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McVicker BL, Simpson RL, Hamel FG, Bennett RG. Reduction in Obesity-Related Hepatic Fibrosis by SR1664. Biology (Basel) 2023; 12:1287. [PMID: 37886997 PMCID: PMC10604321 DOI: 10.3390/biology12101287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Abstract
Peroxisome-proliferator-activated receptor gamma (PPARγ) is a transcription factor with adipogenic, insulin-sensitizing, and antifibrotic properties. Strong PPARγ activators, such as the thiazolidinediones, can induce unwanted effects such as edema, weight gain, and bone loss, and therefore selective modulators of PPARγ are in development. We previously reported that one selective PPARγ modulator, SR1664, reduced toxin-induced hepatic fibrosis and the activation of hepatic stellate cells (HSCs), the main collagen-producing liver cell in fibrosis. In this study, we used a high fat and high carbohydrate (HFHC) model of hepatic steatosis and fibrosis to determine the effect of SR1664. Mice were placed on a standard chow or HFHC diet for 16 weeks, with SR1664 or control treatment for the final 4 weeks. SR1664 did not alter weight gain or fasting insulin or glucose levels. The size of lipid droplets in the HFHC group was reduced by SR1664, but there was no effect on total liver triglyceride levels. The degree of fibrosis was significantly reduced by SR1664 in mice on the HFHC diet, and this was accompanied by a decrease in activated HSC. In summary, SR1664 improved insulin sensitivity and reduced fibrosis in the HFHC diet, suggesting selective PPARγ modulation is effective in obesity-related liver fibrosis.
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Affiliation(s)
- Benita L. McVicker
- Research Service, Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.)
- Departments of Internal Medicine and Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ronda L. Simpson
- Research Service, Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.)
- Departments of Internal Medicine and Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Frederick G. Hamel
- Research Service, Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.)
- Departments of Internal Medicine and Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Robert G. Bennett
- Research Service, Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.)
- Departments of Internal Medicine and Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
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McVicker BL, Hamel FG, Simpson RL, Bennett RG. A Selective PPARγ Modulator Reduces Hepatic Fibrosis. Biology (Basel) 2020; 9:biology9070151. [PMID: 32630819 PMCID: PMC7407562 DOI: 10.3390/biology9070151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 12/11/2022]
Abstract
Hepatic fibrosis is the accumulation of excess collagen as a result of chronic liver injury. If left unabated, hepatic fibrosis can lead to the disruption of the liver architecture, portal hypertension, and increased risk of progression to cirrhosis and hepatocellular carcinoma. The thiazolidinedione class of antidiabetic drugs, through their target peroxisome proliferator-activated receptor γ (PPARγ), have protective effects against liver fibrosis, and can inhibit the profibrotic activity of hepatic stellate cells, the major collagen-producing liver cells. However, these drugs have been ineffective in the treatment of established fibrosis, possibly due to side effects such as increased weight and adiposity. Recently, selective PPARγ modulators that lack these side effects have been identified, but their role in treating fibrosis has not been studied. In this study, we tested the effectiveness of one of these selective modulators, SR1664, in the mouse carbon tetrachloride model of established hepatic fibrosis. Treatment with SR1664 reduced the total and type 1 collagen content without increasing body weight. The abundance of activated hepatic stellate cells was also significantly decreased. Finally, SR1664 inhibited the profibrotic phenotype of hepatic stellate cells. In summary, a selective PPARγ modulator was effective in the reduction of established hepatic fibrosis and the activated phenotype of hepatic stellate cells. This may represent a new treatment approach for hepatic fibrosis.
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Affiliation(s)
- Benita L. McVicker
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.); (R.L.S.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Frederick G. Hamel
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.); (R.L.S.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ronda L. Simpson
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.); (R.L.S.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Robert G. Bennett
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, NE 68105, USA; (B.L.M.); (F.G.H.); (R.L.S.)
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, NE 68198, USA
- Correspondence:
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Bennett RG, Simpson RL, Hamel FG. Serelaxin increases the antifibrotic action of rosiglitazone in a model of hepatic fibrosis. World J Gastroenterol 2017; 23:3999-4006. [PMID: 28652653 PMCID: PMC5473119 DOI: 10.3748/wjg.v23.i22.3999] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 03/30/2017] [Accepted: 05/09/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the effect of combined serelaxin and rosiglitazone treatment on established hepatic fibrosis.
