Excessive collagen accumulation in dystrophic (mdx) respiratory musculature is independent of enhanced activation of the NF-kappaB pathway.

Skeletal muscle fibrosis is present in the diaphragm of the mdx mouse, a model for Duchenne dystrophy. In both the mouse and human, dystrophic muscle exhibits pronounced increases in NF-kappa B signaling. Various inhibitors of this pathway, such as pyrrolidine dithiocarbamate (PDTC) and ursodeoxycholic acid (UDCA), have been shown to have beneficial effects on dystrophic (mdx) muscle. The present study characterizes the development of fibrosis in the mdx musculature, and determines the fibrolytic efficacy of PDTC and UDCA. The results indicate that collagen accumulation and the expression of fibrogenic (TGF-beta1) and fibrolytic (MMP-9) mediators are dependent on muscle origin in both nondystrophic and mdx mice. Excessive collagen accumulation is observed in the mdx respiratory musculature prior to substantial muscle degeneration and cellular infiltration, and is associated with dystrophic increases in the expression of TGF-beta1 with no corresponding increases in MMP-9 expression. Treatment with PDTC or UDCA did not influence collagen deposition or TGF-beta1 expression in the mdx respiratory musculature. These results indicate that dystrophic increases in collagen are the result of NF-kappaB-independent signaling abnormalities, and that efforts to reduce excessive collagen accumulation will require treatments to more specifically reduce TGF-beta1 signaling or enhance the expression and/or activity of matrix metalloproteases.

Dissociation between hand motion and population vectors from neural activity in motor cortex.

The population vector hypothesis was introduced almost twenty years ago to illustrate that a population vector constructed from neural activity in primary motor cortex (MI) of non-human primates could predict the direction of hand movement during reaching. Alternative explanations for this population signal have been suggested but could not be tested experimentally owing to movement complexity in the standard reaching model. We re-examined this issue by recording the activity of neurons in contralateral MI of monkeys while they made reaching movements with their right arms oriented in the horizontal plane-where the mechanics of limb motion are measurable and anisotropic. Here we found systematic biases between the population vector and the direction of hand movement. These errors were attributed to a non-uniform distribution of preferred directions of neurons and the non-uniformity covaried with peak joint power at the shoulder and elbow. These observations contradict the population vector hypothesis and show that non-human primates are capable of generating reaching movements to spatial targets even though population vectors based on MI activity do not point in the direction of hand motion.

Expression of an intracisternal A-particle-like element in rat ovary.

We have isolated a rat intracisternal-A particle element (IAP)-like element (IAP-LE) from ovarian granulosa cells that appears to be identical to the rat EST clone AA964260. The compiled cDNA sequences contain several putative in-frame translation initiation codons with the largest capable of encoding a 365 amino acid protein with a reverse transcriptase domain in the N-terminus as well as a bipartite nuclear localization signal sequence in the middle. Northern blotting shows a major approximately 7 Kb transcript and a minor approximately 5 Kb transcript that are abundantly expressed in the ovary. In situ hybridization histochemistry using ovaries from gonadotropin-treated immature rats and regularly cycling adult rats show that this transcript is predominantly localized to granulosa cells of all healthy follicles, including primary follicles, and to newly-formed and healthy corpora lutea. This cell-specific expression pattern of the IAP-LE gene is distinct from those of the several known retroviral elements, suggesting the potentially novel functional importance of the IAP-LE gene. Taken together, our results demonstrate abundant and cell-specific expression of a novel IAP-LE in rat granulosa cells.

The development and testing of the patient record pain management assessment tool.

The article reports a study whose purpose was to develop and test the Patient Record Pain Management Assessment Tool, an instrument to evaluate compliance with the American Pain Society's quality assurance standards on acute pain and cancer pain in chart documentation. Content validity, overall validity, and interrater reliability were all found to be acceptable. The instrument is therefore a useful tool for documenting the level of pain management practice in institutional settings.

The pharmacokinetics of ibuprofen suspension, chewable tablets, and tablets in children with cystic fibrosis.

OBJECTIVES: The objectives of this study were to compare the pharmacokinetic parameters of ibuprofen administered as a suspension, chewable tablet, or tablet in children with cystic fibrosis and to determine the optimal blood sampling times for measuring ibuprofen peak concentrations. STUDY DESIGN: A single oral 20 mg/kg dose of ibuprofen was administered, and blood samples were obtained at 15, 30, 45, 60, 120, 240, and 360 minutes after the dose was administered. Peak plasma concentration (Cmax ), time to peak concentration (Tmax ), and other pharmacokinetic parameters were determined and compared (analysis of variance and analysis of covariance). RESULTS: Thirty-eight children were included (22, 4, and 12 in the suspension, chewable tablet, and tablet groups, respectively). Tmax was the only parameter for which statistical differences were noted (suspension vs tablet, P

Lessons learned in implementing a staff education program in pain management in the acute care setting.

