Compressive three-dimensional super-resolution microscopy with speckle-saturated fluorescence excitation.

Nonlinear structured illumination microscopy (nSIM) is an effective approach for super-resolution wide-field fluorescence microscopy with a theoretically unlimited resolution. In nSIM, carefully designed, highly-contrasted illumination patterns are combined with the saturation of an optical transition to enable sub-diffraction imaging. While the technique proved useful for two-dimensional imaging, extending it to three-dimensions is challenging due to the fading of organic fluorophores under intense cycling conditions. Here, we present a compressed sensing approach that allows 3D sub-diffraction nSIM of cultured cells by saturating fluorescence excitation. Exploiting the natural orthogonality of speckles at different axial planes, 3D probing of the sample is achieved by a single two-dimensional scan. Fluorescence contrast under saturated excitation is ensured by the inherent high density of intensity minima associated with optical vortices in polarized speckle patterns. Compressed speckle microscopy is thus a simple approach that enables 3D super-resolved nSIM imaging with potentially considerably reduced acquisition time and photobleaching.

Tiempo requerido para la administración y evaluación del Cuestionario Prunape Pre-Pesqusia (CPPP) / Time needed for the adminsitration and evaluation of the Prunape Pre- Pesquisia (CPPP) questionnaire

Con el objetivo de evaluar el tiempo que toma la administración de Cuestionario PrunPe Pre-Pesquisa (CPPP), diseñado en Acumar para detectar en forma confiable aquellos niños con alto riesgo de no pasar la Prueba Nacional de Pesquisa (PRUNAPE), se midió en forma ciega a 98 madres con sus niños, el tiempo que lleva su llenado y evaluación de dos formas: autoadministrado (por la madre), y administrado por personal de salud. Se evaluaron dos partes: a) la administración, y b) la evaluación final (pasa / no pasa el cuestionario). El tiempo lo midieron los mismos 11 profesionales de la salud que administraron el cuestionario, con cronómetros de teléfonos celulares, y con la precisión de un segundo. Los cuestionarios son cinco, uno para cada grupo de edad: 6 a 11, 12 a 17, 18 a 29, 30 a 47, 48 a 71 meses. La mediana del tiempo total de toma del cuestionario fue de 7 minutos (´) 33segundos (“), y 4´47” y 12¨19” para los percentiles 10° y 90° respectivamente. Los tiempos no fueron los mismos para los cinco formularios ni para los que pasaron o no pasaron el cuestionario. El análisis de variancia (P 0.01)mostró que las dos variables influyen significativamente en la duración de la toma: si el niño no pasa y el niño es mayor de 30 meses, el tiempo es más largo. El CPPP resulta una herramienta que se administra en poco tiempo, lo que la hace costo-efectiva para seleccionar los niños a quienes es altamente necesario administrarle la Prueba Nacional de Pesquisa en programas de tamizaje en grandes grupos de población.

With the aim to evaluate the time to administer the PrunPe Pre-Pesquisa Questionnaire (CPPP), designed in Acumar to reliably identify those children at high risk of not passing the National Screening Test (PRUNAPE)....

Tiempo requerido para la administración y evaluación del Cuestionario Prunape Pre-Pesqusia (CPPP) / Time needed for the adminsitration and evaluation of the Prunape Pre- Pesquisia (CPPP) questionnaire

Con el objetivo de evaluar el tiempo que toma la administración de Cuestionario PrunPe Pre-Pesquisa (CPPP), diseñado en Acumar para detectar en forma confiable aquellos niños con alto riesgo de no pasar la Prueba Nacional de Pesquisa (PRUNAPE), se midió en forma ciega a 98 madres con sus niños, el tiempo que lleva su llenado y evaluación de dos formas: autoadministrado (por la madre), y administrado por personal de salud. Se evaluaron dos partes: a) la administración, y b) la evaluación final (pasa / no pasa el cuestionario). El tiempo lo midieron los mismos 11 profesionales de la salud que administraron el cuestionario, con cronómetros de teléfonos celulares, y con la precisión de un segundo. Los cuestionarios son cinco, uno para cada grupo de edad: 6 a 11, 12 a 17, 18 a 29, 30 a 47, 48 a 71 meses. La mediana del tiempo total de toma del cuestionario fue de 7 minutos (´) 33segundos (ô), y 4´47ö y 12¿19ö para los percentiles 10° y 90° respectivamente. Los tiempos no fueron los mismos para los cinco formularios ni para los que pasaron o no pasaron el cuestionario. El análisis de variancia (P 0.01)mostró que las dos variables influyen significativamente en la duración de la toma: si el niño no pasa y el niño es mayor de 30 meses, el tiempo es más largo. El CPPP resulta una herramienta que se administra en poco tiempo, lo que la hace costo-efectiva para seleccionar los niños a quienes es altamente necesario administrarle la Prueba Nacional de Pesquisa en programas de tamizaje en grandes grupos de población

Herlitz junctional epidermolysis bullosa: laminin-5 mutational profile and carrier frequency in the Italian population.

