No description available.

The mechanisms that govern the repression of 5-HT1A receptor gene expression mediated by a novel mental retardation gene, Freud-1, were examined in HEK293 and SKNSH cells. This study provides a possible mechanism of 5-HT1A receptor gene regulation by Freud-1, which, to mediate its action, recruits Swi/Snf and Sin3A/histone deacetylase (HDAC) complexes in non-neuronal HEK293 cells and Swi/Snf only in neuronal, 5-HT1A receptor-expressing SKNSH cells. Thus, Freud-1 has a dual mechanism of repression depending on cell type: HDAC dependent in HEK293 cells and HDAC independent in SKNSH cells. In addition, I present evidence that Freud-1 is not sumoylated at its consensus sumoylation sites and I present the lipid binding properties of Freud-1 and Freud-1 mutants.

The mechanisms that govern the repression of 5-HT1A receptor gene expression mediated by a novel mental retardation gene, Freud-1, were examined in HEK293 and SKNSH cells. This study provides a possible mechanism of 5-HT1A receptor gene regulation by Freud-1, which, to mediate its action, recruits Swi/Snf and Sin3A/histone deacetylase (HDAC) complexes in non-neuronal HEK293 cells and Swi/Snf only in neuronal, 5-HT1A receptor-expressing SKNSH cells. Thus, Freud-1 has a dual mechanism of repression depending on cell type: HDAC dependent in HEK293 cells and HDAC independent in SKNSH cells. In addition, I present evidence that Freud-1 is not sumoylated at its consensus sumoylation sites and I present the lipid binding properties of Freud-1 and Freud-1 mutants.

The mechanisms that govern the repression of 5-HT1A receptor gene expression mediated by a novel mental retardation gene, Freud-1, were examined in HEK293 and SKNSH cells. This study provides a possible mechanism of 5-HT1A receptor gene regulation by Freud-1, which, to mediate its action, recruits Swi/Snf and Sin3A/histone deacetylase (HDAC) complexes in non-neuronal HEK293 cells and Swi/Snf only in neuronal, 5-HT1A receptor-expressing SKNSH cells. Thus, Freud-1 has a dual mechanism of repression depending on cell type: HDAC dependent in HEK293 cells and HDAC independent in SKNSH cells. In addition, I present evidence that Freud-1 is not sumoylated at its consensus sumoylation sites and I present the lipid binding properties of Freud-1 and Freud-1 mutants.

Objetivos: estabelecer o diagnóstico de uma amostra de indivíduos com deficiência auditiva (DA) e comprometimento de outras estruturas anatômicas e/ou sistemas fisiológicos, cadastrados no CEDALVI/HRAC-USP-Bauru; verificar possíveis fatores etiológicos envolvidos e investigar possível correlação do tipo de DA com as diferentes síndromes encontradas. Local: Serviço de Genética Clínica do CEDALVI/HRAC-USP, Bauru-SP. Participantes: 93 indivíduos com DA e comprometimento de outras estruturas anatômicas e/ou sistemas fisiológicos. Intervenções: Avaliação genética-clínica; estudo citogenético; avaliações radiológica, oftalmológica, otorrinolaringológica, audiológica e outras. Resultados: Dos 93 indivíduos, 51 eram do sexo masculino e 42, do feminino. Recorrência familial foi observada em 31 casos e, consangüinidade parental em 8. Na amostra, 25 síndromes gênicas conhecidas, 5 síndromes cromossômicas, 5 quadros de etiologia ambiental e 2 quadros de etiologia heterogênea foram estabelecidos em 87 indivíduos. Em 1 caso, não foi possível definir entre 2 condições gênicas e em 5, não foi possível se chegar a um diagnóstico. Conclusões: a casuística se compôs de síndromes etiologicamente heterogêneas, com maior freqüência de etiologia genética; o tipo de DA nas síndromes gênicas foi condizente com o quadro diagnosticado; 3 indivíduos apresentaram síndromes ambientais clássicas, com diferentes tipos de DA; 2 indivíduos apresentaram quadro clínico, possivelmente decorrente de efeito teratogênico; implicação direta de fatores de risco para DA, na etiologia dessa, nos indivíduos com síndromes gênicas conhecidas sem DA; 1 caso, possivelmente, representa uma síndrome nova de padrão único, de etiologia desconhecida; o aconselhamento genético está na dependência da fase em que se encontra o processo de delineamento das diferentes condições estabelecidas. / Objectives: The purposes of this study were to establish the diagnostic of the individuals with hearing loss and presenting other additional anatomic structures and/or physiologic systems involvement, recorded in the CEDALVI/HRAC-USP-Bauru; to verify possible etiologic factors involved and to investigate a possible correlation of the hearing loss type with the different diagnosis syndromes. Setting: Clinical genetic service of the CEDALVI/HRAC-USP, Bauru- P. Participants: The sample was comprised of 93 individuals with hearing loss and involvement of other anatomic structures and/or physiologic systems. Interventions: Clinical genetic evaluation; cytogenetic study; radiological, ophtalmological, othorinolaryngological, audiologycal evaluation, etc. Results: From the total of the sample, 51 were male and 42 were female. Familial recurrence was observed in 31 cases and parental consanguinity in 8. In the present sample, 25 known genic syndromes, 5 chromosomal syndromes, 5 environmental conditions, and 2 heterogeneous conditions were established in 87 individuals. The diagnosis was not established in 5 individuals and in 1 case it was not possible to define between 2 genic conditions. Conclusions: The casuistic was composed of etiologically heterogeneous syndromes with greater frequency of genetic etiology; the type of hearing loss in the genic syndromes was concordant with the diagnosed condition; 3 individuals presented classic environmental syndromes with different types of hearing loss; 2 individuals presented clinical picture, possibly due to teratogenic effect; hearing impairment related to risk factors of the hearing loss in the individuals with known genic syndromes without hearing loss; probable a new unique-pattern syndrome, of unknown etiology in 1 case; the genetic counseling will depend on the step of delineation process of the different diagnosed condition.

