The primary care specialties working together: a model of success in an academic environment.

In today's environment of decreasing resources and increasing competition among clinical delivery systems, survival and ultimate success require interdisciplinary cooperation and, if possible, integration. Academic leaders at the University of California, Irvine (UCI), have developed a collaborative model in which faculty in family medicine, general internal medicine, and general pediatrics cooperate extensively in education, research, and patient care. Generalist faculty jointly administer and teach both a four-year "doctoring" curriculum for medical students and an array of integrated curricula for primary care residents, including a communication skills course.

Total quality improvement assessment of the EPO co-ordinator role.

Total quality management or total quality improvement has developed and grown from the process of quality assurance. Its main features are, quality is a management led approach, top management participation is essential, it is a concept for preventing mistakes, not finding fault and correcting it. A client centred approach and teamwork are seen as key components.

A nurse-led, unit-based program to reduce restraint use in acute care.

Although the effectiveness of restraints is not proven, the dangers of restraints are clear. Many advocate for the reduction of restraint use in tertiary care settings. The Joint Commission on the Accreditation of Healthcare Organizations is setting the standard by insisting that hospital administrations create a culture that emphasizes restraint reduction.

Influence of southern spiritual beliefs on perceptions of mental illness.

Cultural religious beliefs influence perceptions of mental illness, and any clinician interested in treating mentally ill people and their families must consider these beliefs so that he or she can develop culturally specific interventions. This article reports on the results of interviews with African American experts, mentally ill persons, and nurses caring for the mentally ill. A case study is used to illustrate the influence of southern religious beliefs on perceptions of mental illness and the behaviors of people who are mentally ill.

Location of and post-mortem changes in some cytoskeletal proteins in pork and cod muscle.

The cytoskeletal proteins actin, nebulin, spectrin, desmin, vinculin and talin were labelled immunohistochemically in sections of muscle from commercially available pigs and cod (Gadus morhua) taken pre-rigor and from samples stored for several days. Actin, nebulin and spectrin gave similar labelling patterns in both pork and cod muscle which remained the same in stored samples. Desmin was intensely labelled at the cell boundaries and within the body of the cells in both pork and cod in the initial and the stored samples.

Regulation and function of the interaction between the APC tumour suppressor protein and EB1.

The interaction between the adenomatous polyposis coli (APC) tumour suppressor and the microtubule-associated protein EB1 was examined. Immunoprecipitation suggested that APC and EB1 were not associated in cultures of HCT116 cells arrested in mitosis. The C-terminal 170 amino acids of APC, purified as a bacterial fusion protein, precipitated EB1 from cell extracts, significantly refining the location of the EB1 interaction domain in APC.

Periconception care.

If we are to provide periconception care to all American men and women of reproductive age, we must consider it all "routine visits." For prevention of birth defects, all reproductive-age women should be counseled about folic acid supplementation and rubella immunity. Many clinicians consider risk reduction and anticipatory activities important in periconception care.

Activated mesothelial cells produce heparin-binding growth factors: implications for tumour metastases.

Curative surgery for gastrointestinal malignancy is commonly thwarted by local tumour recurrence. The heparin-binding growth factors, basic fibroblast growth factor (bFGF), heparin-binding epidermal growth factor-like growth factor (HB-EGF) and vascular epidermal growth factor (VEGF) are all implicated in the metastatic process, but whether or not these essential growth factors are produced by the activated peritoneum is unknown. This study reveals that peritoneal mesothelial cells constitutively express mRNA for bFGF, HB-EGF and two VEGF spliced variants, VEGF121 and VEGF165.

Truncated adenomatous polyposis coli (APC) tumour suppressor protein can undergo tyrosine phosphorylation.

Numerous mutations in the adenomatous polyposis coli (APC) gene have been described in colorectal cancer. The vast majority introduce nonsense codons leading to the production of truncated N-terminal APC fragments. Mutations occurring before APC codon 158, have been associated with an attenuated form of familial adenomatous polyposis whereas those occurring at codon 168 or beyond lead to the characteristic form of the disease.

Processing of procorticotropin-releasing hormone (pro-CRH): molecular forms of CRH in normal and preeclamptic pregnancy.

This study examined the different molecular forms of CRH in normal and preeclampsia maternal plasma and protease-blocked placental extracts using antibodies to different regions of the CRH precursor, pro-CRH. In the absence of protease inhibitors, chromatographed normal placental extracts contained four peaks of immunoreactivity corresponding to unprocessed approximately 19-kDa pro-CRH, its approximately 8-kDa intermediate metabolite, pro-CRH125-194, its approximately 2.8-kDa midportion fragment, pro-CRH125-151, and 4.

Genetic liver disease in adults. Early recognition of the three most common causes.

The most common clinically important genetic diseases leading to liver dysfunction in adults are Wilson's disease, HHC, and alpha 1AT deficiency. Advances in molecular biology have led to the identification and characterization of the genetic defects in these conditions. Consequently, genetic testing for disease-causing mutations is now available for most of these disorders.

