There is now evidence that the immediate cause of the loss of proliferative capacity in senescent cells is mediated by a specific inhibitor. If this tentative interpretation is correct, the next hurdle will be to determine mechanism(s) that regulate this putative senescence cell inhibitor that would, in effect, be the determinant of proliferative life span. One previously proposed hypothesis predicts that the decline of replicative activity is analogous to a checkpoint response to accumulated chromosomal damage (Rosenberger et al., 1991). Advances in our basic understanding of the nature of DNA damage, DNA repair mechanisms, and the response of eukaryotic cells to accumulated DNA damage provide a solid rationale for a reassessment of the causal role of the accumulation of chromosomal damage in cell senescence in vitro.

Animals↗

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Laboratory diagnosis of latent human papillomavirus infection.

The etiologic association of human papillomavirus (HPV) with uterine cervical cancer has prompted the need for improved laboratory diagnosis of this virus. The application of conventional hybridization technology, including filter in situ hybridization (FISH) and Southern-blot analysis, has revealed that the detection and typing of the virus is inconsistent between sequential specimens from the same individual. To determine whether the polymerase chain reaction (PCR) can be used to provide a more accurate assessment of infection status, two exfoliated cervical cell specimens obtained sequentially from a cohort of 30 women without clinical evidence of cervical abnormalities were analyzed in parallel by FISH and PCR at 6-month intervals. Neither of the procedures provided consistent findings with two sequential specimens suggesting that multiple analyses are necessary to assess infection accurately. However, PCR was less subjective in interpretation and demonstrated greater specificity than did FISH. With the increased sensitivity inherent to PCR, our findings indicated that PCR is more likely to identify latent HPV infection with a single specimen.

Base Sequence↗

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Medically complex pregnancy: a case report illustrating CNM/MD collaborative management.

In contemporary society, many women with complex medical conditions are attempting fertility and becoming pregnant. The patient presents with an impressive medical complication, yet many of her key educational and psychosocial needs are typical of those for any pregnant woman. Striving for "normalcy," she may actively seek midwifery care to help her create a family-centered birth experience. Indeed, the midwife practicing with physician colleagues may have the opportunity to collaboratively manage increasingly complex cases. This article describes the case of collaborative management during pregnancy and delivery of a patient with the cardiac syndrome Wolff-Parkinson White syndrome (WPW). First diagnosed with WPW at the age of 13, the patient's condition was initially controlled with oral medication. Eventually, the patient's symptomology worsened and required repeated treatment by cardiac ablation of the accessory pathway. Illustrative of the possibilities for enhanced care of the medically complex pregnant patient via collaborative management, the discussion details not only the pertinent physiologic events but the benefits and process of care. A review of the cardiophysiology of WPW is also presented.

Adolescent↗

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Infection control in the laundry.

Explore the source record for details and available documents.

Bedding and Linens↗

PubMedDate not supplied

A model for predicting motor urge urinary incontinence.

BACKGROUND: While the historical interview has been shown to diagnose stress urinary incontinence (UI) with reasonable accuracy, it is less accurate in the diagnosis of urge or mixed UI. OBJECTIVES: To construct an optimal model for the diagnosis of motor urge UI, and to refine this model into a simplified instrument that can be used to diagnose motor urge UI during a routine incontinence evaluation. METHODS: A model was constructed to allow a more accurate diagnosis of motor urge UI using historical data. Initially, an optimal model was developed that used three key symptoms, age, gender, a history of neurologic disorder, obstruction diagnosed via voiding pressure study, and the urethral resistance algorithm to diagnose motor urge UI. A simplified model was then constructed using factors such as symptoms of motor urge UI, age, and gender that were readily accessible to the nurse when completing a routine UI evaluation. This simplified model was used to develop an instrument for the clinical diagnosis of motor urge UI. RESULTS: While the agreement between clinical and urodynamic diagnosis was relatively high among patients with genuine stress UI (93% accuracy rate), it was considerably less among patients with urge and mixed UI, yielding accuracy rates of 63% and 35%, respectively. An optimal model for diagnosing motor urge UI was constructed and provided an overall accuracy rate of 91%. A simplified model was then constructed and evaluated for performance by least squares fit test. It revealed an R2 of 0.85 and an adjusted R2 of 0.84. CONCLUSIONS: A combination of age, gender, and three key symptoms (diurnal frequency, nocturia, and symptom of urge incontinence) provide an accurate and clinically useful model for the diagnosis of motor urge UI. Additional research is recommended to test the validity and reliability of the instrument derived from this model.

Adolescent↗

PubMedDate not supplied