A case report, focused on vasopressor use and presented in this article, is likely to resonate with many critical care nurses. In this article the authors describe opportunities to enhance safety ...with vasopressor therapy. Specifically, the goal of improving communication among physicians, nurses, and pharmacists around desired endpoints for vasopressor therapy, triggers for reassessment of the therapeutic strategy and cause of the patient's shock was identified as an area for improvement. A form piloted within an organization for use during multidisciplinary rounds and key findings is shared. Vasopressors constitute the mainstay of therapy for nearly every hemodynamically unstable patient in critical care. It is hoped that the lessons and information shared help empower critical care nurses to facilitate vasopressor stewardship within their facilities and, ultimately, enhance patient safety.
A case report, focused on vasopressor use and presented in this article, is likely to resonate with many critical care nurses. In this article the authors describe opportunities to enhance safety ...with vasopressor therapy. Specifically, the goal of improving communication among physicians, nurses, and pharmacists around desired endpoints for vasopressor therapy, triggers for reassessment of the therapeutic strategy and cause of the patients shock was identified as an area for improvement. A form piloted within an organization for use during multidisciplinary rounds and key findings is shared. Vasopressors constitute the mainstay of therapy for nearly every hemodynamically unstable patient in critical care. It is hoped that the lessons and information shared help empower critical care nurses to facilitate vasopressor stewardship within their facilities and, ultimately, enhance patient safety.
A central question in the post-genomic era is how genes interact to form biological pathways. Measurements of gene dependency across hundreds of cell lines have been used to cluster genes into ...'co-essential' pathways, but this approach has been limited by ubiquitous false positives. In the present study, we develop a statistical method that enables robust identification of gene co-essentiality and yields a genome-wide set of functional modules. This atlas recapitulates diverse pathways and protein complexes, and predicts the functions of 108 uncharacterized genes. Validating top predictions, we show that TMEM189 encodes plasmanylethanolamine desaturase, a key enzyme for plasmalogen synthesis. We also show that C15orf57 encodes a protein that binds the AP2 complex, localizes to clathrin-coated pits and enables efficient transferrin uptake. Finally, we provide an interactive webtool for the community to explore our results, which establish co-essentiality profiling as a powerful resource for biological pathway identification and discovery of new gene functions.
Anxiety, stress, and low mood are closely related and may contribute to depressive symptoms. Among non-pharmacological solutions to improve subclinical mood symptoms and resilience to stress, natural ...products such as saffron-identified as promising following preliminary beneficial effects in major depressive disorder-represent a relevant strategy. This study aimed to assess the efficacy of 8 weeks' supplementation with 30 mg standardized saffron extract on emotional well-being in healthy adults with subclinical feelings of low mood and anxiety and/or stress and evaluate the acute effect of saffron in response to a lab-based psychosocial stressor. The study adopted a double-blind, randomized, parallel groups design in which 56 healthy male and female individuals (18-54 years) received either a saffron extract or a placebo for 8 weeks. Chronic effects of saffron on subjective anxiety, stress, and depressive feelings were assessed using a questionnaire battery including Profile of Mood State-2, (POMS) and acute effects in response to a lab-based psychosocial stressor were measured through psychological and physiological parameters. Urinary crocetin levels were quantified. Participants who received the saffron extract reported reduced depression scores and improved social relationships at the end of the study. Urinary crocetin levels increased significantly with saffron supplementation and were correlated with change in depression scores. The typical stress-induced decrease in heart rate variability (HRV) during exposure to the stressor was attenuated following acute saffron intake. Saffron extract appears to improve subclinical depressive symptoms in healthy individuals and may contribute to increased resilience against the development of stress-related psychiatric disorders.
NCT03639831.
In humans, the length of gestation and the onset of parturition have
been linked to the exponential production of placental CRH and a late
gestational decline in maternal plasma CRH-binding protein ...(CRH-BP).
CRH has been shown to have direct effects on the myometrium and on the
fetal adrenal, where it stimulates production of the estrogen precursor
dihydroepiandrosterone sulfate. In vitro placental CRH
production is stimulated by cortisol and inhibited by progesterone. To
determine whether this mechanism might operate in other apes, we
sampled eight chimpanzees and two gorillas through their pregnancies
for CRH, CRH-BP, cortisol, estradiol, progesterone, andα
-fetoprotein. We show that both chimpanzee and gorilla maternal
plasma CRH concentrations rise exponentially as observed in the human.
The gorillas exhibited a human-like antepartum fall in CRH-BP, whereas
CRH-BP in the chimpanzee remained stable. Pregnancy-associated changes
in cortisol, estradiol, progesterone, and α-fetoprotein were
qualitatively similar to those observed in humans. Maternal plasma
cortisol correlated with plasma CRH in both gorillas (r = 0.60;
P < 0.05) and chimpanzees (r = 0.36;
P < 0.02). Further, there was a strong correlation
between plasma estradiol and the log of plasma CRH in the gorilla
(r = 0.93; P < 0.0001) and in the chimpanzee
(r = 0.72; P < 0.001), which is consistent
with the hypothesis that placental CRH determines the placental
production of estradiol by stimulating the production of fetal adrenal
dehydroepiandrosterone sulfate. Plasma CRH and progesterone were
positively correlated providing no in vivo support for
progesterone inhibition of CRH release.
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