METHODS Hepatic fibrosis was induced in mice by carbon tetrachloride administration for 6 wk, or vehicle alone (nonfibrotic mice). For the final 2 wk, mice were treated with rosiglitazone, serelaxin, or both rosiglitazone and serelaxin. Serum liver enzymes and relaxin levels were determined by standard methods. The degree of liver collagen content was determined by histology and immunohistochemistry. Expression of type I collagen was determined by quantitative PCR. Activation of hepatic stellate cells was assessed by alpha-smooth muscle actin (SMA) levels. Liver peroxisome proliferator activated receptor-gamma coactivator 1 alpha (PGC1α) was determined by Western blotting.
RESULTS Treatment of mice with CCl4 resulted in hepatic fibrosis as evidenced by increased liver enzyme levels (ALT and AST), and increased liver collagen and SMA. Monotherapy with either serelaxin or rosiglitazone for 2 wk was generally without effect. In contrast, the combination of serelaxin and rosiglitazone resulted in significantly improved ALT levels (P < 0.05). Total liver collagen content as determined by Sirius red staining revealed that only combination treatment was effective in reducing total liver collagen (P < 0.05). These results were supported by immunohistochemistry for type I collagen, in which only combination treatment reduced fibrillar collagen levels (P < 0.05). The level of hepatic stellate cell activation was modestly, but significantly, reduced by serelaxin treatment alone, but combination treatment resulted in significantly lower SMA levels. Finally, while hepatic fibrosis reduced liver PGC1α levels, the combination of serelaxin and rosiglitazone resulted in restoration of PGC1α protein levels.
CONCLUSION The combination of serelaxin and rosiglitazone treatment for 2 wk was effective in significantly reducing established hepatic fibrosis, providing a potential new treatment strategy.
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Singh S, Simpson RL, Bennett RG. Relaxin activates peroxisome proliferator-activated receptor γ (PPARγ) through a pathway involving PPARγ coactivator 1α (PGC1α). J Biol Chem 2014; 290:950-9. [PMID: 25389293 DOI: 10.1074/jbc.m114.589325] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Relaxin activation of its receptor RXFP1 triggers multiple signaling pathways. Previously, we have shown that relaxin activates PPARγ transcriptional activity in a ligand-independent manner, but the mechanism for this effect was unknown. In this study, we examined the signaling pathways of downstream of RXFP1 leading to PPARγ activation. Using cells stably expressing RXFP1, we found that relaxin regulation of PPARγ activity requires accumulation of cAMP and subsequent activation of cAMP-dependent protein kinase (PKA). The activated PKA subsequently phosphorylated cAMP response element-binding protein (CREB) at Ser-133 to activate it directly, as well as indirectly through mitogen activated protein kinase p38 MAPK. Activated CREB was required for relaxin stimulation of PPARγ activity, while there was no evidence for a role of the nitric oxide or ERK MAPK pathways. Relaxin increased the mRNA and protein levels of the coactivator protein PGC1α, and this effect was dependent on PKA, and was completely abrogated by a dominant-negative form of CREB. This mechanism was confirmed in a hepatic stellate cell line stably that endogenously expresses RXFP1. Reduction of PGC1α levels using siRNA diminished the regulation of PPARγ by relaxin. These results suggest that relaxin activates the cAMP/PKA and p38 MAPK pathways to phosphorylate CREB, resulting in increased PGC1α levels. This provides a mechanism for the ligand-independent activation of PPARγ in response to relaxin.