INTRODUÇÃO: A doença diarréica aguda é ainda importante causa de morbidade no mundo. Sua elevada incidência e a aceitação de sua ocorrência como fato "normal" impõem desafios para seu registro e implantação de seus sistemas de vigilância. OBJETIVOS: Conhecer as características epidemiológicas da diarréia aguda e avaliar a capacidade de detecção de surtos pelo Programa de Monitorização da Doença Diarréica Aguda, no município de Avaré. MÉTODOS: De 27 de fevereiro a 16 de julho 2005, realizou-se estudo prospectivo da diarréia em unidade sentinela do programa. Os surtos identificados foram investigados por estudos descritivos e analíticos. Amostras de fezes foram coletadas para os casos envolvidos nos surtos. A avaliação dos propósitos do programa embasou-se em indicadores de utilidade, sensibilidade e oportunidade. RESULTADOS: Foram identificados 408 casos (Coeficiente de Incidência = 4,7/1000 habitantes); idade mediana de 7 anos (variação de 1 mês a 89 anos) e 54% do sexo masculino. Dos quatro surtos de diarréia confirmados, dois ocorreram em uma creche e em um orfanato, devido à Giárdia lamblia e Cryptosporidum spp.; um intradomiciliar de origem alimentar, sem identificação do agente, e uma epidemia na comunidade associada ao rotavírus. Dos casos atendidos, 63 (15,5%) pertenciam a surtos, identificando-se mais 56 casos, em um total de 119 casos (Coeficiente de Incidência de Surtos=1,4/1000 habitantes). CONCLUSÕES: O estudo mostrou que o programa responde ao seu principal propósito, respeitando-se as condições de regularidade na informação, análises dos padrões da diarréia e investigação criteriosa. Intensificar treinamentos para aumentar a habilidade das equipes locais nas avaliações e investigações é uma das principais recomendações deste estudo. / BACKGROUND: Acute diarrheal illness remains an important cause of morbidity worldwide. Its high incidence and the acceptance of its occurrence as “normal” fact impose challenges for its report and implantation of its surveillance systems. OBJECTIVES: To describe the epidemiologic characteristics of the acute diarrhea and to evaluate the capacity of the Monitoring Program of the Acute Diarrheal Illness for early detection of outbreaks, in the city of Avaré, State of São Paulo, Brazil. METHODS: From February 16 to July 28, 2005, was a prospective study of the diarrhea in a sentinel health service of the program. Descriptive and analytical studies were developed to investigate the potential outbreaks identified in this period. Stool samples were collected from the involved cases in the outbreaks. The evaluation of purpose of the program was based on indicators of usefulness, sensitivity and timeliness. RESULTS: A total of 408 cases were identified (incidence rate=4.7/1000 inhabitants). The median age was 7 years (range 1-89 years) and 54% were male. Among four confirmed diarrhea outbreaks, two occurred in a day nursery and orphanage, due to Giardia lamblia and Cryptosporidum spp., respectively; one was caused by food in dwelling-house, without identification of the agent, and one caused by rotavirus spread citywide. Of all monitored cases, 63 (15.5%) were involved in outbreaks, linked to more 56 cases, in a total of 119 cases (outbreaks incidence rate=1.4/1000 inhabitants). CONCLUSIONS: The study showed that the program enables prompt detection and investigation of outbreaks, respected the conditions of reliability of the information, evaluation of the acute diarrhea trends and careful inquiry. To intensify training to increase the ability of local professionals to recognize patterns of possible outbreaks and for suitable investigations is one of the major recommendations of this study.

