The LysR-type transcriptional regulator VirR is required for expression of the virulence gene vapA of Rhodococcus equi ATCC 33701.

The virulence of the intracellular pathogen Rhodococcus equi in foals is dependent on the presence of an 81-kb virulence plasmid encoding the virulence protein VapA. Expression of this protein is induced by exposure to oxidative stress, high temperatures, and low pHs, which reflect the conditions encountered by R. equi when it enters the host environment.

The burden of atopy and asthma in children.

Background: There has been a world-wide increase in the prevalence of atopic diseases. These atopic diseases, including asthma, allergic rhinoconjunctivitis and atopic eczema/dermatitis, are common in childhood and create a challenge of management for physicians and parents.

Methods: MEDLINE was searched for articles related to atopy, allergy asthma, allergic rhinoconjunctivitis and atopic eczema/dermatitis.

Review of the unique properties of budesonide.

Background: The aim of inhaled corticosteroid (ICS) therapy for asthma is to attain high therapeutic activity in the airways while keeping the risk of systemic adverse effects relatively low. However, the physicochemical and pharmacokinetic properties of various ICSs affect this ratio, thereby influencing their ability to fulfill the requirements of an ideal agent.

Objective: This article reviews the physical and pharmacokinetic properties of budesonide, outlining how they, safety data, and use of different inhalation devices enable budesonide to meet many of the clinical requirements of an ideal ICS for the treatment of asthma.

Disordered verbalizations in schizophrenia: a speech disturbance or thought disorder?

This research provides empirical data relevant to the long-standing theoretical issue of whether disordered speech in schizophrenia should be viewed as a speech disturbance or a thought disorder. The study analyzed whether schizophrenia patients with disordered speech on one test also show strange nonverbal behavior and unrealistic ideas on other assessments. One hundred eighty-four patients, including 55 schizophrenia patients, were assessed at the acute phase and followed up twice, over 4.

Federal CAT policy: politics and practice.

The critical care nurse encounters a patient in a setting that is charged with overt physiologic needs that are addressed by an array of healthcare providers in a setting dominated by covert political dynamics. Understanding these dynamics can empower critical care nurses to create a voice of agency to advocate disciplinary nursing concerns. Policy skills enable nurses to participate in meaningful ways in the policy process.

Pediatric allergy: a brief review of risk factors associated with developing allergic disease in childhood.

Objective: To briefly review some of the factors that have been implicated in the causation of the increased prevalence of allergic disease in children.

Data Sources: MEDLINE search of original research and review articles related to the various risk factors considered responsible for the increased prevalence of allergic disease in children.

Study Selection: Author selected references.

Efficacy of budesonide in moderate to severe asthma.

Background: The worldwide prevalence of asthma is increasing by approximately 50% per decade. Budesonide is one of several inhaled corticosteroids available for the treatment of asthma and has been extensively evaluated in clinical trials.

Objective: This article reviews the published literature on the efficacy of budesonide in the management of adult and pediatric patients with moderate to severe asthma and compares budesonide with other inhaled corticosteroids and nonsteroidal treatment options.

School attendance and school performance: a population-based study of children with asthma.

Objective: To analyze school attendance and school achievement as outcomes of the care of children with asthma.

Methods: A previously identified Rochester, Minnesota, cohort of children with asthma and age- and sex-matched children without asthma were studied. School attendance, standardized achievement test scores, grade point average, grade promotion, and class rank of graduating students for children with asthma and control subjects were obtained from the Rochester Public School system.

Women at mid-life: symptoms, attitudes, and choices, an internet based survey.

Objectives: This Internet-based survey questioned middle-aged women (age 35-69) regarding their current attitudes, beliefs, symptoms, and treatment choices surrounding the climacteric.

Methods: 448 respondents completed the 189 item, WEB-based survey that included measures of quality of life, lifestyle habits, anxiety symptoms, and questions regarding attitude toward and sources of information about menopause.

Results: Three relationships were hypothesized and supported: frequency of self-reported menopause symptoms would be: (1) negatively associated with healthy behaviors; (2) positively associated with anxiety; (3) positively associated with stress.

A knowledge-based patient assessment system: conceptual and technical design.

This paper describes the design of an inpatient patient assessment application that captures nursing assessment data using a wireless laptop computer. The primary aim of this system is to capture structured information for facilitating decision support and quality monitoring. The system also aims to improve efficiency of recording patient assessments, reduce costs, and improve discharge planning and early identification of patient learning needs.

Nebulized lidocaine in the treatment of severe asthma in children: a pilot study.

Background: Glucocorticoids have been used to treat asthma since the 1950s; however, their adverse systemic effects have limited their duration of use and dosage. Unfortunately, many patients with severe asthma often require oral glucocorticoids in addition to inhaled glucocorticoids. Alternatives to glucocorticoids have been sought with mixed success.

Modifiable templates facilitate customization of physician order entry.

Physician order entry is a key factor in improving the quality of healthcare, while simultaneously reducing its cost. This paper describes an editor, a database, and a run-time system for creating and executing highly customized, user modifiable, order entry templates. The system allows non-programmers to create new order entry templates rapidly.

Anti-inflammatory drugs for controlling asthma.

