RESUMO
The Women In Cardiothoracic Anesthesiology (WICTA), a special interest group of the Society of Cardiovascular Anesthesiologists, has been highly successful in mobilizing WICTA, a historically underrepresented and marginalized group in the subspecialty, and in supporting real and meaningful change in the professional community. The experience of WICTA as a professional affinity group in impacting a professional organization to diversify, evolve, and become more responsive to a wider professional audience has important lessons for other professional organizations. This article discusses the recent history of affinity organizations in anesthesiology, the benefits they offer professional organizations, and the strategies that have been used to effectively motivate change in professional communities. These strategies include engaging a strong advisory board, identifying the need of constituents, creating additional opportunities for networking and membership, addressing gaps in professional development, and aligning goals with those of the larger national organization. WICTA is just one example of the potential opportunities that affinity groups offer to professional societies and organizations for expanding their reach, enhancing their impact on physicians in their target audience, and achieving organizational missions.
Assuntos
Anestesiologia , Médicos , Humanos , Feminino , Opinião Pública , AnestesiologistasRESUMO
The demographics of the United States is changing with 51% of the population being female, and 32% of the population identifying as an underrepresented minority (URM, ie, African American/black, Hispanic/Latino, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). Women and URMs have been historically underrepresented in medicine and in academic anesthesiology. This article provides an overview of the current status of women and URM faculty in academic anesthesiology and provides a framework for academic advancement. Throughout the text, the terms woman/women are used, as opposed to female, as the terms woman/women refer to gender, and female refers to biological sex.
Assuntos
Anestesiologia , Grupos Minoritários , Médicas , Academias e Institutos , Anestesiologia/tendências , Autoria , Feminino , Humanos , Liderança , Recursos HumanosAssuntos
Transtornos Cromossômicos/diagnóstico , Ultrassonografia Pré-Natal , Transtornos Cromossômicos/diagnóstico por imagem , Transtornos Cromossômicos/genética , Feminino , Hong Kong , Humanos , Cariotipagem , Medição da Translucência Nucal , Gravidez , Primeiro Trimestre da Gravidez , Estudos ProspectivosRESUMO
OBJECTIVES: To evaluate the morphological outcome of levator ani muscle (LAM) avulsion 3-5 years after a first delivery and to assess the effect of a second delivery on this condition. The impact of LAM avulsion on pelvic floor disorders was also studied. METHODS: Six hundred and sixty-six women who had been assessed for LAM avulsion 8 weeks after their first delivery were invited for a follow-up examination 3-5 years later. Women completed the Pelvic Floor Distress Inventory including the Urinary Distress Inventory (UDI) and Pelvic Organ Prolapse Distress Inventory (POPDI) questionnaires to explore symptoms of pelvic floor disorders, and the pelvic floor was examined using three-dimensional translabial ultrasound and assessed using the pelvic organ prolapse quantification system. RESULTS: Three hundred and ninety-nine women completed the study, of whom 151 were multiparous. Mean interval between first delivery and follow-up was 42.3 ± 7.6 months. Among 69 women who had LAM avulsion 8 weeks after their first delivery, nine (13.0%) had no LAM avulsion at follow-up. One (0.9%) woman had a new LAM avulsion after her second vaginal delivery. A greater proportion of women with LAM avulsion reported symptoms of stress urinary incontinence (SUI) (adjusted odds ratio, 2.09 (95% CI, 1.18-3.70); P = 0.01) and symptoms of prolapse than did women without avulsion; however, this difference did not reach statistical significance (P = 0.61). Women with LAM avulsion had higher UDI and POPDI scores than did women without avulsion (median UDI score, 17.7 (interquartile range (IQR), 5.0-32.4) vs 9.2 (IQR, 0.0-22.1); P = 0.045 and median POPDI score, 20.8 (IQR, 8.8-40.5) vs 10.7 (IQR, 0.0-32.8); P = 0.021). CONCLUSIONS: The risk of developing new LAM avulsion after a second vaginal delivery is low (0.9%). Healing of LAM avulsion was observed in 13% of women who had at least one vaginal delivery. At 3-5 years after delivery, women with LAM avulsion reported symptoms of SUI more often than did those without, and had higher UDI and POPDI scores, implying more bothersome symptoms. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Assuntos
