Search

A Hmong cultural model of type 2 diabetes has not been described. We analyzed 20 group discussions during 21 group visits over 1 year with 39 Hmong adults with type 2 diabetes in order to describe a model that underlines their discussions. These Hmong adults attribute their diabetes to their refugee experience. They do not fit with the food, activity, weather, or community in the United States. Consuming sugar, salt, fat, and chemicals and then not sweating them out of the body, combined with emotional losses of being refugees, the participants feel they are out of balance. And being out of balance, they develop diabetes. The participants interpret biomedical information, community experiences, and personal sensations of diabetes in terms of a traditional health model of balance and in the context of refugee loss of place. Throughout their discussions, the shared suffering of their personal experiences of diabetes was evident. This cultural model may help providers implement diabetes treatment and prevention programs. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the urinary stone composition of Indonesian population. Material & Methods: This is a retrospective study analyzing total 277 urinary stone, obtained from urinary stone patient that underwent treatment in Cipto Mangunkusumo Hospital Jakarta in period 2000-2013. Results: Urinary stone disease is more common in male, with male : female ratio 1.8 : 1, with both in male and female patient, the incidence are highest at 51-60 years old. Calcium containing stone is predominant in this study with calcium oxalate as the most frequent stone with 61% overall, 43.7% in male and 17.3% in female and founded most frequent in 51-60 years old. Uric acid become the second most common stone after calcium containing stone with 9.0% overall, 6.5% in male and 2.5% in female. Infection associated stone such as struvite is 5.8% and Amonium urate 0.7%. In our study, struvite is founded more in male 3.6% than in female 2.2%. Cystine is a rare stone which is only founded 0.7%, in young age at 21-30 years old. Conclusion: Calcium oxalate is the most frequently stone type in our country as it is worldwide. This study revealed information of stone composition in Indonesian population, that could be beneficial for strategies and management to prevent urinary stone disease and recurrence.

This article is the eighth in an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr Kaplan, and the editorial board for the opportunity to continue this series. In most cases, these will be research articles targeted at the perioperative echocardiographic diagnosis and treatment of patients after cardiothoracic surgery; but in some cases, the articles will target the use of perioperative echocardiography in general., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Synaptotagmin 1 (Syt1) is an integral membrane protein whose phospholipid-binding tandem C2 domains, C2A and C2B, act as Ca 2+ sensors of neurotransmitter release. Our objective was to understand the role of individual metal-ion binding sites of these domains in the membrane association process. We used Pb 2+ , a structural and functional surrogate of Ca 2+ , to generate the protein states with well-defined protein-metal ion stoichiometry. NMR experiments revealed that binding of one divalent metal ion per C2 domain results in loss of conformational plasticity of the loop regions, potentially pre-organizing them for additional metal-ion and membrane-binding events. In C2A, a divalent metal ion in site 1 is sufficient to drive its weak association with phosphatidylserine-containing membranes, whereas in C2B, it enhances the interactions with the signaling lipid phosphatidylinositol-4,5-bisphosphate. In full-length Syt1, both Pb 2+ -complexed C2 domains associate with phosphatidylserine-containing membranes. Electron paramagnetic resonance experiments show that the extent of membrane insertion correlates with the occupancy of the C2 metal ion sites. Together, our results indicate that upon partial metal ion saturation of the intra-loop region, Syt1 adopts a dynamic, partially membrane-bound state. The properties of this state, such as conformationally restricted loop regions and positioning of C2 domains in close proximity to anionic lipid headgroups, "prime" Syt1 for cooperative binding of a full complement of metal ions and deeper membrane insertion., (Copyright © 2020 Biophysical Society. Published by Elsevier Inc. All rights reserved.)

Objective: To assess pregnant women adherence level to antenatal care visit and its effect on perinatal outcome among mothers in Tigray Public Health institutions, 2017., Results: The overall adherence level of the women towards to antenatal care visit was 49.9% and incidence of PPH, still birth, early neonatal death, late neonatal death and low birth weight complication was 4.3%, 2.3%, 2.7%, 1.9% and 7.5% respectively. PPH, preterm labor, early neonatal death and LBW complication was reduced by 81.2%, 52%, 61% and 46% respectively among women's with complete adherence to ANC visit.