Anti-inflammatory agents are the first-line treatment for controlling mild persistent, moderate persistent, and severe persistent asthma. The choice of drug and dosage must be individualized to the patient. In general, the glucocorticoids are widely accepted as the most potent and preferred asthma treatment in most adults and some children.

Volumetric assessment of airborne pollen and spore levels in Rochester, Minnesota, 1992 through 1995.

Objective: To reassess airborne pollen counts and to study spore counts by volumetric collection in Rochester, Minnesota.

Material And Methods: Samples of pollen and spores were collected from the top of a six-story building in downtown Rochester by use of a rotational rod sampler, which was activated for 30 seconds every 10 minutes for 24 hours a day, 5 days a week, from mid-April to mid-October 1992 through 1995. Particles were stained with Calberla's fluid and viewed microscopically by transmitted light.

Functional respiratory disorders.

Learning Objectives: Reading this article will enable health care providers to recognize and to diagnose paroxysmal sneezing, sighing dyspnea, habit cough, and vocal cord dysfunction and to reinforce their knowledge of the epidemiology, etiopathology, clinical features, and treatment of these disorders.

Data Sources: The literature was reviewed using a MEDLINE search for information relating to the above-mentioned disorders. Indexing terms used included psychogenic wheezing, vocal cord dysfunction, functional respiratory disorders, sighing dyspnea, paroxysmal sneezing, habit cough, and psychogenic stridor.

Familial interstitial lung disease in children: response to chloroquine treatment in one sibling with desquamative interstitial pneumonitis.

We describe a male infant with biopsy-confirmed interstitial lung disease (ILD) who responded to chloroquine, after he failed to improve on oral corticosteroids or cyclophosphamide. The infant presented at 8 days of age with respiratory distress and cyanosis. Lung biopsy at 8 weeks of age was consistent with desquamative interstitial pneumonitis (DIP).

Expression of IFN regulatory factor family proteins in lymphocytes. Induction of Stat-1 and IFN consensus sequence binding protein expression by T cell activation.

Interferon consensus sequence binding protein (ICSBP) is a transcription factor of the IFN regulatory factor (IRF) family. Evidence indicates that this family has a function in the immune system. Unlike other members of the family, ICSBP is expressed exclusively in the immune system.

A comprehensive inpatient discharge system.

Our group has developed a computer system that supports all phases of the inpatient discharge process. The system fills in most of the physician's discharge order form and the nurse's discharge abstract, using information available from sign-out, order entry, scheduling, and other databases. It supplies information for referrals to outside institutions, and provides a variety of instruction materials for patients.

An information system to improve the safety and efficiency of chemotherapy ordering.

We developed a computer application to support the ordering of chemotherapy. Key goals were to guard against errors in chemotherapy ordering and dosing, to, coordinate the outpatient and inpatient chemotherapy services, and to support the overall process flow of a chemotherapy cycle. In a six-month period, 512 daily-dose and 386 weekly-dose warnings were generated; 167 (19%) resulted in a cancellation or re-evaluation of the dose.

Clinical evaluation of asthma.

Objective: The purpose of this article is to review the medical history and physical examination of the asthmatic patient.

Data Sources: English references identified from relevant articles and book chapters, experts, and MEDLINE search, using "asthma," "physical diagnosis," and "medical history."

Study Selection: Clinical studies of the medical history or physical examination in subjects with respiratory disease were selected for review.

Evidence for lineage commitment and initiation of positive selection by thymocytes with intermediate surface phenotypes.

Previous studies have shown that both MHC class I and class II molecules can stimulate CD4+CD8+ thymocytes to develop into TCRint cells with surface phenotypes, suggesting initial differentiation along either the CD4 or CD8 developmental pathways. In accord with the view that these cells have undergone lineage commitment, we show here that CD4intTCRint cells generated by recognition of either MHC class show the same partial down-regulation of CD8 from the level on precursor double positive thymocytes as do almost mature CD4intTCRhigh cells positively selected only by MHC class I recognition. As expected of cells undergoing positive selection, we find that either class I or class II MHC molecules on radioresistant thymic stromal cells alone are sufficient for generation of both types of transitional phenotype cells.

Enhancement of clinician workflow with computer order entry.

Physician-operated order entry systems can bring great benefits to an institution. Such systems can improve the consistency, accuracy, safety, and cost-effectiveness of orders. When building or selecting order entry for an institution, consideration must be given to the many different scenarios in which orders are written and communicated.

Long-term survival of a cohort of community residents with asthma.

Background: Reports of an increase in asthma-related mortality have been based on studies of death certificates from the general U.S. population on which asthma was listed as an underlying cause of death.

Characterization of cDNAs encoding the murine interleukin 2 receptor (IL-2R) gamma chain: chromosomal mapping and tissue specificity of IL-2R gamma chain expression.

The IL-2R gamma chain (IL-2R gamma) is an essential component of high- and intermediate-affinity IL-2Rs, playing critical roles for ligand binding and internalization. Recently, our laboratory has demonstrated that IL-2R gamma mutation results in X chromosome-linked severe combined immunodeficiency in humans, suggesting that IL-2R gamma plays a vital role in thymic maturation of human T cells. We now report the isolation and characterization of cDNAs encoding murine IL-2R gamma.