Myths & facts ... about chronic nonmalignant pain.
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Biomedical subjects
Publications and source records attributed to M McCaffery.
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Giardia lamblia, which belongs to the earliest identified lineage to diverge from the eukaryotic line of descent, is one of many protists reported to lack a Golgi apparatus. Our recent finding of a developmentally regulated secretory pathway in G. lamblia makes it an ideal organism with which to test the hypothesis that the Golgi may be more readily demonstrated in actively secreting cells. These ultrastructural studies now show that a regulated pathway of transport and secretion of cyst wall antigens via a novel class of large, osmiophilic secretory vesicles, the encystation-specific vesicles (ESV), is assembled during encystation of G. lamblia. Early in encystation, cyst antigens are localized in simple Golgi membrane stacks and concentrated within enlarged Golgi cisternae which appear to be precursors of ESV. This would represent an unusual mechanism of secretory vesicle biogenesis. Later in differentiation, cyst antigens are localized within ESV, which transport them to the plasma membrane and release them by exocytosis to the nascent cell wall. ESV are not observed after completion of the cyst wall. In contrast to the regulated transport of cyst wall proteins, we demonstrate a distinct constitutive lysosomal pathway. During encystation, acid phosphatase activity is localized in endoplasmic reticulum, Golgi, and small constitutive peripheral vacuoles which function as lysosomes. However, acid phosphatase activity is not detectable in ESV. These studies show that G. lamblia, an early eukaryote, is capable of carrying out Golgi-mediated sorting of proteins to distinct regulated secretory and constitutive lysosomal pathways.
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Inadequate knowledge of opioid analgesic drugs and the incidence of psychological dependence are major barriers to nursing management of patients in pain. This study analyzed data obtained from 27 workshops on pain across 14 states (2,459 nurses) to determine current nursing knowledge of pharmacological management of pain. Results indicate that nurses lack knowledge in classification of opioids ranging from 23 to 98% correct response across seven analgesic drugs. Less than 25% of nurses correctly identified the frequency of psychological dependence. Further analysis revealed significant differences in basic versus advanced learners and geographical differences in knowledge. Implications are made for nursing education and practice.
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