Management of upper and lower urinary tract infections in pregnant women

Nurse practitioners often manage pregnant women for many health problems. Early recognition, treatment, or timely referral of any infectious process, especially urinary tract infections, is crucial to an optimal pregnancy outcome. Knowledge of urinary tract anatomic and physiologic changes in pregnancy and bacterial features necessary for infection to occur expands understanding the foundation of urinary tract infection prevention and treatment. This article discusses urinary tract infections, specifically focusing on clinical features, diagnosis, and treatment measures among pregnant women.     

Milk production, health, behavior, and endocrine responses of cows exposed to electrical current during milking

Six cows were exposed during milkings to electrical current to assess its effects on behavior, health, milking performance, and endocrine responses. Three treatments (0, 4, and 8 mA) were applied in a changeover design over three consecutive 1-wk periods. A cow received the same current treatment during 14 consecutive milkings, beginning with the evening milking (d 1) and ending with the morning milking (d 8). Treatments began 5 min before milking and continued until milking unit removal. Treatments consisted of 60 Hz square wave current of 5-s duration applied every 30 s from udder to hooves. Milk accumulation curves provided information about milk yields, milking times, peak milk flow rates, and times of peak milk flow. Residual milk yields also were measured. Milk was analyzed for protein, fat, and somatic cells. Blood samples from 60 min before to 60 min after treatment were collected, and oxytocin, prolactin, and cortisol concentrations were measured. Behavioral responses to current decreased with time. Changes of milking performance and milk composition were not significant. Changes of milking related cortisol responses during 8-mA current stimulation were significant. Oxytocin release was delayed during 8-mA treatments. Current treatments did not affect prolactin.     

Molecular basis and species specificity of high affinity binding of vasoactive intestinal polypeptide by the rat secretin receptor

The affinity and specificity of the binding interaction between ligands and their receptors are key for appropriate hormonal regulation of target tissues. However, it is now apparent that vasoactive intestinal polypeptide (VIP) binds to the rat secretin receptor with similar affinity to that for its natural ligand, secretin (Holtmann et al., 1995). In this report, we establish that this is not a characteristic of the human secretin receptor, and use rat-human secretin receptor chimeras, site mutants and truncated receptor constructs to establish the molecular basis for this unusual binding interaction. Of note, isolated N-terminal domains of the rat secretin and the VIP receptors are capable of high affinity binding of VIP. In the recently recognized secretin family of receptors, this domain has six conserved cysteine residues and disulfide bonds that are likely important to achieve the complex conformation critical for this binding. A single acidic residue (Asp98) present in the rat secretin receptor appears to be critical, because a site-mutant changing this to the polar, but uncharged residue present in that position in the human receptor (Asn) eliminates the high affinity binding of VIP. Of interest, a previously identified critical basic residue in VIP (Lys15) provides a candidate for charge-pairing with this residue, potentially aligning the peptide ligand in a nonproductive orientation within this receptor.     

Regulation of conventional protein kinase C isozymes by phosphoinositide-dependent kinase 1 (PDK-1)

BACKGROUND: Phosphorylation critically regulates the catalytic function of most members of the protein kinase superfamily. One such member, protein kinase C (PKC), contains two phosphorylation switches: a site on the activation loop that is phosphorylated by another kinase, and two autophosphorylation sites in the carboxyl terminus. For conventional PKC isozymes, the mature enzyme, which is present in the detergent-soluble fraction of cells, is quantitatively phosphorylated at the carboxy-terminal sites but only partially phosphorylated on the activation loop. RESULTS: This study identifies the recently discovered phosphoinositide-dependent kinase 1, PDK-1, as a regulator of the activation loop of conventional PKC isozymes. First, studies in vivo revealed that PDK-1 controls the amount of mature (carboxy-terminally phosphorylated) conventional PKC. More specifically, co-expression of the conventional PKC isoform PKC betaII with a catalytically inactive form of PDK-1 in COS-7 cells resulted in both the accumulation of non-phosphorylated PKC and a corresponding decrease in PKC activity. Second, studies in vitro using purified proteins established that PDK-1 specifically phosphorylates the activation loop of PKC alpha and betaII. The phosphorylation of the mature PKC enzyme did not modulate its basal activity or its maximal cofactor-dependent activity. Rather, the phosphorylation of non-phosphorylated enzyme by PDK-1 triggered carboxy-terminal phosphorylation of PKC, thus providing the first step in the generation of catalytically competent (mature) enzyme. CONCLUSIONS: We have shown that PDK-1 controls the phosphorylation of conventional PKC isozymes in vivo. Studies performed in vitro establish that PDK-1 directly phosphorylates PKC on the activation loop, thereby allowing carboxy-terminal phosphorylation of PKC. These data suggest that phosphorylation of the activation loop by PDK-1 provides the first step in the processing of conventional PKC isozymes by phosphorylation.     

