SoM Articles

Steps to success: introducing PDAs at the University of Connecticut Health Center School of Medicine

Evelyn B. Morgen et al. — Fri, 19 Oct 2012 13:30:44 PDT

The LM Stowe Library helps implement and support a personal digital assistant (PDA) program for the School of Medicine at the University of Connecticut Health Center in Farmington, Connecticut. This article describes the role of the library and the library staff in purchasing and supporting PDA content and in providing student academic computing support for the students who are required to purchase PDAs in their second year of medical school. The PDAs are used principally for providing full text decision making tools at the point of care and for maintaining logs of aggregate data about each student’s patient encounters. This latter use helps ensure students see an adequate variety of of patients such as obstetric, cardiac or adolescent patients.

Kitchen Pharmacy: Garlic for Ayurvedic Recipe

Amala Guha — Thu, 14 Oct 2010 10:27:28 PDT

The Sympathetic Arterial Innervation and Body Stress

James O'Rourke et al. — Thu, 14 Oct 2010 09:20:31 PDT

Ayurvedic Approach to Rheumatologic Disorders

Amala Guha — Thu, 11 Mar 2010 05:00:55 PST

In Ayurvedic texts rheumatologic diseases are described under 'Sandhgat Roga", the diseases of joints. Although many of the diseases under this category resemble rheurnatologic diseases classified under western medicine, the approach to differential diagnosis may be different. For greater understanding of Ayurvedic concept of rheurnatologic diseases only few diseases are discussed here. The case presentation of Amavafa provides greater understanding of how Ayurvedic differential diagnosis is made in context of its western counterpart, the rheumatoid arthritis.

Ayurvedic Concept of Food and Nutrition

Amala Guha — Wed, 03 Mar 2010 13:10:42 PST

Ayurveda places special emphasis on Ahar (diet) and Anna (food) and believes that healthy nutrition nourishes the mind, body and soul. Ayurveda does not discriminate food to be good, or bad, instead it emphasizes various factors that influence food, such as its biological properties, origin, environmental factors, seasons, preparation, freshness, and provides a logical explanation of how to balance food according to one's dosha and physical needs.

Agni: the Vital Source of Life

Amala Guha — Wed, 03 Mar 2010 13:07:22 PST

Neuroimmune Interactions: a Bidirectional Flow that Leads to Health and Disease

Robert E. Cone — Wed, 03 Mar 2010 13:03:32 PST

The Vedic philosophy deals with harmony and balance between the mind and the body as well as interactions with nature. This ancient approach to health and well-being is being more and more appreciated in part as we understand the intimate relationship between the immune system, our major defense mechanism and the nervous system. Like other organ systems, the immune system is dependent on the central nervous system (CNS) and the endocrine system in its role for effective defense against foreign and domestic invaders.

What Really Matters: Opening Keynote, International Society for Ayurveda and Health, June 2004

Peter J. Deckers — Wed, 03 Mar 2010 12:59:29 PST

Importance of Prakurti Analysis in Ayurvedic Diagnosis: an Interview with Dr. Doiphode

Amala Guha — Wed, 03 Mar 2010 12:26:40 PST

Role of Ashwangandha (Withania Somnifera) in Immune Modulation: Proposed Influence in Immune-Regulation

Subhasis Chattopadhyay et al. — Wed, 03 Mar 2010 12:26:38 PST

The immune system evolved to protect organisms from an infinite variety of disease-causing agents but to avoid harmful responses to self. However, such a powerf~dl efense mechanism requires regulation. Immune regulation includes homeostatic and cellmediated targeted mechanisms to the activation, differentiation and function of antigen-triggered immuno-competent cells and irnmunoregulatory cells. The regulation of the immune system has been a major challenge for the management of autoimmune disorders, tumor immunity, infectious diseases and organ transplants. However, irnmuno-modulatory procedures used by modern medicine to induce immunoregulatory function have deleterious side effects. Ashwangandha (Withania somnifera), an herb used in Ayurvedic medicine is being tested and used in experimental and clinical cases with potential immuno-modulatory functions without any side effects. Here we propose future usages of Ashwangandha for immuno-regulatory function in translational research.

Therapeutic Use of Ginkgo Biloba

Amala Guha — Wed, 03 Mar 2010 10:44:16 PST

Gingko biloba, one of the most popular herbs in the USA is known for its various therapeutic uses and is now well researched for its various active compounds. Although originally grown in Asia, the tree is distributed all over the world. Leaves, bark, roots all have therapeutic properties and are used for various illnesses like asthma, circulatory ailments and cognitive support or dysfunction.

Microtubule dynamics and glutathione metabolism in phagocytizing human polymorphonuclear leukocytes.

