Acute Manipulations of Clathrin-Mediated Endocytosis at Presynaptic Nerve Terminals.

Acute perturbations of clathrin and associated proteins at synapses have provided a wealth of knowledge on the molecular mechanisms underlying clathrin-mediated endocytosis (CME). The basic approach entails presynaptic microinjection of an inhibitory reagent targeted to the CME pathway, followed by a detailed ultrastructural analysis to identify how the perturbation affects the number and distribution of synaptic vesicles, plasma membrane, clathrin-coated pits, and clathrin-coated vesicles. This chapter describes the methodology for acutely perturbing CME at the lamprey giant reticulospinal synapse, a model vertebrate synapse that has been instrumental for identifying key protein-protein interactions that regulate CME in presynaptic nerve terminals with broader extension to nonneuronal cell types.

Feasibility of Using an Arm Weight-Supported Training System to Improve Hand Function Skills in Children With Hemiplegia.

Objective: This investigation was a pilot feasibility trial evaluating the use of an arm-weight-supported training device to improve upper-extremity function in children with hemiplegia.

Method: A single-group within-subject design was used. Participants were 6 children ages 7-17 yr with upper-extremity weakness secondary to hemiplegia.

Identifying Targets for Improving Mental Healthcare of Adolescents with Systemic Lupus Erythematosus: Perspectives from Pediatric Rheumatology Clinicians in the United States and Canada.

Objective: To identify targets for improving mental healthcare of adolescents with systemic lupus erythematosus (SLE) by assessing current practices and perceived barriers for mental health intervention by pediatric rheumatology clinicians.

Methods: Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed a Web-based survey assessing current mental health practices, beliefs, and barriers. We examined associations between provider characteristics and the frequency of barriers to mental health screening and treatment using multivariable linear regression.

Treatment of early non-response in patients with schizophrenia: assessing the efficacy of antipsychotic dose escalation.

Background: Early non-response to antipsychotic treatment in patients with schizophrenia has been shown in multiple studies to predict poor response at short-term trial endpoint. Therefore, strategies to address the challenge of non-improvement early in the course of treatment are needed. A novel trial design was developed to assess the potential utility of antipsychotic dose escalation in patients with an inadequate initial treatment response.

A quality improvement project to decrease emergency department and medical intensive care unit transfer times.

Objective: To reduce transfer time of critically ill patients from the emergency department (ED) to the medical intensive care unit (MICU).

Design: A prospective, observational study assessing preimplementation and postimplementation of quality improvement interventions in a tertiary academic medical center.

Interventions: A team of frontline health care professional including ED, MICU, and supporting services using the clinical microsystems approach mapped out existing practice patterns, determined causes for delays, and used the Plan-Do-Study-Act to test changes.

CF healthcare workers feel unprepared in providing suitable end of life care and desire more education: Results of a nationwide survey.

Introduction: Little is known about the depth of knowledge and preparedness of CF caregivers in delivering end of life and palliative care to CF patients and families.

Method: Nationwide survey questionnaires for CF care providers using the CF Foundation Listserv electronic web-based tool.

Results: The majority of non-physician CF care providers (55%) had more than 15 years of experience in their discipline and 84% of physician had greater than 15 years of experience.

B cells in the aging immune system: time to consider B-1 cells.

The investigation of immune senescence has uncovered many changes in B cell development, maintenance, and function with increasing age. However, most of these studies have focused on conventional B cell subsets in the spleen. The B-1 cell subset is an essential arm of the innate immune system, which in general has been understudied in terms of immune senescence.

The human counterpart of mouse B-1 cells.

B-1 cells represent a subpopulation of B cells that has been extensively studied in mice and shown to spontaneously generate natural antibody that provides antimicrobial protection and helps dispose of cellular debris. Mouse B-1 cells originate from distinct progenitors and express additional immune properties that include phagocytosis, antigen presentation, immune suppression, and polarization of T cell differentiation. Confusion regarding the existence of human B-1 cells with mouse B-1-like properties has recently been addressed by identification of a new phenotypic profile.

Pediatric antiphospholipid syndrome.

Antiphospholipid syndrome (APS) is a multisystem autoimmune condition characterized by vascular thromboses associated with persistently positive antiphospholipid antibodies. There is currently a paucity of data (incidence, prevalence, thrombosis risk, and effective treatment) in pediatric APS. The purpose of this report is to review the current literature on APS in children and neonates, identify the gaps in current knowledge, and suggest avenues for studies to fill those gaps.

Medical intensive care unit consults occurring within 48 hours of admission: a prospective study.

Rationale: Critical care consults requested shortly after admission could represent a triage error. This consult process has not been adequately assessed, and data are retrospective relying on discharge diagnoses.

Objectives: The aims of this study were to identify reasons for medical Intensive care unit (MICU) consultations within 48 hours of admission and to detect differences between those accepted and those denied MICU admission.

Hospitalization rates in patients switched from oral anti-psychotics to aripiprazole once-monthly: final efficacy analysis.

Objective: To compare hospitalization rates in patients with schizophrenia treated prospectively with aripiprazole once-monthly 400 mg (AOM 400; an extended-release injectable suspension) vs the same patients' retrospective rates with their prior oral anti-psychotic therapy.