A questionnaire study among 171 medical candidates enrolled in a PhD program. Three elements in the PhD education: supervision, research courses and international relations

One hundred and seventy-one medical doctors (median age 34 years) registered as Ph.D.-students at the Medical Faculty, University of Aarhus, were given a questionnaire concerning the Ph.D-program (91% reply rate). The Ph.D.-students had typically graduated four years before enrollment and had gained basic clinical experience. Eighty-four percent had been involved in research projects prior to their formal research education. In general, the Ph.D.-students found the supervision offered by senior researchers adequate, although, more Ph.D.-students in clinical than in preclinical departments would have liked their main supervisor to be more enthusiastic and have more specific expertise. By tradition, the Medical Faculty in Aarhus offers a broad introductory course on research methodology, this was appreciated by the Ph.D.-students. However, they found that too much time was allocated for this purpose. The Ministry of Education recommends that Ph.D.-students gain experience from international collaboration, preferably from a stay abroad. However, only 24% of Ph.D.-students had stayed at an international collaborating institution. Although the overall evaluation of the medical Ph.d.-program was positive, the Ph.D.-students pointed out weaknesses and conflicts requiring adjustment.     

A novel k-space trajectory measurement technique

OBJECTIVE: To report our experience with erosion of permanent suture or mesh material after abdominal sacrocolpopexy. METHODS: A retrospective chart review was performed to identify patients who underwent sacrocolpopexy by the same surgeon over 8 years. Demographic data, operative notes, hospital records, and office charts were reviewed after sacrocolpopexy. Patients with erosion of either suture or mesh were treated initially with conservative therapy followed by surgical intervention as required. RESULTS: Fifty-seven patients underwent sacrocolpopexy using synthetic mesh during the study period. The mean (range) postoperative follow-up was 19.9 (1.3-50) months. Seven patients (12%) had erosions after abdominal sacrocolpopexy with two suture erosions and five mesh erosions. Patients with suture erosion were asymptomatic compared with patients with mesh erosion, who presented with vaginal bleeding or discharge. The mean (+/-standard deviation) time to erosion was 14.0+/-7.7 (range 4-24) months. Both patients with suture erosion were treated conservatively with estrogen cream. All five patients with mesh erosion required transvaginal removal of the mesh. CONCLUSION: Mesh erosion can follow abdominal sacrocolpopexy over a long time, and usually presents as vaginal bleeding or discharge. Although patients with suture erosion can be managed successfully with conservative treatment, patients with mesh erosion require surgical intervention. Transvaginal removal of the mesh with vaginal advancement appears to be an effective treatment in patients failing conservative management.     

Life table study of Aedes aegypti (Diptera: Culicidae) in Puerto Rico fed only human blood versus blood plus sugar

Life table studies were performed in 1996 with Aedes aegypti (L.) during the low (cool/dry) and high (hot/rainy) dengue virus transmission seasons in Puerto Rico. Mated adult females from field-collected pupae were placed individually in cages and divided into 2 treatment groups: one was fed only human blood and the other human blood plus a 10% sucrose solution. Survival and number of eggs laid were recorded daily for each female. During both seasons, age specific survivorship was higher for the blood plus sugar group, groups fed only human blood had higher reproductive outputs (mx), and net replacement rates (Ro) for blood only groups were higher than for those fed blood plus sugar. Intrinsic rates of growth (r) were the same for both treatments during the low (cool/dry) transmission season, but higher for the blood-only treatment during the high (hot/rainy) transmission season. Our results indicate that feeding on only human blood provides an evolutionary advantage to Ae. aegypti females in Puerto Rico. These results are similar to those from an earlier study carried out with Ae. aegypti in Thailand; the advantage of feeding on human blood does not seem to be restricted to a particular geographic region. We also found that the benefits associated with human feeding persist through epidemiologically different times of the year. We conclude that feeding on human blood is reproductively beneficial for Ae. aegypti, which may increase their contact with human hosts, and therefore may influence their vectorial capacity for dengue viruses through frequent feeding on blood.