Troponin I inhibits capillary endothelial cell proliferation by interaction with the cell's bFGF receptor.

Troponin I (TnI) is a novel cartilage-derived angiogenesis inhibitor, first demonstrated by Moses et al. (1999, Proc. Natl. Acad. Sci. USA 2645-2650) to inhibit endothelial cell proliferation and angiogenesis, both in vivo and in vitro, and to inhibit metastasis of a wide variety of tumors in vivo. Despite convincing evidence of its efficacy, little is known about the mechanism of action of TnI as an anti-proliferative and anti-angiogenic agent. In the current article we demonstrate that TnI inhibits both bFGF-stimulated and basal levels of endothelial cell proliferation, and we hypothesize that this inhibition is occurring, at least in part, via an interaction of TnI with the cell-surface bFGF receptor on capillary endothelial cells. We further support this hypothesis by providing the first evidence that TnI can act on nonendothelial as well as endothelial cells and by demonstrating that this inhibitory action is specific for the bFGF receptor on the target cells. Preliminary data suggest that TnI may be competing with bFGF for interaction with the bFGF receptor on responsive cells.     

Cardiac Troponin I and Myocardial Contusion in the Rabbit

Background: Patients with cardiac contusion have a high risk of cardiac complications during emergency anesthesia. Despite the progress in cardiac imaging, a biologic marker of myocardial damage such as cardiac troponin I remains useful and has been proposed in clinical practice. The relationship among histologic injury, left-ventricular function, and release of cardiac enzymes and cardiac troponin I has been investigated after a controlled myocardial contusion in a rabbit model.

Methods: A global trauma (two levels of energy: 250 and 350 mJ) was produced on an isolated preparation of rabbit's heart, of which the temperature, perfusion flow, beating rate, and left-ventricular volume were kept constant. Left-ventricular pressure and its first derivative as a function of time were measured during a 60-min period after the blow; a timed collection of the effluent was made to assess creatine kinase, lactate dehydrogenase, and cardiac troponin I. At the end of the period, an anatomic score of the contusion was calculated by histologic examination of the hearts.

Results: Compared with a control group, the two levels of cardiac trauma resulted in a proportional anatomic injury significantly correlated with left-ventricular dysfunction ([DELTA]%dP/dtmax = -16 +/- 12 and -36 +/- 20% at 3 min, mean +/- SD). Transient releases in cardiac markers after the lesser amount of trauma contrasted with a prolonged and biphasic release of cardiac troponin I after the greater amount. Peak cardiac troponin I level was correlated with anatomic injury ([rho] = 0.596, P = 0.001) and negatively correlated with left-ventricular dysfunction (r = -0.375, P = 0.04).     

The Rural Dental Health Program: The Long-Range Effect of a School-Based Enriched Dental Health Program on Children's Oral Health*

ABSTRACT: In November 1985, 406 children ages 15 to 19 were clinically examined, answered survey questions covering dental attitudes and behaviors, and were tested to determine their dental knowledge. This group included 56 percent of the 725 first through third graders who participated in the Rural Dental Health Program beginning in the fall of 1975. The Rural Dental Health Program was a study designed, in part, to measure the effect of a school-based dental health program on the oral health of children in a rural, underserved Pennsylvania county. Measures taken on 406 children, six and one-half years after the educational program ended were used to test for its possible long-term impact on oral health. Evidence obtained from analysis of covariance supports the hypothesis that dental health education had a positive effect on children's oral health.     

Safety and efficacy of radiofrequency ablation of common atrial flutter in elderly patients: a single center prospective study