BACKGROUND: Herlitz junctional epidermolysis bullosa (HJEB; MIM 226700) is a rare epithelial adhesion disorder caused by null mutations in any of the three genes encoding the alpha3, beta3 and gamma2 chains of laminin-5, and is mainly characterized by extensive mucocutaneous blistering, recurrent infections and early lethality. OBJECTIVES: To perform immunoepitope mapping, electron microscopy and molecular analysis of five Italian patients with HJEB in order to complete the clinical and molecular characterization of patients with HJEB collected in the Italian Registry of hereditary epidermolysis bullosa (IRHEB) and to calculate the HJEB carrier frequency in this population. METHODS: Skin biopsies from perilesional skin of all patients were employed for immunoepitope mapping and electron microscopy examination. Blood genomic DNA was used for mutation analysis in the LAMA3, LAMB3 and LAMC2 genes by heteroduplex scanning, preceded by a search for Italian recurrent mutations. Carrier frequency calculation was performed assuming Hardy-Weinberg equilibrium. RESULTS: Two novel mutations in the LAMA3 (p.R782X) and LAMC2 (c.3235delA) genes, as well as three known and recurrent mutations in the LAMB3 (c.31insC and p.R81X) and LAMC2 (p.Y355X) genes were identified. Based on disease incidence reported in the IRHEB and the prevalence of mutations in each laminin-5 gene, the population carrier risk for HJEB was calculated to be one in 375. CONCLUSIONS: Our delineation of a laminin-5 mutational spectrum in the general Italian population provides a solid basis for expedited diagnosis, accurate genetic counselling and DNA-based prenatal testing for Italian families at risk for recurrence of HJEB.

[Exposure of distal internal carotid artery through mandibular vertical ramus osteotomy]. / Accesso chirurgico all'arteria carotide interna distale medicante osteotomia mandiobolare verticale.

Exposure of the distal internal carotid artery at the level of the second cervical vertebra required manoeuvers such as division of digastric muscle or mandibular subluxation. These increase the exposure but may not provide adequate access and are associated with significant cranial nerves or temporal mandibular joint complications. Vertical Ramus Osteotomy (VRO) provided access of the internal carotid artery (ICA) up to the base of the skull, with low incidence of cranial nerve injury temporo-mandibular joint (TMJ) pain and no preincision preparation. We report two cases in which vertical division of the mandibular ramus provided access of the ICA up to the base of the skull. Preoperative Duplex Scan examination and in the second case the arteriography revealed ICA preocclusive stenosis within 1.5 cm of the skull base. VRO was performed trouhgh a standard neck incision and miniature titanium plates were used to reapproximate the mandible after vascular procedure. There were no death, cranial nerve injury, mandibular nonunion, malocclusion or TMJ pain. We found that VRO is useful when carotid artery pathology extends beyond the usual field of exposure, avoiding nerve injury or TMJ lesion and requires no additional pre-incision preparation.

Validación de la prueba nacional de pesquisa de trastornos de desarrollo psicomotor en niños menores de 6 años / Validation of the national development disorders screening test in children younger thn 6 years

