Clinical case management & referral success outcomes.

Despite the prevalence of clinical case management services in university counseling centers, there is scant research on practices and effectiveness in case management services. The purpose of this brief report is to review the role of a clinical case manager, examine referral outcomes of referred students, and provide recommendations on case management practices. We hypothesized that students who received referrals at an in-person appointment would be more likely to be successfully referred than those who obtained email referrals.

Propagation of Recombinant Genes through Complex Microbiomes with Synthetic Mini-RP4 Plasmid Vectors.

The promiscuous conjugation machinery of the Gram-negative plasmid RP4 has been reassembled in a minimized, highly transmissible vector for propagating genetically encoded traits through diverse types of naturally occurring microbial communities. To this end, the whole of the RP4-encoded transfer determinants (, genes, and origin of transfer ) was excised from their natural context, minimized, and recreated in the form of a streamlined DNA segment borne by an autoselective replicon. The resulting constructs (the pMATING series) could be self-transferred through a variety of prokaryotic and eukaryotic recipients employing such a rationally designed conjugal delivery device.

Evidence of transmission from fully vaccinated individuals in a large outbreak of the SARS-CoV-2 Delta variant in Provincetown, Massachusetts.

Multiple summer events, including large indoor gatherings, in Provincetown, Massachusetts (MA), in July 2021 contributed to an outbreak of over one thousand COVID-19 cases among residents and visitors. Most cases were fully vaccinated, many of whom were also symptomatic, prompting a comprehensive public health response, motivating changes to national masking recommendations, and raising questions about infection and transmission among vaccinated individuals. To characterize the outbreak and the viral population underlying it, we combined genomic and epidemiological data from 467 individuals, including 40% of known outbreak-associated cases.

Refactoring the Conjugation Machinery of Promiscuous Plasmid RP4 into a Device for Conversion of Gram-Negative Isolates to Hfr Strains.

Chromosomal exchange and subsequent recombination of the cognate DNA between bacteria was one of the most useful genetic tools (e.g., Hfr strains) for genetic analyses of before the genomic era.

A Live-Cell Screen for Altered Erk Dynamics Reveals Principles of Proliferative Control.

Complex, time-varying responses have been observed widely in cell signaling, but how specific dynamics are generated or regulated is largely unknown. One major obstacle has been that high-throughput screens are typically incompatible with the live-cell assays used to monitor dynamics. Here, we address this challenge by screening a library of 429 kinase inhibitors and monitoring extracellular-regulated kinase (Erk) activity over 5 h in more than 80,000 single primary mouse keratinocytes.

Pleomorphic lipoma of the bulbar conjunctiva.

A 55-year-old woman presented with a painless, pink mass of the right eye bulbar conjunctiva that had been gradually increasing in size for the past 10 years. Excisional biopsy with histopathological analysis revealed a rare diagnosis of pleomorphic lipoma. There was no recurrence at last follow-up evaluation 6 months postoperatively.

Visual prognosis in compressive optic neuropathy secondary to sphenoid sinus mucocele: A systematic review.

Sphenoid sinus mucoceles (SSMs) are rare, benign lesions that can expand, often presenting with ocular symptoms-decreased vision, diplopia, visual field defects, proptosis, and external ophthalmoplegia. Reported cases are few, visual compromise varies, and factors affecting visual prognosis are poorly characterized. We investigate whether prompt surgical intervention (within 2 weeks of visual symptom onset) affects best-corrected visual acuity (BCVA) regained in patients with vision loss secondary to compressive SSM.

Antiphospholipid Antibody Syndrome: Raised Intracranial Pressure Without Cerebral Venous Sinus Thrombosis.

Antiphospholipid antibody syndrome (APS) has been reported to cause elevated intracranial pressure, but usually this is due to cerebral venous sinus thrombosis (CVST). We present a 36-year old man with APS with elevated intracranial pressure with neuro-ophthalmic, renal and hematological involvement without identifiable CVST.

Pseudo third cranial nerve palsy secondary to orbital ectopic lacrimal gland cyst: management with functional endoscopic sinus surgery.

An otherwise healthy 13-month-old girl was noted by her pediatrician to have developed a left head turn. The patient was referred to a pediatric ophthalmologist, who noticed signs of incomplete third cranial nerve palsy. Magnetic resonance imaging revealed the presence of an abnormal lesion in the inferonasal orbit that was abutting the ethmoid sinus.

Pupil size and anisocoria in children measured by the plusoptiX photoscreener.

Purpose: To investigate pupil size and the incidence of anisocoria in children at a single community-based practice using the plusoptiX A04 and A09 photoscreeners (plusoptiX GmbH, Nuremberg, Germany).

Methods: The medical records of consecutive patients <1 to 17 years of age who had received a comprehensive ophthalmological examination that included photoscreening with the plusoptiX were retrospectively reviewed. Data collected included sizes of both pupils, age, sex, laterality, and magnitude of anisocoria.

Periocular necrotizing fasciitis causing blindness.

Importance: Periocular necrotizing fasciitis is a rare but potentially devastating disease, accompanied by high rates of morbidity and mortality.

Observations: We report 5 cases of periocular necrotizing fasciitis resulting in severe vision loss, 3 of which required exenteration to contain the disease and only 1 of which recovered vision. Three cases were caused by group A streptococcus; 1, by methicillin-resistant Staphylococcus aureus; and 1, by Streptococcus anginosus constellatus.

Ocular motor dysfunction in Parry-Romberg syndrome: four cases.

The authors describe four patients with Parry-Romberg syndrome (PRS) who had abnormal eye movements, ptosis, and facial hemiatrophy. There were delays in diagnosis in all cases, often requiring multiple imaging studies, prior to diagnosis of PRS. These cases demonstrate the variable ophthalmic manifestations of PRS, which can lead to difficulty in diagnosis.

