Submitted by: Lunas, Anna Carmela L.

Submitted to: Sir Dexter Mirabueno

Date Submitted: 07/26/11 Course|Section|Group Number: BSN3A Group 3

Gene therapy stimulates protein that blocks immune attack and prevents Type 1 diabetes in mice
(July 4, 2011 by admin)

Increasing a specific protein in areas of the pancreas that produce insulin blocks the immune attack that causes type 1 diabetes, researchers reported in the August issue of the Journal of Clinical Investigation, published early online. The discovery could lead to a drug that prevents the progression of type 1 diabetes in people newly diagnosed who are in the honeymoon phase of the disease, when the immune system has not yet destroyed all of the insulin-producing beta cells in the pancreas. The finding could also lead to new drugs for overcoming organ rejection in transplant patients and for improving the survival of transplanted islets A the clusters of cells in the pancreas that contain beta cells. Normally, as the immune system successfully defeats an infection, a special type of white blood cell called T-regulatory cells produce chemical signals that turn off the immune response. The researchers took advantage of this phenomenon as they sought to protect the beta cells from immune attack. They used a modified virus to insert the gene for a protein called CCL22 into the beta cells of a strain of mice known to develop diabetes. The gene caused the beta cells to produce the CCL22 protein. This attracted T-regulatory cells, which blocked the attacking immune cells and prevented most of the mice from developing type 1 diabetes. CCL22 was discovered years ago by ovarian cancer researchers who noticed that tumours emit the protein to avoid being destroyed by the immune system. Its a novel way to turn down the immune system specifically in the region of the beta cells inside the pancreas, and that may be a big advantage over general immune suppression, which can have significant side effects, says Dr. Bruce Verchere, one of the studys principal investigators. He is head of the diabetes research program at the Child & Family Research Institute (CFRI) at BC Childrens Hospital, Irving K Barber Chair in Diabetes Research, and professor, Department of Pathology & Laboratory Medicine and Department of Surgery at the University of British Columbia (UBC). The studys co-lead author Dr. Joel Montane says more research is needed before the findings can be used clinically. Next, we need to better understand the mechanism, says Dr. Montane, a UBC post-doctoral fellow at CFRI. We dont know exactly how CCL22 attracts T-regulatory cells to inhibit the immune response. Once we understand that, it may lead to a drug that can prevent or reverse diabetes. The research points to CCL22, or a modified form of it, as a potential drug to control the immune response, says Dr. Loraine Bischoff, the co-lead author. Our strategy might also be used in other autoimmune disorders and in transplantation. The issue is how to administer it to humans. Its exciting because there are presently clinical trials using T-regulatory cells to prevent autoimmune disease. A team of CFRI-UBC scientists, including co-principal investigator Dr. Rusung Tan, worked on this discovery. ### This research was funded by the Canadian Institutes of Health Research, the Juvenile Diabetes Research Foundation, and the Michael Smith Foundation for Health Research. The Diabetes Research Program at CFRI is supported by BC Childrens Hospital Foundation and the Canucks for Kids Fund. CFRI conducts discovery, clinical and applied research to benefit the health of children and families. It is the largest institute of its kind in Western Canada. CFRI works in close partnership with UBC; BC Childrens Hospital and Sunny Hill Health Centre for Children, BC Womens Hospital & Health Centre, agencies of PHSA; and BC Childrens Hospital Foundation. CFRI has additional important relationships with British Columbias (B.C.s) five regional health authorities and with B.C. academic institutions Simon Fraser University, the University of Victoria, the University of Northern British Columbia, and the British Columbia Institute of Technology. For more information, visit www.cfri.ca. UBC is one of Canadas largest and most prestigious public research and teaching institutions, and one of only two Canadian institutions to be consistently ranked among the worlds 40 best universities. Surrounded by the beauty of the Canadian West, it is a place that inspires bold, new ways of thinking that have helped make it a national leader in areas as diverse as community service learning, sustainability and research commercialization. UBC attracts $550 million per year in research funding from government, non-profit organizations and industry through 7,000 grants. For more information, visit www.ubc.ca.
Contact: Jennifer Kohm jkohm@cfri.ca 604-875-2401 Child & Family Research Institute Source: http://www.breakthroughdigest.com/medical-news/gene-therapy-stimulates-protein-that-blocks-immune-attack-andprevents-type-1-diabetes-in-mice/

Generic Name

Brand Name

Classification

Indication
For treatment of shock and low blood pressure due to heart attack, trauma, infections, surgery, and other causes. It is also used to help improve heart function when it is unable to pump enough blood. It may also be used for other conditions as determined by your doctor.