Canal Anal/lesões , Músculo Esquelético/lesões , Complicações do Trabalho de Parto/epidemiologia , Distúrbios do Assoalho Pélvico/epidemiologia , Adulto , Canal Anal/diagnóstico por imagem , Feminino , Seguimentos , Hong Kong/epidemiologia , Humanos , Escala de Gravidade do Ferimento , Estudos Longitudinais , Músculo Esquelético/diagnóstico por imagem , Complicações do Trabalho de Parto/diagnóstico por imagem , Distúrbios do Assoalho Pélvico/diagnóstico por imagem , Gravidez , Prevalência , Fatores de Risco , Ultrassonografia Pré-NatalAssuntos
Epigênese Genética , Tuberculose Latente/imunologia , Macrófagos/imunologia , Tuberculose/imunologia , Estudos de Casos e Controles , Metilação de DNA , Humanos , Tuberculose Latente/genética , Tuberculose Latente/microbiologia , Macrófagos/microbiologia , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/genética , Tuberculose/microbiologiaRESUMO
In Papua New Guinea there are many organizations providing sparsely spread and fragmented health services. Government health facilities are often relatively well functioning in urban and periurban areas, but sporadic or nonexistent in rural areas. In some remote areas churches are the major health service providers. Increasingly other community groups are providing village-based health services. Much financial support is now pledged by major international donors for community-based health services, but few people working at a district or community level have the management skills to access the funds or plan programs effectively, and few of the major donors have any significant presence in rural areas. Such a management skill gap also exists at the level of many provincial health offices and this seriously limits the effectiveness of all major donor projects. There is need for integration of health services to avoid replication and to extend services to areas where no effective services are currently provided. There is also a great need to train people at a community and district level in program planning and management. Non-government organizations (NGOs) working at a district or community level have the potential to bridge this skill gap and to help integrate community-based services with government institutions. This paper reports, as an example, the activities of Save the Children, an international NGO in Papua New Guinea. Essential for the success of community-based health projects is the development of local management skills, reliable funding, integration with established health institutions, objective evaluation and community support. Skilled NGOs working at a community, district or provincial level can have important roles in assisting local people to run effective and sustainable health programs.
Assuntos
Serviços de Saúde da Criança/organização & administração , Proteção da Criança , Planejamento em Saúde Comunitária , Criança , Agentes Comunitários de Saúde , Humanos , Papua Nova GuinéRESUMO
Fluoxetine (Prozac) is an antidepressant that is thought to act by blocking presynaptic reuptake of the neurotransmitter serotonin. Despite widespread clinical use of fluoxetine, direct evidence for this mechanism has been difficult to obtain in vivo. We have determined that fluoxetine has an additional neuromuscular effect on C. elegans that is distinct from inhibition of serotonin reuptake. By screening for mutants resistant to this effect, we have identified seven genes. We report that two of these genes are homologous to each other and define a novel gene family that encodes over a dozen multipass transmembrane proteins. Our findings may have clinical implications for the mechanism of action of fluoxetine.
