Peripartum cardiomyopathy: diagnosis and management

No abstract available

Fractalkine-CX3CR1 signaling is critical for progesterone-mediated neuroprotection in the retina

Retinitis pigmentosa (RP) encompasses a group of retinal diseases resulting in photoreceptor loss and blindness. We have previously shown in the rd10 mouse model of RP, that rd10 microglia drive degeneration of viable neurons. Norgestrel, a progesterone analogue, primes viable neurons against potential microglial damage. In the current study we wished to investigate this neuroprotective effect further. We were particularly interested in the role of fractalkine-CX3CR1 signaling, previously shown to mediate photoreceptor-microglia crosstalk and promote survival in the rd10 retina. Norgestrel upregulates fractalkine-CX3CR1 signaling in the rd10 retina, coinciding with photoreceptor survival. We show that Norgestrel-treated photoreceptor-like cells, 661Ws, and C57 explants modulate rd10 microglial activity in co-culture, resulting in increased photoreceptor survival. Assessment of Norgestrel’s neuroprotective effects when fractalkine was knocked-down in 661 W cells and release of fractalkine was reduced in rd10 explants confirms a crucial role for fractalkine-CX3CR1 signaling in Norgestrel-mediated neuroprotection. To further understand the role of fractalkine in neuroprotection, we assessed the release of 40 cytokines in fractalkine-treated rd10 microglia and explants. In both cases, treatment with fractalkine reduced a variety of pro-inflammatory cytokines. These findings further our understanding of Norgestrel’s neuroprotective properties, capable of modulating harmful microglial activity indirectly through photoreceptors, leading to increased neuroprotection

Nurses\u27 Alumnae Association Bulletin - Volume 5 Number 8

Calling All Nurses Financial Report Calendar of Events Lest You Forget! Attention Review of the Alumnae Association Meetings President\u27s Report Barton Memorial Division Oxygen Therapy Welcome, White Haven Alumnae Clinical Use of Penicillin in Infections of the Ears, Nose and Throat Address - Graduation of Nurses, 1945 Miscellaneous Items The Blood that Kills The Story of Malaria Program Prizes - May, 1946 Capping Exercises The Economic Security Program of the Pennsylvania State Nurses\u27 Association The Clara Melville Scholarship Fund Card of Thanks The Poet\u27s Corner The Hospital Pharmacy Jefferson Medical College Hospital School of Nursing Faculty Jefferson Hospital Gray Lady Unite, A.R.R. The Volunteer Nurses\u27 Aides Salute Jefferson Nurses Changes in the Staff at Jefferson Hospital Red Cross Recruits Did You Know That The Pennsylvania Nurse Medical College News Magazine and Newspaper Items Central Dressing Room and Transfusion Unit Rules Concerning Central Dressing Room Radios and Electrical Appliances Attending College Nurses in Anesthesia Condolences Marriages New Arrivals Deaths The Bulletin Committee Attention, Alumnae New Addresse

Pro-survival redox signalling in progesterone-mediated retinal neuroprotection

Retinitis pigmentosa (RP) is a group of hereditary retinal diseases, characterised by photoreceptor cell loss. Despite a substantial understanding of the mechanisms leading to cell death, an effective therapeutic strategy is sought. Our laboratory has previously demonstrated the neuroprotective properties of Norgestrel, a progesterone analogue, in the degenerating retina, mediated in part by the neurotrophic factor basic fibroblast growth factor (bFGF). In other retinal studies, we have also presented a pro-survival role for reactive oxygen species (ROS), downstream of bFGF. Thus, we hypothesized that Norgestrel utilises bFGF-driven ROS production to promote photoreceptor survival. Using the 661W photoreceptor-like cell line, we now show that Norgestrel, working through progesterone receptor membrane complex 1 (PGRMC1); generates an early burst of pro-survival bFGF-induced ROS. Using the rd10 mouse model of RP, we confirm that Norgestrel induces a similar early pro-survival increase in retinal ROS. Norgestrel-driven protection in the rd10 retina was attenuated in the presence of antioxidants. This study therefore presents an essential role for ROS signalling in Norgestrel-mediated neuroprotection in vitro and demonstrates that Norgestrel employs a similar pro-survival mechanism in the degenerating retina

Progesterone analogue protects stressed photoreceptors via bFGF-mediated calcium influx.