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Affiliation(s)
- Sudhir Singh
- From the Medical Research Service, The Department of Veterans Affairs, Nebraska-Western Iowa Health Care System, Omaha, Nebraska 68105 and the Departments of Biochemistry & Molecular Biology, Internal Medicine and Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Ronda L Simpson
- From the Medical Research Service, The Department of Veterans Affairs, Nebraska-Western Iowa Health Care System, Omaha, Nebraska 68105 and the Departments of Biochemistry & Molecular Biology, Internal Medicine and Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, Nebraska 68198
| | - Robert G Bennett
- From the Medical Research Service, The Department of Veterans Affairs, Nebraska-Western Iowa Health Care System, Omaha, Nebraska 68105 and the Departments of Biochemistry & Molecular Biology, Internal Medicine and Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, Nebraska 68198
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Osna NA, Kharbanda KK, Sun Y, Simpson RL, Poluektova LE, Ganesan M, Wisecarver JL, Mercer DF. Ethanol affects hepatitis C pathogenesis: humanized SCID Alb-uPA mouse model. Biochem Biophys Res Commun 2014; 450:773-6. [PMID: 24953695 DOI: 10.1016/j.bbrc.2014.06.048] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 06/11/2014] [Indexed: 02/08/2023]
Abstract
Alcohol consumption exacerbates the course of hepatitis C viral (HCV) infection, worsens outcomes and contributes to the development of chronic infection that exhibits low anti-viral treatment efficiency. The lack of suitable in vivo models makes HCV-ethanol studies very difficult. Here, we examine whether chimeric SCID Alb-uPA mice transplanted with human hepatocytes and infected with HCV develop worsening pathology when fed ethanol. After 5 weeks of feeding, such mice fed chow+water (control) or chow+20% ethanol in water (EtOH) diets mice developed oxidative stress, decreased proteasome activity and increased steatosis. Importantly, HCV(+) mice in the control group cleared HCV RNA after 5 weeks, while the infection persisted in EtOH-fed mice at the same or even higher levels compared with pre-feeding HCV RNA. We conclude that in chimeric SCID Alb-uPA mice, EtOH exposure causes the complex biochemical and histological changes typical for alcoholic liver injury. In addition, ethanol feeding delays the clearance of HCV RNA thereby generating persistent infection and promoting liver injury. Overall, this model is appropriate for conducting HCV-ethanol studies.
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Affiliation(s)
- Natalia A Osna
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA.
| | - Kusum K Kharbanda
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Yimin Sun
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Ronda L Simpson
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Larisa E Poluektova
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - Murali Ganesan
- Research Service, Veterans Affairs Nebraska-Western Iowa Health Care System, Omaha, NE, USA; Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - James L Wisecarver
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE 68105, USA
| | - David F Mercer
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68105, USA
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Bennett RG, Heimann DG, Singh S, Simpson RL, Tuma DJ. Relaxin decreases the severity of established hepatic fibrosis in mice. Liver Int 2014; 34:416-26. [PMID: 23870027 PMCID: PMC3843971 DOI: 10.1111/liv.12247] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 06/09/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND & AIMS Hepatic fibrosis is characterized by excess collagen deposition, decreased extracellular matrix degradation and activation of the hepatic stellate cells. The hormone relaxin has shown promise in the treatment of fibrosis in a number of tissues, but the effect of relaxin on established hepatic fibrosis is unknown. The aim of this study was to determine the effect of relaxin on an in vivo model after establishing hepatic fibrosis METHODS Male mice were made fibrotic by carbon tetrachloride treatment for 4 weeks, followed by treatment with two doses of relaxin (25 or 75 μg/kg/day) or vehicle for 4 weeks, with continued administration of carbon tetrachloride. RESULTS Relaxin significantly decreased total hepatic collagen and smooth muscle actin content at both doses, and suppressed collagen I expression at the higher dose. Relaxin increased the expression of the matrix metalloproteinases MMP13 and MMP3, decreased the expression of MMP2 and tissue inhibitor of metalloproteinase 2 (TIMP2) and increased the overall level of collagen-degrading activity. Relaxin decreased TGFβ-induced Smad2 nuclear localization in mouse hepatic stellate cells. CONCLUSIONS The results suggest that relaxin reduced collagen deposition and HSC activation in established hepatic fibrosis despite the presence of continued hepatic insult. This reduced fibrosis was associated with increased expression of the fibrillar collagen-degrading enzyme MMP13, decreased expression of TIMP2, and enhanced collagen-degrading activity, and impaired TGFβ signalling, consistent with relaxin's effects on activated fibroblastic cells. The results suggest that relaxin may be an effective treatment for the treatment of established hepatic fibrosis.
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Affiliation(s)
- Robert G. Bennett
- Research Service, VA Nebraska-Western Iowa Health Care System, Omaha, USA
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA
- Department of Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, USA
- Department of Pharmacology & Experimental Neuroscience, University of Nebraska Medical Center, Omaha, USA
| | - Dean G. Heimann
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA
| | - Sudhir Singh
- Department of Biochemistry & Molecular Biology, University of Nebraska Medical Center, Omaha, USA
| | - Ronda L. Simpson
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA
| | - Dean J. Tuma
- Department of Internal Medicine, University of Nebraska Medical Center, Omaha, USA
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Abstract
The key to averting disaster or minimizing its effects is a solid data security plan. Learn the types of data risks that exist, how to develop a plan to counteract them, and your role in ensuring the safety of health and patient data.
