Steroid hormonal activation of the Na+-K+-ATPase enzyme was examined in enriched preparations of outer medullary collecting tubules (MCT) and outer medullary thick ascending limbs of the loop of Henle (MAL), prepared by sedimentation through a discontinuous Ficoll gradient. Using morphological criteria, there was a 2.9-fold enrichment of MCT in fraction 1 when compared with fraction 2 and a 2.2-fold enrichment of MAL in fraction 2 when compared with fraction 1. This separation was further defined using biochemical markers. Na+-K+-ATPase activity, Mg2+-ATPase activity, and the adenylate cyclase response to a number of hormones each supported the morphologic definition of separation. The two preparations were challenged in vitro with both aldosterone and dexamethasone. In fraction 1, the fraction enriched in the MCT, 10(-8) M aldosterone stimulated Na+-K+-ATPase activity by 37%. The same concentration of dexamethasone was without effect. In contrast, 10(-8) M dexamethasone stimulated Na+-K+-ATPase activity by 27% in fraction 2, the fraction enriched in the MAL. In this fraction an equimolar concentration of aldosterone was without effect. Thus, the regulation of Na+-K+-ATPase activity by mineralocorticoids on the one hand and by glucocorticoids on the other would appear to be discontinuously localized along the length of the outer medullary distal nephron.

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Context In their role as health care providers, student athletic therapists (SATs) are responsible for the prevention and management of injuries. To fully understand an injury, SATs require knowledge of contributing factors, including medications and their use and misuse. Opioid misuse by athletes to manage pain has been documented in the literature, highlighting the importance of SATs being able to recognize opioid use and misuse. Opioids are known to alleviate pain, to impair cognition, and to have addictive qualities which prevents appropriate assessment and management of injuries. Objective The objective of this study was to understand SATs' knowledge of pain-relieving medication, particularly opioids. Design Qualitative study. Setting Semistructured interview. Patients or Other Participants SATs at an accredited institution in Canada. Data Synthesis Data were collected through interviews and transcribed. Themes were developed using triangulation that reflected the data Results Four themes were uncovered: (1) SATs had experienced both personal and professional use of opioids, which formulated their current knowledge; (2) SATs lacked appropriate knowledge of pain-relieving medications in general and of the potential consequences of their lack of knowledge; (3) SATs' knowledge stemmed from culture, social media, and news organizations; (4) SATs felt considerable pressure to provide correct information due to their autonomous role with a team. Conclusions SATs lacked enough knowledge to be able to appropriately recognize and advise athletes on pain-relieving medications, particularly opioids. SATs formulated their knowledge and opinions from sources that were not rooted in research and as such may transfer incorrect information to their athletes. SATs stigmatized athletes who were using pain-relieving medication, which may factor into inappropriate decisions regarding an athlete's care. Finally, SATs carried a significant burden to share correct information with their athletes and did not refer to outside sources (eg, physicians) when they were unsure of the information they were sharing with their athletes.