Mutational Studies of Aldose Reductase to Trace a Transient Pocket Opening and to Explain Ligand Affinity Cliffs.

Human aldose reductase, a target for the development of inhibitors for preventing diabetic complications, displays a transient specificity pocket which opens upon binding with specific, potent inhibitors. We investigated the opening mechanism of this pocket by mutating leucine residues involved in the gate keeping mechanism to alanine. Two isostructural inhibitors distinguished only by a single nitro to carboxy group replacement, have a 1000-fold difference in their binding affinity to the wild type.

Coping strategies during legally enforced quarantine and their association to psychological distress level: a cross-sectional study.

Objectives: The non-pharmacological measures to contain the COVID-19 pandemic may lead to considerable psychological distress. The aim of the CoCo-Fakt study was to investigate possible coping strategies and their effects on psychological distress during legally enforced quarantine of infected persons (IPs) and their close contacts (CPs).

Study Design: This was a cross-sectional cohort study.

Changes in Alcohol Consumption, Eating Behaviors, and Body Weight during Quarantine Measures: Analysis of the CoCo-Fakt Study.

Introduction: Public health measures enacted to reduce COVID-19 transmission have affected individuals' lifestyles, mental health, and psychological well-being. To date, little is known how stay-at-home orders have influenced the eating behaviors, weight development, and alcohol consumption of quarantined persons. The CoCo-Fakt cohort study analyzed these parameters and their association with psychological distress and coping strategies.

The Role of Extracorporeal Membrane Oxygenation Simulation Training at Extracorporeal Life Support Organization Centers in the United States.

Introduction: Extracorporeal membrane oxygenation (ECMO) requires a multidisciplinary healthcare team. The Extracorporeal Life Support Organization publishes training guidelines but leaves specific requirements up to each institution. Simulation training has shown promise, but it is unclear how many institutions have incorporated simulation techniques into ECMO training to date.

Antithrombin III administration in neonates with congenital diaphragmatic hernia during the first three days of extracorporeal membrane oxygenation.

Purpose: To evaluate the effect of Antithrombin III (ATIII) on blood product requirement in neonates receiving extracorporeal membrane oxygenation (ECMO).

Methods: A retrospective case control study of neonates presenting with or without congenital diaphragmatic hernia (CDH) requiring ECMO between 2006 and 2010 was performed. Patient demographics, laboratory data, and information on blood products administered were compared in patients treated before (n=37) and after (n=38) a protocol for antithrombin-III (ATIII) administration was implemented.

Five-year prospective evaluation of mandibular overdentures retained by two microthreaded, TiOblast nonsplinted implants and retentive ball anchors.

Purpose: The aim of this 5-year prospective evaluation was to assess the bone and peri-implant mucosa responses at unsplinted, microthread implants supporting mandibular overdentures and to determine patient responses to therapy.

Materials And Methods: Two implants were placed by a 1-stage procedure in the parasymphyseal mandibles of 59 subjects. Implant placement was followed by immediate insertion of overdentures without connection to abutments.

Probable epitopes: Relationships between myelin basic protein antigenic determinants and viral and bacterial proteins.

Nature holds numerous viral and bacterial proteins with regions of similarity to myelin basic protein antigenic determinants. Bioinformatic technology, including sequence similarity searches, may allow for the detection of biochemical and biophysical relationships between these peptides. Understanding these relationships is essential to understanding immune-mediated disease and, consequently, may be used to elucidate the etiology of pathological demyelinating diseases such as multiple sclerosis.

Essential case management services for young children in foster care.

A growing number of children in the United States are being placed into foster care. Past studies indicate that effective case manager interventions have helped foster families with a variety of different problems. This study enrolled a randomly selected sample of 130 children under age four who had been newly placed into foster care.

Combined radical retropubic prostatectomy and rectal resection.

Objectives: To present our experience with a small series of men who underwent simultaneous radical retropubic prostatectomy and rectal resection.

Methods: Three men with newly diagnosed prostate cancer were found to have concurrent rectal tumors requiring resection. All three men underwent non-nerve-sparing radical retropubic prostatectomy and abdominoperineal resection (APR) or low anterior resection (LAR) of the rectum at the same operation.

Foster care children and family homelessness.

Objectives: This study examined the association between family homelessness and children's placement in foster care.

Methods: The prevalence of homelessness in a random sample of 195 young foster children was examined.

Results: Almost half of the birth parents of the foster children had experienced homelessness.

Foster care's youngest: a preliminary report.

The impact of welfare reform on foster care is examined in relation to children's mental health. Initial assessment of 125 young foster children randomly assigned to a special program found that half rated below normal on mental and psychomotor development, with two-thirds below normal on emotional regulation and motor quality. Implications for social policy and program planning, and the need for ongoing research, are discussed.