Um dos grupos de doenças mais importante que acomete o desenvolvimento da caixa craniana humana é o das craniossinostoses, caracterizado pelo fechamento prematuro de uma ou mais suturas cranianas. Entre as formas mendelianas das craniossinostoses sindrômicas, mutações dominantes em FGFR2 são uma das causas mais frequentes e estão associadas às síndromes de Apert, de Crouzon e de Pfeiffer. A sinalização intracelular subseqüente à ativação de FGFR2, tanto selvagem quanto mutante, é bastante intrincada e pode sofrer inúmeras bifurcações. As porções iniciais destas vias, imediatamente subsequentes à ativação do receptor, são relativamente bem compreendidas. Grande parte, porém, do controle dessas vias, principalmente no que tange a regulação transcricional e sua associação com alterações em comportamentos celulares, não é entendido. Assim sendo, os objetivos gerais deste trabalho foram: 1) estudar o potencial de diferenciação e o perfil diferencial de transcrição gênica de culturas primárias de células fibroblastóides isoladas a partir do periósteo das suturas coronais de pacientes acometidos por síndrome de Apert (heterozigotos para a mutação de ganho de função p.Ser252Trp em FGFR2, a mutação mais comum em pacientes com esta síndrome) e 2) estudar o potencial de diferenciação osteogênico e o perfil transcricional respectivamente de células mesenquimais e de tecido provenientes de sutura coronal de um modelo murino para Síndromes de Crouzon/Pfeiffer (heterozigotos para a mutação p.Cys342Tyr em Fgfr2, a mutação mais comum associada a estas síndromes). Certificamo-nos da expressão gênica e proteica de FGFR2 nas células fibroblastóides humanas e de Fgfr2 nas células mesenquimais murinas. Em seguida, testamos o potencial osteogênico (in vitro e in vivo ) e adipogênico (in vitro ) das células de pacientes com Síndrome de Apert, comparadas a células do mesmo tecido mas de indivíduos sem esta mutação e o potencial osteogênico (in vitro ) das células mesenquimais de camundongos portadores da mutação p.Cys342Tyr em Fgfr2, comparadas a células também das suturas coronais mas de animais selvagens. O potencial de diferenciação das células mutantes, nos dois grupos de experimentos, foi muito aumentado em relação ao potencial das células livres destas mutações. Conduzimos experimentos de microarrays de expressão gênica (sistema CodeLink) com 7 amostras de culturas primárias de células de pacientes com S. de Apert e as comparamos com 7 amostras de culturas primárias controles. Identificamos 263 genes com valores de expressão estatisticamente diferentes (SNR ≥ |0.4|, P ≤ 0,05) nas amostras de pacientes com S. de Apert quando comparadas às controles (118 superexpressos, 145 subexpressos). Categorias funcionais enriquecidas foram regulação de proliferação celular, metabolismo de nucleotídeos, regulação de expressão gênica, adesão celular, organização de matriz extracelular e cascata PI3K MAPK. Para a validação deste experimento constatamos superexpressão, por PCR em tempo real, de genes identificados como superexpressos na assinatura de expressão associada às células mutadas, além de verificarmos o mesmo comportamento destes genes em células controles tratadas com FGF2 exógeno para superativação do receptor. Os experimentos de expressão gênica com os tecidos de suturas coronais do modelo murino foram feitos com 15 amostras de tecidos de animais mutantes em 3 grupos de 5 e comparadas a amostras de mesmo tecido de animais selvagens agrupadas da mesma forma. Identificamos três listas de genes diferencialmente expressos: a primeira contendo 188 transcritos (P ≤0,05, FC ≥ 1,5,sendo 91 superexpressos e 97 subexpressos), e as outras duas filtradas previamente para coeficiente de variação < 50% dentro de cada grupo, contendo 488 transcritos (P ≤0,05, FC ≥ 1,2, sendo 183 superexpressos e 305 subexpressos) e 31 transcritos (P ≤0,05, FC ≥ 1,5, sendo 11 superexpressos e 20 subexpressos). Categorias funcionais mais enriquecidas foram crescimento, proliferação e ciclo celular, diferenciação celular, sinalização célula-célula, resposta imune mediada por células e sinalização por receptor Wnt. Estes resultados nos permitiram: a) demonstrar que células fibroblastóides de periósteo craniano de paciente portadores de S. de Apert (mutação p.Ser252Trp em FGFR2) e células mesenquimais do modelo murino para S. de Crouzon e Pfeiffer, portador da mutação p.Cys342Tyr em Fgfr2, apresentam potencial osteogênico aumentado, agregando evidências que sugerem que esta alteração de comportamento celular tem função fundamental no desencadeamento das craniossinostoses nestas síndromes; b) revelar assinaturas de expressão gênicas associadas a estas mutações nas condições estudadas, que podem reger este comportamento celular anormal; c) identificar um novo grupo de genes associados à patofisiologia da Síndrome de Apert ou às