Introducción.El uso de una prueba de pesquisa en los primeros años de vida permite la detección temprana de retrasos en el desarrollo psicomotor y su tratamiento oportuno.En la Argentina contamos con una prueba Nacional de Pesquisa preparada en base a un estudio nacional.El objetivo del trabajo fue validar la prueba,comparando sus resultados con evaluaciones diagnósticas,realizadas en forma simultanea por varios servicios del Hospital Garrahan.Pacientes y métodos.Se selecciono una muestra de 106 niños de 0 a 5,99 años que concurrián al área de bajo riesgo del Hospital.Se realizaron los siguientes estudios diagnosticos:evaluacion del desarrollo psicomotor(Bayley II)examen neurológico,salud mental,coeficiente intelectual(Wechsler,Terman)conducta adaptativa(Vineland)lenguaje(prueba de Gardner receptiva y expresiva,ITPA)audición(emisiones otoacústicas,audiometría tonal,PEAT)examen visual.Se utilizó el DSM-IV como referencia de trastornos del desarrollo.Se evaluó la sensibilidad y especifidad obtenidas según la aplicación de diferentes puntos de corte(número de ítems fracasados).Resultados:El mejor punto de corte se estableció en un ítem tipo A o tipo B,con una sensibilidad del 80 por ciento,especificidad:93 por ciento,valor predictivo positivo:94 por ciento,valor predictivo negativo:77 por ciento,porcentaje de coincidencia:85 por ciento.Fue inesperada la elevada prevalencia de problemas de desarrollo encontrada en la muestra:57 por ciento.La prueba es capaz de detectar problemas en las cuatro áreas del desarrollo,incluidos trastornos del lenguaje.Conclusión.Los resultados confirman a la prueba Nacional de Pesquisa como un instrumento válido para ser usado en el primer nivel de atención para el reconocimiento de niños con sospechas de sufrir trastornos de desarrollo,Asimismo,el trabajo de información permite establecer diferentes puntos de corte y constituye un instrumento útil para su aplicación en la práctica pediátrica

Validación de la prueba nacional de pesquisa de trastornos de desarrollo psicomotor en niños menores de 6 años / Validation of the national development disorders screening test in children younger thn 6 years

Introducción.El uso de una prueba de pesquisa en los primeros años de vida permite la detección temprana de retrasos en el desarrollo psicomotor y su tratamiento oportuno.En la Argentina contamos con una prueba Nacional de Pesquisa preparada en base a un estudio nacional.El objetivo del trabajo fue validar la prueba,comparando sus resultados con evaluaciones diagnósticas,realizadas en forma simultanea por varios servicios del Hospital Garrahan.Pacientes y métodos.Se selecciono una muestra de 106 niños de 0 a 5,99 años que concurrián al área de bajo riesgo del Hospital.Se realizaron los siguientes estudios diagnosticos:evaluacion del desarrollo psicomotor(Bayley II)examen neurológico,salud mental,coeficiente intelectual(Wechsler,Terman)conducta adaptativa(Vineland)lenguaje(prueba de Gardner receptiva y expresiva,ITPA)audición(emisiones otoacústicas,audiometría tonal,PEAT)examen visual.Se utilizó el DSM-IV como referencia de trastornos del desarrollo.Se evaluó la sensibilidad y especifidad obtenidas según la aplicación de diferentes puntos de corte(número de ítems fracasados).Resultados:El mejor punto de corte se estableció en un ítem tipo A o tipo B,con una sensibilidad del 80 por ciento,especificidad:93 por ciento,valor predictivo positivo:94 por ciento,valor predictivo negativo:77 por ciento,porcentaje de coincidencia:85 por ciento.Fue inesperada la elevada prevalencia de problemas de desarrollo encontrada en la muestra:57 por ciento.La prueba es capaz de detectar problemas en las cuatro áreas del desarrollo,incluidos trastornos del lenguaje.Conclusión.Los resultados confirman a la prueba Nacional de Pesquisa como un instrumento válido para ser usado en el primer nivel de atención para el reconocimiento de niños con sospechas de sufrir trastornos de desarrollo,Asimismo,el trabajo de información permite establecer diferentes puntos de corte y constituye un instrumento útil para su aplicación en la práctica pediátrica

Ingredients of an old and healthy life. A centenarian perspective.

This phenomenological study elicited centenarians' meanings of longevity and their perceptions of any common biological or psychosocial factors that they attributed to health and functioning. Twelve centenarians, ages 100 to 109, were interviewed. Common themes in their lived experiences included the meaning of long life, views of health, relationships with others, affirmation of worth, reasons for longevity, and God. Centenarians are long-term "survivors" with important lessons to share about high functioning, productive lives.

Chronic neutrophilic leukemia evolving from a myelodysplastic syndrome.

Chronic neutrophilic leukemia (CNL) is a rare hematologic disorder usually presenting with a persistent neutrophilia in the leukemoid range (WBC > 40-50 x 10(9)/1) and consisting largely of mature neutrophils. Patients have no obvious cause for an elevated white count and typically have an elevated leukocyte alkaline phosphatase score, hepatosplenomegaly, elevated vitamin B12 and are Philadelphia chromosome-negative. CNL has occasionally been associated with paraproteinemia or outright myeloma. Dysplastic features within the neutrophils in CNL have rarely been reported. We report the clinical, pathological and cytogenetic features of a case of CNL in an elderly white female initially diagnosed with refractory anemia with excess blasts, which subsequently progressed to CNL.