Little data is available concerning the invasive treatment of atrial flutter (AFL) in elderly patients. The purpose of this prospective study was to evaluate the risks, safety, and follow-up of radiofrequency (RF) catheter ablation of common AFL in patients >75 years old (n = 61) (Group I) compared to patients younger than 75 years (n = 187) (Group II). The study population consisted of 248 patients (81% men/19% women), 21 to 96 years old (mean 66.3 +/- 12 years) with AFL, referred for RF from June 1999 to June 2001. RF endpoint was the assessment of the bidirectional block. The cumulative risk of atrial fibrillation (AF) was analyzed by the Kaplan-Meier method and log-rank test. The mean follow-up was 12.4 +/- 9 months. No complication occurred. Group I (80.1 +/- 4.5 years) did not differ significantly from Group II (61 +/- 11 years) regarding: AF history before ablation (34.4% vs 39.8%), structural heart disease (54% vs 42%), LVEF (57%+/- 12% vs 58%+/- 12%), left atrial size (43.8 +/- 7 vs 42.5 +/- 7), cava-tricuspid isthmus dimension (40 +/- 10 vs 39 +/- 4 mm), bidirectional block (100% vs 96.2%), RF application (12.5 +/- 10 vs 13.5 +/- 12 minutes), AFL recurrence (3.3% vs 5.3%), antiarrhythmic agents at hospital discharge (34.4% vs 38.9%), mean follow-up (12 +/- 9 vs 13 +/- 9 months) and AF occurrence (29.5% vs 20.3%; P = 0.2). Of these, the incidence of AF in patients without prior history (n = 150) was 7 (18%) of 39 for Group I and 11 (10%) of 111 for Group II (P = 0.1) after follow-up. Catheter ablation of AFL in very elderly patients appears to be a reasonable approach regarding feasibility, effectiveness, and low procedural risk.     

The impact of osteoporosis continuing education on nurses' knowledge and attitudes

BACKGROUND: Osteoporosis has rapidly evolved into a severe health threat to Americans and a major public health problem. The increasing incidence of this disease and related fractures mandates that continuing education include osteoporosis content to ensure nurses provide competent education and care. An osteoporosis educational program was presented to nurses as part of a continuing education symposium on women's health issues. The program was tested to determine its effectiveness in augmenting the osteoporosis-related knowledge and attitudes of nurses. METHOD: Eighty-one RNs with educational levels varying from associate degrees to doctorates attended the continuing education program. Sixty-three of the program participants completed pretest and posttest measures. FINDINGS: The educational program significantly increased osteoporosis knowledge in this cohort of nurses. Additionally, nurses indicated they were more likely to pay attention to their own bone health as a result of attending the program. CONCLUSION: Results of this study reinforce the need for osteoporosis-related continuing education.     

Clonal spread of fluoroquinolone non-susceptible Streptococcus pyogenes

BACKGROUND: Fluoroquinolones are an important group of antibiotics widely used in adults, and, despite the absence of official approval, these drugs are also used in children. So far, resistance to fluoroquinolones in Streptococcus pyogenes is very rare. METHODS: During a national surveillance programme in Belgium from 1999 to 2002, 2793 non-duplicate S. pyogenes recovered from tonsillopharyngitis patients were screened for fluoroquinolone resistance. Mutations in topoisomerase genes and the presence of any efflux pump activity were investigated to elucidate the fluoroquinolone resistance mechanisms. Clonality was assessed by pulsed-field gel electrophoresis (PFGE) and emm typing. RESULTS: Non-susceptibility to fluoroquinolones, defined as ciprofloxacin MIC > or = 2 mg/L, was identified in 152 (5.4%) of 2793 S. pyogenes. Fifty-five (36%) fluoroquinolone non-susceptible isolates were investigated for known resistance mechanisms; all showed mutations in parC, and 29 (19%) isolates also in parE; antibiotic efflux was not noted. Two major PFGE types comprised 88% of fluoroquinolone non-susceptible S. pyogenes and belonged to serotypes emm6 and emm75. Overall, emm6 and emm75 constituted >90% of all fluoroquinolone non-susceptible isolates and showed a significant temporal and geographical shift within Belgian provinces. Although fluoroquinolone-susceptible S. pyogenes also showed fluctuations in the predominant S. pyogenes serotypes, emm6 or emm75 were under-represented in this population. Approx. 55% of the fluoroquinolone non-susceptible isolates were recovered from children ( < or =16 years). CONCLUSIONS: We show here, for the first time, a multi-clonal spread of fluoroquinolone non-susceptible S. pyogenes exhibiting a known resistance mechanism. Non-susceptibility to fluoroquinolones in paediatric isolates is of concern.