Removal of hydrogen peroxide by a 1-cysteine peroxiredoxin enzyme of the filarial parasite Dirofilaria immitis.

Prior studies have shown that filarial nematodes can effectively metabolize hydrogen peroxide in excess of that generated by activated host cells. However, the mechanisms of H2O2 removal by the filarial parasites are unclear. Herein we report the results of studies carried out on the biochemical activity and on immunolocalization of a recombinant peroxiredoxin (Prx) enzyme from the dog filarial parasite Dirofilaria immitis. A full-length cDNA encoding a 1-Cys Prx enzyme from the dog heartworm D. immitis was expressed in Escherichia coli as a recombinant polyhistidine fusion protein (rDiPrx-1). rDiPrx-1 was capable of reducing H2O2 in the presence of dithiothreitol. The apparent kinetic constants determined for DiPrx-1 using H2O2 as a substrate were a Michaelis constant (Km) of 16.28 mM and a maximal velocity (Vmax) of 16 micromol/min(-1). Consistent with the enzyme activity, D. immitis adult worms could detoxify exogenously added H2O2 in vitro. Antibodies to rDiPrx-1 identified a 27-kDa native antigen in parasite extracts and larval and adult excretory-secretory products. The antibodies were used to localize the native antigen to the lateral hypodermal chords of both male and female worms by immunohistochemistry. In addition, labeling was seen in the afibrillar muscle cells in male worms and in some areas of the uterine wall in female worms. Thus, DiPrx-1 is the first parasite Prx to be shown to detoxify exogenously added H2O2 in an in vitro system.

A comparison of nursing and medical diagnoses in predicting hospital outcomes.

UNLABELLED: The main premise of the Nursing Minimum Data Set (NMDS) is that nursing data should be included in the hospital discharge abstract. Yet to date, little empirical evidence has been published to measure the efficacy or usefulness of these nursing data elements. We report the results of a comparison between a daily collection of nursing assessments using nursing diagnoses (NDX) to the Diagnostic Related Group (DRG) and the All Payer Refined DRG (APR-DRG) in their ability to predict three common outcome variables: hospital days, ICU day, and total charges. A secondary data analysis was performed from a large existing data set of four years patient data from a Midwest University hospital. FINDINGS: NDX is significantly associated with hospital length of stay, ICU length of stay, and total charges. NDX also improves explanatory power when added to models with DRG or APR-DRG. This suggests that nursing data compliments existing data and is not redundant with the DRG or APR-DRG. The findings also suggest that NDX explains a different portion of the variance of the three outcome variables in this series. The results of this study support the argument that nursing data should be included in the hospital discharge abstract.

Differential expression of the muscarinic m2 acetylcholine receptor by small and large motoneurons of the rat spinal cord.

The purpose of this study was to determine if motoneurons in the spinal ventral horn express the muscarinic m2 acetylcholine receptor. Motoneurons were retrogradely labelled in adult rats by intramuscular injection of Fluorogold and examined with confocal microscopy for evidence of immunoreactivity for the receptor. The cells were also double-labelled for choline acetyltransferase to determine if they were contacted by cholinergic axons. Almost all large motoneurons (diameters greater than 35 microm) displayed intense immunoreactivity for the receptor which was evenly distributed along the plasma membrane. Small cells were immunonegative for the receptor or weakly labelled. As large cells probably correspond to alpha-motoneurons and receive many cholinergic contacts, it is concluded that acetylcholine can influence this type of motoneuron by acting through the m2 receptor.

Fund raising mentors: wisdom for winning.

This article shares some of the most important lessons I have learned in 31 years of marketing and fund-raising activities from five mentors. It also points out the critical role that mentors play in one's career.

Uptake and release of neurotransmitter candidates, [3H]serotonin, [3H]glutamate, and [3H]gamma-aminobutyric acid, in taste buds of the mudpuppy, Necturus maculosus.

Neurotransmitters in vertebrate taste buds have not yet been identified with confidence. Serotonin, glutamate, and gamma-aminobutyric acid (GABA) have been postulated, but the evidence is incomplete. We undertook an autoradiographic study of [3H]serotonin, [3H]glutamate, and [3H]GABA uptake in lingual epithelium from the amphibian, Necturus maculosus, to determine whether taste bud cells would accumulate and release these substances. Lingual epithelium containing taste buds was incubated in low concentrations (0.4-6 microM) of these tritiated transmitter candidates and the tissue was processed for light microscopic autoradiography. Merkel-like basal taste cells accumulated [3H]serotonin. When the tissue was treated with 40 mM K+ after incubating the tissue in [3H]serotonin, cells released the radiolabelled transmitter. Furthermore, depolarization (KCl)-induced release of [3H]serotonin was Ca-dependent: if Ca2+ was reduced to 0.4 mM and 20 mM Mg2+ added to the high K+ bathing solution, Merkel-like basal cells did not release [3H]serotonin. In contrast, [3H]glutamate was taken up by several cell types, including non-sensory epithelial cells, Schwann cells, and some taste bud cells. [3H]glutamate was not released by depolarizing the tissue with 40 mM K+. [3H]GABA uptake was also widespread, but did not occur in taste bud cells. [3H]GABA accumulated in non-sensory epithelial cells and Schwann cells. These data support the hypothesis that serotonin is a neurotransmitter or neuromodulator released by Merkel-like basal cells in Necturus taste buds. The data do not support (nor rule out) a neurotransmitter role for glutamate or GABA in taste buds.

