Search

The effect of sertraline, a selective serotonin reuptake inhibitor (SSRI), on cytosolic free Ca²⁺ concentrations ([Ca²⁺](i)) in a rabbit corneal epithelial cell line (SIRC) is unclear. This study explored whether sertraline changed basal [Ca²⁺](i) levels in suspended SIRC cells by using fura-2 as a Ca²⁺-sensitive fluorescent dye. Sertraline at concentrations between 10-100 μM increased [Ca²⁺](i) in a concentration-dependent manner. The Ca²⁺ signal was reduced by 23% by removing extracellular Ca²⁺. Sertraline induced Mn²⁺ influx, leading to quench of fura-2 fluorescence, suggesting Ca²⁺ influx. This Ca²⁺ influx was inhibited by phospholipase A₂ inhibitor aristolochic acid, but not by store-operated Ca²⁺ channel blockers and protein kinase C/A modulators. In Ca²⁺-free medium, pretreatment with the endoplasmic reticulum Ca²⁺ pump inhibitor thapsigargin, cyclopiazonic acid or 2,5-di-tert-butylhydroquinone greatly inhibited sertraline-induced Ca²⁺ release. Inhibition of phospholipase C with U73122 abolished sertraline-induced [Ca²⁺](i) rise. At concentrations of 5-50 μM, sertraline killed cells in a concentration-dependent manner. The cytotoxic effect of 25 μM sertraline was not reversed by prechelating cytosolic Ca²⁺ with BAPTA/AM. Collectively, in SIRC cells, sertraline induced [Ca²⁺](i) rises by causing phospholipase C-dependent Ca²⁺ release from the endoplasmic reticulum and Ca²⁺ influx via phospholipase A₂-sensitive Ca²⁺ channels. Sertraline-caused cytotoxicity was mediated by Ca²⁺-independent pathways.

Nursing clinical practice has changed dramatically in recent years due to advances in medical science. Increasing medical costs and the rising prevalence of chronic diseases in growing elderly populations have encouraged the development of various new case management care models. The purpose of this study was to introduce the current status and future development of case management and telehealth care as well as to challenge and guide nurses. Rather than turning a blind eye to new developments in information technology, we must use such to help nurses develop individualized and humanized care plans. New technologies can also assist nurses to deliver efficient and effective professional nursing care. Nurse case managers must increase competencies in assessment, critical thinking, evidence-practice, communication and negotiation, cooperation and problem solving. Case managers must practice independently while cooperating with other team members. The case manager is also a vanguard in the application of telehealth care in the nursing profession. Such professionals have a strong potential role to play in the future development of the nursing profession.