Objective: To assess health care providers adherence to immediate postpartum care and associated factors among women's who gave birth in Mekele teaching public hospitals, 2018., Results: The Health care providers' complete adherence to immediate postpartum care guideline was 22.8%. Health care providers who have complete adherence to prenatal care guideline were 93.3% less likely to have incomplete adherence to immediate postpartum care guideline (AOR 95% CI 0.067 (0.036-0.125)).

Lead (Pb) is a potent neurotoxin that disrupts synaptic neurotransmission. We report that Synaptotagmin I (SytI), a key regulator of Ca2+-evoked neurotransmitter release, has two high-affinity Pb2+ binding sites that belong to its cytosolic C2A and C2B domains. The crystal structures of Pb2+-complexed C2 domains revealed that protein-bound Pb2+ ions have holodirected coordination geometries and all-oxygen coordination spheres. The on-rate constants of Pb2+ binding to the C2 domains of SytI are comparable to those of Ca2+ and are diffusion-limited. In contrast, the off-rate constants are at least two orders of magnitude smaller, indicating that Pb2+ can serve as both a thermodynamic and kinetic trap for the C2 domains. We demonstrate, using NMR spectroscopy, that population of these sites by Pb2+ ions inhibits further Ca2+ binding despite the existing coordination vacancies. Our work offers a unique insight into the bioinorganic chemistry of Pb(ii) and suggests a mechanism by which low concentrations of Pb2+ ions can interfere with the Ca2+-dependent function of SytI in the cell.

C2 domains are independently folded modules that often target their host proteins to anionic membranes in a Ca 2+ -dependent manner. In these cases, membrane association is triggered by Ca 2+ binding to the negatively charged loop region of the C2 domain. Here, we used a non-native metal ion, Cd 2+ , in lieu of Ca 2+ to gain insight into the contributions made by long-range Coulombic interactions and direct metal ion-lipid bridging to membrane binding. Using X-ray crystallography, NMR, Förster resonance energy transfer, and vesicle cosedimentation assays, we demonstrate that, although Cd 2+ binds to the loop region of C2A/B domains of synaptotagmin 1 with high affinity, long-range Coulombic interactions are too weak to support membrane binding of individual domains. We attribute this behavior to two factors: the stoichiometry of Cd 2+ binding to the loop regions of the C2A and C2B domains and the impaired ability of Cd 2+ to directly coordinate the lipids. In contrast, electron paramagnetic resonance experiments revealed that Cd 2+ does support membrane binding of the C2 domains in full-length synaptotagmin 1, where the high local lipid concentrations that result from membrane tethering can partially compensate for lack of a full complement of divalent metal ions and specific lipid coordination in Cd 2+ -complexed C2A/B domains. Our data suggest that long-range Coulombic interactions alone can drive the initial association of C2A/B with anionic membranes and that Ca 2+ further augments membrane binding by the formation of metal ion-lipid coordination bonds and additional Ca 2+ ion binding to the C2 domain loop regions.

Hmong refugees with type 2 diabetes mellitus (DM2) have poor glycemic control. For Hmong adults with DM2, group visits were instituted at a community health center and evaluated for their influence on diabetes management. Pre- and postintervention measures of physical health, mental health, and behavior were collected on 39 participants (64% participation rate). Baseline characteristics and clinical outcomes of 39 group visit participants were compared with 22 Hmong DM2 adults who refused to participate and 216 nonparticipating Hmong DM2 adults from a local diabetes registry. Baseline characteristics were similar among the three groups. Although participants received good medical services and their mental health improved (p < 0.05), clinical outcomes did not significantly improve. Although group visits are feasible for providing medical services for Hmong adults with DM2, clinical outcomes remain outside of recommended targets. Addressing mental health in this population may be necessary before people can institute behavioral changes that improve diabetes management.

Migration of an Antheor caval filter into the pulmonary artery was observed in a 66-year old male patient referred for multifocal pulmonary embolism in a context of heparin-induced thrombocytopenia. The inferior vena cava was of small diameter (18 mm). The filter was removed under cardio-pulmonary bypass and total heparinization, despite the proven thrombocytopenia. The postoperative period was marked by tamponade which had to be drained. The long-term results were satisfactory. This seems to be the first documented case of Antheor caval filter migration into the cardiac cavities.