Glutamate uptake into synaptic vesicles--inhibition by sulphur amino acids.

In an attempt to investigate the apparent absolute selectivity of the synaptic vesicle L-glutamate carrier, L- and D-enantiomers of excitatory sulphur-containing amino acid (SAA) transmitter candidates (which are close structural analogues of L-glutamate) were tested for their capacity to compete for vesicular L-[3H]-glutamate uptake. All SAAs inhibited, to varying degrees (52-86%), the vesicular uptake of L-[3H]-glutamate. A similar level of inhibition was exerted by SAAs with either a shorter or equal carbon chain length to L-glutamate. Moreover, inhibition was stereospecific in favour of the D-enantiomers. These studies indicate an appreciable interaction of the SAAs with the recognition site of the vesicular L-glutamate carrier. Further investigations are required to establish the substrate potential of the SAAs.     

Panton-Valentine leukocidin: raising practitioner awareness

Media reports have focused recently on methicillin-resistant Staphylococcus aureus (MRSA). Panton-Valentine leukocidin is a toxin carried by MRSA. With reported increases in community-acquired MRSA, this article seeks to raise practitioner awareness of this toxin and its effects on dermal tissue. A case study and anecdotal evidence is given.     

The Effect of Education and Self-monitoring of Blood Glucose on Glycosylated Hemoglobin in Type I Diabetes

ABSTRACT The influence on glycosylated hemoglobin (HbA₁) of formal education as compared with self-monitoring of blood glucose (SMBG) was studied in a randomized 18-month trial. All adult type I diabetics in a community were identified. Forty-one of these patients had had diabetes for 20 years or less. Thirty-seven patients were included in the study and finally randomized into four groups. Ten patients received individual formal education followed by SMBG, eight patients were instructed in SMBG without pre-education, nine patients were given only formal education and 10 patients made up a reference group. Education did not improve the mean HbA₁ values. SMBG resulted in a decrease by 2% in HbA₁ from 12 to 10% (p<0.05). The final HbA₁ level, however, did not differ significantly between any of the groups. SMBG was accepted by 80% of the patients. The liability to hypoglycemia was about equal in the four groups. It was concluded that SMBG, but not education, improved metabolic control to a certain degree.     

Using a scoping exercise to guide the development of a care homes learning network

This article describes a project involving various stakeholders designed to develop a learning network for care homes in Bristol and the scoping exercise that gave the project team direction.     

Impact of multiple joint problems on daily living tasks in people in the community over age fifty-five

OBJECTIVE: To establish the prevalence of multiple joint problems and their impact on everyday tasks. METHODS: A random sample of the UK population was assessed using a postal questionnaire. Data on overall joint pain, swelling and stiffness, and activities of daily living were obtained from 16,222 individuals >55 years of age (86% response rate). Prevalence estimates of joint problems were established and the impact of multiple joint pathologies on common physical tasks was determined. RESULTS: Single joint involvement was unusual (median joint involvement 4). Although the knee was the most frequently involved joint (220.30 per 1,000), isolated knee pathology accounted for only 1 in 11 patients with knee pain. Although single joint disorders increased the risk of experiencing functional difficulty, this risk was substantially increased with multiple joint problems: individuals with knee and feet problems were 14 times more likely to experience difficulty standing and walking than those without knee problems (odds ratio [OR] 14.50); knee and hip problems increased the risk >12 times (OR 12.43) whereas knee, back, feet, and hip involvement increased the risk 60 times (OR 62.41). CONCLUSION: Multiple-site joint problems are much more common than single joint problems. Although individual joint problems have a considerable impact on a person's functional ability, this risk is substantially increased when other joints are involved. With the increasing burden associated with the aging population, it is essential that the management of joint pain be considered in light of the impact of multiple, rather than single, joint problems.