Development of a computerized database for a nursing quality management program.

There has been little study on how nurse managers collect, store, process and retrieve quality management data, yet nearly every nursing department has an existing program to provide these functions. We investigated our current paper-based system and found several deficiencies. Guided by structured interviews, task analysis, and focus groups we developed a networked computerized quality management database to provide more timely data reporting and consistency of analysis. This paper describes the development and implementation of the system with discussion on how it will be evaluated in the future.

Patient outcomes and nurses' classification data.

The patient classifications done by nurses for all adult patients (n = 15,500) discharged from an urban teaching hospital in one year were retrieved and analyzed by discharge status. Classification results were summarized by physical-functional, psychological-social, and dependence categories and were associated with discharge disposition; patients discharged home were less dependent than others discharged to nursing homes or those who died in the hospital. Diagnosis related group (DRG) payment weights were somewhat independent of the patient classification scores and were not associated with adverse outcomes.

Automating and improving the data quality of a nursing department quality management program at a university hospital.

BACKGROUND: The development and implementation of a relational database program for nursing quality management at a university hospital was stimulated by a lack of consistent data management and analysis tools in the existing noncomputerized program. PROGRAM DEVELOPMENT AND IMPLEMENTATION: An initial software prototype implemented in the critical care service included data collection instruments for five areas: medication errors, patient falls, returns to an intensive care unit within 48 hours, hospital-acquired skin breakdown, and unplanned extubations. Access to the database was limited and paper reports only were disseminated on a scheduled basis. In a second phase, the database is being deployed throughout the nursing department using a local area network. Nurse managers will enter and interact with the quality database online and have access to graphics, reports, and action plan development. POSSIBLE ERRORS: A wide range of potential errors influences decisions on how to collect, store, retrieve, and process quality management data. Each type of error affects the nurse manager's ability to identify significant patterns or trends that are amenable to intervention. There is no right way of constructing and implementing a quality improvement database; only an optimum balance between cost, complexity, and efficacy. SUMMARY AND CONCLUSIONS: Initial feedback from end uses has been positive. A three-year experience with a personal computer database suggests that the personal computer-based information technology is appropriate for small to medium applications and can support departmentwide CQI efforts. A case scenario using simulated data is included to illustrate the use of computerized reports in assessing and taking action on an increase in falls.

Immunocytochemical survey of putative neurotransmitters in taste buds from Necturus maculosus.

To investigate synaptic mechanisms in taste buds and collect information about synaptic transmission in these sensory organs, we have examined taste buds of the mudpuppy, Necturus maculosus for the presence of neurotransmitters and neuromodulators. Immunocytochemical staining at the light microscopic level revealed the presence of serotonin-like and cholecystokinin-like (CCK) immunoreactivity in basal cells in the taste bud. Nerve fibers innervating taste buds were immunoreactive for vasoactive intestinal peptide-like (VIP), substance P-like, and calcitonin gene-related peptide-like (CGRP) or compounds closely related to these substances. Immunoreactivity for tyrosine hydroxylase (TH) and choline acetyltransferase (ChAT) in the taste cells and nerve fibers was absent. These data suggest that serotonin, CCK, VIP, substance P, and CGRP are involved in synaptic transmission or neuromodulation in the peripheral organs of taste. No evidence was found for cholinergic or adrenergic mechanisms on the basis of the absence of immunocytochemical staining for key enzymes involved in these two transmitter systems.

Schools in the welfare network.

This paper examines the place of schools within the welfare network for children and young people, and notes potentially disfunctional elements of the social division of welfare. The stratification between welfare professions and the relationship between normal and crisis care is discussed. Three levels of school based welfare systems are identified, working alongside school attached and community based professions, each with its own characteristics. Trends are identified which reflect the development of more effective multi-professional cooperative care.

Association between hepatobiliary cancer and typhoid carrier state.

A case-control study of deceased typhoid carriers registered by the New York City Health Department between 1922 and 1975 was carried out to test for an association between the typhoid-carrier state and death due to hepatobiliary cancer. 471 carriers were matched with 942 controls for sex, age at death, year of death, borough in which the carrier died, and where they were born. The results show that chronic typhoid carriers die of hepatobiliary cancer six times more often than the matched controls and that this difference is significant (P less than 0.001) by simple chi2 test and by the Mantel-Haenszel method of chi2 for matched triples. Possible mechanisms for this association are discussed.