Pathophysiology of Sepsis Associated Acute Kidney Injury

Sepsis is a common cause of AKI. The research shows that AKI associated sepsis has high morbidity and mortality rates. According to Bonventre and Yang (2011) even if a patient survives the acute phase of kidney injury there are many chronic consequences that can occur as a result. These can include chronic kidney disease and end-stage renal disease (p. 4210). This makes keeping up with further research and developments related to AKI all the more important to nurses. Many factors contribute to the occurrence of sepsis associated AKI. Sepsis is a major cause of AKI due to the alterations in microcirculation and the effects it has on homeostasis. Current therapy focuses on early antibiotic initiation and fluid resuscitation but a lot of clinical trials are being done to see if better treatments are out there that could reduce morbidity and mortality rates. As new treatments are tested and developed it is extremely important for nurses to stay up to date on best practice related to this serious clinical issue. Nurses have the opportunity to positively affect a huge number of patients if strides in research are made

Living a Healthier Life: A Connection Between Mind, Body and Spirit

This thesis project is a wellness center for the city of Moorhead, MN. The site is located on Main Avenue next to the Red River. The site features easy access to both Fargo and Moorhead?s downtown areas and the bike path system. Patrons will use this facility to become one with their mind, body and spirit. The techniques of Feng Shui, which have been practiced for ages and are shown to have positive effects on a person, have driven the design

Estudo fitoquímico, testes biológicos, ensaios farmacológicos e atividades hipoglicêmicas de Cantinoa althaeifolia Pohl ex Benth Harley & J. F. B. Pastore (Lamiaceae)

Orientadora: Profa. Dra. Marilis Dallarmi MiguelCoorientador: Prof. Dr. Obdulio Gomes MiguelTese (doutorado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Ciências Farmacêuticas. Defesa : Curitiba, 12/04/2021Inclui referências: p. 131-136Resumo: O objetivo deste estudo foi compor a composição fitoquímica, investigar as propriedades toxicológicas, antioxidantes, microbiológicas e introduzir o farmacológico da espécie vegetal C. althaeifolia (Pohl ex Benth) Harley & J. F. B. Pastore (Lamiaceae). Esta espécie não é endêmica no Brasil, mas se dispõem nas regiões Centro-Oeste, Sudeste e Sul. As folhas e caule foram coletadas no bairro Boqueirão Município de Curitiba - Paraná, Brasil. O material foi seco em temperatura ambiente e armazenado para preparação dos extratos para os testes analíticos e biológicos. Na sequência, foi realizado o estudo fitoquímico onde foi confirmado a presença de esteroides, terpenos, flavonoides, cumarinas e taninos nas folhas e caule. Na extração do óleo vegetal, foi encontrado diversos componentes importantes, dentre eles, o cariofileno e o óxido de cariofileno, gama himachaleno, espatulenol e o pogostol que conferem atividades antioxidantes, antimicrobianas e toxicológicas que foram posteriormente confirmadas suas atividades nos ensaios biológicos e toxicológicos. Nas atividades frente ao microcrustáceo Artemia salina e na atividade alelopática, não apresentaram toxicidade, neste último corrobora com o meio de vida da planta. Na atividade hemolítica, o óleo essencial apresentou maior toxicidade, depois as folhas e por último o caule que apresentou toxicidade apenas nas amostras mais polares. Na atividade antioxidante, no teste de compostos fenólicos totais, as amostras apresentaram um potencial antioxidante médio-alto, altas concentrações foram encontradas também na atividade antioxidante por redução do complexo fosfomolibdênio e na atividade antioxidante por redução do radical 2,2-difenil-1 -picrilhidrazil (DPPH), as amostras menos polares obtiveram resultados mais próximos aos padrões testados. Para a análise microbiológica, foram testadas as cepas Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa e Candida albicans inicialmente, onde apresentaram boa sensibilidade para as amostras testadas. Posteriormente, foram testadas as cepas Candida glabrata, Candida guilliermondii, Candida tropicalis, Candida parapsilosis, Candida auris 01, Candida auris 02, Candida auris 03 e Candida krusei, a amostra da fração remanescente apresentou resistência a todos os microrganismos testados. Na análise toxicológica in vitro, foram testadas as linhagens celulares de Melanoma murinho (B16F10), Carcinoma de câncer de mama humano (MCF7), Leucemia mielóide crônica (K562) e Leucemia Linfoma de célula T (Jurkat) e como linhagem celular comparativa foi utilizada a linhagem celular de Fibroblasto murinho (3T3). As amostras apresentaram uma concentração inibitória (CI) de 50% de morte nas concentrações de 25 e 50 ug. No ensaio preliminar farmacológico, foram utilizados ratos wistar machos, foram separados em 6 grupos diferentes. A droga padrão utilizada foi a metformina. Foi administrado estreptozotocina para indução do diabetes mellitus. Foi analisado o índice de ingestão de água pós indução do diabetes mellitus e o aumento do consumo de ração pós indução do diabetes mellitus.Abstract: The aim of this study was to compose the phytochemical composition, investigate the toxicological, antioxidant, microbiological properties and introduce the pharmacological of the vegetable species Cantinoa althaeifolia (Pohl ex Benth) Harley & J. F. B. Pastory (Lamiaceae). This species is not endemic in Brazil, but is available in the Midwest, Southeast and South regions. The leaves and stem were collected in the neighborhood Boqueirão Municipality of Curitiba - Paraná, Brazil. The material was dried at room temperature and stored for the preparation of extracts for analytical and biological tests. Afterwards, a phytochemical study was carried out, where the presence of steroids, terpenes, flavonoids, coumarins and tannins in the leaves and stem was confirmed. In the extraction of vegetable oil, several important components were found, among them, the caryophyllene and caryophyllene oxide, himachalene range, spatulenol and pogostol that confer antioxidant, antimicrobial and toxicological activities that were subsequently confirmed in biological and toxicological tests. In the activities against the microcrustacean Artemia salina and in the allelopathic activity, they did not present toxicity, in the latter corroborates with the plant's livelihood. In hemolytic activity, the essential oil showed greater toxicity, then the leaves and finally the stem that showed toxicity only in the most polar samples. In the antioxidant activity, in the test of total phenolic compounds, the samples showed medium-high antioxidant potential, high concentrations were also found in the antioxidant activity by reduction of the phosphomolibdenum complex and in the antioxidant activity by reduction of the radical 2,2-diphenyl-1- picril-hydrazil (DPPH), the less polar samples obtained results closer to the tested standards. For the microbiological analysis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans strains were initially tested, where they showed good sensitivity for the tested samples. Subsequently, the strains Candida glabrata, Candida guilliermondii, Candida tropicalis, Candida parapsilosis, Candida auris 01, Candida auris 02, Candida auris 03 and Candida krusei were tested, the sample of the remaining fraction showed resistance to all tested microorganisms. In the in vitro toxicological analysis, the cell lines of murine Melanoma (B16F10), Human breast cancer carcinoma (MCF7), Chronic myeloid leukemia (K562) and Leukemia T-cell lymphoma (Jurkat) were tested and a comparative cell line was used. the murine Fibroblast cell line (3T3). The samples showed an inhibitory concentration (CI) of 50% of death at concentrations of 25 and 50 ug. In the preliminary pharmacological trial, male wistar rats were used, separated into 6 different groups. The standard drug used was metformin. Streptozotocin was administered to induce diabetes mellitus. The water intake index after diabetes mellitus induction and the increase in feed consumption after diabetes mellitus induction were analyzed

