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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
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Assembly and function of a bacterial genotoxin.

Dragana Nesić1, Yun Hsu, C Erec Stebbins

  • 1Laboratory of Structural Microbiology, The Rockefeller University, New York 10021, USA.

Nature
|May 28, 2004
PubMed
Summary

The cytolethal distending toxin (CDT) holotoxin structure reveals its genotoxic mechanism. Its DNase-I enzyme and ricin-like lectin domains, along with specific interactions, are crucial for DNA damage and host cell toxicity.

Area of Science:

  • Microbiology
  • Structural Biology
  • Toxicology

Background:

  • Cytolethal distending toxin (CDT) is a tripartite toxin causing cell cycle arrest and apoptosis.
  • CDT's nuclease subunit, CdtB, translocates into host cells to induce DNA damage.

Purpose of the Study:

  • To elucidate the crystal structure of the Haemophilus ducreyi CDT holotoxin.
  • To identify structural features critical for CDT's genotoxic activity and host cell interactions.

Main Methods:

  • X-ray crystallography to determine the holotoxin structure.
  • Biochemical assays to assess DNA binding and genotoxicity.

Main Results:

  • The holotoxin comprises a DNase-I family enzyme (CdtB) and two ricin-like lectin domains (CdtA, CdtC).

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  • Complex formation involves interdependent globular and non-globular interfaces.
  • Aromatic surfaces on lectin subunits and a steric block by CdtC are critical for toxicity.
  • Putative DNA binding residues in CdtB essential for genotoxicity were identified.

    • Conclusions:

    • The determined structure provides a molecular basis for CDT's genotoxic mechanism.
    • Structural insights highlight key interactions and domains responsible for toxin activity.
    • This work facilitates understanding of bacterial toxin function and potential therapeutic strategies.