OCT1 mediates hepatic uptake of sumatriptan and loss-of-function OCT1 polymorphisms affect sumatriptan pharmacokinetics.

The low bioavailability of the anti-migraine drug sumatriptan is partially caused by first-pass hepatic metabolism. In this study, we analyzed the impact of the hepatic organic cation transporter OCT1 on sumatriptan cellular uptake, and of OCT1 polymorphisms on sumatriptan pharmacokinetics. OCT1 transported sumatriptan with high capacity and sumatriptan uptake into human hepatocytes was strongly inhibited by the OCT1 inhibitor MPP(+) . Sumatriptan uptake was not affected by the Met420del polymorphism, but was strongly reduced by Arg61Cys and Gly401Ser, and completely abolished by Gly465Arg and Cys88Arg. Plasma concentrations in humans with two deficient OCT1 alleles were 215% of those with fully active OCT1 (P = 0.0003). OCT1 also transported naratriptan, rizatriptan, and zolmitriptan, suggesting a possible impact of OCT1 polymorphisms on the pharmacokinetics of other triptans as well. In conclusion, OCT1 is a high-capacity transporter of sumatriptan and polymorphisms causing OCT1 deficiency have similar effects on sumatriptan pharmacokinetics as those observed in subjects with liver impairment.

[Invested time in private care: estimated by people in need of help and care and their private caregivers]. / Zeitaufwand in der häuslichen Pflege: Wie schätzen ihn Hilfe- und Pflegebedürftige und ihre privaten Hauptpflegepersonen selbst ein?

The amount of time that ought to be invested for private care is regulated by the German Care Assurance (SGB XI). Whether this reflects the actual amount of help given to the people cornered is not certain. In our qualitative study, which was part of the project "Potentials and Limits of Independent Living in Private Households in Germany" [1] funded by the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth, we had the chance to document the amount of time people themselves think they spend or vice versa receive for help and care with a timetable. Even if the amount of time alone does not yet lead to a conclusion about the quality of the given effort, it is one indicator for an adequate care that allows living at home as long as possible.

[Training of communication skills in stationary long care homes--the evaluation of a model project to develop communication skills and transfer it into practice]. / Kommunikationsschulung in der stationären Altenpflege. Ergebnisse der Evaluation eines Modellprojektes zur Entwicklung der Kommunikationskultur und zur Transfersicherung.

The training of communication skills of professional caregivers in six homes for elderly people has been developed and evaluated in a model project. The purpose of the project was to strengthen the staff's orientation towards the residents, their needs, handicaps and abilities. Therefore, a series of 8 in-house training courses as well as procedures to establish the contents of the program into daily care-giving (transfer) have been developed and implemented with six teams during one year. The evaluation included interviews, questionnaires and observations and was realized with participants and non-participants of the program once before the implementation of the training program and once afterwards. We found evidence for positive effects of the training: although the staff's positive self perception of the climate of communication remained stable and mainly not affected by the training, this was contradictory to the observations. The way of giving information to the residents was improved by the training program as well as the quality of relations between staff and residents. Again, sending messages about oneself which are not care-oriented had not been affected by the training-as to the observations of care giving situations. Although the staff's self perception about the change of sending these messages was highly positive.Thus, the further development of the training program has to consider these effects.To establish the transfer of the training program into daily care giving, it proved to be helpful to specify exercises after each session which had to be carried out and discussed by the participants until the next training session.

Detection of NGF-receptors TrkA and p75NTR in human tumor cell lines and effect of NGF on the growth characteristic of the UT-7/EPO cell line.

The receptors for nerve growth factor (NGF)--TrkA and p75NTR--were detected at the mRNA and the protein level in various human tumor cell lines. The NGF receptor TrkA was found on all examined tumor cell lines and is not restricted to cells belonging to the nervous system. NGF did not influence the proliferation rate of TrkA-positive cells NMB, K562, UT-7/EPO and PC-12. After NGF induction, the production level of the differentiation marker c-fos was increased in UT-7/EPO and PC- 12 cells. NGF-treatment of the UT-7/EPO cells and deprivation of erythropoietin (EPO) led to the new adherent cell line UT-7/NGF. Although UT-7/NGF showed a similar growth curve as UT-7/EPO, there were differences in the pattern of adhesion molecules and of the cytoskeleton. The effect of NGF on the cytoskeleton could not be induced in other human cell lines like NMB or KTCTL-30. TrkA inhibition with K252a--a blocker of Trk-induced receptor kinase--suggests, that the NGF signal may be transduced by the TrkA receptor in UT-7/NGF cells. This indicates that NGF is a decisive mediator of cellular adhesion.

Radiation exposure during chest X-ray examinations in a premature intensive care unit: phantom studies.

BACKGROUND: There are few reports on the radiation dose received by infants, their family and radiographers exposed to scatter radiation in a premature baby intensive care unit. OBJECTIVE: To evaluate the degree of radiation exposure from diagnostic X-ray examinations with mobile X-ray machines in a premature intensive care unit. MATERIALS AND METHODS: The radiation exposure of an adjacent newborn, the radiographer and other persons in the room was simulated using phantoms during X-ray examination of the chest using vertical and horizontal beams. RESULTS: Most of the measured doses were below the registration limit of the measuring apparatus and had to be extrapolated by multiple exposures. Without exception, the maximal doses were significantly lower than the permitted limit for persons not professionally exposed to X-rays. CONCLUSIONS: Recommendations to avoid unnecessary radiation exposure are given.