Pharmacy-based skin-testing program in a community hospital.

The establishment of a pharmacy-based skin-testing program at a community hospital is described. Problems with existing skin testing were brought to the attention of the pharmacy and therapeutics committee, which decided that one group of caregivers within the hospital should be chosen and trained to perform skin testing. A problem-solving team identified specific problems and developed solutions. The top four causes of the skin-testing problems were failure to follow procedure, inaccurate reading of tests, failure to report positive results, and failure to document results. Groups within the hospital who might perform skin testing were assessed according to several criteria; the pharmacy staff was selected because of ease of notification, availability, and ability to conduct follow-through (reading, documenting, and reporting results). Other improvements were step-by-step instructions for all phases of skin testing, a portable skin-test supply kit, and a skin-test record form to be placed in the physician progress notes. Pharmacists were trained by the employee health nurse. Pharmacist skin testing began in March 1995. Pharmacists administered tests to 93 inpatients and about 250 employees during the first 13 months of the program, and no problems were reported. Establishment of a pharmacy-based skin-testing program improved the quality of inpatient skin testing and enabled pharmacists to increase their role in patient care.

Distribution of RNA editing sites in Oenothera mitochondrial mRNAs and rRNAs.

To investigate whether RNA editing in plant mitochondria modifies structural RNAs as well as protein-coding RNAs we compared the genomic-encoded information with the respective transcripts of several genes in Oenothera. The genes analysed are the 5S, 18S and 26 S rRNAs, the alpha-subunit of ATPase (atpA), cytochrome b (cytb), orfB, which is located upstream of cytochrome oxidase subunit III, and the respective leader, trailer and spacer sequences. All open reading frames were found to be edited to some degree. The atpA coding region has the least edited mRNA in Oenothera mitochondria, with only four nucleotides altered in the 1533 nucleotide open reading frame. From this analysis we conclude that frequent RNA editing is indicative of functional protein coding regions in plant mitochondria. The extensive editing in orfB, for example, suggests that this orf codes for a mitochondrial protein. No RNA editing event was found in the 5S rRNA or in the 1824 nucleotides analysed of the 18S rRNA, but two nucleotides were found to be altered in the 1970 nucleotides compared for the 26S rRNA. One nucleotide alteration has changed C to U, the other in reverse U to C. However, only one of five cDNA clones covering this region shows the modifications, similar to many silent editing events in open reading frames. RNA editing in the structural RNAs thus does not seem to be essential for their function in the mitochondrial ribosome.