Pseudechetoxin binds to the pore turret of cyclic nucleotide-gated ion channels.

Peptide toxins are invaluable tools for studying the structure and physiology of ion channels. Pseudechetoxin (PsTx) is the first known peptide toxin that targets cyclic nucleotide-gated (CNG) ion channels, which play a critical role in sensory transduction in the visual and olfactory systems. PsTx inhibited channel currents at low nM concentrations when applied to the extracellular face of membrane patches expressing olfactory CNGA2 subunits.

Estimating selected disease and nonbattle injury Echelon I and Echelon II outpatient visits of United States soldiers and Marines in an operational setting from corresponding Echelon III (hospitalizations) admissions in the same theater of operation.

Currently, disease and nonbattle injury estimates are based on hospital admission logs and not on battalion aid stations nor medical company patient logs. A significant amount of morbidity can be overlooked and can mislead commanders and their staffs into believing that their unit is at a higher strength level. The objective of this article is to provide a tool for estimating these "hidden" disease and nonbattle injury cases.

Implementing a randomized clinical trial on a pediatric psychiatric inpatient unit at a children's hospital: the case of clonidine for post-traumatic stress.

Randomized clinical trials (RCTs) of psychotropic medications are uncommon among child and adolescent populations, and even rarer on pediatric, psychiatric inpatient units. We mention some of these studies, and then discuss the advantages and challenges of conducting a RCT among youngsters on an inpatient psychiatric unit in a pediatric hospital, using as an example our ongoing study of clonidine for intrusive symptoms of post-traumatic stress. Our purpose is to alert potential investigators to the obstacles they may encounter while implementing a RCT, while also pointing the way to potential resources.

Selective termination of anomalous fetuses in multifetal pregnancies: two hundred cases at a single center.

Objective: The objective of this study was to summarize the outcome of 200 selective termination (ST) procedures performed at a single center.

Study Design: Two hundred patients underwent ST at the Mt Sinai Medical Center from 1986 to 2000. The following data were collected for each patient: indication for the ST, gestational age (GA) at the time of the procedure, starting and ending number of fetuses, which fetus(es) underwent ST (presenting vs nonpresenting), and GA at delivery or at spontaneous pregnancy loss less than 24 weeks.

A single center experience with 1000 consecutive cases of multifetal pregnancy reduction.

Objective: Multifetal pregnancy reduction (MPR) is a technique developed to reduce the risks of a multifetal pregnancy. The objective of this article was to report the outcome of MPR in the largest single-center experience to date.

Study Design: A computerized database was used to determine the outcome of 1000 consecutive cases patients undergoing transabdominal MPR between the years 1986 and 1999.

A teaching module: promoting awareness of effective bacterial endocarditis prophylaxis in children.

In an era of declining health care dollars, the preventive aspect of health care is a topical issue worthy of wider attention. Nurses can promote innovative teaching methods to further clients' well-being while meeting their educational needs. Teaching packages for educating the pediatric population, which include the child and his or her caregiver(s), need to be understandable, concise, and logical.

Effects of a milk-based bioactive micronutrient beverage on pain symptoms and activity of adults with osteoarthritis: a double-blind, placebo-controlled clinical evaluation.

Objectives: A 6 wk, double-blind, placebo-controlled study investigated the effects of a nutritional supplement beverage containing milk-based micronutrients and fortified with vitamins and minerals on pain symptoms and activity in adults with osteoarthritis.

Methods: Thirty-one subjects with osteoarthritis of both knees were randomized into two groups and given 12 oz daily of the micronutrient-containing beverage or a placebo for 6 wk. Subjects were instructed not to change their normal activities and diets.

Difficult airway management of a child impaled through the neck.

We report the difficult airway management of a child impaled through the neck by a wooden plant support. The various options are discussed and the involvement of experienced personnel together with a clear preformulated plan of action is stressed.

Distinct ligand-binding modes for integrin alpha(v)beta(3)-mediated adhesion to fibronectin versus vitronectin.

Cell surface integrins can adopt distinct conformations in response to ligand binding and intracellular signals. Several integrins including alpha(v)beta(3) can bind to multiple ligands. The binding of alpha(v)beta(3) to fibronectin and vitronectin was used as a model to determine whether the same or distinct forms of the receptor were utilized in strong binding to the two different ligands.