Some clinical factors contributing to the development of the diabetic foot.

Clinical neurological studies, blood pressure measurements and some haematological investigations were performed on a random sample of forty-four patients, at the Diabetes Out-Patient Clinic of the University Hospital of the West Indies (UHWI), to examine some of the factors that predispose to the development of the diabetic foot. Our results revealed that 86% of the patients had elevated glycosylated haemoglobin (HbA1 > 9.0%), 82% had clinical signs of peripheral sensory neuropathy, 29% had signs of autonomic neuropathy in addition to peripheral sensory neuropathy.

Yesterday a learner, today a teacher too: residents as teachers in 2000.

Resident physicians spend numerous hours every week teaching medical students and fellow residents, and only rarely are they taught how to teach. They can, however, be taught to teach more effectively. Teaching skills improvement initiatives for residents are taking a more prominent place in the educational literature.

EB1, a protein which interacts with the APC tumour suppressor, is associated with the microtubule cytoskeleton throughout the cell cycle.

The characteristics of the adenomatous polyposis coli (APC) associated protein EB1 were examined in mammalian cells. By immunocytochemistry EB1 was shown to be closely associated with the microtubule cytoskeleton throughout the cell cycle. In interphase cells EB1 was associated with microtubules along their full length but was often particularly concentrated at their tips.

Erroneous beliefs about research held by staff nurses.

Background: Experiences in working with nurses conducting research in clinical settings have uncovered a number of beliefs that may create unnecessary obstacles and limit research efforts. This article discusses these beliefs and provides examples.

Method: Although this article was not conceptualized as a research study, the information was gleaned through working with nurses on a day-to-day basis as a researcher.

Development of a multi-item scale to quantitatively assess sexual behaviors and the transmission of high- and low-risk human papillomaviruses.

Background: Epidemiologic research is frequently hindered by the inherent difficulty in quantifying the risk of sexually transmitted disease (STD) acquisition associated with individual patterns of sexual behavior.

Goal Of The Study: To develop a quantitative sexual behavior risk scale and demonstrate its predictive validity in an assessment of risk factors for incident infection with human papillomaviruses (HPVs).

Study Design: Data from a prospective study of HPV infection in female university students was used to generate quantitative multi-item sexual behavior scales which were used in Cox regression analyses.

Common peripartum emergencies.

Peripartum emergencies occur in patients with no known risk factors. When the well-being of the fetus is in question, the fetal heart rate pattern may offer etiologic clues. Repetitive late decelerations may signify uteroplacental insufficiency, and a sinusoidal pattern may indicate severe fetal distress.

Differences in the intracellular localization and fate of herpes simplex virus tegument proteins early in the infection of Vero cells.

The fate of herpes simplex virus 1 (HSV-1) tegument proteins during infection in Vero cells was investigated immunochemically. Input virion-associated VP13/14 and VP16 localized to the nucleus early in infection, while VP1/2 localized to the nuclear envelope of the cell and VP22 could not be detected using monoclonal antibody P43. Western blotting suggested that virion-associated VP13/14, VP16 and VP22 were stable in infected cells whereas VP1/2 appeared to be processed or modified.

Intracellular retention of the corticotrophin-releasing hormone (CRH) precursor within COS-7 cells.

We investigated the intracellular localization of CRH in transiently transfected COS-7 cells expressing the full-length rat corticotropin-releasing hormone (CRH) precursor cDNA. CRH synthesized by transfected COS-7 cells is mainly stored intracellularly. In contrast, CHO-K1 cells expressing the same CRH precursor stored and released equal amounts of immunoreactive (IR)-CRH.

The effects of guided bone regeneration and grafting on implants placed into immediate extraction sockets. An experimental study in dogs.

Guided bone regeneration (gbr) for the treatment of insufficient bone volume around implants can be performed using membranes with or without grafting materials (i.e., autogenous, allogenous, xenogenous, or alloplastic grafts).

Immunolocalisation of intermediate filament proteins in porcine meat. Fibre type and muscle-specific variations during conditioning.

Two intermediate filament proteins, desmin and vinculin, were immunofluorescently localised in porcine longissimus dorsi(∗∗) and iliocostalis muscles up to 7 days post mortem. Changes in tenderness of the m. longissimus and the water-holding capacity of both muscles were also monitored throughout this storage period.

Phosphorylation of structural components promotes dissociation of the herpes simplex virus type 1 tegument.

The role of phosphorylation in the dissociation of structural components of the herpes simplex virus type 1 (HSV-1) tegument was investigated, using an in vitro assay. Addition of physiological concentrations of ATP and magnesium to wild-type virions in the presence of detergent promoted the release of VP13/14 and VP22. VP1/2 and the UL13 protein kinase were not significantly solubilized.