Challenges for nephrology nurses in the management of children with chronic kidney disease.

An important treatment goal for pediatric nephrology caregivers is the optimization of a child's capacity for normal growth and development. However, the physiologic and metabolic derangements associated with chronic kidney disease (CKD) significantly alter these processes, creating important challenges in the care of affected children. Evidence-based clinical practice guidelines support early recognition and treatment of CKD-related complications to improve growth and development and, ultimately, quality of life for children with this chronic condition.     

Relation between actual heart rate and autonomic effects of beta blockade in healthy men

This study evaluated the effect of beta blockade on cardiac autonomic control and its dependence on heart rate change. The relations between RR interval duration, heart rate variability (HRV), and baroreflex sensitivity (BRS) were studied in 111 healthy men and in 21 male volunteers before and after a 100-mg oral dose of metoprolol. HRV and BRS correlated significantly with mean RR (r = 0.39, r = 0.57). Metoprolol administration increased both mean RR (from 996 to 1,176 ms, p <0.001), BRS from 24 to 36 ms/mm Hg (p = 0.003), and the SD of RR from 61 to 74 ms (p = 0.05). However, metoprolol-induced changes of HRV and BRS became insignificant (p = 0.69 and 0.48) after they were normalized to the same cycle length, suggesting that the improvement of cardiac autonomic control after beta blockade could be explained by a change of heart rate.     

Tobacco use amongst high school students in the Czech Republic

OBJECTIVE: We were interested in the prevalence of smoking amongst teen-age students, its possible causes, and their understanding of its associated health risks. METHODS: We constructed a questionnaire that was responded to by a total of 419 students from 5 high schools in Prague, Czech Republic. Students were classified as non-smokers, mild (1-10 cigarettes daily), moderate (11-20 cigarettes daily), and severe smokers (>20 cigarettes daily). The survey also contained questions about passive smoking, motivation for smoking, the understanding of its associated health risks, alcohol consumption, and drugs. RESULTS: We found that amongst 16-20 years old high school students there are 37.5% smokers (38.0% men, and 37.0% women). The majority are mild smokers (82.3%), 15.8% moderate smokers and 1.9% heavy smokers. 29.0% of non-smokers reported passive smoking; i.e. that 65.7% of students are exposed to harmful effect of tobacco smoke. The average onset of smoking is at 14 years of age. The youngest smoker started smoking at the age of 5 years. Parents of 52.0% of students smoke (69.4% of smokers and 41.6% of non-smokers). Most of students know about the risk of lung cancer and cardiovascular diseases (86-99%). CONCLUSIONS: The prevalence of active and passive smoking among high school students is high. Parents smoking is significantly more frequent in teen-age smokers than in non-smokers. We consider the "teen-age" population together with their parents to be the key target for a successful antismoking campaign.     

Penetrating injuries of the heart and great vessels

Between January 1975 and June 2000 565 patients with thoracic injuries were treated at our institution. 116 of them had penetrating thoracic traumas and 42 injuries of the heart and great vessels. Study includes two groups of patients: hemodynamic stable and hemodynamic unstable ones. Different algorithms of management, techniques, treatment and prognosis are described. In the group of hemodynamic unstable patients the emergency surgical treatment had to be performed sometimes even without the benefit of any radiological imaging method. Mortality rate of patients having reached the hospital equated 23.8%. The surgical treatment results were better in the past decade because of improvement in prehospital care and higher quality of emergency medical system. The possibility of fast transportation allowed a higher percentage of critically injured patients to reach the hospital alive.     

Detection and characterization of the protein encoded by the v-rel oncogene

To identify the protein encoded by v-rel, the oncogene of reticuloendotheliosis virus (REV-T), antisera have been raised to three synthetic peptides derived from the translation of our previously published v-rel DNA sequence [R.M. Stephens, N.R. Rice, R.R. Hiebsch, H.R. Bose, Jr., and R.V. Gilden, Proc. Natl. Acad. Sci. USA 80, 6229-6233 (1983)]. Sera to all three peptides precipitate a 59,000 Da protein from REV-T-transformed chicken lymphoid cells. This protein is not detectable in uninfected chick embryo fibroblasts, and its observed size is in good agreement with the 56,000 Da predicted by the DNA sequence. We conclude that this protein is the v-rel product and designate it p59rel. To search for evidence of post-translational processing of this protein, cells were grown in the presence of glycosylation inhibitors. These resulted in no detectable difference in the size of p59rel. Nor was its size detectably altered during the course of a pulse-chase experiment. Growth of cells in the presence of [32P] orthophosphate, however, revealed that p59rel is a phosphoprotein. It is also closely associated with a protein kinase activity, for precipitation with one of the peptide antisera (but not the other two) resulted in strong kinase activity in the immune complex pellet. During this reaction, p59rel itself becomes phosphorylated. Kinase activity was retained in the immune complex following detergent and high salt washes, leaving open the possibility that p59rel is itself a kinase.