains from which mrcA (PBP 1a) was deleted were also missing two neighboring genes of unknown function (yrfE and yrfF). We created a new deletion mutation in mrcA and reconstructed 63 strains lacking PBP 1a and other PBP mutant combinations. The new mrcA mutants do not exhibit mucoidy, phage resistance, temperature sensitivity, growth rate defects, or antibiotic resistance, suggesting that these phenotypes require the loss of either yrfE or yrfF alone or in combination with the absence of multiple PBPs.
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Proteínas Bacterianas , Proteínas Portadoras , Escherichia coli/genética , Hexosiltransferasas/genética , Complejos Multienzimáticos/genética , Muramoilpentapéptido Carboxipeptidasa , Mutación , Peptidil Transferasas/genética , Genes Bacterianos , Proteínas de Unión a las Penicilinas , FenotipoRESUMEN
Escherichia coli has 12 recognized penicillin binding proteins (PBPs), four of which (PBPs 4, 5, and 6 and DacD) have DD-carboxypeptidase activity. Although the enzymology of the DD-carboxypeptidases has been studied extensively, the in vivo functions of these proteins are poorly understood. To explain why E. coli maintains four independent loci encoding enzymes of considerable sequence identity and comparable in vitro activity, it has been proposed that the DD-carboxypeptidases may substitute for one another in vivo. We tested the validity of this equivalent substitution hypothesis by investigating the effects of these proteins on the aberrant morphology of DeltadacA mutants, which produce no PBP 5. Although cloned PBP 5 complemented the morphological phenotype of a DeltadacA mutant lacking a total of seven PBPs, controlled expression of PBP 4, PBP 6, or DacD did not. Also, a truncated PBP 5 protein lacking its amphipathic C-terminal membrane binding sequence did not reverse the morphological defects and was lethal at low levels of expression, implying that membrane anchoring is essential for the proper functioning of PBP 5. By examining a set of mutants from which multiple PBP genes were deleted, we found that significant morphological aberrations required the absence of at least three different PBPs. The greatest defects were observed in cells lacking, at minimum, PBPs 5 and 6 and one of the endopeptidases (either PBP 4 or PBP 7). The results further differentiate the roles of the low-molecular-weight PBPs, suggest a functional significance for the amphipathic membrane anchor of PBP 5 and, when combined with the recently determined crystal structure of PBP 5, suggest possible mechanisms by which these PBPs may contribute to maintenance of a uniform cell shape in E. coli.
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Proteínas Bacterianas , Carboxipeptidasas/metabolismo , Proteínas Portadoras/metabolismo , Escherichia coli/citología , Escherichia coli/enzimología , Hexosiltransferasas , Muramoilpentapéptido Carboxipeptidasa/metabolismo , Peptidil Transferasas , Sitios de Unión , Carboxipeptidasas/genética , Proteínas Portadoras/genética , Membrana Celular/enzimología , Escherichia coli/genética , Escherichia coli/fisiología , Eliminación de Gen , Prueba de Complementación Genética , Muramoilpentapéptido Carboxipeptidasa/genética , Proteínas de Unión a las Penicilinas , Plásmidos/genéticaRESUMEN
OBJECTIVES: To assess the reliability and validity of measures on the BRFSS, to assist users in evaluating the quality of BRFSS data, and to identify areas for further research. METHODS: Review and summary of reliability and validity studies of measures on the BRFSS and studies of measures that were the same or similar to those on the BRFSS from other surveys. RESULTS: Measures determined to be of high reliability and high validity were current smoker, blood pressure screening, height, weight, and BMI, and several demographic characteristics. Measures of both moderate reliability and validity included when last mammography was received, clinical breast exam, sedentary lifestyle, intense leisure-time physical activity, and fruit and vegetable consumption. Few measures were of low validity and only one measure was determined to be of low reliability. Several other measures were of high or moderate reliability or validity, but not both. The reliability or validity could not be determined for some measures, primarily due to lack of research. CONCLUSIONS: Most questions on the core BRFSS instrument were at least moderately reliable and valid, and many were highly reliable and valid. Additional research is needed for some measures.