Basal cell cystadenoma of the lacrimal gland: diagnostic pitfalls of a basaloid pattern in lacrimal tumours.

An 85-year-old male experienced a painless swelling along the left lateral orbit for one year. A computed tomography scan demonstrated a cystic mass in the orbit adjacent to the lacrimal gland. There was a concern for malignancy considering the large size and the patient's age, so the tumour was excised.

Glycosaminoglycan metabolism before molecular biology: reminiscences of our early work.

This article concerns personal reminiscences of research on proteoglycans accomplished by Jeremiah Silbert and his co-investigators over a 25-30 year period beginning in 1961. Radiolabeled substrates were prepared and incubated with subcellular particles from mast cells and cartilage to determine pathways and organization of heparin and chondroitin glycosaminoglycan formation together with sulfation. Microsomal/Golgi fractions were examined for localization and organization of synthesis.

Dietary glucosamine under question.

Annual sales of glucosamine as a neutraceutical for affecting cartilage in treatment of osteoarthritis are close to a billion dollars, but recent clinical studies have currently raised severe criticism regarding its functional value. Additional doubts can be raised by the knowledge of the well-defined cellular steps in glucosamine formation and production of glycosaminoglycans such as chondroitin. Glucosamine is produced in an activated state from glucose by essentially all cells for incorporation into glycosaminoglycans and glycoproteins, and there have been no reports of any deficiencies in its production under any conditions.

Recurrent vision loss after endoscopic sinus surgery managed with palmar pressure.

A 41-year-old woman underwent endoscopic sinus surgery and 24 hours later, she developed acute orbital emphysema with marked vision loss. CT showed disruption of the inferior aspect of the medial wall of the orbit with fat herniation. She was immediately treated with the application of bedside palmar pressure to the globe with complete return of her vision without the need for a needle aspiration or orbital decompression.

Sulphate and osteoarthritis: decrease of serum sulphate levels by an additional 3-h fast and a 3-h glucose tolerance test after an overnight fast.

Background: Low sulphate levels in blood may contribute to osteoarthritis by decreasing cartilage chondroitin sulphation.

Objective: To measure serum levels of sulphate during 3 h of fasting or glucose ingestion after overnight fasts to determine how much sulphate lowering may occur during this period.

Methods: Sera from 14 patients with osteoarthritis who fasted overnight were obtained every 15-30 min during 3 h of continued fasting and during 3 h after ingestion of 75 g of glucose.

Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis.

Background: and objective: Glucosamine is suggested to affect glucose transport and insulin resistance. The effects of oral glucosamine on serum glucose and insulin levels at the initiation and throughout the duration of a 3-h oral glucose tolerance test were examined.

Methods: Sera from 16 patients with osteoarthritis, but with no other diagnosed medical condition who had fasted overnight, were obtained every 15-30 min during the 3 h of continued fasting and during the 3 h after ingestion of 75 g of glucose with or without ingestion of 1500 mg of glucosamine sulphate.

Fasting serum sulfate levels before and after development of osteoarthritis in participants of the veterans administration normative aging longitudinal study do not differ from levels in participants in whom osteoarthritis did not develop.

Objective: To determine whether the development of osteoarthritis (OA) in men over a 33-year period is related to lower sulfate levels in stored serum collected during that time interval.

Methods: Stored serum samples from participants in the Veterans Administration Normative Aging Study were assayed for sulfate by ion-exchange chromatography. Samples had been obtained every 3-5 years during part or all of a 33-year portion of the study.

Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness.

Background: Oral glucosamine preparations are widely used as a treatment for osteoarthritis, purportedly functioning by a variety of mechanisms suggested by results of in vitro experiments, and generally using glucosamine concentrations well in excess of 100 micromol/l.

Objective: To use high performance liquid chromatography with a high sensitivity Metrohm-Peak instrument for pulsed amperometric measurement of human serum glucosamine; a detection limit of 0.5 micromol/l at 1:10 serum dilution allowed measurement of low levels of glucosamine in human serum, which previously has not been possible.

Use of 3H-glucosamine and 35S-sulfate with cultured human chondrocytes to determine the effect of glucosamine concentration on formation of chondroitin sulfate.

Objective: To determine whether addition of glucosamine will stimulate synthesis of chondroitin sulfate by cultures of human chondrocytes, and to compare the relative contribution of endogenous glucosamine to exogenous glucosamine in forming chondroitin sulfate.

Methods: Cultured human chondrocytes were incubated with (35)S-sulfate and various amounts of glucosamine to determine whether any incremental formation of chondroitin (35)S-sulfate occurred. Similarly, chondrocytes incubated with variable concentrations of (3)H-glucosamine were examined to determine how much the incorporation into (3)H-chondroitin sulfate was diluted by provision of endogenous glucosamine that was derived by metabolism from glucose.

Effects of [3H]glucosamine concentration on [3H]chondroitin sulphate formation by cultured chondrocytes.

GlcN (glucosamine) is now promoted over the counter for implied treatment of osteoarthritis, ostensibly by stimulating biosynthesis of cartilage chondroitin sulphate. In order to evaluate whether exogenous GlcN has any stimulatory effect, we have incubated mouse chondrocytes with [(35)S]sulphate and various amounts of GlcN, to determine whether any increment in chondroitin [(35)S]sulphate formation occurs. Similarly we have used varying concentrations of [(3)H]GlcN to determine the dilution of incorporation into [(3)H]chondroitin sulphate due to provision of endogenous GlcN by metabolism from glucose at two different glucose concentrations.