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Affiliation(s)
- R L Simpson
- Nursing Informatics, Cerner Corp., Kansas City, Mo., USA
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8
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Abstract
Automated physician order entry systems can reduce medication errors and improve patient outcomes. But there are a variety of barriers--psychological, behavioral and technological--to physician adoption. Nursing not only has a stake in this issue, but plays a valuable role in resolving it.
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Abstract
Use improvements in data accuracy and nursing productivity to enhance your quality of care.
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10
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Simpson RL, Keegan A. There is no "I" in team, but there is one in meeting. Semin Nurse Manag 2001; 9:206-10. [PMID: 12030078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Increasingly, emotional intelligence (EI) and one's emotional quotient, or EQ, have become critical workforce success factors. This article examines the often overlooked issue of EI and EQ in group situations. It will delineate the three types of groups that show the most variance in emotional dynamics, and explore the application of EI and EQ to these group settings.
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11
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Simpson RL. "Techno-marvels" just around the corner. Nurs Manag (Harrow) 2001; 32:50-2. [PMID: 15124365 DOI: 10.1097/00006247-200112000-00015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the next 18 months, cutting-edge information technology will likely become commonplace in hospitals.
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Affiliation(s)
- R L Simpson
- Nursing Informatics, Cerner Corp., Kansas City, Mo., USA
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12
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Simpson RL. Mortality on convict voyages 1787-1820: whose responsibility? Occas Pap Med Hist Aust 2001; 4:85-92. [PMID: 11622913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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13
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Curtin L, Simpson RL. Preventing fraud. Health Manag Technol 2001; 22:66. [PMID: 11584707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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Curtin L, Simpson RL. Automated billing systems and compliance. Nurses must become knowledgeable about software systems that can and cannot help eliminate errors. Health Manag Technol 2001; 22:40-1. [PMID: 11499133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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15
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Simpson RL. Leapfrog is no threat. Hosp Health Netw 2001; 75:12, 14. [PMID: 11573430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Abstract
As the largest professional caregiving group, nurses have a stake in preventing misuse of the reimbursement system. Technology also plays a crucial role, as automated billing systems can both prevent and enable billing fraud.
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Curtin L, Simpson RL. Can you keep a secret? Health Manag Technol 2001; 22:44. [PMID: 11409284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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18
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Abstract
Burns of the lower eyelid represent a difficult management problem. Even with skin grafting, scarring and contraction can result in ectropion. This condition creates a marked aesthetic deformity, poses a risk of corneal exposure, and jeopardizes the patient's vision. Historically, full-thickness skin grafts and tarsorrhaphies have been described to manage recurrent ectropion. The lower eyelid fascial sling (LEFS) uses a temporalis fascial strip to create a suspension sling for the lower eyelid. In a series of 7 patients, the LEFS procedure resolved the symptoms permanently in all patients. Because the LEFS procedure counteracts the natural scar contraction forces of lower eyelid burns, it can resolve recalcitrant ectropion successfully while preserving the function and aesthetics of the lower eyelid.
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Affiliation(s)
- J de la Torre
- University of Alabama at Birmingham, Division of Plastic Surgery 35294-3295, USA
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Curtin L, Simpson RL. What Merrill Lynch's CIO survey says...what it means for nursing. Health Manag Technol 2001; 22:46. [PMID: 11351821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Abstract
While technology increases the accessibility of patient data, it also compromises its confidentiality. Here, review the federal government's solutions.
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Curtin L, Simpson RL. Standards of practice for nursing informatics. Health Manag Technol 2001; 22:52. [PMID: 11299925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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22
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Abstract
Before we can tackle the complexities of solid nursing IT, we need a set of standards on which to base our efforts. Learn how three groups--HIPAA, JCAHO, and the Workgroup--are building nursing a firm foundation.
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Abstract
In today's health care environment, nurses are finding themselves working in nontraditional roles and settings. Some fear technology will all but replace them. In some cases--given the speed at which technology has and continues to advance--that fear is well placed. For nursing to remain viable as a profession, it must incorporate information technology (IT) not only into today's practices, but also into tomorrow's unfolding roles, from advancing practice with new technology-based delivery models to moving away from direct patient care to become informaticians. Nursing administrators and managers must also embrace technology, for their ability to direct IT policy will directly influence their chances for career advancement. But what is required to map an IT career? How is the value of experience balanced against the need for education? Will nursing's core competencies remain constant over time?