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Conductas Relacionadas con la Salud , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Indicadores de Salud , Encuestas Epidemiológicas , Vigilancia de la Población , Adulto , Femenino , Humanos , Estilo de Vida , Masculino , Reproducibilidad de los Resultados , Factores de Riesgo , Estados UnidosRESUMEN
Changes with age in the diet and metabolism of the extinct European cave bear (Ursus spelaeus) from the Divje Babe archaeological site in northwestern Slovenia were investigated by comparing the stable carbon isotope ratio of whole bone collagen with that of the peptide-bonded carboxyl carbons in collagen. These carboxyl carbons were selectively released by decarboxylation of the collagen hydrolysate with ninhydrin (2,2-dihydroxy-1,3-indanedione). The stable carbon isotope ratio increased with age for both the peptide-bonded and other carbons. Although only one-third of the carbon atoms in collagen are peptide-bonded, they account for most of the observed change with age of the stable carbon isotope ratio of the whole collagen. Stable nitrogen isotope ratios decreased with age and were negatively correlated with changes in the stable carbon isotope ratios. These observations support previous investigations on the unique metabolism of hibernating bears.
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Mitr1 and Mitr2 from Mesembryanthemum crystallinum (common ice plant) are members of a family of genes homologous to H+[or Na+]/myo-inositol symporters (ITRs), not previously studied in plants. MITR1 complemented an Itr1-deficient yeast strain. Mitr1 is strongly expressed in roots, moderately in stems, and weakly in leaves. Its transcripts increased in all organs, most dramatically in roots, under salinity stress. Mitr2 constitutes a rare transcript, slightly upregulated by salt stress in leaves only. Mitr1 transcripts are present in all cells in the root tip, but become restricted to phloem-associated cells in mature roots. Peptide antibodies against the two proteins indicated the presence of MITR1 in all organs and of MITR2 in leaves. Both are located in the tonoplast. MITR1 acts in removing sodium from root vacuoles, correlated with findings of low root sodium, while leaf vacuoles accumulate sodium in the ice plant. Up-regulation in leaves and stems is also found for Na+/H+-antiporter (Nhx-type) transcripts. Under comparable stress conditions, Nhx-and Itr-like transcripts in Arabidopsis were regulated differently. In the ice plant, co-ordinate induction of Na+/H+-antiporters and Na+/myo-inositol symporters transfers sodium from vacuoles in root cells into the leaf mesophyll as a halophytic strategy that lowers the osmotic potential. The tissue-specific differential expression of Itr- and Nhx-type transcripts suggests that the vacuolar sodium/inositol symporters function to reduce sodium amounts in cells of the root and vascular tissue, while sodium/proton antiporters in leaf tissues function to partition sodium into vacuoles for storage.
