A significant increase in both basal and maximal calcineurin activity in the rat pilocarpine model of status epilepticus.

This study focused on the effects of status epilepticus on the activity of calcineurin, a neuronally enriched, calcium-dependent phosphatase. Calcineurin is an important modulator of many neuronal processes, including learning and memory, induction of apoptosis, receptor function and neuronal excitability. Therefore, a status epilepticus-induced alteration of the activity of this important phosphatase would have significant physiological implications. Status epilepticus was induced by pilocarpine injection and allowed to continue for 60 min. Brain region homogenates were then assayed for calcineurin activity by dephosphorylation of p-nitrophenol phosphate. A significant status epilepticus-dependent increase in both basal and Mn(2+)-dependent calcineurin activity was observed in homogenates isolated from the cortex and hippocampus, but not the cerebellum. This increase was resistant to 150 nM okadaic acid, but sensitive to 50 microM okadaic acid. The increase in basal activity was also resistant to 100 microM sodium orthovanadate. Both maximal dephosphorylation rate and substrate affinity were increased following status epilepticus. However, the increase in calcineurin activity was not found to be due to an increase in calcineurin enzyme levels. Finally, increase in calcineurin activity was found to be NMDA-receptor activation dependent. The data demonstrate that status epilepticus resulted in a significant increase in both basal and maximal calcineurin activity.

Secondary health conditions among middle-aged individuals with chronic physical disabilities: implications for unmet needs for services.

Data from the Aging with Disability (AwD) Study are used to examine variations in the types and frequency of secondary conditions experienced by 301 middle-aged individuals living with the effects of three disabling conditions: polio (n = 124), rheumatoid arthritis (RA) (n = 103), and stroke (n = 75). All respondents were randomly selected from a county rehabilitation hospital or a community-based subject pool. Secondary conditions are operationalized as (1) the number of new health problems diagnosed or treated since the onset of the primary disability and (2) the amount of change/decline in basic and instrumental daily activities since a previous reference period in the disability trajectory. Also analyzed are changes in use of assistive devices and unmet needs for services. Differences in secondary conditions are examined within the AwD sample by impairment group and between samples by comparing AwD rates to national estimates for the same cohort. Results reveal significant differences in the types of new health problems reported by persons living with polio, RA, and stroke and document marked disparities, or accelerated aging, between disabled and nondisabled adults. Findings are discussed in terms of the changing health care needs of persons aging with disability and the importance of improving access to preventive services, ongoing rehabilitation, and assistive technology.

The Arab Muslim client: implications for anesthesia.

The Arab Muslim client has unique cultural characteristics that should be incorporated into anesthetic care. In obtaining a preoperative assessment and consent, issues such as privacy, family roles, body language, group decision making, communication distances, and use of translators should be addressed. Intraoperatively, the need for modesty and the client's possible adherence to folk beliefs should also be recognized. Postoperatively, pain and overall needs assessments are a continuing challenge. The anesthetist must also understand the underlying family roles, the high correlation between fear and pain, and the possible coexisting folk beliefs when working within the labor and delivery setting. By addressing these unique issues, the anesthetist can provide appropriate and safe anesthetic care.