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ERα is expressed in macrophages and other immune cells known to exert dramatic effects on glucose homeostasis. We investigated the impact of ERα expression on macrophage function to determine whether hematopoietic or myeloid-specific ERα deletion manifests obesity-induced insulin resistance in mice. Indeed, altered plasma adipokine and cytokine levels, glucose intolerance, insulin resistance, and increased adipose tissue mass were observed in animals harboring a hematopoietic or myeloid-specific deletion of ERα. A similar obese phenotype and increased atherosclerotic lesion area was displayed in LDL receptor-KO mice transplanted with ERα–/– bone marrow. In isolated macrophages, ERα was necessary for repression of inflammation, maintenance of oxidative metabolism, IL-4–mediated induction of alternative activation, full phagocytic capacity in response to LPS, and oxidized LDL-induced expression of ApoE and Abca1. Furthermore, we identified ERα as a direct regulator of macrophage transglutaminase 2 expression, a multifunctional atheroprotective enzyme. Our findings suggest that diminished ERα expression in hematopoietic/myeloid cells promotes aspects of the metabolic syndrome and accelerates atherosclerosis in female mice.

Background: Comprehensive screening mechanisms are critical and must be utilized in an appropriate fashion in populations with a presumed high prevalence of disease, requires low cost of screening, and available and effective treatment modalities. Alarmingly, racial and socioeconomic disparities in medical screening programs remain vast and ultimately contribute to poorer outcomes. Improving screening in areas of lower socioeconomic status extends a service to individuals who may have otherwise gone undiagnosed, in areas where disease is often diagnosed as late-stage disease, accompanied by comorbid conditions. Methods: The authors coordinated and implemented three unique mobile health initiatives throughout underserved populations in metropolitan Atlanta. For each health initiative, a corresponding review of the English literature was performed using PubMed/MEDLINE. Special attention was paid to minority populations. Reference searches of the retrieved articles were performed manually to ensure that all available studies and data were reviewed. Results: Mobile health screening was performed in three ways. The first focused on hypertension and asthma by screening individuals at a location commonly visited, ie, the grocery store. The second targeted obesity in underserved populations through a simple identification program that educated individuals on foods that are healthy and those that are not. This was performed in grocery stores, which we consider the “frontline” of nutrition-based decisions. Lastly, we developed an educational program targeting tobacco products, particularly e-cigarettes, which we implemented for adolescent populations through our metropolitan area. Conclusion: Mobile screening is the first step in a facet of prevention that goes beyond traditional “in-office” screening. Targeting specific populations is of utmost importance, and engaging individuals at the community level can greatly improve the likelihood of success, particularly if the health care practitioners involved understand the cultural characteristics and customs of that population. Engaging health care practitioners in mobile screening represents a significant previously untapped resource that can increase screening throughput and greatly improve outcomes for patients who would otherwise go with an undiagnosed disease process.

ER... is expressed in macrophages and other immune cells known to exert dramatic effects on glucose homeostasis. We investigated the impact of ERα expression on macrophage function to determine whether hematopoietic or myeloid-specific ERα deletion manifests obesity-induced insulin resistance in mice. Indeed, altered plasma adipokine and cytokine levels, glucose intolerance, insulin resistance, and increased adipose tissue mass were observed in animals harboring a hematopoietic or myeloid-specific deletion of ERα. A similar obese phenotype and increased atherosclerotic lesion area was displayed in LDL receptor-KO mice transplanted with ... bone marrow. In isolated macrophages, ERα was necessary for repression of inflammation, maintenance of oxidative metabolism, IL-4-mediated induction of alternative activation, full phagocytic capacity in response to LPS, and oxidized LDL-induced expression of ApoE and Abca1. Furthermore, we identified ERα as a direct regulator of macrophage transglutaminase 2 expression, a multifunctional atheroprotective enzyme. Our findings suggest that diminished ERα expression in hematopoietic/myeloid cells promotes aspects of the metabolic syndrome and accelerates atherosclerosis in female mice. (ProQuest: ... denotes formulae/symbols omitted.)

Head and neck cancer is the ninth most common cancer in the USA, accounting for 3.3 % of all cancers. The incidence of head and neck cancer has plateaued recently; however, morbidity and mortality continue to remain high. Moreover, racial disparity between African-American and White patients has been studied in the head and neck community, and a vast difference still remains in mortality rate and late stage at presentation. A review of the English literature was performed using PubMed/MEDLINE for demographics, epidemiology, and studies that focused on the disparity in head and neck cancer between African-American and White patients. Age-adjusted incidence of head and neck cancer is increased in African-Americans, while the 5-year survival is decreased compared to Whites. African-American patients present with more advanced disease. When receiving similar multidisciplinary care, the overall survival was not significantly different, but racial disparity often persists in treatment regimens. Socioeconomic determinants such as insurance status play a critical role in racial disparity, along with low levels of public awareness, a lack of knowledge of specific risk factors, and a sense of mistrust that is seen in the African-American population. Disparity in the head and neck cancer community is worrisome, and although efforts have been taken to decrease the disparity, a significant difference exists. Fortunately, the disparity is reversible and can be eliminated. To do so, it is critical to extend to underserved community programs that provide appropriate screening and diagnosis, with subsequent follow-up and treatment following the standards of care.