Violet/blue light activates Nrf2 signaling and modulates the inflammatory response of THP-1 monocytes

Several studies suggest that light in the UVA range (320–400 nm) activates signaling pathways that are anti-inflammatory and antioxidative.

Creating order out of chaos: models of GNP practice with hospitalized older adults

It has been well documented that hospitalization of an older adult can trigger a cascade of events that negatively affect quality of life long after hospitalization. Three models of care directed by hospital-based geriatric nurse practitioners (GNPs) are described. The GNPs' roles include primary care provider, consultant, educator, researcher, and/or administrator. In one model, the GNP collaborated with a multi-disciplinary team to create a clinical pathway, the Functional Recovery Pathway. In the second model, the GNP and nurse manager addressed the issue of fall risk with an education program for the staff. As a result, the fall rate decreased 5.8%. In a third model, the GNP coordinated care of hospitalized nursing home residents in a "scatter bed" program. Working synergistically with a case management program, the length of stay for this group of patients decreased from a median of 12 days to 9 days in the first year to 6.8 days in the third year. All three models showed that the GNP facilitate change, improve resource utilization, and create innovative strategies to optimize care for hospitalized elders.

Programmed stimulation for simulation of atrial tachyarrythmias

Swine have become the preeminent non-human animal model for testing of cardiac assistance devices. Such devices must be robust to perturbations in the EKG; therefore it is expeditious, as part of cardiac assistance device testing, to simulate arrhythmias such as atrial flutter and fibrillation in swine. Methods for producing atrial tachyarrythmias include surgical ablation or crushing of atrial tissue and the administration of drugs. These are dangerous, unreliable and usually irreversible; in varying combinations and degrees. When we applied rapid evenly spaced electrical atrial pacing in swine, the variability of ventricular response was less than expected from the corresponding arrhythmia in man. We will describe efforts to produce reversible atrial tachyarrythmias in swine, using programmed stimulation, with the desired degree of ventricular response variability.

Essential amino acid reference profile affects the evaluation of enteral feeding products

The chemical score is a measure of the predicted metabolic usefulness of a protein in a food based on the comparison (ratio or percentage) of the concentrations of the essential amino acids (EAAs) to a "profile" assumed to reflect the true needs of the body. The score for the limiting EAA is taken to represent the value of the food. Such a chemical score is particularly useful for therapeutic diets where bioassay (such as nitrogen-balance studies) in a large number of patients may be unethical or impractical. Although a major limitation to the chemical-score method previously was scarcity and/or imprecision of data about EAA concentrations in foods, this situation has been mitigated by modern analytic methods. The validity of a chemical score is also exquisitely sensitive to the EAA profile used for comparison. Chemical scores published for a variety of enteral and parenteral feeding products implied a low (approximately 50%) protein value. These computations were based on the EAA profile of egg protein. This pattern is sufficient, in most cases, for body needs, but it may be far more than is necessary. Recently published profiles, based on measurements in human beings of actual protein and EAA requirements, point to a more realistic chemical-score computation. These profiles accommodate age and lifestyle factors and provide greater flexibility in the formulation of therapeutic diets.

Optimal controller for intraaortic balloon pumping

An optimal control algorithm was adapted to identify and track the optimal deflation time of the intraaortic balloon pump (IABP). Routines for handling physiologically imposed constraints were added to the algorithm which was implemented in a computer-controlled system. The system was designed to provide real time optimization for the clinical setting. The controller continuously maximizes a performance index while observing the constraints. The index is composed of clinically available hemodynamic variables which indicate changes in myocardial energy balance. Proper values for the algorithm parameters were determined and the system was tested in animal experiments. The results indicate that controlling deflation time relative to the R wave, which precedes the next ejection phase, reduces the time required for optimization when the heart rate varies.

The physiologic changes of aging

It is estimated that by the year 2030, 21.2% of the United States population will be 65 years of age or older. The elderly are the fastest growing segment of the population and use health care services extensively. Today 30% of all hospitalized individuals are elderly. The professional nurse must therefore be able to assess and assist elderly persons during the course of hospitalization. An important component of assessment is the ability to differentiate the normal physiologic changes of aging from the pathologic changes. To effectively intervene in a therapeutic plan of care the nursing professional must be aware of the limitations brought on by aging.

Showcase, a veterinary case authoring and presentation system

Showcase is an instructional authoring and case presentation system for veterinary medicine. It is intended to permit instructors and students to deal with clinical case information in a dynamic and interactive way. The programs are distributed as "adware;" and, it is hoped, the case files will be freely shared and distributed.