A new mammalian model system for thalidomide teratogenesis : Monodelphis domestica

We thank the members of the Sears Lab and J. Marcot for discussion of ideas presented in this manuscript, and the DAR at the University of Illinois for insights into animal husbandry. We also thank the Suarez Lab for the use of equipment. This research was supported by National Science Foundation (1257873) and University of Illinois Research Board (16056) grants to K.E.SPeer reviewedPostprin

Misremembering pain: A memory blindness approach to adding a better end.

How people remember feeling in the past informs future decisions; however, memory for past emotion is subject to a number of biases. Previous research on choice blindness has shown that people often fail to notice when they are exposed to misinformation about their own decisions, preferences, and memories. This type of misinformation can influence how they later remember past events. In the present study, we examined the memory blindness effect in a new domain: memory for pain. Participants (N = 269) underwent a cold-pressor task and rated how much pain, distress, and positive and negative affect they had experienced. Later, participants were shown their pain ratings and asked to explain them. Some of the participants were shown lower pain ratings than they had actually made. In a second session, participants recalled how painful the task had been and how much distress and positive and negative affect they remembered experiencing. The results indicated that the majority of participants who were exposed to misinformation failed to detect the manipulation, and subsequently remembered the task as being less painful. The participants in the misinformation condition were not overall more willing to repeat the study tasks, but the participants who recalled less distress, less negative affect, and more positive affect were more willing to repeat the study tasks again in a future experiment. These results demonstrate the malleability of memory for painful experiences and that willingness to repeat aversive experiences may depend more on memory for affective reactions to the original experience than on memory for the physical pain itself

Characteristics and survival of patients with cancer with intended off-label use-a cohort study.

