Platelet-activating factor (1-alkyl-2-acetyl-sn-glycero-3-phosphocholine, or PAF) has previously been shown to induce glycogenolysis in the perfused adult rat liver and in the lung and liver of 24 day (gestational age) fetal rabbits in utero. In the present report, the effect of PAF was examined in fetal rats that were intravenously injected (through the vitellin vein) at a stage in their gestational development characterized by rapid glycogen depletion and surfactant accumulation. At 24 h after PAF administration of 2.5 micrograms and 5.0 micrograms to 19.5- and 20.5-day-old fetal rats, respectively, the lung glycogen content decreased significantly. In contrast, the inactive enantiomer of PAF did not modify the glycogenolytic response in vivo. When [14C]glucose (5 muCi) and PAF (5 micrograms) were simultaneously injected through the vitellin vein of the fetus, the radioactivity incorporated into lung glycogen was reduced as compared with control fetuses receiving the vehicle alone. An additional effect of PAF was noted in experiments designed to correlate glycogen breakdown to surfactant phospholipid biosynthesis. An inhibition of [3H]choline uptake and incorporation into phospholipids of fetal human lung explants and fetal lung type II pneumonocytes was induced by PAF. It is concluded that PAF appears to be a potential inducer of glycogen breakdown in the fetal lung and the relationship of these findings to fetal lung maturation is discussed.

Animals↗

PubMedDate not supplied

The False Claims Act as a remedy to the inadequate provision of nutrition and wound care to nursing home residents.

Under the federal Nursing Home Reform Act (NHRA), long-term care (LTC) facilities must provide care adequate to maintain residents' highest practicable physical, mental, and psychosocial well-being. Long-term care facilities that participate in Medicare and Medicaid also must meet specific requirements set by the federal and state governments and, by submitting a claim for reimbursement, certify that the services billed were actually provided. This case report centers on a Pennsylvania LTC facility that was sued by the federal government for inadequate care of three residents. For the first time, the government used the NHRA and the federal False Claims Act to enforce quality of care standards set by Congress. The implications of this case-that providing inadequate care now translates into a false claim to the government for payment-are dramatic for LTC facilities that care for Medicare and Medicaid patients.

Aged↗