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In summary, the naturopathic approach would treat this patient with dietary modification, nutritional and herbal supplements, regular preventive nasal irrigation, and adjunctive therapies such as homeopathy and osteopathic manipulation as indicated. Hopefully, this preventive approach will reduce or eliminate the need for the use of antibiotics to treat the acute exacerbations of what is really a chronic, lifestyle-related condition. As illustrated here, the Naturopathic Therapeutic Order can both guide us in treating a specific condition and assist us in assessing our patients on an individual, prevention-oriented basis.     

Site-directed mutagenesis of the human D antigen: definition of D epitopes on the sixth external domain of the D protein expressed on K562 cells

BACKGROUND: The antigens of the human Rh system are of great clinical significance in transfusion medicine and pregnancy. Of the Rh system antigens, D is clinically the most important, being one of the most immunogenic structures arising from human cells. The human D antigen represents a collection of epitopes expressed on a red cell membrane protein that is predicted to have 12 membrane-spanning segments giving rise to six exofacial domains. STUDY DESIGN AND METHODS: By site-directed mutagenesis using the method of inverse polymerase chain reaction, cE and D cDNA mutant constructs were generated with changes to the RHD-specific residues 350, 353, and 354 in the predicted sixth exofacial loop. Each mutant cDNA was subcloned into the pBabe puromycin retroviral vector, and supernatants were used to transduce K562 cells. Puromycin-resistant K562 clones were screened by flow cytometric analysis using a panel of monoclonal antibodies with specificities to ep (epitope) D1 through epD9. RESULTS: De novo expression of epD3 and epD9 was generated in the K562 cell lines expressing the mutated cE polypeptide (cE-Asp350His, Gly353Trp, Ala354Asn). Expression of c and E was unaffected. Conversely, the cells expressing the mutated D polypeptide demonstrated loss of expression of epD1, epD2, epD3, epD4, and epD9. CONCLUSION: The data provide strong evidence for the critical involvement of three amino acids, Asp₃₅₀, Gly₃₅₃, and Ala₃₅₄, in the expression of epD3 and epD9 on the predicted sixth external domain of the D protein. This domain also appears to be essential for the expression of epD1, epD2, and epD4, as a loss of expression of these epitopes was observed in K562 cells transduced with the D_mut construct (encoding His₃₅₀, Trp₃₅₃, and Asn₃₅₄). The K562/D_mut, cell line has an identical molecular and serologic profile as the red cell D^IVb pheno-type, which confirms that retroviral gene transfer of Rh cDNA into K562 cells provides us with a powerful means by which to further map epitopes of D.     

Nurses' adoption of the AWHONN/NANN Neonatal Skin Care Project

The purpose of this project was to evaluate the nurses' adoption of the AWHONN/NANN Neonatal Skin Care Project Protocols that were implemented at 54 clinical sites across the United States, and to examine perceived barriers in the implementation process. One hundred thirty-six nurses from 26 hospitals returned the survey packets that included the Neonatal Nurse Opinion Survey and the Barriers Scale. Nurses had a higher-than-average level of education, describing themselves as leaders and innovators. In general, the protocols were well accepted and adopted into practice. Some protocols were not perceived as better than pre-existing practice, and nurses reported difficulty in the implementation of some protocols. The main barriers were a lack of skill in reading and understanding research, lack of authority, and lack of support from physicians and other staff. The project raised national awareness about neonatal skin care, involved nurses from the beginning and throughout the process, and removed several barriers to research utilization. Copyright © 2001 by W.B. Saunders Company