Research Design And Methods: Multi-center, open-label, mirror-image, naturalistic study in a community setting in North America. Patients who required a change in treatment and/or would benefit from long-acting injectable anti-psychotic therapy were treated prospectively for 6 months with AOM 400.

Establishing an evidence base for critical laboratory value thresholds.

Objectives: Critical values denote laboratory test results indicating a life-threatening situation. The outcomes of this premise have not been rigorously evaluated.

Methods: Five years of inpatient admissions were examined for critical or "near-critical" results (total admissions = 165,066; total test results = 872,503).

Non-mammalian model systems for studying neuro-immune interactions after spinal cord injury.

Mammals exhibit poor recovery after injury to the spinal cord, where the loss of neurons and neuronal connections can be functionally devastating. In contrast, it has long been appreciated that many non-mammalian vertebrate species exhibit significant spontaneous functional recovery after spinal cord injury (SCI). Identifying the biological responses that support an organism's inability or ability to recover function after SCI is an important scientific and medical question.

Efficacy and safety of aripiprazole in Chinese Han schizophrenia subjects: a randomized, double-blind, active parallel-controlled, multicenter clinical trial.

Objective: Antipsychotics, such as aripiprazole and risperidone, are often used to treat individuals with schizophrenia. The efficacy as well as safety of aripiprazole in Western populations has been described. The objective of this study is to investigate the efficacy, safety, and tolerability of aripiprazole and risperidone in Chinese Han schizophrenia subjects in mainland China.

Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study.

Background: Long-acting injectable formulations of antipsychotics are treatment alternatives to oral agents.

Aims: To assess the efficacy of aripiprazole once-monthly compared with oral aripiprazole for maintenance treatment of schizophrenia.

Method: A 38-week, double-blind, active-controlled, non-inferiority study; randomisation (2:2:1) to aripiprazole once-monthly 400 mg, oral aripiprazole (10-30 mg/day) or aripiprazole once-monthly 50 mg (a dose below the therapeutic threshold for assay sensitivity).

Advanced echocardiography for the critical care physician: part 2.

This article is the second part of a series that describes practical techniques in advanced critical care echocardiography and their use in the management of hemodynamic instability. Measurement of left ventricular function and segmental wall motion abnormalities, evaluation of left ventricular filling pressures, assessment of right-sided heart function, and determination of preload sensitivity, including passive leg raising, are discussed. Video examples help to demonstrate techniques described in the text.

Advanced echocardiography for the critical care physician: part 1.

This is the first of a two-part series that reviews advanced critical care echocardiography (CCE) techniques designed for critical care physicians. In this section, we review training in basic and advanced CCE. This is followed by a review of Doppler principles, including pulsed wave, continuous wave, and color flow Doppler.

Targeting HMGB1 in the treatment of sepsis.

Introduction: Sepsis refers to the host's deleterious and non-resolving systemic inflammatory response to microbial infections and represents the leading cause of death in the intensive care unit. The pathogenesis of sepsis is complex, but partly mediated by a newly identified alarmin molecule, the high mobility group box 1 (HMGB1).

Areas Covered: Here we review the evidence that support extracellular HMGB1 as a late mediator of experimental sepsis with a wider therapeutic window and discuss the therapeutic potential of HMGB1-neutralizing antibodies and small molecule inhibitors (herbal components) in experimental sepsis.

Strange Vibes - Novel Presentation of Prostatitis.

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has significant variability in its presentation. In this study, we present 2 novel cases of prostatitis in which "buzz" is described as the primary pain symptom. These cases describe patients with the primary complaint of "cell phone-like buzzing" within the perineum, with accompanying urinary symptoms consistent with prostatitis.

Hilar clamping versus off-clamp laparoscopic partial nephrectomy for T1b tumors.

Purpose Of Review: An off-clamp, or zero-ischemia, approach to laparoscopic partial nephrectomy has been a proposed means of preserving global renal function by preventing ischemia to normal renal parenchyma. However, for clinical stage T1b tumors this provides a unique challenge as the large size of these tumors further complicates an already difficult procedure. This review provides an overview of outcomes for laparoscopic partial nephrectomies performed with or without hilar clamping for clinical stage T1b tumors.

Hospitalisation rates in patients switched from oral anti-psychotics to aripiprazole once-monthly for the management of schizophrenia.

Objective: To report the design and preliminary results of a mirror-image study comparing total psychiatric hospitalisation rates pre- and post-switch to aripiprazole once-monthly, an extended release injectable solution.

Methods: A multi-center, open-label mirror-image study of patients (18-65 years) with schizophrenia to compare total psychiatric hospitalisation rates between retrospective treatment with oral standard-of-care (SOC) anti-psychotics and prospective treatment with aripiprazole once-monthly in a naturalistic community setting in North America. Total psychiatric hospitalisation rates were assessed between retrospective (Months -4 to -1) and prospective treatment periods (Months 4-6) for patients who completed ≥3 months aripiprazole once-monthly.

Common presentations of pediatric rheumatologic diseases: a generalist's guide.

Purpose Of Review: To present a case-based approach of three common scenarios which often present to the primary care physician. The approach to these cases and the differential diagnosis are discussed for these common rheumatologic diseases.

Recent Findings: Numerous healthy children and adolescents are referred to pediatric rheumatologists for the evaluation of suspected rheumatologic diseases.