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Affiliation(s)
- R L Simpson
- Nursing Informatics, Cerner Corporation, Kansas City, Missouri, USA
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Abstract
Computers get smarter and smarter, but they'll never replace human caring. View the nature of compassion and its unique role in nursing, as well as our challenge to measure the abstract quality. The surprising revelation: Computers are our best bet.
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Curtin L, Simpson RL. Making the leap to avoid medication errors. Health Manag Technol 2001; 22:28. [PMID: 11213612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- L Curtin
- CurtinCalls, Cincinnati, OH, USA
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Curtin L, Simpson RL. 10 tips for recruiting nurses on the Web. Health Manag Technol 2000; 21:46. [PMID: 11141998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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Curtin L, Simpson RL. Not for nurses only. A NIDSEC (Nursing Information and Data Set Evaluation Center) primer. Health Manag Technol 2000; 21:60, 62. [PMID: 11155636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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Abstract
The number of reported nursing errors in hospitals has increased in each of the past 5 years. Information technology can help nurses make better care decisions in today's harried hospital environment.
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30
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Riina LH, Simpson RL, Gudjonsson O, Glickman LT, Harris SU, Johnson D, Ginocchio M. Burn injury in kitchen workers: a cause for prevention. J Burn Care Rehabil 2000; 21:563-4; discussion 562. [PMID: 11194812 DOI: 10.1097/00004630-200021060-00017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Preventable thermal injuries in professional kitchen workers have been identified, and we have introduced a protective garment. Because of the nature of their occupation, kitchen workers are prone to thermal injuries. It has been our experience that the majority of these injuries are scald injuries on the ankles and dorsum of the feet. We propose that a protective garment, such as a waterproof shoe and garter, could reduce the incidence of these injuries.
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Affiliation(s)
- L H Riina
- Nassau County Medical Center Burn Center, East Meadow, New York, USA
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31
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Curtin L, Simpson RL. Nursing a merger. Health Manag Technol 2000; 21:46. [PMID: 11143059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- L Curtin
- Cerner Corp., Kansas City, MO, USA
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32
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Abstract
This article provides a brief overview of the problem of chronic disease, presents some of the emerging models of care delivery for the chronically ill, and discusses information technology's (IT) role in supporting those models and assisting in the search for cures.
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Affiliation(s)
- R L Simpson
- Nursing Informatics, Cerner Corporation, Kansas City, Missouri, USA
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Curtin L, Simpson RL. Quality of care and the 'low hanging fruit'. Simple principles to alleviate human factor errors. Health Manag Technol 2000; 21:48-9. [PMID: 11187260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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34
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Abstract
XML promises to be the next big thing in health care information.
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35
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Abstract
The IOM says tens of thousands die each year from medical errors. Learn lessons from the aviation industry and how we can build a culture of safety with information technology and clinical information systems.
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Abstract
This article will discuss key trends--from globalization to the culture of change and the rise of the information age--fueling development and deployment of 21st century IT. It will describe some of the new technologies, their applications, and implications for nursing.
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Abstract
Today, the question is not whether organizations should measure outcomes, but how. Right now, there are several initiatives, but no single, collaborative effort to tie them all together. This article will discuss the rise and early history of outcomes assessment in health care and highlight some key current initiatives (for example, OASIS [home health], QISMC [managed care organizations], HCQIP [inpatient care], ACQIP [ambulatory care], Joint Commission's ORYX accreditation initiative [hospitals, long-term care, home care, behavioral health care, and networks]). It will also delineate some of the problems with measuring outcomes and discuss where more work is needed. It will go on to discuss the role of IT in outcomes measurement, including its contributions, goals, effects, categories of IT support, infrastructure solutions, and analysis.
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Simpson RL. Nursing information systems: who needs them? Nurs Adm Q 2000; 23:94-6. [PMID: 10711149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
This article examines some of the reasons why--both financial and perceptual--organizations are becoming skeptical of nursing information systems. Then it delineates some key benefits and explains how nursing can and should be prepared to head off such skepticism.
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39
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Curtin LL, Simpson RL. Biometrics, technology and Nostradamus.... Health Manag Technol 2000; 21:50-1. [PMID: 10787553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Abstract
Read about emerging models of care delivery for the chronically ill and how information technology supports them and the search for cures.
