Association between concentrations of chromium in drinking water and mortality due to suicide in Alabama.

Preclinical studies and clinical data from case series and placebo-controlled trials suggest that chromium might have antidepressant effects. We conducted an observational study in order to assess the association between concentrations of chromium in drinking water and mortality due to suicide in Alabama. Publicly available databases were used to determine both county-level concentrations of chromium in drinking water and county-level rates of mortality due to suicide in the years 2005-2015. Data analyses comparing county-level concentrations of total chromium in drinking water with mortality rate due to suicide were conducted using a two-tailed nonparametric Spearman's rank correlation, with statistical significance set at p ≤ 0.01 and 99% confidence interval. Sub-analyses were conducted examining males, females, whites, and blacks/other minorities. There were no statistically significant findings concerning concentrations of chromium and suicide rate in the general population (p = 0.35, r = -0.12); however, there was a statistically significant inverse relationship between the concentration of chromium and suicide deaths in whites (p = 0.009, r = -0.32). There were no statistically significant findings in the remaining demographic subgroups. Chromium in drinking water might have a protective effect against mortality due to suicide, at least in the Caucasian population.

Effect of an Individualized Post-Examination Instructor Remediation on Pharmacy Student Performance in a Biochemistry Course.

Objective. To assess the effectiveness of a post-examination, one-on-one instructor remediation process on student performance in a pharmacy biochemistry course by measuring the degree of score improvement on a subsequent examination. Methods. Students who scored below 70% on any examination were encouraged to meet with the course coordinator. A typical remediation session lasts about 30 minutes, and covers academic preparation, study habits, concept understanding, application, critical thinking, time management, and stress control. Scores in two consecutive examinations were compared between students who underwent remediation and those who did not. All scores were adjusted for level of difficulty. Results. At-risk students with relatively lower scores are more likely to seek remediation. After receiving a score below 70%, students perform better on the next examination regardless of remediation. However, the remediation process results in a statistically significant 43% increase in the degree of improvement in student performance on the next examination. Conclusion. A post-examination, one-on-one remediation is effective in enhancing student performance in the biochemistry course. As this course is one of the two with the highest failure rates in the PharmD program, current intervention might improve student retention.

Value of pharmacy services to the healthcare system: an interdisciplinary assessment.

OBJECTIVES: The purpose of this project was to determine how pharmacists and physicians view the extending role of the hospital pharmacist in Tennessee, USA. METHODS: An 18-question survey was sent via e-mail to five selected hospitals in Tennessee. The survey was comprised of questions related to the interaction of the pharmacist with other healthcare professionals and their role in the healthcare team. KEY FINDINGS: This survey achieved a 40.1% response rate. Ninety-one per cent of physicians and pharmacists in the sample are receptive to an extended role of the pharmacist and agree that pharmacists provide a benefit to patients and to the healthcare system. A minority of respondents, including pharmacists, do not consider the pharmacist a member of the healthcare team and suggest that barriers in the transition away from the traditional pharmacy role are time, staffing and reimbursement/funding. CONCLUSIONS: Results from this survey reveal that the majority of physicians and pharmacists in non-academic settings embrace an extended role of the pharmacist as part of the healthcare team and have an overall good perception of contemporary pharmacy practice. Clinical pharmacies are in place worldwide, making this topic applicable in many settings.

Overexpression of manganese superoxide dismutase protects against ATP depletion-mediated cell death of proximal tubule cells.

We have previously shown that in vivo renal ischemia/reperfusion results in ATP depletion, oxidant production, and manganese superoxide dismutase (MnSOD) inactivation. Current studies were designed to compare the effect of ATP depletion (Antimycin A treatment) on cell death pathways using renal proximal tubular cells and identical cells that overexpress MnSOD. ATP depletion in wild-type cells induced an apoptotic cascade that involved caspase 9 activation; MnSOD overexpressing cells afforded protection against apoptosis. This protection did not appear to involve a cytochrome c-related mechanism, but may be related to altered levels of nitric oxide within the cell. Further studies suggested that nitric oxide was required to protect the renal cells from caspase-mediated cell death. Interestingly, treatment of renal cell extracts with reductants (DTT and ascorbate) enhanced caspase activation. Taken together, these results suggest that cysteine nitrosylation may be playing a role in caspase dysfunction in cells overexpressing MnSOD following ATP depletion.

Mitochondrial targets of oxidative stress during renal ischemia/reperfusion.

Endogenous tyrosine nitration and inactivation of manganese superoxide dismutase (MnSOD) has previously been shown to occur in both human and rat chronic renal allograft rejection. To elucidate the time course of MnSOD inactivation and mitochondrial dysfunction at earlier times during renal transplantation, we developed a rodent model of renal ischemia/reperfusion (I/R). Renal function was significantly impaired at 16 h reperfusion following 30 min of warm ischemia. Tyrosine nitration of specific mitochondrial proteins, MnSOD and cytochrome c, occurred at the earliest time point examined, an event that preceded significant renal injury. Interestingly, a small percentage of both mitochondrial proteins were also located in the cytosol. This leakage and decreased adenosine 5(')-triphosphate levels indicate loss of mitochondrial membrane integrity during renal I/R. Inactivation of MnSOD occurred rapidly in this model of renal I/R, suggesting that loss of MnSOD activity leads to further renal injury and nitration of other mitochondrial targets.