The role of biotin-dependent enzymes in the fatty liver and kidney syndrome of young chicks was studied. Under conditions of a marginal deficiency of dietary biotin, the level of biotin in the liver has differing effects on the activities of two biotin-dependent enzymes, pyruvate carboxylase and acetyl-CoA carboxylase. The activity of acetyl-CoA carboxylase is increased, but when the dietary deficiency of biotin produces biotin levels which are below o· 8 p,g/g of liver, the activity of pyruvate carboxylase may be insufficient to completely metabolize pyruvate via gluconeogenesis. There is an increase in liver size and in the activities of enzymes involved in alternate pathways for the removal of pyruvate. Blood lactate accumulates and there is increased synthesis of fatty acids, and an accumulation of palmitoleic acid; these steps are accomplished by increased activities of at least the following enzymes: acetyl-CoA carboxylase, malate dehydrogenase (decarboxylating) (NADP+) and the desaturase enzyme. When the biotin level is below 0·35 p,g/g of liver and the chick is subjected to a stress, physiological defence mechanisms of the chick may be inadequate to maintain homeostasis and they finally collapse, resulting in accumulation of triacylglycerol in the liver and blood; the chick is unable to maintain blood glucose levels and death occurs, often only a few hours after the imposition of the stress.
Intravenous (IV) catheters, both central and peripheral, are among the most common invasive clinical devices used in a hospital setting, with up to 70% of patients in the United States requiring at least one IV catheter during an episode of care [1]. Because these devices allow intravenous administration of drugs, fluids, and blood products, they are a critical aspect of patient care. In the United States alone, healthcare providers insert between 150 -300 million peripheral IV catheters and 5 million central IV catheters in hospitalized patients each year [1][2][3]. Unfortunately, IVs are also associated with high complication rates. Even in large medical centers with dedicated phlebotomy teams, the IV catheter failure rate is between 35% and 50% [4]. These frequent failures are costly to both the
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