Insoluble fibronectin activates the Na/H antiporter by clustering and immobilizing integrin alpha 5 beta 1, independent of cell shape.

Growth of anchorage-dependent cells requires both soluble mitogens and insoluble extracellular matrix molecules such as fibronectin. Soluble growth factors activate chemical signaling pathways and stimulate proliferation by binding to transmembrane receptors. Insoluble fibronectin also binds to cell-surface receptors; however, it is thought to act primarily via effects on the cytoskeleton and cell shape. We recently demonstrated that cell spreading on surface-adsorbed fibronectin activates the Na/H antiporter and that inhibition of this chemical-signaling pathway suppresses growth. We now show that insoluble fibronectin activates the Na/H antiporter by clustering and immobilizing integrin alpha 5 beta 1, independent of effects on cell shape. These results show that an extracellular matrix receptor can behave similarly to a growth factor receptor to activate a signaling pathway implicated in growth control.     

CRSET syndrome: association with erythema figuratum

We report on a 69-year-old woman showing simultaneous occurrence of CRSET-syndrome and erythema figuratum. As far as we known, the association of these two diseases has not been observed before.     

Multiple dermal fibroblasts in patients with pruritic urticarial papules and plaques of pregnancy. A clue to the etiology?

We have recently demonstrated that in pruritic urticarial papules and plaques of pregnancy (PUPPP) there are multiple dermal fibroblasts with no deposition of mucin. We suggest that in the dermis of patients with PUPPP there is a deposition of a substance that induces fibroblasts proliferation. We assume that this substance (marked as F-substance) is a product of the placenta, which is released to the maternal circulation during pregnancy.     

Topical treatment with minoxidil 2% and smoking intolerance.

OBJECTIVE: To report smoking intolerance that occurred in two patients while they were treated with minoxidil. DATA SYNTHESIS: Minoxidil is a potent vasodilator useful in treating severe hypertension. Topical minoxidil was approved as a treatment for androgenital alopecia. Only few side effects have been reported during treatment with topical minoxidil, most of them localized skin reactions. Two of our patients developed smoking intolerance during treatment with topical minoxidil for androgenital alopecia. The relation between treatment with minoxidil and smoking intolerance was emphasized by stopping treatment and the disappearance of the smoking intolerance, and then by rechallenge in both patients. CONCLUSIONS: Topical minoxidil may cause smoking intolerance; further studies are needed to evaluation this side effect.     

Mechanobiology and diseases of mechanotransduction

The current focus of medicine on molecular genetics ignores the physical basis of disease even though many of the problems that lead to pain and morbidity, and bring patients to the doctor's office, result from changes in tissue structure or mechanics. The main goal of this article is therefore to help integrate mechanics into our understanding of the molecular basis of disease. This article first reviews the key roles that physical forces, extracellular matrix and cell structure play in the control of normal development, as well as in the maintenance of tissue form and function. Recent insights into cellular mechanotransduction — the molecular mechanism by which cells sense and respond to mechanical stress — also are described. Re‐evaluation of human pathophysiology in this context reveals that a wide range of diseases included within virtually all fields of medicine and surgery share a common feature: their etiology or clinical presentation results from abnormal mechanotransduction. This process may be altered by changes in cell mechanics, variations in extracellular matrix structure, or by deregulation of the molecular mechanisms by which cells sense mechanical signals and convert them into a chemical or electrical response. Molecules that mediate mechanotransduction, including extracellular matrix molecules, transmembrane integrin receptors, cytoskeletal structures and associated signal transduction components, may therefore represent targets for therapeutic intervention in a variety of diseases. Insights into the mechanical basis of tissue regulation also may lead to development of improved medical devices, engineered tissues, and biologically‐inspired materials for tissue repair and reconstruction.     

Inpatient rehabilitation facilities’ hospital readmission rates for medicare beneficiaries treated following a stroke

ABSTRACT

Background

Stroke is the leading cause for admission to the nearly 1,200 Inpatient Rehabilitation Facilities (IRFs) nationally in the US. For many patients, post-acute care is an important component of their rehabilitation. Several quality measures have been publicly reported for post-acute care providers, including hospital readmissions. However, to date none have focused on specific medical conditions, limiting the usability for patients and quality improvement.