A co-culture system was used to study the effect of reactive nitrogen species (RNS) generated by RAW 264.7 macrophages grown on filters and activated by lipopolysaccharide and interferon-gamma, on the alpha-tocopherol levels in ECV 302 endothelial cells. The results indicate that: RNS generated by activated macrophages or by direct administration of peroxynitrite lead to a significant loss of alpha-tocopherol in endothelial cells; pre-incubation with procyanidin extracted from pine bark (Pycnogenol) protects alpha-tocopherol of endothelial cells and enhances by about 15% basal endogenous levels of alpha-tocopherol. These results demonstrate flavonoids participate in the cellular antioxidant network and suggest that Pycnogenol may play an important role in the protection of endothelium from oxidative stress induced by reactive nitrogen species.
Background: Pandemics create challenges for medical centers, which call for innovative adaptations to care for patients during the unusually high census, to distribute stress and work hours among providers, to reduce the likelihood of transmission to health care workers, and to maximize resource utilization. Methods: We describe a multidisciplinary vascular access team’s development to improve frontline providers’ workflow by placing central venous and arterial catheters. Herein we describe the development, organization, and processes resulting in the rapid formation and deployment of this team, reporting on notable clinical issues encountered, which might serve as a basis for future quality improvement and investigation. We describe a retrospective, single-center descriptive study in a large, quaternary academic medical center in a major city. The COVID-19 vascular access team included physicians with specialized experience in placing invasive catheters and whose usual clinical schedule had been lessened through deferment of elective cases. The target population included patients with confirmed or suspected COVID-19 in the medical ICU (MICU) needing invasive catheter placement. The line team placed all invasive catheters on patients in the MICU with suspected or confirmed COVID-19. Results and conclusions: Primary data collected were the number and type of catheters placed, time of team member exposure to potentially infected patients, and any complications over the first three weeks. Secondary outcomes pertained to workflow enhancement and quality improvement. 145 invasive catheters were placed on 67 patients. Of these 67 patients, 90% received arterial catheters, 64% central venous catheters, and 25% hemodialysis catheters. None of the central venous catheterizations or hemodialysis catheters were associated with early complications. Arterial line malfunction due to thrombosis was the most frequent complication. Division of labor through specialized expert procedural teams is feasible during a pandemic and offloads frontline providers while potentially conferring safety benefits.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.