OBJECTIVE To describe the characteristics and the survival of patients with cancer with intended off-label use (OLU) cancer treatment and reimbursement request. DESIGN Cohort study using medical record data. SETTING Three major cancer centres in Switzerland. PARTICIPANTS 519 patients with cancer and a reimbursement request for OLU between January 2015 and July 2018. MAIN OUTCOMES Characteristics of patients with cancer with and without access to intended OLU. Characteristics included the Glasgow prognostic score (GPS) which includes C reactive protein and albumin and discriminates prognostic groups. RESULTS OLU was intended for 519 (17%) of 3046 patients with cancer, as first-line treatment in 51% (n=264) and second-line in 31% (n=162). Of the 519 patients, 63% (n=328) were male, 63% (n=329) had solid cancer and 21% (n=111) had a haematological malignancy. Their median overall survival was 23.6 months (95% CI: 19.0 to 32.5). Access to OLU had 389 (75%) patients who were compared with patients without access on average 4.9 years younger (mean; 95% CI: 1.9 to 7.9 years), had a better overall prognosis according to the GPS (51% with GPS of 0 vs 39%; OR: 1.62 (95% CI: 1.01 to 2.59)), had less frequently solid cancer (62% vs 71%; OR: 0.66 (95% CI: 0.41 to 1.05)) and advanced stage cancer (53% vs 70%; OR: 0.48 (95% CI: 0.30 to 0.75)), were more frequently treatment-naive (53% vs 43%; OR: 1.55 (95% CI 1.01 to 2.39)) and were more frequently in an adjuvant/neoadjuvant treatment setting (14% vs 5%; OR: 3.39 (95% CI: 1.45 to 9.93)). Patients with access to OLU had a median OS of 31.1 months versus 8.7 months for patients without access (unadjusted HR: 0.54; (95% CI: 0.41 to 0.70)). CONCLUSION Contrary to the common assumption, OLU in oncology is typically not primarily intended for patients with exhausted treatment options. Patient characteristics largely differ between patients with and without access to intended OLU. More systematic evaluations of the benefits and harms of OLU in cancer care and the regulation of its access is warranted

A cembranoid from tobacco prevents the expression of nicotineinduced withdrawal behavior in planarian worms

Using an adaptation of published behavioral protocols, we determined that acute exposure to the cholinergic compounds nicotine and carbamylcholine decreased planarian motility in a concentration-dependent manner. A tobacco cembranoid (1S,2E,4R,6R,7E,11E)-cembra-2,7,11- triene-4,6-diol (4R-cembranoid), also decreased planarian motility. Experiments in the presence of 1 μM 4R-cembranoid did increase the IC50 for nicotine- but not carbamylcholine-induced decrease in planarian motility. When planarians were exposed for 24 h to either nicotine or carbamylcholine at concentrations near their respective IC50 values and then transferred to plain media, nicotineexposed, but not carbamylcholine- or cembranoid-exposed worms displayed withdrawal-like distress behaviors. In experiments where planarians were pre-exposed to 100 μM nicotine for 24 h in the presence of 1 μM 4R-cembranoid, the withdrawal-like effects were significantly reduced. These results indicate that the 4R-cembranoid might have valuable applications for tobacco abuse research. This experimental approach using planarians is useful for the initial screening of compounds relevant to drug abuse and dependence

FAMÍLIA LAMIACEAE E A SUA INFLUÊNCIA NO DIABETES MELITUS: BREVE REVISÃO

Estudos indicaram que as Lamiaceae possuem uma grande variedade de classes químicas que estão envolvidas na redução do nível de glicose no sangue. Grande número de espécies de plantas tem sido usado experimentalmente para tratar os sintomas do diabetes melito e a distância filogenética entre este grupo de plantas é forte indicação da natureza variada de seus constituintes. Tem sido constatado que muitas substâncias extraídas de plantas reduzem o nível de glicose no sangue. Sua grande diversidade de classes químicas indica que uma variedade de mecanismos de ação deve estar envolvida na redução do nível de glicose no sangue. Algumas destas substâncias podem ter potencial terapêutico enquanto outras podem produzir hipoglicemia como um efeito colateral devido à sua toxicidade, especialmente hepatotoxidade

Efavirenz use during pregnancy and for women of child-bearing potential

BACKGROUND: Efavirenz is the preferred non-nucleoside reverse transcriptase inhibitor for first-line antiretroviral treatment in many countries. For women of childbearing potential, advantages of efavirenz are balanced by concerns that it is teratogenic. This paper reviews evidence of efavirenz teratogenicity and considers implications in common clinical scenarios. FINDINGS: Concerns of efavirenz-induced fetal effects stem from animal studies, although the predictive value of animal data for humans is unknown. Four retrospective cases of central nervous system birth defects in infants with first trimester exposure to efavirenz have been interpreted as being consistent with animal data. In a prospective pregnancy registry, which is subject to fewer potential biases, no increase was detected in overall risk of birth defects following exposure to efavirenz in the first-trimester. DISCUSSION: For women planning a pregnancy or not using contraception, efavirenz should be avoided if alternatives are available. According to WHO guidelines for resource-constrained settings, benefits of efavirenz are likely to outweigh risks for women using contraception. Women who become pregnant while receiving efavirenz often consider drug substitution or temporarily suspending treatment. Both options have substantial risks for maternal and fetal health which, we argue, appear unjustified after the critical period of organogenesis (3–8 weeks post-conception). Efavirenz-based triple regimens, initiated after the first trimester of pregnancy and discontinued after childbirth, are potentially an important alternative for reducing mother-to-child transmission in pregnant women who do not yet require antiretroviral treatment. CONCLUSION: Current recommendations for care for women who become pregnant while receiving efavirenz may need to be re-considered, particularly in settings with limited alternative drugs and laboratory monitoring. With current data limitations, additional adequately powered prospective studies are needed