B R Burchill et al. — Tue, 03 Oct 2006 15:03:10 PDT

Glutathione oxidants such as tertiary butyl hydroperoxide were shown previously to prevent microtubule assembly and cause breakdown of preassembled cytoplasmic microtubules in human polymorphonuclear leukocytes. The objectives of the present study were to determine the temporal relationship between the attachment and ingestion of phagocytic particles and the assembly of microtubules, and simultaneously to quantify the levels of reduced glutathione and products of its oxidation as potential physiological regulators of assembly. Polymorphonuclear leukocytes from human peripheral blood were induced to phagocytize opsonized zymosan at 30 degrees C. Microtubule assembly was assessed in the electron microscope by direct counts of microtubules in thin sections through centrioles. Acid extracts were assayed for reduced glutathione (GSH) and oxidized glutathione (GSSG), by the sensitive enzymatic procedure of Tietze. Washed protein pellets were assayed for free sulfhydryl groups and for mixed protein disulfides with glutathione (protein-SSG) after borohydride splitting of the disulfide bond. Resting cells have few assembled microtubules. Phagocytosis induces a cycle of rapid assembly followed by disassembly. Assembly is initiated by particle contact and is maximal by 3 min of phagocytosis. Disassembly after 5-9 min of phagocytosis is preceded by a slow rise in GSSG and coincides with a rapid rise in protein-SSG. Protein-SSG also increases under conditions in which butyl hydroperoxide inhibits the assembly of microtubules that normally follows binding of concanavalin A to leukocyte cell surface receptors. No evidence for direct involvement of GSH in the induction of assembly was obtained. The formation of protein-SSG, however, emerges as a possible regulatory mechanism for the inhibition of microtubule assembly and induction of their disassembly.

Demonstration of Rhodanese Activity in Polyacrylamide Gels.

J R Murphy et al. — Tue, 03 Oct 2006 14:46:47 PDT

Rhodanese activity from crude extracts of Thiobacillus sp. strain IV-85 was demonstrated in polyacrylamide gels after incubation in the reaction mixture by staining with dichloroindophenol in the presence of methylphenazonium methosulfate. The sensitivity of the staining system was found to be 8 x 10 moles of sulfite.

Chemotactic factor inactivator in normal human serum.

J L Berenberg et al. — Thu, 28 Sep 2006 11:37:52 PDT

Normal human serum contains an inactivator of chemotactic factors for neutrophilic leukocytes. The chemotactic factor inactivator (CF-I) remains soluble when serum is fractionated with ammonium sulfate (at 45% saturation), directly and irreversibly inactivates chemotactic factors, and it has a broad spectrum of activity as indicated by its inactivation of the chemotactic fragments of human C3 and C5 (third and fifth components of complement), C5̅6̅7̅, and the bacterial chemotactic factor derived from Escherichia coli. CF-I appears as a biphasic activity according to preparative techniques of sucrose density ultracentrifugation, electrophoresis, and gel filtration. Studies on the interaction of CF-I with the radiotagged C5 chemotactic fragment fail to reveal evidence for irreversible binding as the basis for inactivation. CF-I varies from the anaphylatoxin inactivator in several physical-chemical respects, but evidence does not permit a conclusive statement about the relationship of the two inactivators. CF-I may function as a regulator of inflammatory responses.

Intrinsic characteristics of the proton pump in the luminal membrane of a tight urinary epithelium. The relation between transport rate and delta mu H.

O S Andersen et al. — Tue, 15 Aug 2006 14:08:24 PDT

A number of tight urinary epithelia, as exemplified by the turtle bladder, acidify the luminal solution by active transport of H+ across the luminal cell membrane. The rate of active H+ transport (JH) decreases as the electrochemical potential difference for H+ [delta mu H = mu H(lumen) - mu H(serosa)] across the epithelium is increased. The luminal cell membrane has a low permeability for H+ equivalents and a high electrical resistance compared with the basolateral cell membrane. Changes in JH thus reflect changes in active H+ transport across the luminal membrane. To examine the control of JH by delta mu H in the turtle bladder, transepithelial electrical potential differences (delta psi) were imposed at constant acid-base conditions or the luminal pH was varied at delta psi = 0 and constant serosal PCO2 and pH. When the luminal compartment was acidified from pH 7 to 4 or was made electrically positive, JH decreased as a linear function of delta mu H as previously described. When the luminal compartment was made alkaline from pH 7 to 9 or was made electrically negative, JH reached a maximal value, which was the same whether the delta mu H was imposed as a delta pH or a delta psi. The nonlinear JH vs. delta mu H relation does not result from changes in the number of pumps in the luminal membrane or from changes in the intracellular pH, but is a characteristic of the H+ pumps themselves. We propose a general scheme, which, because of its structural features, can account for the nonlinearity of the JH vs. delta mu H relations and, more specifically, for the kinetic equivalence of the effects of the chemical and electrical components of delta mu H. According to this model, the pump complex consists of two components: a catalytic unit at the cytoplasmic side of the luminal membrane, which mediates the ATP-driven H+ translocation, and a transmembrane channel, which mediates the transfer of H+ from the catalytic unit to the luminal solution. These two components may be linked through a buffer compartment for H+ (an antechamber).