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Proteínas Portadoras/genética , Inositol/metabolismo , Proteínas de Plantas , Plantas/genética , Sodio/metabolismo , Simportadores , Secuencia de Aminoácidos , Arabidopsis/efectos de los fármacos , Arabidopsis/genética , Transporte Biológico , Proteínas Portadoras/metabolismo , ADN Complementario/química , ADN Complementario/genética , Regulación de la Expresión Génica de las Plantas/efectos de los fármacos , Prueba de Complementación Genética , Proteínas de la Membrana/metabolismo , Datos de Secuencia Molecular , Mutación , Plantas/efectos de los fármacos , Plantas/metabolismo , ARN de Planta/efectos de los fármacos , ARN de Planta/genética , ARN de Planta/metabolismo , Saccharomyces cerevisiae/genética , Alineación de Secuencia , Análisis de Secuencia de ADN , Homología de Secuencia de Aminoácido , Cloruro de Sodio/farmacología , Distribución Tisular , Transcripción Genética/efectos de los fármacos , Vacuolas/metabolismoRESUMEN
We have characterized a decrease in photic responsiveness of the mammalian circadian entrainment pathway caused by light stimulation. Phase delays of the running-wheel activity rhythm were used to quantify the photic responsiveness of the circadian system in mice (C57BL/6J). In an initial experiment, the authors measured the responsiveness to single "saturating" light pulses ("white" fluorescent light; approximately 1876 [microW; 15 min). In two additional experiments, the authors measured responses to this stimulus at several time points following a saturating pulse at CT 14 or CT 16. Data from these experiments were analyzed in two manners. Experiment 2 was analyzed assuming that the phase of the circadian pacemaker was unchanged by an initial pulse, and Experiment 3 was analyzed assuming that the initial pulse induced an instantaneous phase delay. Results reveal a significant reduction in responsivity to light that persists for at least 2 h and possibly up to 4 h after the initial stimulus. Immediately after the stimulus, the responsiveness of the photic entrainment pathway was reduced to levels < or = 12% of normal. After 2 h, the responsiveness was < or = 42% of normal, and by 4 h, responsiveness had recovered to levels that were < or = 60% of normal (levels not statistically different from controls). By the following circadian cycle, responsiveness was more completely recovered, although the magnitude of some phase delays remained < or = 85% of normal. These major reductions in the magnitude of phase delays (and phase response curve amplitude) caused by saturating light pulses confound interpretations of two-pulse experiments designed to measure the rate of circadian phase delays. In addition, the time course for this reduced responsiveness may reflect the time course of cellular and molecular events that underlie light-induced resetting of the mammalian circadian pacemaker.
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Ritmo Circadiano/efectos de la radiación , Luz , Animales , Relojes Biológicos/efectos de la radiación , Oscuridad , Ratones , Ratones Endogámicos C57BLRESUMEN
OBJECTIVE: To examine trends in diabetes prevalence in the U.S. RESEARCH DESIGN AND METHODS: This study was conducted via telephone surveys in states that participated in the Behavioral Risk Factor Surveillance System between 1990 and 1998. The participants consisted of noninstitutionalized adults aged 18 years or older. The main outcome measure was self-reported diabetes. RESULTS: The prevalence of diabetes rose from 4.9% in 1990 to 6.5% in 1998--an increase of 33%. Increases were observed in both sexes, all ages, all ethnic groups, all education levels, and nearly all states. Changes in prevalence varied by state. The prevalence of diabetes was highly correlated with the prevalence of obesity (r = 0.64, P<0.001). CONCLUSIONS: The prevalence of diabetes continues to increase rapidly in the U.S. Because the prevalence of obesity is also rising, diabetes will become even more common. Major efforts are needed to alter these trends.
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Diabetes Mellitus/epidemiología , Adulto , Factores de Edad , Anciano , Peso Corporal , Demografía , Escolaridad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad , Grupos Raciales , Factores de Riesgo , Factores Sexuales , Fumar , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVES: This study determined the validity of self-reported data on selected health insurance characteristics. METHODS: We obtained telephone survey data on the presence of health insurance, source of insurance, length of time insured, and type of insurance (managed care or fee-for-service) from a random sample of 351 adults in 3 Wisconsin counties and compared findings with data from respondents' health insurers. RESULTS: More than 97% of the respondents correctly reported that they were currently insured. For source of insurance among persons aged 18 to 64 years, sensitivity was high for those covered through private health insurance (93.8%) but low for those covered through public insurance (6.7%). Only 33.1% of the respondents accurately categorized length of enrollment in their current plan. Overall estimates for managed care enrollment were similar for the 2 sources, but individual validity was low: 84.2% of those in fee-for-service believed that they were in managed care. CONCLUSIONS: Information obtained from the general population about whether they have health insurance is valid, but self-reported data on source of insurance, length of time insured, and type of insurance are suspect and should be used cautiously.
