pH-Dependent Conformations of an Antimicrobial Spider Venom Peptide, Cupiennin 1a, from Unbiased HREMD Simulations.

Cupiennin 1a is an antimicrobial peptide found in the venom of the spider . A highly cationic peptide, its cell lysis activity has been found to vary between neutral and charged membranes. In this study, Hamiltonian replica-exchange molecular dynamics (HREMD) was used to determine the conformational ensemble of the peptide in both charged (pH 3) and neutral (pH 11) states.

Evidence-based practice and patient-centered care: Doing both well.

Background: Health care organizations increasingly strive to deliver care that is both evidence based and patient centered. Although often complementary, fundamental contradictions may exist between these goals, and the organizational culture and infrastructure necessary to be successful in one domain may inherently diminish performance in the other.

Purpose: We assessed the relationship between evidence-based practice (EBP) and patient-centered care (PCC) by seeking to identify specific behavioral and process mechanisms, along with organizational characteristics that distinguish medical centers that are able to provide inpatient care that is both evidence based and patient centered from those where performance is either mixed or low in both domains.

Understanding collaborative care implementation in the Department of Veterans Affairs: core functions and implementation challenges.

Background: The collaborative care model is an evidence-based practice for treatment of depression in which designated care managers provide clinical services, often by telephone. However, the collaborative care model is infrequently adopted in the Department of Veterans Affairs (VA). Almost all VA medical centers have adopted a co-located or embedded approach to integrating mental health care for primary care patients.

Patient navigation: development of a protocol for describing what navigators do.

Objective: To develop a structured protocol for observing patient navigators at work, describing and characterizing specific activities related to their goals.

Data Sources/setting: Fourteen extended observations of navigators at three programs within a national trial of patient navigation.

Study Design: Preliminary observations were guided by a conceptual model derived from the literature and expert consensus, then coded to develop and refine observation categories.

Crafting a melanoma educational campaign to reach middle-aged and older men.

Background: From 1973 through 2002, melanoma mortality rates have risen steeply in middle-aged and older men. Men's higher mortality rate from melanoma is hardly an isolated example of the ways in which men's health lags behind women's health. Given the significantly higher melanoma mortality rates of men compared with women, there is now a need for a melanoma education program targeted to middle-aged and older men and their closest contacts, including spouses, significant others, and health care professionals.

Baclofen in the treatment of detrusor-sphincter dyssynergia in spinal cord injury patients.

The pharmacodynamics of baclofen on the bladder and urethral sphincters in acute and chronic spinal cord injury male patients were evaluated. A total of 100 supine and sitting urodynamic profiles was done in 25 patients. Baclofen decreased external urethral sphincter resistance by depressing pudendal-to-pudendal nerve reflex through spinal cord presynaptic hyperpolarization.

Effects of transcutaneous nerve stimulation on the vesicourethral function in spinal cord injury patients.

There were 17 spinal cord injury men with drug-resistant pain who were treated with transcutaneous nerve stimulation. Bladder and sphincter dysfunctions were evaluated by gas cystosphincterometry and rectal sphinctero-electromyography with the patient in 2 different positions. With the use of transcutaneous nerve stimulation for pain we noted no demonstrable urodynamic changes in acute and chronic paraplegics and chronic quadriplegics.

Effects of bethanechol chloride on the external urethral sphincter in spinal cord injury patients.

The neuropharmacodynamics of bethanechol chloride on the external urethral sphincter in male spinal cord injury patients with chronic lesions have been investigated. There were 90 cystosphincterometric and sphincteroperineal electromyographic studies conducted on 45 subjects in 4 different positions, showing varying urodynamic patterns. A gross postural cystophincteric discordant reflex was noted in the majority of patients with recent complete upper motor neuron bladders (less than 2 years in duration).

Extratesticular lipoma: report of 2 cases and a new classification.

We report 2 cases of intrascrotal extratesticular lipoma and propose a new classification. If the possible anatomic sites of origin and the histology of this neoplasm are considered during dissection the tumor can be excised without unnecessary orchiectomy when the blood supply of the testicle can be preserved.