With the release of Acute Pain and Cancer Pain Guidelines from the federal government, many healthcare agencies will be instituting programs to improve pain management. The authors describe a pilot project in acute pain management that did not yield desired results. On the basis of this experience and through a review of the literature, information is provided to staff development educators about problems and issues in planning and executing a program in pain management using structure, process, and outcome as a framework.

Humor won, humor too: a model to incorporate humor into the healthcare setting (revised)

The benefits of using humor in health care include stress reduction and improved psychological well-being for patients and the nursing staff. The authors discuss a model to incorporate humor into a specific healthcare setting, and include a detailed description of two humor programs: the Chuckle Wagon and Nursing Humor Resource Center.

Camp Fresh Horizons: an innovative wellness experience for patients with cancer.

Recognizing that cancer and its treatment can negatively affect many aspects of an individual's functioning, the Western New York Chapter of the Oncology Nursing Society (ONS) designed an outdoor camping experience that allowed patients to refocus their lives, briefly, from disease and treatment to life and living. The camp, Camp Fresh Horizons, incorporated wellness-related activities designed to assist patients toward self-actualization. Twenty-four adults with cancer, 16 of their guests, and approximately 80 volunteers attended the weekend camp, which included indoor and outdoor recreational programs. Informal evaluations indicated that an experience based on wellness may offer improved emotional and physical functioning for people with cancer. This project proved to be a refreshing and different approach to patient- and family-centered support. The authors suggest that this wellness-centered project may be an important patient intervention useful to other ONS chapters.

Humor won, humor too: a model to incorporate humor into the healthcare setting.

The benefits of using humor in health care include stress reduction and improved psychological well-being for patients and the nursing staff. The authors discuss model to incorporate humor into a specific health-care setting, and include a detailed description of two humor programs: the Chuckle Wagon and Nursing Humor Resource Center.

Reducing the incidence of stomatitis using a quality assessment and improvement approach.

Stomatitis occurs in approximately 40% of the patients receiving systemic administration of chemotherapy and cancer treatments such as radiation to the head and neck. The presence of stomatitis affects the course of treatment and a patient's quality of life. An oncology nursing unit developed a quality assessment and improvement indicator addressing stomatitis. Oral cavity screening, dental consultations, oral care techniques, and patient teaching were included in the nursing interventions, which resulted in a marked reduction of new cases of stomatitis.

The effect of continuous low-dose epidural analgesia on uterine work during the active phase of the first stage of labour.

Fifty-six patients admitted to hospital in normal spontaneous labour were given a continuous epidural infusion of 10 ml (12.5 mg) of 0.125% bupivacaine during the 1st stage of labour. Uterine contractions were monitored with an intra-uterine pressure transducer and uterine work expressed both in Alexandria units and the area under the curve of the intra-uterine pressure recording summated over 15 minutes. Variables that have been shown to affect uterine contractions were strictly excluded. Our study showed that continuous low-dose epidural analgesia had no significant effect on uterine work during the active phase of the 1st stage of labour when cervical dilatation was 5 cm or more. If cervical dilatation was between 3 and 4 cm there was a 2.9% reduction. This reduction in uterine work was also not significant and in all patients spontaneously returned to its previous level within 91 minutes.

Salivary calcium, magnesium, phosphate, chloride, sodium and potassium in pregnancy and labour.

Pregnancy and labour produce significant changes in salivary calcium, magnesium, phosphate and chloride when pregnant patients in labour are compared with non-pregnant patients. There is a decrease in concentration of these constituents in the 3rd trimester of pregnancy followed by a marked increase when labour occurs. Magnesium and chloride are the constituents most significantly affected and show the largest increase during labour. Changes in saliva flow rate were accounted for and are not responsible for these changes noted. Sodium and potassium follow a similar pattern. When their levels are corrected for saliva flow rate changes, both show a significant increase with the onset of labour.

Small-bowel obstruction in pregnancy after Scopinaro weight reduction operation. A case report.

A case of small-bowel volvulus occurring during pregnancy after pancreaticobiliary bypass for morbid obesity is presented. The association between pregnancy, previous small-bowel bypass surgery and intestinal volvulus is discussed.