características fenotípicas do modelo murino investigado, podendo também ser genes candidatos a outras craniossinostoses de causa desconhecida. / Craniosynostosis is one of the most important group of diseases linked to the development of the human skull and is characterized by the premature fusion of one or more cranial sutures. Dominant mutations in FGFR2 are frequent molecular causes amongst the mendelian inherited forms of the syndromic craniosynostosis and are associated to Apert, Crouzon and Pfeiffer syndromes. The intracellular signaling pathways following the activation of wild type or mutant FGFR2 are very complex due to several possible bifurcations. The initial portions of these pathways, immediately following the receptor activation, are relatively well delineated. However the great majority of the events related to the control of these pathways is still not well understood, mainly concerning its transcriptional regulation and its association to other cell behavior anomalies. Therefore the key scopes of this work were: 1) to study the differentiation potential and the differential gene expression profile of primary fibroblastoid cell cultures isolated from the periosteum of the coronal sutures of Apert Syndrome patients (heterozygous for the mutation p.Ser252Trp in FGFR2, the most common cause of the Apert Syndrome condition) and 2) to study the osteogenic differentiation potential and the transcriptional profile of mesenchymal cells and tissue isolated from the coronal sutures of a mouse model for the Crouzon and Pfeiffer Syndromes (heterozygous for the p.Cys342Tyr mutation in Fgfr2, the mutation most commonly associated to these syndromes). We assured the FGFR2 /FGFR2 gene and the protein expression in human fibroblastoid cells and Fgfr2 /Fgfr2 expression in the mesenchymal murine cells. We tested the (in vitro and in vivo ) osteogenic and the (in vitro ) adipogenic potentials of the Apert Syndrome patients cells compared to cells from the same tissue but from subjects without this mutation and the (in vitro ) osteogenic potential of mesenchymal cells from mice bearing the p.Cys342Tyr mutation in Fgfr2 compared to coronal suture cells but from wild type mice. On both experiments the differentiation potential of the mutant cells were very increased when compared to the potential of the wild type cells. We conducted gene expression microarray experiments (CodeLink system) using 7 samples from primary cultures of cells from Apert Syndrome patients compared to 7 samples from primary control cultures. We identified 263 genes with significantly different expression (SNR ≥ |0.4|, P ≤ 0,05) associated to the Apert Syndrome profile (118 upregulated, 145 downregulated). Enriched functional cathegories were regulation of cell proliferation, nucleotide metabolism, gene expression regulation, cell adhesion, extracellular matrix organization and PI3K MAPK cascades. In order to validate this gene expression signature we confirmed through Real-Time PCR the upregulation of genes identified as upregulated in the Apert cell profile in samples from the microarray experiment and in control cells treated with exogenous overactivate the receptor. The gene expression experiments with the coronal suture tissues from the mouse model were performed with 15 samples of mutant animal tissue in 3 groups of 5 and compared to samples from the same tissue of wild type animals, with identical grouping. We identified three sets of differentially expressed genes: the first set containing 188 transcripts (P ≤0,05, FC ≥ 1,5, 91 upregulated e 97 downregulated), and the other two filtered for coeficient of variation < 50% in each group, containing 488 transcripts (P ≤0,05, FC ≥ 1,2, sendo 183 upregulated and 305downregulated) e 31 transcripts (P ≤0,05, FC ≥ 1,5, 11 upregulated and 20 downregulated). The most enriched functional categories were growth, proliferation and cell cycle, cell differentiation, cell-to-cell signaling, cell mediated immune response and Wnt receptor signaling. These results allowed us: a) to demonstrate that fibroblastoid cells from coronal periosteum PF Apert Syndrome patients (p.Ser252Trp mutation in FGFR2) and mesenchymal cells from the coronal tissue of the mouse model for Crouzon and Pfeiffer syndromes (bearing the p.Cys342Tyr in Fgfr2) have enhanced osteogenic potential, summoning evidences suggesting that this cell behavior alteration have a fundamental role to the craniosynostotic process in these syndromes; b) to unravel gene expression signatures linked to these mutations in the studied conditions, that could orchestrate this abnormal cell behavior; c) to identify a ser of genes associated to the pathophysiology of Apert Syndrome and to the phenotypic characteristics of the animal model investigated, which might be candidate genes to other craniosynostosis of unknown cause.

