Ca2+/calmodulin-dependent protein phosphorylation is not altered by amygdaloid kindling

Kindling is a process in which episodic electrical stimulation permanently increases seizure susceptibility. One mechanism to account for a change in seizure susceptibility is some alteration in signal transduction, possibly at the level of second messenger systems. In this study, male Long-Evans rats were kindled in the amygdala, and Ca2+/calmodulin (Ca2+/CaM)-dependent protein phosphorylation was assessed at the site of the primary kindled focus using one- and two-dimensional gel electrophoresis. In vitro phosphorylation of membrane and cytosol fractions in the presence of absence of Ca2+/CaM did not differentiate kindled from nonkindled amygdaloid tissue. These results suggest that changes in Ca2+/CaM-dependent phosphorylation are not related to the mechanism(s) underlying the establishment of an amygdaloid kindled focus.     

Improved quality of care and reduction of housestaff workload using trauma nurse practitioners

The University of California, Davis, Medical Center introduced the use of nurse practitioners (NPs) to the trauma service in fiscal year 1986-87 to alleviate the increasing burdens placed on the surgical housestaff in their attempt to accommodate the rising patient volume and acuity. The use of NPs was associated with a decrease in average length of stay for the seriously injured patients from 8.10 to 7.05 days while the length of stay for other patients in the hospital remained unchanged. Documentation of quality of care in the medical record increased substantially. For example, discharge summaries that were dictated by the NPs were judged complete in all aspects in at least 95% of sampled records compared with approximately 75% of records that were dictated by the residents. With introduction of the NPs, outpatient clinic waiting times decreased from 41 to 19 minutes. Patient complaints regarding the trauma team decreased from 16 to seven/year. Time saved for the housestaff averaged 352 minutes/day while the NPs were on duty. The NPs were well received by the hospital nurses, hospital quality assurance personnel, and ancillary services. They have proved to be of great value to the patients, the patients' families, the hospital, and the trauma team.     

Ganglioside treatment partially counteracts neurotoxic effects of trimethyltin but may itself cause neurotoxicity in rats: experimental results and a critical review.

We have demonstrated a deficit in working memory and/or consolidation of information in working memory into reference memory by a single oral dose of the neurotoxin trimethyltin(TMT). Moreover, TMT causes loss of hippocampal corticosterone receptors and increases brain glial fibrillary acidic protein(GFAP), an index of the astrocytic reaction to diverse types of CNS lesions. We tried to block the TMT-induced cognitive deficit and these biochemical markers by treating rats with purified mixed gangliosides (GS) for 21 days, starting 2 days before the TMT treatment. As expected, TMT decreased the number of corticosterone receptors in hippocampi and increased the GFAP concentration in hippocampi and to a lesser extent, in frontal cortices, measured more than 8 mon after treatment. The small increase in GFAP in frontal cortices was attenuated by GS but not in hippocampi. The pronounced learning deficits caused by TMT were attenuated to a small extent by GS in the TMT-GS group, when a learning criterion was used for the last session's performance of acquired lever-directed behavior. GS also delayed the appearance of significant performance differences between Controls and TMT-treated rats, when probed with a progressive fixed ratio schedule of reinforcement. However, most measures of learning and performance indicated that GS did not block the dysfunctional consequences of TMT treatment but instead caused similar functional decrements in rats treated with water instead of TMT. Corticosterone receptors in hippocampi were reduced to about 65% of Controls in the TMT-Water, TMT-GS, and Water-GS groups. A reduction in corticosterone receptors in hippocampi after TMT treatment probably reflects the loss of one or more cell types (e.g., pyramidal cells), which is supported by the increase in GFAP in this region. However, we did not observe a reciprocal relation between steroid receptors and GFAP after GS alone, indicating that GS did not cause detectable cell loss or cell damage, measured in this manner. Thus, reactive gliosis probably was not a pre-condition for the cognitive dysfunction. The fact that the cognitive deficits are probably related to hippocampal dysfunction supports the notion of a causal relationship between corticosterone receptor reduction and/or their altered function and cognitive impairment of this special type. The possibility that our results demonstrate potential neurobehavioral toxicity of GS is discussed in light of many reports which present data that can be similarly interpreted.     

The prevalence of peripheral arterial disease and medial arterial calcification in patients with chronic renal failure: requirements for diagnostics

BACKGROUND: Knowledge of the prevalence of peripheral arterial disease (PAD) in patients with chronic renal failure (CRF) is limited because of a lack of uniformity in disease definition and recognition. Furthermore, little is known of the prevalence of medial arterial calcification (MAC) in patients with CRF. Our goal is to study the prevalence of PAD and MAC defined by ankle brachial index (ABI) or toe brachial index (TBI) measurements in a Finnish population of patients with CRF consisting of predialysis and dialysis patients, as well as renal transplant recipients. METHODS: We examined 136 patients with CRF and 59 control subjects. Fifty-nine of the patients with CRF had moderate to severe predialysis CRF, 36 patients were on dialysis treatment, and 41 were renal transplant recipients. Mean age of patients was 51.9 +/- 11.5 years, and 39 patients (29%) had diabetes. ABI and TBI were measured by means of photoplethysmography. The definition of PAD required an ABI value of 0.90 or less, a TBI value of 0.60 or less, or a previous positive lower-extremity angiogram result. ABI values of 1.3 or greater or incompressible arteries at ankle level indicated MAC. The presence of claudication was determined by an interview. RESULTS: Prevalences of PAD on this study were 22.0% in patients with predialysis CRF, 30.6% in patients on dialysis treatment, 14.6% in renal transplant recipients, and 1.7% in the control group (P = 0.001). Prevalences of MAC were 23.7%, 41.7%, 23.1%, and 3.4% (P < 0.001), respectively. Only 9 patients had claudication, and 6 of those patients had PAD. CONCLUSION: Both asymptomatic PAD and MAC are common in patients with CRF. Therefore, we recommend the use of both ABI and TBI measurements in the evaluation of PAD in patients with CRF.