Mechanisms of K+ transport in isolated turtle urinary bladder. Induction of active K+ secretion in a K+-absorbing epithelium.

R F Husted et al. — Mon, 31 Jul 2006 13:07:30 PDT

Variation at APOE and STH loci and Alzheimer's disease.

Lingjun Zuo et al. — Wed, 19 Jul 2006 07:03:26 PDT

ABSTRACT: BACKGROUND: The apolipoprotein E (APOE) and tau proteins play important roles in the pathological development of Alzheimer's disease (AD). Many studies have shown an association between the APOE gene and AD. Association between AD and the newly discovered saitohin (STH) gene, nested within the intron of the tau gene, has been reported. The present study aimed to elucidate the association between APOE and AD, and between STH and AD in our sample. METHODS: The functional polymorphisms, rs429358 and rs7412, in the APOE gene (which together define the {epsilon}2, {epsilon}3, and {epsilon}4 alleles), and the Q7R SNP in the STH gene, were genotyped in 369 patients with AD and 289 healthy European-Americans. The associations between these two genes and AD were analyzed in a case-control design. RESULTS: Consistent with previously reported results, the frequencies of the APOE {epsilon}4 allele, {epsilon}4/{epsilon}4 genotype and {epsilon}3/{epsilon}4 genotype were significantly higher in AD cases than controls; the {epsilon}4/{epsilon}4 genotype frequency was significantly higher in early-onset AD (EOAD) than late-onset AD (LOAD); the frequencies of the {epsilon}2 allele, {epsilon}3 allele, {epsilon}3/{epsilon}3 genotype and {epsilon}2/{epsilon}3 genotype were significantly lower in AD cases than controls. Positive likelihood ratios (LRs+) of APOE alleles and genotypes increased in a linear trend with the number of {epsilon}4 alleles and decreased in a linear trend with the number of {epsilon}2 or {epsilon}3 alleles. There was no significant difference in the STH allele and genotype frequency distributions between AD cases and controls. CONCLUSIONS: This study confirmed that the {epsilon}4 allele is a dose-response risk factor for AD and the {epsilon}4/{epsilon}4 genotype was associated with a significantly earlier age of onset. Moreover, we found that the {epsilon}2 allele was a dose-response protective factor for AD and the {epsilon}3 allele exerted a weaker dose-response protective effect for risk of AD compared with {epsilon}2. In a clinical setting, APOE genotyping could offer additional biological evidence of whether a subject may develop AD, but it is not robust enough to serve as an independent screening or predictive test in the diagnosis of AD. STH variation was not significantly associated with AD in our sample.

Investigating the Role of Small, Acid-Soluble Spore Proteins (SASPs) in the Resistance of Clostridium Perfringens Spores to Heat.

Deepa Raju et al. — Tue, 18 Jul 2006 09:11:22 PDT

BACKGROUND: Clostridium perfringens type A food poisoning is caused by enterotoxigenic C. perfringens type A isolates that typically possess high spore heat-resistance. The molecular basis for C. perfringens spore heat-resistance remains unknown. In the current study, we investigated the role of small, acid-soluble spore proteins (SASPs) in heat-resistance of spores produced by C. perfringens food poisoning isolates.

RESULTS: Our current study demonstrated the presence of all three SASP-encoding genes (ssp1, 2 and 3) in five surveyed C. perfringens clinical food poisoning isolates. beta-Glucuronidase assay showed that these ssp genes are expressed specifically during sporulation. Consistent with these expression results, our study also demonstrated the production of SASPs by C. perfringens food poisoning isolates. When the heat sensitivities of spores produced by a ssp3 knock-out mutant of a C. perfringens food poisoning isolate was compared with that of spores of the wild-type strain, spores of the ssp3 mutant were found to exhibit a lower decimal reduction value (D value) at 100 degrees C than exhibited by the spores of wild-type strain. This effect was restored by complementing the ssp3 mutant with a recombinant plasmid carrying wild-type ssp3, suggesting that the observed differences in D values between spores of wild-type versus ssp3 mutant was due to the specific inactivation of ssp3. Furthermore, our DNA protection assay demonstrated that C. perfringens SASPs can protect DNA from DNase I digestion.