Action

Dopamine

No brand names available

adrenergic and dopaminergic cardiac stimulants excluding glycosides

Dopamine is a vasopressor and inotropic agent. It works by increasing the pumping strength of the heart and the kidney blood supply.

Aminophylline

Phyllocontin, Truphylline

Methylxanthine

Aminophylline is used to treat the symptoms of asthma, bronchitis, and emphysema.

Aminophylline works in several ways: it relaxes muscles in your lungs and chest to allow more air in, decreases the sensitivity of your lungs to allergens and other substances that cause inflammation, and increases the contractions of your diaphragm to draw more air into the lungs.

Midazolam

Dormicum

Benzodiazepine derivatives

Tab: Sleep disturbances, insomnia. Tab/Injection: Sedation in premedication before surgical or diagnostic procedures, induction and maintenance of anesthesia. Control of severe or incapacitating allergic conditions intractable to adequate trials of conventional treatment in asthma, atopic dermatitis, contact dermatitis, drug hypersensitivity reactions, perennial or seasonal allergic rhinitis, serum sickness, transfusion reactions. Treating anxiety disorders or for the short-term relief of the symptoms of anxiety. It is also used to treat seizures, certain types of muscle spasms, and symptoms of alcohol withdrawal (eg, agitation, tremor, hallucinations). Diazepam is also used before surgery or other medical procedures to help reduce anxiety and tension. It may also be used for other conditions as determined by your doctor. Pyrexia of unknown origin. Fever & pain associated w/ common childhood disorders, tonsillitis, upper resp tract infections postimmunization reactions, after tonsillectomy & other conditions. Prevention of febrile convulsion. Headache, cold,sinusitis, muscle pain, arthritis & toothache. Temporary control of heart rate and blood pressure. It may also be used for other conditions as determined by your doctor.

Enhance sedative effects of neuroleptics, tranquilizers, antidepressants, sleep-inducing drugs, analgesics & anesth.

hydrocortisone sodium succinate

Solu-Cortef

Gluco-corticoid

Solu-Cortef Sterile Powder is an anti-inflammatory glucocorticoid, which contains hydrocortisone sodium succinate as the active ingredient.

Diazepam

Valium

Benzodiazepamine

Diazepam is a benzodiazepine. It works by increasing the action of a certain chemical (gammaaminobutyric acid [GABA]) in the brain and nervous system. This helps to reduce anxiety. It also helps to reduce seizure activity in the brain and to reduce muscle spasms.

Aeknil

Paracetamol

Analgesic

Paracetamol produces analgesia by raising the threshold of the pain center in the brain and by obstructing impulses at the painmediating chemoreceptors. The drug produces antipyresis by an action on the hypothalamus; heat dissipation is increased as a result of vasodilation and increased peripheral blood flow. Brevibloc is a beta-blocker. It works by reducing the workload on the heart and helping the heart beat more regularly by affecting certain nerve impulses in the body.

Esmolol

Brevibloc

Beta-blocker

Hydralazine

Apresoline

Vasodilator

Hydralazine is used to treat high blood pressure (hypertension).

Hydralazine is a vasodilator that works by relaxing the muscles in your blood vessels to help them dilate (widen). This lowers blood pressure and allows blood to flow more easily through your veins and arteries. Digoxin is derived from leaves of a digitalis plant. It helps make the heart beat stronger and with a more regular rhythm.

Digoxin

Lanoxin

Digitalis glycosides

Digoxin is used to treat congestive heart failure. It is also used to treat atrial fibrillation, a heart rhythm disorder of the atria (the upper chambers of the heart that allow blood to flow into the heart).

Epinephrine

Adrenalin

adrenergic and dopaminergic cardiac stimulants excluding glycosides-Used in the treatment of heart failure. adrenergic inhalants, alpha- and beta-adrenoreceptor agonists. Used in the treatment of obstructive airway diseases. phenylalkylamine derivative selective calcium-channel blockers

Epinephrine injection is used to treat severe allergic reactions (anaphylaxis) to insect stings or bites, foods, drugs, and other allergens. Epinephrine is also used to treat exercise-induced anaphylaxis.

Epinephrine is a chemical that narrows blood vessels and opens airways in the lungs. These effects can reverse severe low blood pressure, wheezing, severe skin itching, hives, and other symptoms of an allergic reaction.

