Reducing Inappropriate Antibiotics for Urinary Tract Infections in Long-Term Care: A Replication Study.

Background: Nursing home providers face challenges in urinary tract infection assessment and treatment, often prescribing unnecessary antibiotics for asymptomatic bacteriuria, a practice that can result in adverse drug reactions, drug resistance, and an increase in antibiotic-associated diarrhea.

Purpose: The purpose of this project was to replicate the Cooper Urinary Tract Infection Program in another facility and measure its effectiveness.

Methods: Using a pre-post design, this project was implemented at a 120-bed, long-term care and rehabilitation facility located in the Midwest United States.

Successful interventions for smoking cessation in pregnancy.

The purpose of this article is to evaluate research regarding beneficial approaches to smoking cessation interventions during pregnancy. Research about nicotine replacement, nurse-managed counseling sessions, hypnosis, and behavioral modifications are presented. One of the most useful types of program for smoking cessation in pregnancy (as measured by cotinine-validated abstinence) described in the literature thus far has been the nurse-managed smoking cessation program, which includes a 15-minute individualized counseling session combined with a telephone contact 7-10 days after the prenatal visit.

Metabolic reduction of chromium as a threshold mechanism limiting its in vivo activity.

Various mechanisms tend to reduce hexavalent chromium (Cr(VI] in the organism, both outside and inside target cells. A reducing activity has been demonstrated in the blood (mainly in erythrocytes), in secretions of the alimentary tract (saliva, gastric juice) and in the lumen of terminal airways (epithelial-lining fluid and alveolar macrophages). Preparations of several types of cells from various animal species--including human liver, lung parenchyma and bronchial tree cells--are capable of metabolically reducing Cr(VI) to a variable extent.

Metabolic reduction of chromium by alveolar macrophages and its relationships to cigarette smoke.

Pulmonary alveolar macrophages (PAM), obtained by bronchoalveolar lavage from 47 individuals, reduced hexavalent chromium [Cr(VI)] and decreased its mutagenicity. Their specific activity--mostly mediated by cytosolic, enzyme-catalyzed mechanisms--was significantly higher than in corresponding preparations of mixed-cell populations from human peripheral lung parenchyma or bronchial tree, or from rat lung or liver. At equivalent number of PAM, Cr(VI) reduction, total protein, and some oxidoreductase activities were significantly increased in smokers.

Specificity and inducibility of the metabolic reduction of chromium(VI) mutagenicity by subcellular fractions of rat tissues.

The mutagenicity of sodium dichromate in the Ames test was decreased as a consequence of chromium(VI) reduction by tissue postmitochondrial (S-9 or S-12) fractions from untreated rats with the following rank of efficiency: liver; kidney; and lung. The effects of lung preparations were significantly enhanced following the intratracheal administration of high doses (0.25 mg/kg) of dichromate itself, 5 times per week for 4 weeks (i.