Interprofessional clinical training based in a federally qualified health center: a short report.

A.T. Still University and HealthPoint, a federally qualified health center, worked together to develop novel interprofessional educational clinical experiences for dental and medical students. This short report is focused on evaluating outcomes related to student and patient experiences. Dental and medical faculty designed the program to be as hands on as possible while minimizing disruption to clinic flow. Second-year medical and fourth-year dental students worked together to assess the physical and oral health of the patients. One hundred forty-eight students participated. Of 429 total patients assessed, 83 were referred from the medical clinic to the dental clinic. Caries was present in 24.9% of patients. Overwhelmingly, the patients enjoyed having teams of students care for them. These types of clinical interprofessional experiences give students valuable opportunities to learn with, from, and about each other while providing hands-on care to patients.

Ribavirin inhibits angiogenesis by tetrahydrobiopterin depletion.

Ribavirin is a broad-spectrum antiviral drug that is used to treat hepatitis C virus (HCV)-infected patients. The virological response after ribavirin treatment appears to be insufficient to fully explain ribavirin-induced beneficial effects. Angiogenesis plays a pathogenic role in HCV-induced liver damage. Here, we investigated the influence of therapeutic ribavirin concentrations on angiogenesis. Ribavirin inhibited endothelial cell tube formation in vitro and vessel formation in the chick chorioallantoic membrane assay in vivo. Ribavirin inhibits inosine monophosphate dehydrogenase, which causes depletion of cellular GTP and in turn reduction of cellular tetrahydrobiopterin levels. The availability of tetrahydrobiopterin limits NO production by endothelial NO synthase. Ribavirin reduced levels of tetrahydrobiopterin (as revealed by HPLC), NO (as revealed by electron spin resonance spectroscopy), and cGMP (as revealed by RIA) in endothelial cells. Addition of tetrahydrobiopterin or NO prevented ribavirin-induced tube formation inhibition. In conclusion, angiogenesis inhibition by ribavirin has not been described before. This inhibition may contribute to ribavirin-induced pharmacological effects including adverse events.