Effect of sertraline on Ca²âº fluxes in rabbit corneal epithelial cells.

The effect of sertraline, a selective serotonin reuptake inhibitor (SSRI), on cytosolic free Ca²âº concentrations ([Ca²âº](i)) in a rabbit corneal epithelial cell line (SIRC) is unclear. This study explored whether sertraline changed basal [Ca²âº](i) levels in suspended SIRC cells by using fura-2 as a Ca²âº-sensitive fluorescent dye. Sertraline at concentrations between 10-100 µM increased [Ca²âº](i) in a concentration-dependent manner. The Ca²âº signal was reduced by 23% by removing extracellular Ca²âº. Sertraline induced Mn²âº influx, leading to quench of fura-2 fluorescence, suggesting Ca²âº influx. This Ca²âº influx was inhibited by phospholipase A2 inhibitor aristolochic acid, but not by store-operated Ca²âº channel blockers and protein kinase C/A modulators. In Ca²âº-free medium, pretreatment with the endoplasmic reticulum Ca²âº pump inhibitor thapsigargin, cyclopiazonic acid or 2,5-di-tert-butylhydroquinone greatly inhibited sertraline-induced Ca²âº release. Inhibition of phospholipase C with U73122 abolished sertraline-induced [Ca²âº](i) rise. At concentrations of 5-50 µM, sertraline killed cells in a concentration-dependent manner. The cytotoxic effect of 25 µM sertraline was not reversed by prechelating cytosolic Ca²âº with BAPTA/AM. Collectively, in SIRC cells, sertraline induced [Ca²âº](i) rises by causing phospholipase C-dependent Ca²âº release from the endoplasmic reticulum and Ca²âº influx via phospholipase A2-sensitive Ca²âº channels. Sertraline-caused cytotoxicity was mediated by Ca²âº-independent pathways.

[Application of telehealth in case management].

Nursing clinical practice has changed dramatically in recent years due to advances in medical science. Increasing medical costs and the rising prevalence of chronic diseases in growing elderly populations have encouraged the development of various new case management care models. The purpose of this study was to introduce the current status and future development of case management and telehealth care as well as to challenge and guide nurses. Rather than turning a blind eye to new developments in information technology, we must use such to help nurses develop individualized and humanized care plans. New technologies can also assist nurses to deliver efficient and effective professional nursing care. Nurse case managers must increase competencies in assessment, critical thinking, evidence-practice, communication and negotiation, cooperation and problem solving. Case managers must practice independently while cooperating with other team members. The case manager is also a vanguard in the application of telehealth care in the nursing profession. Such professionals have a strong potential role to play in the future development of the nursing profession.

Staphylococcal enterotoxin C1-induced pyrogenic cytokine production in human peripheral blood mononuclear cells is mediated by NADPH oxidase and nuclear factor-kappa B.

The staphylococcal enterotoxins produced by Staphylococcus aureus are associated with pyrogenic response in humans and primates. This study investigates the role of NADPH oxidase and nuclear factor-kappa B (NF-kappaB) on enterotoxin staphylococcal enterotoxin C1 (SEC1)-induced pyrogenic cytokine production in human peripheral blood mononuclear cells (PBMC). The results indicate that the febrile response to the supernatant fluids of SEC1-stimulated PBMC in rabbits was in parallel with the levels of interleukin-1beta and interleukin-6 in the supernatants. The release of interleukin-1beta and interleukin-6, nuclear translocation of NF-kappaB and its DNA binding activity in the SEC1-stimulated PBMC were time-dependent and were completely eliminated by pyrrolidine dithiocarbamate or SN-50 (NF-kappaB inhibitors). The release of reactive oxygen species in the supernatants and translocation of the NADPH oxidase p47(phox) subunit to the plasma membrane of SEC1-stimulated PBMC were time-dependent. Administration of apocynin (NADPH oxidase inhibitor) attenuated the febrile response to the supernatants in rabbits and decreased the translocation of NADPH oxidase p47(phox) subunit and NF-kappaB activity in the SEC1-stimulated PBMC, and suppressed reactive oxygen species and pyrogenic cytokine production in the supernatants. Taken together, SEC1 may act through an NADPH oxidase mechanism to release reactive oxygen species, which activate NF-kappaB in PBMC to stimulate the synthesis of pyrogenic cytokines that trigger a fever response in rabbits.