Nurse-managed health care: an ongoing tradition.

Nurse-managed health care is a concept that has received much attention lately; however, it is not a new idea. Nurse-managed health care has been delivered through nursing centers since the beginning of the 20th century. This article examines the history of nursing centers and reports on the current diversity that exists in these centers today. Characteristics of academic and nonacademic nursing centers are examined through a review of the few studies currently available in the literature.

Involvement of the neuropeptide substance P in lung inflammation induced by hepatic ischemia/reperfusion.

OBJECTIVE AND DESIGN: The purpose of this study was to examine the potential role of substance P in accumulation of neutrophils in the lung following hepatic ischemia/reperfusion. MATERIALS AND METHODS: Male C57BL/6 mice (8-10 weeks of age) were subjected to either sham surgery, partial hepatic ischemia with or without reperfusion, or intratracheal administration of saline or 1 ng substance P. Lung neutrophil accumulation was assessed by tissue content of myeloperoxidase. Activation of the transcription factor, NF-kappaB, was determined by electrophoretic mobility shift assay. Levels of substance P and macrophage inflammatory protein-2 (MIP-2) in bronchoalveolar lavage (BAL) fluid was measured using enzyme-linked immunosorbent assays. RESULTS: Significant pulmonary neutrophil accumulation was observed just prior to hepatic reperfusion in association with increased BAL levels of substance P. Intratracheal administration of substance P resulted in a similar pattern of neutrophil accumulation which was associated with activation of NF-kappaB and increased BAL levels of the chemokine, MIP-2. CONCLUSIONS: The data suggest that hepatic ischemia causes substance P release in the lung which activates NF-kappaB leading to the production of MIP-2 and accumulation of neutrophils.