Reticence to prescribe: utilization of expedited partner therapy among obstetrics providers in Arizona.

Expedited partner therapy (EPT) is the practice of providing an extra dose or prescription of antibiotic to patients diagnosed with chlamydia or gonorrhoea to deliver to their sexual partner(s). Obstetrical providers who delivered more than 20 infants in Maricopa County, Arizona, USA, during the year 2008 were surveyed by telephone regarding their use of EPT. A total of 142 eligible respondents completed the survey, representing 34% (142/421) of the delivering providers, 67 (47%) of whom reported the use of EPT in their clinics. Having received information about EPT was significantly associated with its use (67% versus 41%) (P = 0.008). The most common reasons for not using EPT included the inability to obtain allergy history in partners (24%) and concern for liability (11%). Additional education regarding the use of EPT may increase the use of this personal and public health tool among some obstetrics providers in Maricopa County; however, concerns for liability may limit broad utilization.

The Npc1 mutation causes an altered expression of caveolin-1, annexin II and protein kinases and phosphorylation of caveolin-1 and annexin II in murine livers.

We have previously demonstrated (1) an increased expression of caveolin-1 in murine heterozygous and homozygous Niemann-Pick type C (NPC) livers, and (2) an increased concentration of unesterified cholesterol in a detergent insoluble caveolae-enriched fraction from homozygous livers. To define further the relationship between caveolin-1 function and the cholesterol trafficking defect in NPC, we examined the expression and distribution of additional caveolar and signal transduction proteins. The expression of annexin II was significantly increased in homozygous liver homogenates and the Triton X-100 insoluble floating fraction (TIFF). Phosphoamino acid analysis of caveolin-1 and annexin II from the homozygous TIFF demonstrated an increase in serine and tyrosine phosphorylation, respectively. To determine the basis for increased phosphorylation of these proteins, the expression and distribution of several protein kinases was examined. The expression of PKCalpha, PKCzeta and pp60-src (protein kinases) were significantly increased in both heterozygous and homozygous liver homogenates, while PKCdelta was increased only in homozygous livers. Of the protein kinases analyzed, only CK IIalpha was significantly enriched in the heterozygous TIFF. Finally, the concentration of diacylglycerol in the homozygous TIFF was significantly increased and this elevation may modulate PKC distribution and function. These results provide additional evidence for involvement of a caveolin-1 containing cellular fraction in the pathophysiology of NPC and also suggest that the Npc1 gene product may directly or indirectly, regulate the expression and distribution of signaling molecules.