Combining methods to identify new measures of women's drinking problems. Part I: The ethnographic stage.

In recent years, some researchers in the alcohol survey field have raised concerns about the shortcomings in severity/frequency scales for drinking and drinking problems used for both clinical and household survey purposes, especially with regard to women. This article reports on Part I of a two-part study that used ethnographic and survey methods to assess indicators of drinking problems among women across various US subcultures. Methodology for the ethnographic component consisted of three steps: analysis of findings in literature on indicators of women's drinking problems, and analysis of indicators addressed in the most commonly used standard instruments for alcohol assessment; semi-structured interviews with 12 specialists in treatment and/or research who focused on alcohol problems of women; and semi-structured interviews with 65 women from four ethnic populations who were clients in alcohol treatment centers.

Long-term histopathological changes observed in rats subjected to augmentation cystoplasty.

Possible development of proliferative lesions in bladders subjected to augmentation cystoplasty is a matter of concern for many clinicians. We have previously reported on the development of bladder papillomas in 5 of 15 rats approximately 18 months after gastrocystoplasty. We now report a followup study designed to investigate histopathological changes occurring in rat bladders approximately 2 years after augmentation cystoplasty using various gastrointestinal segments.

Indomethacin suppositories versus intravenously titrated morphine for the treatment of ureteral colic.

Study Objectives: To develop a protocol for the blinded IV titration of morphine and to compare the analgesic efficacy and side effect profile of indomethacin suppositories versus IV morphine in the treatment of acute ureteral colic.

Design: Randomized, double-blind, double-dummy, two-period crossover study.

Setting: Emergency department of a central-city, teaching hospital.

Development of an integrated case management program for vulnerable children.

Although case management is a recognized technique to organize and coordinate human services, its use with high-risk children is relatively new. This article describes the development of a case management program for children at the Center for the Vulnerable Child at Children's Hospital, Oakland, California, a health care setting that brings together health, social work, and child welfare services. Case management was introduced into multidisciplinary clinical programs for foster children, drug-exposed infants, and adolescent mothers and their infants.

Urethral polyp presenting as interlabial mass in young girls.

We describe two young girls who presented with an interlabial mass. Histologic examination of each excised mass revealed a benign urethral polyp covered with transitional and squamous epithelium. Urethral polyps should be included in the differential diagnosis of an interlabial mass in young female patients.

Mental health service utilization by children in foster care in California.

An examination of Medi-Cal-paid claims was undertaken to assess the utilization of mental health services by children in California's foster care system. Using unduplicate counts of service use and diagnoses, it was determined that children in foster care account for 41% of all users of mental health services even though they represent less than 4% of Medi-Cal-eligible children. When partitioned into specific service categories, children in foster care account for 53% of all psychologist visits, 47% of psychiatry visits, 43% of Short Doyle/Medi-Cal inpatient hospitalization in public hospitals, and 27% of inpatient psychiatric hospitals.

Children in foster care in California: an examination of Medicaid reimbursed health services utilization.

The number of children in foster care in California doubled from 27,534 in 1980 to more than 62,419 in 1988, representing approximately 1% of the child population in the state. Past studies have demonstrated that children in foster care have high rates of medical and mental health problems. An examination of all Medi-Cal-paid claims was undertaken to describe the utilization of health services by children in foster care.

Implementing critical health services for children in foster care.

This article reports recommendations that were developed at the California Conference on Health Care for Children in Foster Care, organized to discuss implementation in the state of CWLA's Standards for Health Care Services for Children in Out-of-Home Care. Programs and legislation developed in the state are also discussed.

Improving access to health care: case management for vulnerable children.

Health care providers are being confronted by a change in childhood morbidity from primarily physical problems to complex problems rooted in the social, family, and environmental conditions that accompany persistent urban poverty. The clustering of multiple problems in one family necessitates redefining preventive and treatment strategies. Yet the lack of coordination among federal, state and local service programs often exacerbates the vulnerability of these beleaguered children and families.

Early clinical experience with the transverse colon-gastric tube continent urinary reservoir.

The clinical results of the first 4 patients undergoing reconstruction with the transverse colon-gastric tube urinary reservoir are presented. All patients had a minimum 1-year follow-up. All 4 patients are continent with stable or improved renal function.

Indicators of women's alcohol problems: what women themselves report.

In-depth interviews with 65 women in treatment contributed to a taxonomy of indicators of women's alcohol problems, with five major categories and numerous subcategories. The largest number of client indicators appeared in the Individual (psychological and behavioral) category. The Physiological category included unique indicators regarding physical appearance.