The 'Other' Neglected Diseases in Global Public Health: Surgical Conditions in Sub-Saharan Africa:
Currently in sub-Saharan Africa, most patients with surgical problems that are routinely treatable in high-income countries never reach a health facility, or are treated at a facility with inadequate human or physical resources. These conditions lead to premature death or physical disability with a significant economic burden. Meanwhile, the last decade has seen the emergence of numerous "neglected tropical disease" (NTD) initiatives in global public health. As surgeons working with clinicians in sub-Saharan Africa, the momentum for NTDs causes us to ask: Shouldn't surgical conditions also be considered "neglected"?
This article compares NTDs and surgical conditions in sub-Saharan Africa, considering their estimated burden and the cost-effectiveness of treatment, the scope of these conditions and associated global health disparities, and the effect of donor priorities on provision of surgical services. Lessons from NTD initiatives are analyzed among possible solutions to improving access to surgical services in sub-Saharan Africa.
Cell nuclei are like gated communities--quite selective about who gets in. And understandably so, because if the wrong proteins showed up at the wrong time and place, the consequences could be disastrous. The standard procedure for moving large molecules that cannot diffuse from the cytoplasm into the nucleus is to use the transport proteins known as karyopherins as escorts. How do karyopherins know whether their cargo is a protein that ought to get in? By their ability to bind with recognition sites on the cargo: no recognition, no passage. The best known example is the canonical or classical nuclear localization signal (cNLS)--a specific sequence that, when added to a protein, drives its nuclear localization. But more recently, a new class of NLSs has been identified, known as a proline-tyrosine nuclear localization signal (PY-NLS). This new signal is recognized specifically by the highly conserved transporter molecule Karyopherinβ2.
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