Verapamil

Calan

Verapamil is used to treat hypertension (high blood pressure), angina (chest pain), and certain heart rhythm disorders.

Verapamil is in a group of drugs called calcium channel blockers. It works by relaxing the muscles of your heart and blood vessels.

Allopurinol

Lopurin

preparations inhibiting uric acid production

Allopurinol is used to treat gout or kidney stones, and to decrease levels of uric acid in people who are receiving cancer treatment.

Allopurinol reduces the production of uric acid in your body. Uric acid buildup can lead to gout or kidney stones.

Submitted by:Lunas, Anna Carmela L. Submitted to:Sir Dexter Mirabueno

Date: 07-26-11 Course|Section|Group: BSN3A Group 3

Dorothea Orem's Self-Care Theory

A. Theory of Self Care This theory Includes:

Self care practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being Self care agency is a human ability which is "the ability for engaging in self care" -conditioned by age developmental state, life experience sociocultural orientation health and available resources Therapeutic self care demand "totality of self care actions to be performed for some duration in order to meet self care requisites by using valid methods and related sets of operations and actions" Self care requisites-action directed towards provision of self care. 3 categories of self care requisites are-

1. Universal

Developmental Health deviation

2. Universal self care requisites

Associated with life processes and the maintenance of the integrity of human structure and functioning Common to all , ADL Identifies these requisites as: Maintenance of sufficient intake of air ,water, food Provision of care assoc with elimination process Balance between activity and rest, between solitude and social interaction Prevention of hazards to human life well being and Promotion of human functioning

3. Developmental self care requisites

Associated with developmental processes/ derived from a condition. Or associated with an event o E.g. adjusting to a new job o adjusting to body changes Health deviation self care o Required in conditions of illness, injury, or disease .these include:-o Seeking and securing appropriate medical assistance o Being aware of and attending to the effects and results of pathologic conditions o Effectively carrying out medically prescribed measures o Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care o Learning to live with effects of pathologic conditions

B. Theory of self care deficit

Specifies when nursing is needed Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care. Orem identifies 5 methods of helping: o Acting for and doing for others o Guiding others o Supporting another o Providing an environment promoting personal development in relation to meet future demands o Teaching another

C. Theory of Nursing Systems

Describes how the patients self care needs will be met by the nurse , the patient, or both Identifies 3 classifications of nursing system to meet the self care requisites of the patient:Wholly compensatory system Partly compensatory system Supportive educative system Design and elements of nursing system define Scope of nursing responsibility in health care situations General and specific roles of nurses and patients Reasons for nurses relationship with patients and The kinds of actions to be performed and the performance patterns and nurses and patients actions in regulating patients self care agency and in meeting their self care demand Orem recognized that specialized technologies are usually developed by members of the health profession A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavor ,with or without use of materials or instruments

REACTION PAPER:

Dorothea Orem was one of the foremost nursing theorists known to mankind. During the time that she rendered service in different general hospitals throughout her state, that was when she developed her own definition of nursing practice. Her major assumptions included that individuals should be self-reliant, people should be distinct individuals, a persons knowledge of potential health problems is necessary for the promotion of self-care behaviors and that nursing is a form of actioninteraction between two or more persons. Dorothea Orems Theory of Self-Care Deficit is probably one of the best known, easily understood and most applied in the clinical setting. While most of us would recognize the Self-Care Deficit Theory as Orems sole contribution to the development of nursing, she is in fact the author of three, namely: the Self-Care Theory, the Theory of Self-Care Deficit and the Theory of Nursing Systems. All three theories are related to one another. They support the idea that whenever imbalances, disability and illness occur, the individual client would seek the aid of the nurse who possesses the knowledge, skills and ability to help him/her recover. Nevertheless, individual clients have the function, capability and knowledge to maintain health and well-being to take care of themselves. Alligood & Tomey (2006), even stated that" Highly regarded for its usefulness in all aspects of nursing, Orem's Self Care Model continues to be the organizing frame work of many nurse researchers, educators, administrators and providers of client care". Its popularity and practicability can be seen by the different nursing bodies' interest in Orem's model and even the nurses interested in it, have formed an International Orem's Society for nursing science and scholarship. Dorothea Orems contribution to nursing practice is definitely something that nurses worldwide can use in terms of skills development and care management since the theories stated above are all client-centered and can be learned in socio-cultural context.