Aides' involvement in decision-making and the quality of care in institutional settings

Using two measures of the quality of care in institutional settings, we found much variance in the care provided within three institutional settings. Factors that might account for this variance were examined. Aides' perception of their involvement in certain areas of decision-making was shown to be of major importance in accounting for the variance in quality of care.     

Nephrotoxicity of cephaloridine in newborn rabbits: role of the renal anionic transport system

The nephrotoxicity of cephaloridine, cefazolin and mercuric chloride was studied in rabbits of various ages. Cephaloridine produced dose-related elevations in serum urea nitrogen, creatinine and renal tubular necrosis in adult and 30-day-old rabbits, only slight changes at 15 days of age and no effect in 5-day-old rabbits. Cefazolin also produced dose-related nephrotoxicity in adult rabbits but no effect in 15-day-old rabbits. Mercuric chloride administration resulted in similar nephrotoxicity in 5-, 15- and 30-day-old rabbits and adults. The development of susceptibility to cephaloridine nephrotoxicity paralleled the maturation of the renal anionic transport system as determined by the accumulation of p-aminohippurate by renal cortical slices in vitro. Substrate stimulation of the anionic transport system by p-aminohippurate or penicillin increased the nephrotoxicity of cephaloridine in between rabbits. The authors concluded that the lack of cephaloridine nephrotoxicity in newborn rabbits is due to the incomplete development of the renal anionic transport system.     

Conceptual approaches to the diagnosis of stress-induced functional disorders in humans under conditions of industrial activity

In accordance with the fundamental concept of the systems symmetrical approach, a model of the body's "ideal functional status" and a polyparametric method for diagnosing the human functional status (the method has been patented in Russia) were developed, on the basis of the unified set of amplitude and time parameters of a complex of physiological parameters (ECG, etc.). The systems symmetrical approach is basically new in defining the ratio of harmonic parameters acting as new diagnostic evidence for the health status. The unchanging ratio of parameters of autovariation processes in the cardiac, vascular, and respiratory systems, their changes in the development of the adaptative syndrome and the value were examined in healthy individuals at rest and during exercise an intensive productive activity (point brazing at a plant of electron devices), and in the trainees. It was demonstrated that the mechanism of development of adaptative processes was associated with the synchronization of autovariations in the cardiorespiratory and vascular systems and the involution of adaptative processes, their break, depletion, i.e. stress, were determined by the imbalance of relationships and the desynchronization of autovariations in these systems. To define a set of cardiorespiratory and hemodynamic parameters is necessary, but insufficient to evaluate (diagnose) the health status and health-disease intermediate diseases (stress and adaptative overtension). The ratio harmonicity of these parameters, i.e. well-balanced relations between the subsystems is the main characteristic. The assessment of the human health status in terms of the reference-the model of the ideal status as the ideal health status without using the complex and indefinite concept of the normal and moderate health status-is conceptual for polyparametric status estimation.     

Analysis of apoptosis during hair follicle regression (catagen)

Keratinocyte apoptosis is a central element in the regulation of hair follicle regression (catagen), yet the exact location and the control of follicular keratinocyte apoptosis remain obscure. To generate an "apoptomap" of the hair follicle, we have studied selected apoptosis-associated parameters in the C57BL/6 mouse model for hair research during normal and pharmacologically manipulated, pathological catagen development. As assessed by terminal deoxynucleotide transferase dUTP fluorescein nick end-labeling (TUNEL) stain, apoptotic cells not only appeared in the regressing proximal follicle epithelium but, surprisingly, were also seen in the central inner root sheath, in the bulge/isthmus region, and in the secondary germ, but never in the dermal papilla. These apoptosis hot spots during catagen development correlated largely with a down-regulation of the Bcl-2/Bax ratio but only poorly with the expression patterns of interleukin-1beta converting enzyme, p55TNFR, and Fas/Apo-1 immunoreactivity. Instead, a higher correlation was found with p75NTR expression. During cyclophosphamide-induced follicle dystrophy and alopecia, massive keratinocyte apoptosis occurred in the entire proximal hair bulb, except in the dermal papilla, despite a strong up-regulation of Bax and p75NTR immunoreactivity. Selected receptors of the tumor necrosis factor/nerve growth factor family and members of the Bcl-2 family may also play a key role in the control of follicular keratinocyte apoptosis in situ.     

Vasoactive properties of various fragments of human alpha-calcitonin gene-related peptide

Effects of some fragments of alpha-calcitonine gene-related peptide (alpha-CGRP) on the collector lymphatic vessels of the rat small intestine mesenterium, were studied. All the fragments excepting alpha-CGRP (21-24) and (21-31) activate motility of the lymphatic vessels enhancing phasic contractions of the walls. Presence of aminoacid residuals in the 20-29 area is "critical" for realising vasoactive properties by these fragments.     

Comparison of total intravenous, balanced inhalational and combined intravenous-inhalational anaesthesia for tympanoplasty, septorhinoplasty and adenotonsillectomy

The induction of complex bilateral leg muscle activation combined with coordinated stepping movements is demonstrated in patients with complete paraplegia. This was achieved by partially unloading patients who were on a moving treadmill. In comparison to healthy subjects, the paraplegic patients displayed a less dynamic mode of muscle activation. In all other respects leg muscle electromyographic activity was modulated in a similar manner to that in healthy subjects. However, the level of electromyographic activity in the gastrocnemius (the main antigravity muscle during gait) was considerably lower in the patients. During the course of a daily locomotor training program, the amplitude of gastrocnemius electromyographic activity increased significantly during the stance phase, while inappropriate tibialis anterior activation decreased. Incompletely paraplegic patients benefited from the training with respect to performance of unsupported stepping movements on solid ground. In about half of completely paraplegic patients with low muscle tone, no beneficial effect of the training was seen. This may be due to an inhibitory effect on spinal neuronal activity by drugs patients were taking (e.g., prazosin, clonidine, cannabinoids). In this study intrathecal application of clonidine drastically reduced, while epinephrine enhanced locomotor muscle electromyographic activity. The results of this study promise to be significant in the treatment of paraplegic patients.