Assuntos
Proteínas de Caenorhabditis elegans , Caenorhabditis elegans/genética , Fluoxetina/farmacologia , Genes de Helmintos , Proteínas de Membrana/genética , Sequência de Aminoácidos , Animais , Caenorhabditis elegans/efeitos dos fármacos , Caenorhabditis elegans/fisiologia , Mapeamento Cromossômico , Clonagem Molecular , Resistência a Medicamentos , Proteínas de Membrana/química , Dados de Sequência Molecular , Família Multigênica , Mutagênese , Junção Neuromuscular/efeitos dos fármacos , Filogenia , Proteínas Recombinantes/biossíntese , Proteínas Recombinantes/química , Alinhamento de SequênciaRESUMO
The respective production of specific immunoglobulin (Ig)G2a or IgG1 within 5 d of primary immunization with Swiss type mouse mammary tumor virus [MMTV(SW)] or haptenated protein provides a model for the development of T helper 1 (Th1) and Th2 responses. The antibody-producing cells arise from cognate T cell B cell interaction, revealed by the respective induction of Cgamma2a and Cgamma1 switch transcript production, on the third day after immunization. T cell proliferation and upregulation of mRNA for interferon gamma in response to MMTV(SW) and interleukin 4 in response to haptenated protein also starts during this day. It follows that there is minimal delay in these responses between T cell priming and the onset of cognate interaction between T and B cells leading to class switching and exponential growth. The Th1 or Th2 profile is at least partially established at the time of the first cognate T cell interaction with B cells in the T zone. The addition of killed Bordetella pertussis to the hapten-protein induces nonhapten-specific IgG2a and IgG1 plasma cells, whereas the anti-hapten response continues to be IgG1 dominated. This indicates that a Th2 response to hapten-protein can proceed in a node where there is substantial Th1 activity.
Assuntos
Switching de Imunoglobulina , Ativação Linfocitária , Células Th1 , Células Th2 , Vacinação , Animais , Bordetella pertussis/imunologia , Centro Germinativo/imunologia , Haptenos/imunologia , Interferon gama/biossíntese , Interleucina-4/biossíntese , Linfonodos/citologia , Linfonodos/imunologia , Vírus do Tumor Mamário do Camundongo/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Plasmócitos , Baço/citologia , Baço/imunologia , gama-Globulinas/imunologiaRESUMO
The cut locus acts as a bimodal switch controlling cell fate in the peripheral nervous system of Drosophila and is also required for the development of the wing margin. It encodes a protein, Cut, that contains an atypical homeodomain and three copies of a new motif which can bind DNA in vitro. The human protein CDP and the murine protein Cux have recently been isolated as DNA-binding activities and they are structurally related to Cut. We show that ectopic expression of Cut, CDP, or Cux similarly affects embryonic sensory organ development and can rescue a wing scalloping mutant phenotype associated with loss of cut expression along the prospective wing margins. This suggests that the function of Cut is evolutionarily conserved.
Assuntos
Drosophila/embriologia , Proteínas de Homeodomínio/fisiologia , Proteínas Nucleares/fisiologia , Proteínas Repressoras/fisiologia , Animais , Animais Geneticamente Modificados , Feminino , Expressão Gênica , Proteínas de Homeodomínio/genética , Humanos , Larva , Masculino , Mamíferos , Camundongos , Mutação , Neurônios Aferentes , Proteínas Nucleares/genética , Sistema Nervoso Periférico/embriologia , Sistema Nervoso Periférico/crescimento & desenvolvimento , Fenótipo , Proteínas Recombinantes de Fusão , Proteínas Repressoras/genética , Temperatura , Fatores de Transcrição , Asas de Animais/crescimento & desenvolvimentoAssuntos
Poliomielite/complicações , Viroses/complicações , Infecções por Coxsackievirus/complicações , Jejum , Fadiga/etiologia , Alimentos , Gastroenteropatias/complicações , Humanos , Hipersensibilidade , Mononucleose Infecciosa/complicações , Dor/etiologia , Infecções Respiratórias/complicações , Síndrome , Fatores de TempoRESUMO
Specific antitreponemal antibodies have been demonstrated by immunofluorescence techniques in the lymphoplasmocytic infiltrates which characterize early symphilitic lesions. A purified suspension of Nichols strain Treponema pallidum was sonified and labeled with fluorescein isothiocyanate and applied to cryostat sections of 12 biopsy specimens from the cutaneous lesions of 11 patients with proven secondary syphilis, using a modified direct immunofluorescence procedure. Specimens from various inflammatory dermatoses processed similarly served as controls. Granular fluorescence was noted in the dermis in 9 of the 12 specimens corresponding to areas of heavy plasma cell infiltration and some fluorescence was found directly on plasma cells which were identified by subsequent hematoxylin and eosin staining. This fluorescence could be blocked by prior incubation of the sections with unlabeled sonified treponemal suspension. Control slides did not reveal any fluorescence. The use of labeled treponemal antigen may aid the tissue diagnosis of early syphilitic lesions which can mimic a variety of dermatological disorders.
