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S U M M A R YCell walls were obtained from the mycelial and blastospore forms of Candida albicans ; these were delipidized and separated into alkali-soluble and alkali-insoluble fractions. The detailed composition of these fractions was determined in organisms grown on different media at 37' and on the same medium at different temperatures (blastospores 30°, mycelium 40'). The composition of the wall of each form was found to be constant, irrespective of growth conditions, except for some variation in the amounts of mannose and glucose in wall hydrolysates. The alkali-insoluble fraction from the mycelial form contained 3 times as much chitin as that from blastospores and only about one third as much protein. The protein from these two fractions showed marked differences in amino acid composition. Differences between the two morphological forms in the amounts of carbohydrate and protein in the alkali-soluble fractions were also found. The results are discussed in relation to other studies of cell-wall composition in the dimorphic fungi.

Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, the implementation of risk-reducing practices remains poor. This paper describes the results of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of cardiovascular disease risk reduction delivered by nurse practitioner/community health worker (NP/CHW) teams versus enhanced usual care (EUC) to improve lipids, blood pressure, glycated hemoglobin (HbA1c), and patients’ perceptions of the quality of their chronic illness care in patients in urban community health centers. Methods and Results A total of 525 patients with documented cardiovascular disease, type 2 diabetes, hypercholesterolemia, or hypertension and levels of LDL-cholesterol, blood pressure or HbA1c that exceeded goals established by national guidelines were randomized to NP/CHW (n=261) or EUC (n=264) groups. The NP/CHW intervention included aggressive pharmacologic management and tailored educational and behavioral counseling for lifestyle modification and problem solving to address barriers to adherence and control. As compared to EUC, patients in the NP/CHW group had significantly greater 12 month improvement in total cholesterol (difference, 19.7mg/dL), LDL cholesterol (difference,15.9 mg/dL), triglycerides (difference, 16.3 mg/dL), systolic blood pressure (difference, 6.2 mm Hg), diastolic blood pressure (difference, 3.1 mm Hg), HbA1c (difference, 0.5%), and perceptions of the quality of their chronic illness care (difference, 1.2 points). Conclusions An intervention delivered by a NP/CHW team using individualized treatment regimens based on treat-to-target algorithms can be an effective approach to improve risk factor status and perceptions of chronic illnes care in high risk patients.

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