Nurse-managed health centers: safety-net care through advanced nursing practice.

Purpose: To describe the nurse-managed health center (NMHC) as a model for effective health delivery in providing safety-net care to medically underserved populations.

Data Sources: Although the literature regarding outcomes of the model is still building, mounting evidence shows that NMHCs provide quality and cost-effective care to their target populations. The Division of Nursing of the Health Resources and Services Administration has ample data to support the findings that NMHCs are a significant component of the primary healthcare system in providing access particularly for medically underserved and vulnerable populations.

Altered intracellular pH regulation in cells with high levels of P-glycoprotein expression.

P-glycoprotein is an ATP-binding-cassette transporter that pumps many structurally unrelated drugs out of cells through an ATP-dependent mechanism. As a result, multidrug-resistant cells that overexpress P-glycoprotein have reduced intracellular steady-state levels of a variety of chemotherapeutic agents. In addition, increased cytosolic pH has been a frequent finding in multidrug-resistant cells that express P-glycoprotein, and it has been proposed that this consequence of P-glycoprotein expression may contribute to the lower intracellular levels of chemotherapeutic agents.

Brain microvasculature and hypoxia-related proteins in Alzheimer's disease.

Alzheimer's disease (AD) is a progressive, neurodegenerative disease of increasing incidence. The pathologic processes that underlie this disorder are incompletely understood, however, hypoperfusion/hypoxia is thought to contribute to disease pathogenesis. Hypoxia inducible factor 1-alpha (HIF-1α), a key regulator of cellular responses to hypoxia, is elevated in the microcirculation of AD patients.

Steroidogenic acute regulatory protein expression in the central nervous system.

Locally produced neurosteroids are proposed to have many functions in the central nervous system. The identification of the steroidogenic acute regulatory protein in steroid-producing neural cells provides a new tool to understand the sites, regulation, and importance of their synthesis.

Sperm protein 17 is expressed in the sperm fibrous sheath.

Background: Sperm protein 17 (Sp17) is a highly conserved mammalian protein characterized in rabbit, mouse, monkey, baboon, macaque, human testis and spermatozoa. mRNA encoding Sp17 has been detected in a range of murine and human somatic tissues. It was also recognized in two myeloma cell lines and in neoplastic cells from patients with multiple myeloma and ovarian carcinoma.

An evaluation of dapsone gel 5% in the treatment of acne vulgaris.

Background: Oral dapsone has been available for over 60 years. Its first clinical use was discovered in 1945, when it was found to be efficacious in inhibiting the progression of leprosy. The combined antibacterial and anti-inflammatory pharmacologic activities of dapsone have made it a widely investigated drug, particularly for use in refractory and unusual dermatologic conditions.

Regional differences in the temporal expression of non-apoptotic caspase-3-positive bergmann glial cells in the developing rat cerebellum.

Although caspases have been intimately linked to apoptotic events, some of the pro-apoptotic caspases also may regulate differentiation. We previously demonstrated that active caspase-3 is expressed and has an apparent non-apoptotic function during the development of cerebellar Bergmann glia. The current study seeks to further correlate active/cleaved caspase-3 expression with the developmental phenotype of Bergmann glia by examining regional differences in the temporal pattern of expression of cleaved caspase-3 immunoreactivity in lobules of the cerebellar vermis.

Prescribing of Controlled Substances for Non-Patients in the Educational Setting: Review of the Ethical, Legal, and Moral Dilemma for Residents.

Prescription drug abuse is an enormous problem in modern society. Studies have shown that it results in more injuries and deaths to Americans than all illegal drugs combined.1 In this review, the author discusses the prescribing of controlled substances by residents as it relates to intercollegial and other non-patient workplace encounters.

A single proposed algorithm for the surgical treatment of hepatic hemorrhage.

Angiographic embolization safely and effectively controls hemorrhage from the liver. Contrasting algorithms and protocols have, however, created confusion as to how and when to use this procedure. After performing a Medline search, a proposed protocol for the use of angiographic embolization was created.

Construction of a bacterial autoinducer detection system in mammalian cells.

Quorum sensing (QS) is a cell density-dependent signaling system used by bacteria to coordinate gene expression within a population. QS systems in Gram negative bacteria consist of transcription factors of the LuxR family and their acyl homoserine lactone (AHL) ligands. We describe here a method for examining QS signaling systems in mammalian cells that uses engineered LuxR-type proteins from the opportunistic pathogen, Pseudomonas aeruginosa, which can function as AHL-dependent transcription factors.

Acneiform eruption induced by Iressa (gefitinib) tablets used to treat non-small cell lung cancer.

Many medications have been reported to induce acneiform eruptions. A relatively new chemotherapy drug, gefitinib (Iressa), approved by the Food and Drug Administration in 2003 for the treatment of advanced-stage non-small cell lung cancer (NSCLC), has been reported to cause acne or an acne-like eruption. We report an Asian female who presented with hundreds of erythematous papules and pustules on her face, chest, and back, all of which appeared after starting gefitinib to treat non-small cell lung cancer.

New concepts of physiology in obese patients.

According to recent statistical observations, obesity is one of the most common and steadily increasing diseases in the United States, with more than 7.5% of the population suffering from its morbid form. Many different studies have been undertaken with a focus on behavioral, genetic, and epidemiological aspects of this serious health concern, but its etiology and characteristics have not yet been fully defined.

Detection of hCG Responsive Expression of the Steroidogenic Acute Regulatory Protein in Mouse Leydig Cells.

The steroidogenic acute regulatory (StAR) protein, a novel mitochondrial protein, is involved in the regulation of steroid hormone biosynthesis through its mediation of the intramitochondrial transport of the steroid substrate, cholesterol, to the cytochrome P450 cholesterol side chain cleavage (P450scc) enzyme. The expression of StAR protein is regulated by cAMP-dependent signaling in steroidogenic cells. During the course of our studies in mouse Leydig cells, we employ several methods for studying the regulation of StAR protein expression by human chorionic gonadotropin (hCG).

Musculoskeletal infections in adolescents.

Musculoskeletal infections are uncommon disorders in adolescents and represent unique diagnostic and therapeutic challenges to the clinician. The pathogenesis, treatment, and prognosis of many musculoskeletal infections vary markedly in children compared to adults based in part on behavioral differences, bone growth, and changing vascularity patterns. Since adolescents can exhibit manifestations of infection common to either age range, a familiarity with the differences is essential for successful management.

Adolescent infectious disease challenges.

The 20th century brought incredible changes throughout the world and one of the most far-reaching results has been in the arena of public health, which, according to the CDC, means that people now live an average of 30 years longer. Despite these achievements, there are other diseases and health problems to handle. The expansion of world travel has led to increased chances for acquiring rare or exotic diseases.

Psychotropic drugs and falls: new evidence pertaining to serotonin reuptake inhibitors.

Falls are a significant cause of fatal and nonfatal injuries in older persons. Risk factors include previous falls, several disease states, and certain drugs such as tricyclic antidepressants and antihypertensives. We conducted a MEDLINE search from January 1966-March 1999 to identify studies and review articles on the association of neuroleptics, benzodiazepines, and antidepressants with fall risk in older people.

A rapid and simple chemiluminescent assay for Escherichia coli beta-galactosidase.

We describe a chemiluminescent assay for E. coli beta-galactosidase using Lumi-Gal 530, a commercial formulation containing a stable phenylgalactose-substituted dioxetane as the substrate. Removal of the galactose moiety leads to the generation of an unstable dioxetane which decomposes to provide the observed chemiluminescence which is measured with a luminometer.