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ORGANIZATION ADDRESS: 302 N. Jackson Street, Milwaukee PHONE: 414-289-3779 E-MAIL: lorraine.lathen ppwi PROGRAM TITLE: Early Breast Detection Education in Low-income Hispanic Latino Communities In Milwaukee County, the Latino population grew by 85% between 1990 and 2000. Despite their growing numbers, Latinas are disproportionately impacted by breast and cervical cancer. Planned Parenthood of Wisconsin PPWI ; and its community partners will implement programs aimed at addressing structural and cultural barriers that prevent low-income Latina women from accessing breast health care. Similar to Avon or Tupperware parties, PPWI and its "Promotoras de Salud" bilingual volunteer community health educators ; will reach over 1, 400 Latino women and men with breast cancer early detection education. Low-income Latina women between the ages of 15 and 64 and their sexual partners are the primary audience for this intervention. Through our continuing collaboration with the Sixteenth Street Health Center and PPWI's Health Centers, routine clinical breast exams will be provided at no cost. Follow-up care for abnormal breast exams will be provided at no cost to approximately 20 women and doxycycline.

It makes no sense to treat cardiovascular disease in a silo. Cardiologists should not become generalists, but modifying systems of care to facilitate the recognition of key comorbidities, including depression, can lead to the delivery of more patient-centric, higher-quality care. The availability of simple patient surveys for depressive symptoms suggests that depression screening can be integrated into routine cardiac care. Recently developed depression screening questionnaires, such as the Patient Health Questionnaire PHQ-9 ; , are easy to administer and take 5 minutes for patients to complete see the Figure ; .20 A PHQ-9 score of 10 is 88% sensitive and specific for depression. Patients scoring above this level deserve consideration for treatment of depression. This tool can be administered in clinics, in waiting rooms, and before discharge from the hospital eg, after CABG ; , and can be integrated into cardiac rehabilitation and disease management programs. Concern that screening for depression will cause patients to become depressed or suicidal is unfounded and cannot excuse the failure to screen. Once significant depressive symptoms are identified, establishing a system to ensure appropriate consideration for treatment and follow-up is essential. Primary care clinicians can manage 75% of cases of depression, with psychiatric referral reserved for complicated cases eg, depression with psychosis ; and the most severe cases eg, suicidal ideation ; .21 Currently, if a cardiovascular clinician realizes that a patient has a comorbid condition such as diabetes or chronic obstructive pulmonary disease, the clinician either refers the patient to his or her primary care physician or the clinician initiates treatment and refers for follow-up. The same can and should be done for depression. Future research will help us fully understand the mechanisms that link depression and cardiovascular disease, and studies should be designed to answer whether treatment of depression can improve cardiovascular mortality and morbidity. In the meantime, current American College of Cardiology American Heart Association guidelines for CABG surgery, acute MI, and chronic angina all recommend evaluation for symptoms of depression and consideration of treatment of depression. The failure to recognize depression in patients with cardiovascular disease is a failure to provide the best care for our patients.

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Zantac pharmacy Do not take any other prescription or over-the-counter medicines– especially ones for a cold, pain, or heartburn– without first talking to your doctor. The average dose is almost time for a cheap zantac with a legitimate company. Them to maintain their former positions should the new display areas fail ; or mutual benefits obtained from continued joint displays. Such behaviour may also carry costs from increased exposure to predators or increased energy expenditure as the beta travels repeatedly between display areas. This study focused on variability in alliance types, but did not address changes in partnerships that do not result in changes in alliance structure. Future analysis of partnership changes by individual betas will be informative in assessing the relative importance of this budding behaviour compared to other potential ways of attaining alpha status, such as queuing within a social group. Investigating how and why alliances vary is of particular importance in interpreting individual decisions to cooperate. The dynamics of how partnerships are formed remain uncertain, although alliance formation appears to be an active and dynamic search on the part of both the alpha and beta male. I detected no evidence of affiliations among lower-ranking individuals, suggesting that coalitions are not formed for the purpose of `overthrowing' existing alphaebeta partnerships but rather that males attain high status independently and then solidify a display partnership. The variability of male association types reported here suggests that alpha males may form stable alliances in a variety of ways. Future investigations should therefore consider whether individual quality or condition affects the types of alliances that males can join, and whether variability in alliance types affects the fitness benefits for either member. Males that form alliances by selecting from among multiple subordinates may attain a better `fit' than males that start their alpha tenure as solitary alphas and then attract a beta over time, which may result in increased success in attracting females. Of particular interest is the effect of alliance structure and changes in alliances on the mating success of the allied males. Long-term behavioural data from the study population will allow the comparison of the realized reproductive success of individuals with different alliance histories.

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IM-07. SUPERAGONISTS OF A GLIOMA-ASSOCIATED RECEPTOR FOR INTERLEUKIN 13 A.B. Madhankumar, Akiva Mintz, and Waldemar Debinski; Department of Neurosurgery, Pennsylvania State College of Medicine, Hershey, PA, USA We demonstrated that one of the four alpha-helices in interleukin 13 IL13 ; , alpha-helix D, is the site-II of the cytokine that binds a monomeric IL13 receptor-alpha2 IL13R-alpha2 ; . IL13R-alpha2 is a nonsignaling glioma-associated receptor for IL13 of cancer testes tumor antigen type. We have subsequently documented that the site-II in IL13 is composed of residues 105, 106, and 109, among which 105 is highly conserved among species and represents a new receptor binding "hot spot" identified in IL13 moiety. Since residues 105, 106, and 109 in alpha-helix D region of IL13 form the interacting binding triad towards IL13R-alpha2, we have made new substitutions at these three specific residues. The new mutants were produced in Escherichia coli and purified by Pharmacia's FPLC. Circular dichroism and Western blot analyses were used to confirm the structural integrity, conformation, and identity of purified IL13 mutants. The functional interaction of the new IL13 mutants with IL13R-alpha2 on glioma cells was examined. This was performed in neutralization assay in which the blocking of the glioma cells killing by an IL13-based recombinant cytotoxin was determined using an MTS PMS cell proliferation assay. The receptor binding characteristics of IL13 mutants was examined in radioligand binding assay. We found that IL13.K105R and IL13.R109K distinguished themselves from all other substitutions at positions 105, 106, and 109. These two forms of IL13 neutralized much more effectively up to tenfold ; the cell killing by an IL13-based cytotoxin on glioma cells. They also competed with [125I]-IL13 for the IL13Ralpa2 with 77- to 27-fold higher avidity, respectively, than wild-type IL13. In addition, IL13.K105R and IL13.R109K showed a degree of interaction similar to that present in many vital normal tissues, which is mediated by a receptor, that is shared with IL4, IL13 IL4R. We next modeled, in three dimensions, possible structural changes responsible for superagonistic properties of these alpha-helix D mutants of IL13. We have also generated the first IL13.K105R-based, Pseudomonas exotoxin A-containing cytotoxin which shows several-fold better cytotoxicity than wild-type IL13-based cytotoxin in glioma cells. Our study demonstrates for the first time that superagonists of IL13R-alpha2 can be generated and they can be used for even more selective diagnostic therapeutic recognition of the glioma-restricted receptor for IL13. This becomes of high importance as more therapeutic approaches targeting IL13R-alpha2 in GBM, such as active and passive immunotherapies and gene therapy, have entered or are entering the clinic.