CONCLUSION: The results from our current study provide evidences that SASPs produced by C. perfringens food poisoning isolates play a role in protecting their spores from heat-damage, which is highly significant and relevant from a food safety perspective. Further detailed studies on mechanism of action of SASPs from C. perfringens should help in understanding the mechanism of protection of C. perfringens spores from heat-damage.

Age Related Differences in Individual Quality of Life Domains in Youth with Type 1 Diabetes.

Julie A Wagner et al. — Thu, 04 May 2006 10:39:19 PDT

BACKGROUND: Investigating individual, as opposed to predetermined, quality of life domains may yield important information about quality of life. This study investigated the individual quality of life domains nominated by youth with type 1 diabetes.

METHODS: Eighty young people attending a diabetes summer camp completed the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting interview, which allows respondents to nominate and evaluate their own quality of life domains.

RESULTS: The most frequently nominated life domains were 'family', 'friends', 'diabetes', 'school', and 'health' respectively; ranked in terms of importance, domains were 'religion', 'family', 'diabetes', 'health', and 'the golden rule'; ranked in order of satisfaction, domains were 'camp', 'religion', 'pets', and 'family' and 'a special person' were tied for fifth. Respondent age was significantly positively associated with the importance of 'friends', and a significantly negatively associated with the importance of 'family'. Nearly all respondents nominated a quality of life domain relating to physical status, however, the specific physical status domain and the rationale for its nomination varied. Some respondents nominated 'diabetes' as a domain and emphasized diabetes 'self-care behaviors' in order to avoid negative health consequences such as hospitalization. Other respondents nominated 'health' and focused more generally on 'living well with diabetes'. In an ANOVA with physical status domain as the independent variable and age as the dependent variable, participants who nominated 'diabetes' were younger (M = 12.9 years) than those who nominated 'health' (M = 15.9 years). In a second ANOVA, with rationale for nomination the physical status domain as the independent variable, and age as the dependent variable, those who emphasized 'self care behaviors' were younger (M = 11.8 years) than those who emphasized 'living well with diabetes' (M = 14.6 years). These differences are discussed in terms of cognitive development and in relation to the decline in self-care and glycemic control often observed during adolescence.

CONCLUSIONS: Respondents nominated many non-diabetes life domains, underscoring that QOL is multidimensional. Subtle changes in conceptualization of diabetes and health with increasing age may reflect cognitive development or disease adjustment, and speak to the need for special attention to adolescents. Understanding individual quality of life domains can help clinicians motivate their young patients with diabetes for self-care. Future research should employ a larger, more diverse sample, and use longitudinal designs.

Comparisons of Mortality and Pre-discharge Respiratory Outcomes in Small-for-gestational-age and Appropriate-for-gestational-age Premature Infants.

Puneet Sharma et al. — Thu, 04 May 2006 10:23:01 PDT

BACKGROUND: There are differences in the literature regarding outcomes of premature small-for-gestational-age (SGA) and appropriate-for gestational-age (AGA) infants, possibly due to failure to take into account gestational age at birth.

OBJECTIVE: To compare mortality and respiratory morbidity of SGA and AGA premature newborn infants.

DESIGN/METHODS: A retrospective study was done of the 2,487 infants born without congenital anomalies at

RESULTS: Controlling for GA, premature SGA infants were at a higher risk for mortality (Odds ratio 3.1, P = 0.001) and at lower risk of respiratory distress syndrome (OR = 0.71, p = 0.02) than AGA infants. However multivariate logistic regression modeling found that the odds of having respiratory distress syndrome (RDS) varied between SGA and AGA infants by GA. There was no change in RDS risk in SGA infants at GA 32 wk (OR = 0.41, 95% CI 0.27 - 0.63; p < 0.01). After controlling for GA, SGA infants were observed to be at a significantly higher risk for developing chronic lung disease as compared to AGA infants (OR = 2.2, 95% CI = 1.2 - 3.9, P = 0.01). There was no significant difference between SGA and AGA infants in total days on ventilator. Among infants who survived, mean length of hospital stay was significantly higher in SGA infants born between 26-36 wks GA than AGA infants.

CONCLUSIONS: Premature SGA infants have significantly higher mortality, significantly higher risk of developing chronic lung disease and longer hospital stay as compared to premature AGA infants. Even the reduced risk of RDS in infants born at >/=32 wk GA, (conferred possibly by intra-uterine stress leading to accelerated lung maturation) appears to be of transient effect and is counterbalanced by adverse effects of poor intrauterine growth on long term pulmonary outcomes such as chronic lung disease.