Health care needs in a nontraditional university setting.

This paper describes early planning stages of a nurse-managed clinic to offer primary health care services in a nontraditional university setting. A community needs assessment was conducted with quantitative and qualitative findings reported. This unique setting triggered a number of considerations in planning for services. Recommendations for health services and resources for the university community are discussed.

Redox state, antioxidative activity and lipid peroxidation in erythrocytes and plasma of chronic ambulatory peritoneal dialysis patients.

Red blood cells and plasma reduced and oxidized glutathione levels, glutathione peroxidase (GSH-Px) activity, thiobarbituric acid reactants (TBAR) of both chronic ambulatory peritoneal dialysis (CAPD) patients and a matched control group were investigated in this study. Oxidized and reduced pyridinic nucleotides in red blood cells (RBC), in which NADPH is a direct expression of hexose monophosphate shunt function, were also studied. The results obtained indicate that RBC and plasma are exposed to oxidative stress in CAPD. This condition is characterized by a decreased GSH/GSSG ratio, particularly evident in RBC as a consequence of the GSSG accumulation. Lipid peroxidation is increased, as indicated by raised TBAR levels, and reduced pyridinic nucleotides are decreased. Increased GSH-Px levels and unmodified or slightly increased GSH content were observed in the RBC but not in plasma, which showed decreased GSH and unmodified peroxidase activity. Peroxidase correlated positively with TBAR levels in the RBC lysates. In a subgroup of patients treated with erythropoietin (vs. untreated patients and controls) no differences were observed in the glutathione-related parameters studied. These data suggest that a mechanism for adaptation to oxidative conditions may be present in CAPD and its effects on RBC integrity are discussed in comparison with the hemodialysis conditions previously studied.

Erythrocyte redox state in uremic anemia: effects of hemodialysis and relevance of glutathione metabolism.

Reduced and oxidized glutathione and pyridine coenzymes, glutathione-related enzymes and Cu,Zn-superoxide dismutase (Cu,Zn-SOD) were investigated in the RBC of patients with chronic renal failure (CRF) and in age- and sex-matched controls. The effects of hemodialysis (HD) were also studied. A defective RBC redox state was shown in the CRF group based on a decreased GSH/GSSG ratio and NADPH levels. Increased activities of glutathione transferase (GSH-S-T) and Cu,Zn-SOD were observed before HD. Dialysis apparently restores the levels of antioxidant enzymes and at the same time strongly affects the redox state. Thus we can speculate that HD can generate severe redox impairment inducing damage in RBC and plasma antioxidant enzymes. Increased erythrocyte GSSG and GSM-S-T levels coupled with a reduced hexose monophosphate shunt (HMPS) function may be useful indexes of oxidative stress in uremic anemia.

Nursing service data for research in patient care.

Nursing service records from the nontechnical medical care program, an Oklahoma statewide Medicaid long-term community care program, provided a unique data base to gather information for research purposes and program improvement. This article describes the process of developing a data collection (coding) form to extract a minimum data set and a method of training lay coders to use the form. Inherent problems associated with this process from the beginning to the end are also shared.

Baccalaureate curriculum. Gerontological nursing objectives.

1. Gerontological preparation for nursing practice is no longer a curricular luxury; it is a necessity. Baccalaureate nursing education must include broad content and guided practice in gerontological nursing. 2. Incorporating gerontology into a baccalaureate nursing curriculum often is a challenge. Reasons include gerontology not being a "traditional" specialty area; health care professionals in the United States, including nurses, not viewing older adults differently from younger adults; students not being expected to apply knowledge or concepts specifically related to gerontology; and efforts to incorporate gerontological content into a curriculum being resisted due to ageism--a "natural" avoidance of aging from which nursing faculty are not exempt. 3. Because of the limited numbers of nurses with an advanced education in gerontology, the recruitment of experienced, knowledgeable faculty is difficult. Most gerontology faculty are still largely self-taught and enter nursing education via the fields of medical/surgical, psychiatric, or community nursing. It is largely these faculty who must plan and "pioneer" gerontology in the curriculum.