Master of Public Health - MPH / The overall aim of this study was to evaluate quality of STI services in Umjindi local municipality. A concrete objective was to investigate the health system issues that may have a negative impact in the provision of quality STI service in the local municipality. These include accessibility of the STI services to the community, training of health workers in syndromic management, availability of necessary equipment and supplies for STI management, turn-around time for blood results and infrastructure of the facilities. / South Africa

Magister Public Health - MPH / Background: STIs are of major public health concern in developing countries, not least because they facilitate transmission of HIV, but also because they are important causes of mortality and morbidity among African populations, resulting in, among other things, adverse birth outcomes, neonatal and infant infections, ectopic pregnancy, anogenital cancer,infertility, pelvic inflammatory disease, and death. Thus, effective treatment needs to be prompt and accurate to control the spread, and morbidity and mortality of STIs. Even though syndromic approach to the management of STIs is effective, most evaluations have focused on syndromic STI management within STI clinics as opposed to research studies. Partner notification is an integral component of the syndromic approach and is aimed at preventing onward transmission of infection as well as re-infection. It includes informing sexual partners of infected people of their exposure, administering presumptive treatment, and providing advice about the prevention of future infection.Methods: This is a cross sectional descriptive study based on a retrospective review of STI data of study participants in KICoS aged 18 to 34 years. A non probability convenience sampling method was used to recruit study participants. A total of 1,277 participants were prescreened into KICoS of whom 847 were enrolled into this study. Data was collected using CAPI and ACASI questionnaires as well as Teleforms which was analysed in SAS for windows 9.1. Results: Syndromic prevalence of STIs was 5.7% while the aetiological prevalence was 32.8%.Risk factors to STI acquisition included, being female, having multiple sexual partners,having lower than tertiary education, using recreational drugs and being HIV. Agreement between the interviewing methods as well between the syndromic and laboratory diagnosis ranged from fair to substantial. This was also true for the agreement between laboratory and CAPI as well as between the laboratory and ACASI. Sensitivity was generally low while specificity was high. Uptake of contact tracing cards was high though with very low uptake of contact treatment with only 2.1% and 0.4% partners of the syndromically and aetiologically diagnosed participants coming for treatment.Conclusions: STI is a problem in this community and thus there should be more emphasis on risk reduction messages in patient education to mitigate the spread of STIs. The performance of syndromic management was very poor against the aetiological diagnosis thus there needs to further review the use of syndromic diagnosis of STIs in research settings. Partner tracing needs to be intensified since there was very poor partner treatment even with high uptake of contact cards.Acknowledgements: This study would have not been what it was without the immense support I received from many individuals all of whom cannot be mentioned here. I would however want to thank the Dr Wairimu Chege (Principal Investigator, KICoS) for her inspiration and encouragement. I would also like to thank my supervisor, Ernie Kunneke for going through this study with me repeated times including on a ride to the airport. On the same note I would also like to thank my lecturers and student administrators at the SOPH. My gratitude also goes to my colleagues Richard Ndivo, Sherri Pals and Eleanor McLellan-Lemal for all the support they accorded me throughout this research.I would also want to give my heartfelt gratitude to my family. My daughter Akinyi who used to type with me at night, her mother Auma for understanding my late nights up and finally to my Parents Mr and Mrs Gideon and Monica Otieno for understanding the importance of education and taking me to school through all the difficulties. Last but not least I would like to express my gratitude to the almighty God for having seen me through this process.

The mechanisms that govern the repression of 5-HT1A receptor gene expression mediated by a novel mental retardation gene, Freud-1, were examined in HEK293 and SKNSH cells. This study provides a possible mechanism of 5-HT1A receptor gene regulation by Freud-1, which, to mediate its action, recruits Swi/Snf and Sin3A/histone deacetylase (HDAC) complexes in non-neuronal HEK293 cells and Swi/Snf only in neuronal, 5-HT1A receptor-expressing SKNSH cells. Thus, Freud-1 has a dual mechanism of repression depending on cell type: HDAC dependent in HEK293 cells and HDAC independent in SKNSH cells. In addition, I present evidence that Freud-1 is not sumoylated at its consensus sumoylation sites and I present the lipid binding properties of Freud-1 and Freud-1 mutants.