Retinitis pigmentosa (RP) is a degenerative retinal disease leading to photoreceptor cell loss. In 2011, our group identified the synthetic progesterone ‘Norgestrel’ as a potential treatment for RP. Subsequent research showed Norgestrel to work through progesterone receptor membrane component 1 (PGRMC1) activation and upregulation of neuroprotective basic fibroblast growth factor (bFGF). Using trophic factor deprivation of 661W photoreceptor-like cells, we aimed to further elucidate the mechanism leading to Norgestrel-induced neuroprotection. In the present manuscript, we show by flow cytometry and live-cell immunofluorescence that Norgestrel induces an increase in cytosolic calcium in both healthy and stressed 661Ws over 24h. Specific PGRMC1 inhibition by AG205 (1 μM) showed this rise to be PGRMC1-dependent, primarily utilising calcium from extracellular sources, for blockade of L-type calcium channels by verapamil (50 μM) prevented a Norgestrel-induced calcium influx in stressed cells. Calcium influx was also shown to be bFGF-dependent, for siRNA knock down of bFGF prevented Norgestrel-PGRMC1 induced changes in cytosolic calcium. Notably, we demonstrate PGRMC1-activation is necessary for Norgestrel-induced bFGF upregulation. We propose that Norgestrel protects through the following pathway: binding to and activating PGRMC1 expressed on the surface of photoreceptor cells, PGRMC1 activation drives bFGF upregulation and subsequent calcium influx. Importantly, raised intracellular calcium is critical to Norgestrel's protective efficacy, for extracellular calcium chelation by EGTA abrogates the protective effects of Norgestrel on stressed 661W cells in vitro

Risk factors associated with severe hospital burden of COVID-19 disease in Regione Lombardia: a cohort study.

BACKGROUND: Understanding the risk factors associated with hospital burden of COVID-19 is crucial for healthcare planning for any future waves of infection. METHODS: An observational cohort study is performed, using data on all PCR-confirmed cases of COVID-19 in Regione Lombardia, Italy, during the first wave of infection from February-June 2020. A multi-state modelling approach is used to simultaneously estimate risks of progression through hospital to final outcomes of either death or discharge, by pathway (via critical care or not) and the times to final events (lengths of stay). Logistic and time-to-event regressions are used to quantify the association of patient and population characteristics with the risks of hospital outcomes and lengths of stay respectively. RESULTS: Risks of severe outcomes such as ICU admission and mortality have decreased with month of admission (for example, the odds ratio of ICU admission in June vs March is 0.247 [0.120-0.508]) and increased with age (odds ratio of ICU admission in 45-65 vs 65 + age group is 0.286 [0.201-0.406]). Care home residents aged 65 + are associated with increased risk of hospital mortality and decreased risk of ICU admission. Being a healthcare worker appears to have a protective association with mortality risk (odds ratio of ICU mortality is 0.254 [0.143-0.453] relative to non-healthcare workers) and length of stay. Lengths of stay decrease with month of admission for survivors, but do not appear to vary with month for non-survivors. CONCLUSIONS: Improvements in clinical knowledge, treatment, patient and hospital management and public health surveillance, together with the waning of the first wave after the first lockdown, are hypothesised to have contributed to the reduced risks and lengths of stay over time

Nurses Alumni Association Bulletin, Fall 1985

Alumni Calendar Officers and Committee Chairmen The President\u27s Message Treasurer\u27s Report Nurses\u27 Relief Fund Scholarship Fund International Travel as a Nurse Spruce Street Nurses Residence Rules Tempus Fidgets Jefferson Projects Grow Fiftieth Anniversary Happy Birthday Believe It or Not?? Grant Program for Nursing Students in 1984 Bequests Nursing Alumni Association Hosted by Alumni Office and Department of Nursing Resume of Minutes of Alumni Association Meetings Alumni Office News Committee Reports Scholarship Social Satellite Finance In Memoriam, Names of Deceased Graduates A Prayer for the Mature Luncheon Pictures Class Notes Caps, Pins, Transcripts, Class Address Lists Change of Address Form Relief Fund Application Scholarship Fund Application Membership Application Notice, Alumni Luncheo

Healthcare disparities for women hospitalised with myocardial infarction and angina

Ischaemic heart disease persists as the leading global cause of death. Myocardial infarction (MI) accounts for a large proportion of death due to cardiovascular disease. Between 2007 and 2016, age-sex standardised mortality for MI in Scotland has fallen by 42.5% from 129 to 74 per 100,000 population – a trend also apparent in other countries. Despite improvements in survival, considerable disparities exist according to sexin terms of delivery of guideline-recommended treatments and outcomes following MI suggesting women may be disadvantaged. Use of high-sensitivity troponin assays with sex-specific thresholds increases the detection of MI in women. However, women are less likely to undergo percutaneous coronary revascularisation (PCI) and are more often subject to underutilisation of evidence-based secondary preventative pharmacotherapy. Differences in adoption of invasive management may, in part, be explained by a perception held by clinicians and patients that outcomes are worse for women receiving PCI, as well as differences in symptoms and baseline risk profile which may impact clinical decision-making. Adverse events post-MI, including cardiogenic shock, heart failure and death, remain more common in women than in men, most notably in those with ST-elevation myocardial infarction (STEMI). Whether sex remains an independent predictor of adverse events despite adjustments for the higher risk-profile of women, notably age, is less clear. We hypothesised that sex-related differences in demographics and comorbidity underpin disparities in management and outcomes of women and men hospitalised with MI or angina. We investigated this hypothesis by analysis of a contemporary secondary care electronic registry (e-Registry) using electronic patient records (EPRs) for patients admitted to a complex regional healthcare network.PostprintPeer reviewe