Activation of alpha(v)beta3-vitronectin binding is a multistage process in which increases in bond strength are dependent on Y747 and Y759 in the cytoplasmic domain of beta3.

Integrin receptors serve as mechanical links between the cell and its structural environment. Using alpha(v)beta3 integrin expressed in K562 cells as a model system, the process by which the mechanical connection between alpha(v)beta3 and vitronectin develops was analyzed by measuring the resistance of these bonds to mechanical separation. Three distinct stages of activation, as defined by increases in the alpha(v)beta3-vitronectin binding strength, were defined by mutational, biochemical, and biomechanical analyses.

Dopexamine hydrochloride does not modify hemodynamic response or tissue oxygenation or gut permeability during abdominal aortic surgery.

Purpose: To assess the effects of intraoperative infusion of dopexamine (a DA-1 and B2 adrenoreceptor agonist) on hemodynamic function, tissue oxygen delivery and consumption, splanchnic perfusion and gut permeability following aortic cross- clamp and release.

Methods: In a randomised double blind controlled trial 24 patients scheduled for elective infrarenal abdominal aortic aneurysm repair were studied in two centres and were assigned to one of two treatment groups. Group I received a dopexamine infusion starting at 0.

Chorionic villus sampling before multifetal pregnancy reduction.

Objective: This study was undertaken to determine the technical feasibility and accuracy of chorionic villus sampling before multifetal pregnancy reduction and to determine whether sampling increases the pregnancy loss rate after the reduction procedure.

Study Design: Between January 22, 1986, and January 20, 2000, a total of 1183 patients underwent first-trimester multifetal pregnancy reduction at Mount Sinai Medical Center. Chorionic villus sampling was attempted in 86 patients before the reduction procedure.

Systematic identification and intervention for reading difficulty: case studies of children with EAL.

Literacy underpins education. There is now very widespread concern over standards of literacy for children from multi-cultural backgrounds, who are learning English as a second or subsequent language, and who may have special educational needs. Research evidence suggests that the earlier children's difficulties can be identified, the more effective (and cost-effective) intervention will be, provided that the intervention is tailored to the child's abilities and skills.

Magma flow instability and cyclic activity at soufriere hills volcano, montserrat, british west indies.

Dome growth at the Soufriere Hills volcano (1996 to 1998) was frequently accompanied by repetitive cycles of earthquakes, ground deformation, degassing, and explosive eruptions. The cycles reflected unsteady conduit flow of volatile-charged magma resulting from gas exsolution, rheological stiffening, and pressurization. The cycles, over hours to days, initiated when degassed stiff magma retarded flow in the upper conduit.

Reduction of distress in children undergoing sexual abuse medical examination.

A participant modeling film to reduce distress in children (5 to 13 years old) undergoing sexual abuse medical examination was tested. Twenty-one children viewing the participant modeling film reported less fear after film viewing and were behaviorally less distressed and more compliant, as rated by nurses and mothers, during gynecological examination than 21 children viewing a nonrelevant film.

The relationship between hospital length of stay and rate of death in heart failure.

Objective: To study the relationship between length of stay (LOS) and the rate of death among patients hospitalized with congestive heart failure (CHF).

Design: A retrospective, observational study.

Setting: Fifteen acute care community hospitals in upstate New York.

Predictors and determinants of hospital length of stay in congestive heart failure in ten community hospitals.

Background: Little is known about the actual determinants of hospital length of stay (LOS) among patients admitted with congestive heart failure (CHF), in spite of its economic impact. To increase understanding of these factors, we examined the demographic, clinical, laboratory, and treatment characteristics of patients hospitalized with decompensated CHF.

Methods: The charts of consecutive patients admitted to 10 acute care community hospitals during 1995 were reviewed.

First-trimester growth restriction and fetal aneuploidy: the effect of type of aneuploidy and gestational age.

Objective: Our purpose was to determine the effect of type of aneuploidy and gestational age on first-trimester fetal growth.

Study Design: Crown-rump length measurement was obtained in pregnancies undergoing chorionic villus sampling in three large prenatal diagnosis centers. One hundred forty-four aneuploid fetuses, from 9 to 13 weeks' gestation, were compared with 440 matched control fetuses for evidence of crown-rump length shortening.