RESUMEN
AIM: This review discusses the complex epithelial-mesenchymal interactions that occur during tooth development and systemic anomalies that may result in hypodontia. Emphasis is placed on four interacting signaling families (Shh, FGF, BMP, and Wnt) that have been identified for their integral role in complete tooth development and on several genetic mutations in the MSX1, PAX9, EDA, and AXIN2 genes that arrest tooth development. Proposed treatment options are presented, including signaling factor supplementation and stem cell isolation for bioengineering new teeth.
Asunto(s)
Anodoncia/etiología , Anodoncia/genética , Animales , Proteínas Morfogenéticas Óseas/metabolismo , Transición Epitelial-Mesenquimal , Factores de Crecimiento de Fibroblastos/metabolismo , Humanos , Mutación , Regeneración , Transducción de Señal , Vía de Señalización WntRESUMEN
INTRODUCTION: Globally, chronic conditions have become the most prevalent and costly of health problems, imposing a growing drain on healthcare delivery systems and healthcare financing. Depressive symptoms and disorders are one of the most common complications of chronic illness and negatively impact one's perceived quality of life. In recent years, depression has been recognized as a major health problem for rural women. The purpose of this article is to describe the experience of depression in a sample of chronically ill rural women who participated in an online social-support and health education research project. METHODS: Middle-aged rural women with at least one chronic condition were recruited from the western USA to participate in the Women to Women (WTW) project, a 22 week computer-based intervention of virtual support and health education. The presence of depression was measured quantitatively using the Center for Epidemiologic Studies Depression Scale (CES-D). Messages posted by the women (n=82) to the online support forum were carefully examined for evidence of depressive symptomatology, perceptions of the relationship of depression to their chronic illnesses, and their strategies for coping with their depression. RESULTS: Of the 82 women who participated in the support intervention, 47 (57%) demonstrated clinically significant psychological distress at the time of enrollment into the WTW project by scoring 16 or above on the CES-D (range=0-48; x=19.27; sd=11.25). At the end of the computer intervention, complete data were available on 57 women. Of these, 24 (42%) scored 16 or above on the CES-D (range=0-49; x=15.74; sd=11.55) indicating continuing psychological distress. In all, 59 messages were coded 'depression'. The women's messages included descriptions of symptoms consistent with the literature (feelings of worthlessness and guilt; helplessness and hopelessness; alterations in sleep patterns; loss of energy). The interrelationship of depression and illness, pain, and seasonal weather variations was acknowledged; traditional and complementary healthcare treatments were discussed; relationships with healthcare providers and family and friends were described; and a variety of strategies used in coping with their depression were shared. CONCLUSIONS: Rural women with chronic illness struggle with depression. The description of their depressive symptomatology provides insight into the experience and may facilitate healthcare providers' ability to recognize depression and identify strategies to ameliorate the negative impact of depression in chronically ill rural women.
Asunto(s)
Enfermedad Crónica/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Población Rural/estadística & datos numéricos , Salud de la Mujer , Adaptación Psicológica , Adulto , Enfermedad Crónica/psicología , Comorbilidad , Depresión/psicología , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Servicios de Salud Rural/organización & administración , Apoyo Social , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Servicios de Salud para Mujeres/organización & administraciónRESUMEN
BACKGROUND: Factors contributing to the generation of soluble P- and E-selectins remain unclear. RESULTS: This work demonstrates that mice lacking P-selectin glycoprotein ligand-1 (Psgl-1(-/-)) are deficient in soluble P-selectin (sP-sel), which is due to a defective binding interaction between PSGL-1 and P-sel, because mice lacking alpha(1,3)-fucosyltransferase-VII are also deficient in sP-sel. Psgl-1(-/-) mice are also deficient in soluble E-selectin (sE-sel) indicating that leukocyte interactions with endothelial cells lead to the generation of sE-sel. The generation of sE-sel requires an interaction between PSGL-1 and P-sel, as deficiency of sE-sel is observed in both Psgl-1(-/-) and P-sel(-/-) mice. Bone marrow transplantation from Psgl-1(-/-) to Psgl-1(+/+) mice leads to deficiency of sP-sel and sE-sel in recipient mice, establishing the importance of bone marrow-derived PSGL-1 toward the generation of sP-sel and sE-sel. Bone marrow transplantation from P-sel(-/-) to P-sel1(+/+) mice does not lead to a significant reduction in sP-sel, confirming the importance of the endothelium toward the liberation of sP-sel. CONCLUSION: sP-sel and sE-sel reflect an interaction between leukocyte PSGL-1 and endothelial P-sel.
Asunto(s)
Células Endoteliales/metabolismo , Leucocitos/metabolismo , Glicoproteínas de Membrana/metabolismo , Selectina-P/biosíntesis , Animales , Células de la Médula Ósea/metabolismo , Trasplante de Médula Ósea , Selectina E/genética , Fucosiltransferasas/deficiencia , Fucosiltransferasas/genética , Expresión Génica , Genotipo , Glicoproteínas de Membrana/deficiencia , Glicoproteínas de Membrana/genética , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Unión ProteicaRESUMEN
The focus of this article is on the nurse monitor role in a project whose overall goal is to use telecommunication technology to provide information and support to middle-aged rural women living with chronic illness. The impact of participation in these support groups on the women's psychosocial health is also discussed. The purpose of the project, the underlying conceptual framework of social support, a project overview, project philosophy and protocols, and the role of the Nurse Monitor are described.
Asunto(s)
Redes de Comunicación de Computadores/organización & administración , Enfermería , Apoyo Social , Confidencialidad , Femenino , Guías como Asunto , Humanos , Microcomputadores , Montana , Filosofía en Enfermería , Población RuralAsunto(s)
Seguridad de Productos para el Consumidor , Embalaje de Medicamentos , Anciano , Niño , HumanosRESUMEN
An innovative continuing education program provides current gerontic information to geographically isolated nurses who care for the rural elderly.
Asunto(s)
Enfermería en Salud Comunitaria/educación , Educación Continua en Enfermería/organización & administración , Geriatría/educación , Salud Rural , Anciano , Humanos , MontanaRESUMEN
Special approaches need to be developed and used to make gerontic continuing education accessible to nurses in rural settings. Traditional workshops are time-intensive, and expensive to deliver, and are out of the reach of many nurses in rural settings because of great distances, inclement weather, expense, and lack of work coverage. The use of self-study modules featuring in-depth conversations with and demonstrations by gerontological experts is one way to economically deliver current gerontic continuing education to nurses in rural settings.