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Seguro de Salud/estadística & datos numéricos , Adolescente , Adulto , Anciano , Concienciación , Recolección de Datos , Empleo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Autorrevelación , Factores de Tiempo , WisconsinRESUMEN
OBJECTIVES: The purpose of this study was to document and describe Behavioral Risk Factor Surveillance System (BRFSS) data use patterns, benefits, and barriers from 1993 to 1997. METHODS: Data use information was gathered via a Medline database search and a telephone survey of BRFSS program directors (n = 54). RESULTS: The database search uncovered 109 BRFSS-based reports. Program directors indicated that BRFSS data frequently were used to support health policies regarding diabetes, physical activity, and smoking. Frequent data use barriers included insufficient special population data, insufficient city- or county-specific data, and insufficient staff. CONCLUSIONS: Use of BRFSS data, which aid several state health activities, increased from 1993 to 1997.
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Interpretación Estadística de Datos , Bases de Datos Factuales/estadística & datos numéricos , Conductas Relacionadas con la Salud , Vigilancia de la Población , Bases de Datos Factuales/tendencias , Diabetes Mellitus/prevención & control , Ejercicio Físico , Planificación en Salud , Política de Salud , Humanos , Servicios de Información/estadística & datos numéricos , Servicios de Información/tendencias , MEDLINE , Vigilancia de la Población/métodos , Práctica de Salud Pública , Factores de Riesgo , Prevención del Hábito de Fumar , Planes Estatales de Salud , Encuestas y Cuestionarios , Estados UnidosRESUMEN
BACKGROUND: Self-reported data are commonly used to estimate the prevalence of health conditions and the use of preventive health services in the population, but the validity of such data is often questioned. METHODS: The Behavioral Risk Factor Survey (BRFS) was admin istered by telephone to a stratified, random sample of health maintenanc e organization (HMO) subscribers in Colorado in 1993, and self-reports w ere compared with HMO medical records for 599 adults aged >21. Sensitivity and specificity were calculated for three chronic conditions and use of six preventive services. RESULTS: Sensitivity was highest for hypertension (83%), moderate for diabetes (73%), and lowest for hypercholesterolemia (59%); specificity was >80% for all three conditions. Sensitivity ranged from 86% to 99% for influenza immunization, clinical breast examination, blood cholesterol screening, mammography, Pap test, and blood pressure screening; specificity was <75% for all preventive services. CONCLUSIONS: Self-reports are reasonably accurate for certain chronic conditions and for routine screening exams and can provide a useful estimate for broad measures of population prevalence.
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Enfermedad Crónica/epidemiología , Programas Controlados de Atención en Salud/estadística & datos numéricos , Servicios Preventivos de Salud/estadística & datos numéricos , Autorrevelación , Adulto , Anciano , Colorado , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Sistemas Prepagos de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Incidencia , Masculino , Persona de Mediana EdadRESUMEN
Although general physiological functions have been ascribed to the high-molecular-weight penicillin binding proteins (PBPs) of Escherichia coli, the low-molecular-weight PBPs have no well-defined biological roles. When we examined the morphology of a set of E. coli mutants lacking multiple PBPs, we observed that strains expressing active PBP 5 produced cells of normal shape, while mutants lacking PBP 5 produced cells with altered diameters, contours, and topological features. These morphological effects were visible in untreated cells, but the defects were exacerbated in cells forced to filament by inactivation of PBP 3 or FtsZ. After filamentation, cellular diameter varied erratically along the length of individual filaments and many filaments exhibited extensive branching. Also, in general, the mean diameter of cells lacking PBP 5 was significantly increased compared to that of cells from isogenic strains expressing active PBP 5. Expression of cloned PBP 5 reversed the effects observed in DeltadacA mutants. Although deletion of PBP 5 was required for these phenotypes, the absence of additional PBPs magnified the effects. The greatest morphological alterations required that at least three PBPs in addition to PBP 5 be deleted from a single strain. In the extreme cases in which six or seven PBPs were deleted from a single mutant, cells and cell filaments expressing PBP 5 retained a normal morphology but cells and filaments lacking PBP 5 were aberrant. In no case did mutation of another PBP produce the same drastic morphological effects. We conclude that among the low-molecular-weight PBPs, PBP 5 plays a principle role in determining cell diameter, surface uniformity, and overall topology of the peptidoglycan sacculus.