Mechanistic involvement of noradrenergic neuronal neurotransmitter release in cutaneous vasoconstriction during autonomic dysreflexia in persons with spinal cord injury.

Introduction: Autonomic dysreflexia (AD) is a potentially life-threatening consequence in high (above T6) spinal cord injury that involves multiple incompletely understood mechanisms. While peripheral arteriolar vasoconstriction, which controls systemic vascular resistance, is documented to be pronounced during AD, the pathophysiological neurovascular junction mechanisms of this vasoconstriction are undefined. One hypothesized mechanism is increased neuronal release of norepinephrine and co-transmitters.

Are Thermoregulatory Sweating and Active Vasodilation in Skin Controlled by Separate Nerves During Passive Heat Stress in Persons With Spinal Cord Injury?

Background: Sudomotor responses (SR) and active vasodilation (AVD) are the primary means of heat dissipation during passive heat stress (PHS). It is unknown if they are controlled by a single or separate set of nerves. Older qualitative studies suggest that persons with spinal cord injury (SCI) have discordant areas of sweating and vasodilation.

Restoring mitochondrial superoxide levels with elamipretide (MTP-131) protects mice against progression of diabetic kidney disease.

Exposure to chronic hyperglycemia because of diabetes mellitus can lead to development and progression of diabetic kidney disease (DKD). We recently reported that reduced superoxide production is associated with mitochondrial dysfunction in the kidneys of mouse models of type 1 DKD. We also demonstrated that humans with DKD have significantly reduced levels of mitochondrion-derived metabolites in their urine.

C3HeB/FeJ Mice mimic many aspects of gene expression and pathobiological features of human hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) remains a deadly cancer, underscoring the need for relevant preclinical models. Male C3HeB/FeJ mice model spontaneous HCC with some hepatocarcinogenesis susceptibility loci corresponding to syntenic regions of human chromosomes altered in HCC. We tested other properties of C3HeB/FeJ tumors for similarity to human HCC.

Effectiveness of an Antimicrobial Stewardship Approach for Urinary Catheter-Associated Asymptomatic Bacteriuria.

Importance: Overtreatment of asymptomatic bacteriuria (ASB) in patients with urinary catheters remains high. Health care professionals have difficulty differentiating cases of ASB from catheter-associated urinary tract infections.

Objectives: To evaluate the effectiveness and sustainability of an intervention to reduce urine culture ordering and antimicrobial prescribing for catheter-associated ASB compared with standard quality improvement methods.

Variations in pharmacology of beta-blockers may contribute to heterogeneous results in trials of perioperative beta-blockade.

Background: Randomized controlled trials and meta-analyses provide conflicting guidance on the role of beta-adrenergic receptor blockers (beta-blockers) in reducing perioperative complications. We hypothesize that variability in trial results may be due in part to heterogeneous properties of beta-blockers. First, we propose that the extent of beta-blocker metabolism by cytochrome P-450 and the time available to titrate the dosage before surgery (titration time) may interact; dependence on P-450 may be most harmful when titration time is short.

Expression of bone morphogenetic protein-7 mRNA in normal and ischemic adult rat kidney.

BMP-7, a member of the bone morphogenic protein subfamily (BMPs) of the transforming growth factor-beta superfamily of secreted growth factors, is abundantly expressed in the fetal kidney. The precise role of this protein in renal physiology or pathology is unknown. A cDNA that encodes rat BMP-7 was cloned and used as a probe to localize BMP-7 mRNA expression by in situ hybridization in the adult rat kidney.

Shiga toxin 1 elicits diverse biologic responses in mesangial cells.

Background: Shiga toxin 1 (Stx1) is a causative agent in hemolytic uremic syndrome (HUS). Its receptor, the glycosphingolipid globotriaosylceramide (Gb3), is expressed on cultured human endothelial and mesangial cells. Mesangial cell injury in HUS ranges from mild cellular edema to severe mesangiolysis and eventual glomerulosclerosis.

Cross-cultural adaptation of the hearing handicap inventory for the Elderly-Screening Version (HHIE-S) for use with Spanish-speaking Mexican Americans.

Objective: To cross-culturally adapt the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) for use with older Spanish-speaking Mexican Americans.

Subjects And Setting: Two different samples were used. First, a convenience sample of 100 older community-dwelling Mexican American men and women in San Antonio, Texas, was used to test technical equivalence of the Spanish and English language versions of the HHIE-S.

Overview of the management of AIDS-related Kaposi's sarcoma.

Objective: To review the epidemiology, pathogenesis, clinical presentation, diagnosis, and staging of Kaposi's sarcoma (KS), as well as the current role of local and systemic therapies in the management of AIDS-related KS (AIDS-KS).

Data Sources And Study Selection: MEDLINE and CANCERLIT searches of the English-language medical literature were conducted. Emphasis was placed on studies published since the onset of the AIDS epidemic in the early 1980s.

Case-finding instruments for depression in primary care settings.

Objective: To evaluate the usefulness of case-finding instruments for identifying patients with major depression in primary care settings.

Data Sources: A MEDLINE search of the English-language medical literature; bibliographies of selected papers; and experts.

Study Selection: Studies that were done in primary care settings with unselected patients and that compared case-finding instruments with accepted diagnostic criterion standards for major depression were selected.

Depressive disorders in primary care: prevalence, functional disability, and identification.

Objectives: To assess the relative prevalence of subsyndromal depression (SubD) and major depression (MDD) in primary care patients and describe their associated functional impairments, and to define the operating characteristics of a short depression screen (SDS).

Setting: Three primary care clinics: a university-affiliated Veterans Affairs clinic, a county general internal medicine clinic, and a community health center.

Subjects: Randomly selected adult patients (n = 221), aged > or = 30 years, with no history of psychiatric comorbidity, current substance abuse, major depressive disorder, chronic pain disorder, or dementia.

Health care reform from the view of a geriatrician.

In an ideal world, all citizens would receive high-quality health care, all services which are appropriate and necessary, in the setting that can best meet the patients' needs and preferences. The frail, dependent, chronically ill person has been considered an outlier by third party payment systems, including Medicare, the health care system designed for the elderly. Physician payment systems have penalized those who care for the frail, resulting in an inadequate medical workforce to care for the elderly.

The Sickness Impact Profile for nursing homes (SIP-NH).

Background: Valid, feasible measures of functional status are needed to evaluate the expanding nursing home population. This study attempts to increase relevance and reduce respondent burden of the Sickness Impact Profile (SIP) for nursing home residents while maintaining internal consistency and validity.

Methods: 231 residents from one academic and four community nursing homes, aged > or = 60 with a Mini-Mental State Exam score > or = 11, were study participants.

Physical therapy assessment and treatment protocol for nursing home residents.

This article describes a standard protocol for assessing physical function in elderly nursing home residents. Major physical dimensions that are measured with the protocol include range of motion, muscle force, muscle reflex activity, sensation, soft tissue status, balance/coordination, and posture. A practical, functionally prioritized treatment model based on the assessment is also presented.