On the early recognition of neuroleptic malignant syndrome

Neuroleptic Malignant Syndrome, a serious and sometimes fatal complication, has been reported to occur in some patients with the administration of neuroleptic medications. Clinically it is manifested by four groups of symptoms which include muscular hypertonicity, autonomic instability, altered consciousness, and hyperthermia. Laboratory findings such as elevated creatinine phosphokinase and leukocytosis are also seen. While it is true that the incidence of the full blown clinical picture of this syndrome is rare, the authors report that only muscular hypertonicity and autonomic instability have occurred frequently in their setting leading to discontinuation of neuroleptics. Such abortive cases may go undetected. If properly diagnosed, the occurrence of this syndrome is not as rare as the published reports indicate. Second, it is reported that rechallenge with neuroleptics may not induce Neuroleptic Malignant Syndrome again. The authors noted recurrence of fever after rechallenge with a different neuroleptic drug. This article describes the method of early recognition and prevention of morbidity as well as mortality.

Automatic calculation for the renal failure diet

A logical scheme for algorithm for computation of the renal failure diet is presented along with its application to a programmable calculator. The program is user-interractive; the user may add or delete foods without re-entering previous data. Program outputs include water, protein, calories, carbohydrate, sodium, potassium, calcium, phosphorus, and the essential amino acids (EAA) in absolute and percentage terms. As an index of relative protein quality, the chemical score is computed on a meal-by-meal basis. Individual EAA scores are available to permit designation of the limiting EAA of a meal. A major benefit of the program is the ability to explore and document rapidly a wide variety of meal plans. Improvements in "user-friendliness" will facilitate application with patients.

Studies on the importance of the asparagine residue in oxytocin. Synthesis and some pharmacological properties of [1-alpha-mercaptoacetic acid, 5-isoasparagine] oxytocin

[1-Alpha-Mercaptoacetic acid, 5-isoasparagine] oxytocin was synthesized to study the effects of moving the side chain carboxamide group of the amino acid residue in position 5 of oxytocin from the beta to the alpha position. The analog has an isoasparagine residue in position 5 and the 20-membered ring size of oxytocin is maintained by substituting cysteine in position 1 of oxytocin by alpha-mercaptoacetic acid. The analog was found to possess 0.098 +/- 0.002 U/mg of uterotonic activity but no milk-ejecting, antidiuretic or rat pressor activity could be detected. The substance did not inhibit the uterotonic or milk-ejecting activity induced by oxytocin nor the antidiuretic or rat pressor responses to the USP posterior pituitary standard. These results, together with the data available in the literature, indicate that an analog of oxytocin lacking the asparagine residue in position 5 is neither an agonist nor an antagonist. The observations may mean that the asparagine residue is critically important for the interaction of oxytocin with its receptor.

A reticulated cover slip

Preparation and use of a reticulated cover slip is described as an aid in orientation under the microscope.

Confidence regions of planar cardiac vectors

A method is presented for plotting the 90%, 95%, and 99% confidence regions of planar cardiac vectors based on the bivariate normal distribution.

Effect of anticoagulants and glucose on refractometric estimation of protein in canine and rabbit plasma

The effect of ethylenediaminetetraacetate (EDTA) compounds on the refractometric estimation of plasma protein concentration was attributed largely to osmotic fluid shifts, as reflected in changes in hematocrit, and to addition of total solids to the plasma. With H4EDTA, these two mechanisms were additive and caused increased plasma protein readings of significant magnitude even at recommended (1--2 mg/ml) anticoagulant concentrations. For the potassium and sodium salts, the two mechanisms were partly compensatory, which ameliorated the effect at 1--2 mg/ml concentration. At higher concentrations, such as might occur if a blood collecting tube were incompletely filled, all of the EDTA compounds caused technically significant over-estimation of plasma protein. When dextrose (d-glucose) was added in-vitro to canine blood, in amounts analogous to clinical hyperglycemia, the effect upon plasma protein estimation was minimal.

Variation of canine and feline frontal-plane QRS axes with lead choice and augmentation ratio

The intraindividual variability in mean electric axis referable to choice of ECG leads and augmentation ratio was investigated by means of a digital computer program. Although, in theory, the choice of leads for determining the QRS axis should make no difference, the maximum intraindividual variation in axis angle was about 50 degrees for canine and feline subjects. The angle conputed for the lead combinations I and III and I and aVF will usually fall within 5 to 10 degrees of the mean of all lead combinations, but larger variations are seen at time. The application of an "augmentation ratio" for the augmented unipolar leads was most helpful when it was individually computed. Further methods of lead-vector improvement are discussed.

Annotation: Numerical calculation of the mean electrical axis of electrocardiographic deflections

Formulas are presented for numerical calculation of magnitude and direction of the mean electrical axis of electrocardiographic deflections suitable for use with hand calculators and electronic digital computers.