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Abstract
Twenty-five years ago, health care information technology was dramatically different from what it is today. Twenty-five years from now, it promises to be worlds away from what it is today. How good a job has nursing done at keeping up with this exponential change? This article addresses the evolution of technology in health care and nursing's track record of technology expertise. It also discusses the price nursing will pay if it does not keep up with technology and the benefits it can gain if it does.
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Affiliation(s)
- R L Simpson
- Nursing Informatics, Cerner Corporation, Kansas City, Missouri, USA
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42
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Simpson RL. R&D in the mergers and acquisitions age. Nurs Manag (Harrow) 1999; 30:14-5. [PMID: 10818919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Learn about an emerging shift in the way research and development (R&D) is funded and the implications of that shift for health care information technology, product innovation, and delivery.
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Shahinfar S, Simpson RL, Carides AD, Thiyagarajan B, Nakagawa Y, Umans JG, Parks JH, Coe FL. Safety of losartan in hypertensive patients with thiazide-induced hyperuricemia. Kidney Int 1999; 56:1879-85. [PMID: 10571797 DOI: 10.1046/j.1523-1755.1999.00739.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Losartan, an angiotensin II receptor antagonist, has been shown to decrease serum uric acid and to increase urinary excretion of uric acid. METHODS To determine if this effect can increase the risk of acute urate nephropathy, 63 hypertensive patients with thiazide-induced asymptomatic hyperuricemia (serum uric acid 7.0 to 12.0 mg/dl) were randomized double-blind to losartan 50 mg every day (q.d.), losartan 50 mg plus hydrochlorothiazide (HCTZ) 50 mg q.d., HCTZ 50 mg q.d., or placebo for three weeks. To potentiate the risk of crystal formation, patients received a 2 g/kg protein diet one day prior to each clinic visit on days 0 (baseline), 1, 7, and 21. RESULTS Adverse events typically associated with acute urate nephropathy, for example, flank pain, hematuria, or increased blood urea nitrogen/creatinine, were not reported. Uric acid excretion and urine pH increased four and six hours after losartan on day 1 compared with day 0. Dihydrogen urate, the primary risk factor for crystal formation, decreased at four and six hours on day 1 compared with day 0 associated with the concurrent rise in urine pH. Day 7 and 21 changes, compared with day 0, in uric acid excretion rate, urine pH, and dihydrogen urate with losartan were comparable to day 1 results but were not statistically significant. Serum uric acid was significantly reduced after 21 days of therapy with losartan. CONCLUSION Losartan decreased serum uric acid and increased uric acid excretion without increasing urinary dihydrogen urate, the primary risk factor for acute urate nephropathy, during 21 days of dosing in hypertensive patients with thiazide-induced hyperuricemia.
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Simpson RL. What does IT have in store for nursing? Nurs Manag (Harrow) 1999; 30:14-5. [PMID: 15116440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Globalization, our culture of change, and the information age shape 21st-century information technology. Find out the applications and implications for nursing.
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Affiliation(s)
- R L Simpson
- Nursing Affairs, McKessonHBOC, Atlanta, Ga., USA
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Simpson RL. Y2K planning: where do you fit in? Nursing 1999; 29:32hn6-8. [PMID: 10797662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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46
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Abstract
Why have more nurses not fulfilled their role in planning for the year 2000? Nurses need to apply their skills and expertise to solving often overlooked problems such as point-of-service applications, transactions with business partners, and contingency planning.
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47
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Simpson RL. IT takes lead role in outcomes measurement. Nurs Manag (Harrow) 1999; 30:12-3. [PMID: 10562093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
To succeed in outcomes measurement, leaders need to understand key current initiatives, barriers, and the role of information technology.
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Simpson RL. High touch vs. high tech: rediscover the human element. Nurs Manag (Harrow) 1999; 30:33. [PMID: 10562058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Communication technology makes efficiencies possible, but it can cause major personal and organizational problems when it replaces human contact.
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Rubin LR, Rubin JP, Simpson RL, Rubin TR. The search for the neurocranial pathways to the fifth nerve nucleus in the reanimation of the paralyzed face. Plast Reconstr Surg 1999; 103:1725-8. [PMID: 10323713 DOI: 10.1097/00006534-199905060-00027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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50
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Simpson RL. Nursing's role in Y2K planning. Nurs Manag (Harrow) 1999; 30:25-6. [PMID: 10373879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Why haven't more nurses fulfilled their role in Y2K planning? Nurses need to apply their skills and expertise to solving often overlooked problems such as point-of-service applications, transactions with business partners, and contingency planning.
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