Assuntos
Anticorpos Antibacterianos/análise , Sífilis Cutânea/imunologia , Biópsia , Imunofluorescência , Humanos , Tiocianatos , Treponema pallidumRESUMO
Semipermanent mounting media and postfixation of immunofluorescence (IF) slides in alcohol have been effective in preserving specific fluorescence (SF). In the present study the efficacy of such mounting was compared with a simpler technique of sealing the routinely mounted IF slides with nail polish. Frozen sections of skin lesions of systemic lupus erythematosus and lichen planus, and patients' sera known to have pemphigus or pemphigoid antibodies were used for IF procedures. SF was equally detectable with both techniques for over 8 months. Control slides similarly processed but not sealed lost most of their SF within a few weeks.
Assuntos
Cosméticos , Imunofluorescência , Preservação de Tecido/métodos , Álcoois , Humanos , UnhasRESUMO
It is now well established that insulin biosynthesis proceeds through a precursor molecule, proinsulin. This single polypeptide chain form has been identified as a ribosomal product in the microsomal fraction from islet tissues. The newly synthesized peptide chain, after folding and thiol oxidation, is transferred to the Golgi apparatus where it begins to undergo proteolytic processing to insulin and packaging into secretory granules. The secretion from the cells of significant amounts of newly synthesized material by exocytosis begins only one hour or more after biosynthesis and this process is regulated by several factors, including glucose. Foci of current attention discussed in this paper include (1) the possible existence of larger precursor forms than proinsulin, especially short-lived biosynthetic transients with extended NH2-termini analogous to the recently described immunoglobulin L chain and proparathyroid hormone precursors; (2) the large-scale production of insulin by chemical or genetic engineering approaches; (3) isolation of beta-cell plasma membranes; (4) regulatory mechanisms for the biosynthesis and secretion of insulin, the possible role of mRNA modification in this process, and effects of somatostatin on insulin biosynthesis and secretion; (5) studies on the secretion, metabolism and clinical usefulness of the proinsulin C-peptide; (6) finally, the biosynthesis of glucagon and other peptide hormones and the general significance of precursor forms.
Assuntos
Glucagon/biossíntese , Insulina/biossíntese , Adenilil Ciclases/metabolismo , Animais , Membrana Celular/metabolismo , Membrana Celular/ultraestrutura , Teste de Tolerância a Glucose , Hormônios/biossíntese , Insulina/metabolismo , Secreção de Insulina , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/metabolismo , Lectinas/metabolismo , Biossíntese Peptídica , Proinsulina/metabolismo , Ratos , Ribossomos/metabolismo , Somatostatina/farmacologiaRESUMO
Sixty-eight (17 per cent) of 380 patients with acute myocardial infarction had the bradycardia-hypotension syndrome (ventricular rate below 60/min and systolic blood pressure less than 100 mm Hg) during the first 24 hours of admission to a large general hospital. In 61 of the 68 patients, the administration of atropine significantly increased the heart rate (from 46 plus or minus 14 to 79 plus or minus 12/min) (p less than 0.01) and systolic blood pressure (from 70 plus or minus 15 to 105 plus or minus 13 mm Hg) (p less than 0.001). In 26 of the 68 patients, ventricular premature complexes decreased from 9.4 plus or minus 3/min to 2.4 plus or minus 0.7/min (p less than 0.001) after the administration of atropine. It is concluded that the bradycardia-hypotension syndrome is not an uncommon complication following acute myocardial infarction and that selected doses of atropine may have a beneficial effect without significant complications.