A historical perspective on the discovery of adenyl purines.

In 1929, Drury and Szent-Gyorgyi described the effects of a simple extract of heart muscle and other tissues on the mammalian heart. This extract was identified as adenylic acid and found to have profound effects on the cardiovascular system. The discovery and identification of adenyl purines and their effects on the cardiovascular system has now extended to other biological functions such as neurotransmission, neuromodulation, and endocrine/exocrine secretory functions and beyond. This review examines the history of the discovery and identification of the many roles played by adenyl purines in regulation of physiological homeostasis.

Sudden infant death syndrome: a toxic response.

Causes of sudden infant death syndrome (SIDS) remain elusive. Much of the current literature points to an infectious cause with a role for proinflammatory cytokines and septic shock in stimulating an overwhelming response in an infant. This article reviews the literature and possible causes of this devastating condition.

The challenges of early discharge. Common newborn problems in the first few weeks of life.

In a thorough discussion of a published series on early discharge, Britton, Britton and Beebe note that methodological limitations, study design problems and heterogeneity sorely limit the conclusions that may be drawn from published studies about early discharge. These authors found that the 1980 recommendations of the AAP about early discharge are still appropriate. They recommend individualizing the discharge decision based on mother-infant health, as well as on psychosocial and socioeconomic factors. These authors apparently seek to temper the headlong rush to early discharge with an awareness of the wider societal context within which childbirth must be understood. Although the literature paints a positive picture of early home discharge, existing research still lacks the statistical power and scientific evidence to support this practice. There are many positive reasons for the early discharge of a mother-infant dyad, but they may have nothing to do with monetary savings. As with many things we do in our clinical practice, there is much room for the input of nurse practitioners, not only in providing care, but also in the shaping of health care policy.

Monokine production following in vitro stimulation of the THP-1 human monocytic cell line with pertussis vaccine components.

Whole-cell pertussis found in diphtheria-tetanus-pertussis (DTP) vaccine can produce symptoms reminiscent of biological responses to circulating proinflammatory monokines such as IL-6, IL-1beta, and TNFalpha. Therefore the ability of pertussis-containing vaccines and several heat-killed Bordetella pertussis preparations to stimulate cytokine production in a human monocytic cell line, THP-1, were examined. The whole-cell pertussis vaccine induced significantly more IL-6, IL-1beta, and TNFalpha production than did the acellular pertussis or diphtheria-tetanus-only vaccine. Polymyxin B was able to inhibit most of the IL-6 induced by pertussis endotoxin and a heat-killed preparation of B. pertussis containing a null mutation in bvgAS, a regulatory locus required for expression of all known protein virulence factors synthesized by this organism. However, it only partially inhibited IL-6 production induced by other pertussis-containing preparations, including DTP vaccine. These results indicate that in vitro whole-cell vaccine is a potent stimulator of IL-6, IL-1beta, and TNFalpha. They also suggest that although endotoxin is a major inducer of IL-6, other components of B. pertussis also contribute to IL-6 production by monocytes.