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Little Rock, AR, United States

Kortebein P.,University of Arkansas for Medical Sciences | Goodwin M.,Central Arkansas Veterans Healthcare Service | Arant A.,University of Arkansas for Medical Sciences
Rehabilitation Nursing

Limited data exist regarding rehabilitation medicine consultation services in the acute-care hospital setting. We examined implementation rates of rehabilitation consultant recommendations in a university hospital with either a rotating physician service or a single advanced-practice nurse. We performed a retrospective chart review of all patients evaluated by a rehabilitation consultation service for 2 months at a single 300-bed hospital: The first month with rotating physicians (MP) and the second month with a single advanced-practice nurse (SP). Total consultations/recommendations were similar during the 2 months (MP-63/251, SP-68/240, respectively). The overall implementation rate was greater during the month with the SP (SP-74%, MP-47%), although implementation was similar for discharge disposition (MP-82%, SP-85%). In this university hospital, rehabilitation consultation recommendations were more frequently implemented with a single-provider consultation service. Further study of rehabilitation consultation services is needed, including evaluation of nonphysician consultants. Source

Shmookler Reis R.J.,Central Arkansas Veterans Healthcare Service | Shmookler Reis R.J.,University of Arkansas for Medical Sciences | Xu L.,University of Arkansas for Medical Sciences | Lee H.,University of Arkansas for Medical Sciences | And 12 more authors.

Many lifespan-modulating genes are involved in either generation of oxidative substrates and end-products, or their detoxification and removal. Among such metabolites, only lipoperoxides have the ability to produce free-radical chain reactions. For this study, fatty-acid profiles were compared across a panel of C. elegans mutants that span a tenfold range of longevities in a uniform genetic background. Two lipid structural properties correlated extremely well with lifespan in these worms: fatty-acid chain length and susceptibility to oxidation both decreased sharply in the longest-lived mutants (affecting the insulinlike-signaling pathway). This suggested a functional model in which longevity benefits from a reduction in lipid peroxidation substrates, offset by a coordinate decline in fatty-acid chain length to maintain membrane fluidity. This model was tested by disrupting the underlying steps in lipid biosynthesis, using RNAi knockdown to deplete transcripts of genes involved in fatty-acid metabolism. These interventions produced effects on longevity that were fully consistent with the functions and abundances of their products. Most knockdowns also produced concordant effects on survival of hydrogen peroxide stress, which can trigger lipoperoxide chain reactions. © Shmookler Reis et al. Source

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