HOMEOSTASIS, OXYGENATION AND LEVEL OF PAIN

Homeostasis, Oxygenation and Level of Pain



Homeostasis, Oxygenation and Level of Pain

A. Explain key immediate assessments you should make that would help assess the patient's homeostasis, oxygenation, and level of pain?

Several observations were made. First, iron homeostasis was deranged in anemic and nonanemic subjects and characterized by diminished circulating (transferring saturation) and functional (mean cell hemoglobin concentration) iron status in the face of seemingly adequate stores (ferritin). Second, while iron overload and elevated iron stores were rare (1%), iron deficiency (transferrin saturation <20%) was evident in patients. Third, disordered iron homeostasis related closely to worsening inflammation and disease severity and strongly predicted lower hemoglobin levels independently of age, sex, erythrocyte sedimentation rate, New York Heart Association (NYHA) functional class, and creatinine. Fourth, the etiologies of anemia varied with disease severity, with an iron-deficient substrate (anemia of chronic disease and/or iron-deficiency anemia) evident in 16%, 72%, and 100% of anemic NYHA functional class I or II, III, and IV patients, respectively. Although anemia of chronic disease was more prevalent than iron-deficiency anemia, both conditions coexisted in 17% of subjects. Fifth, iron deficiency was associated with lower peak oxygen consumption and higher ratios of ventilation to carbon dioxide production and identified those at enhanced risk for death (hazard ratio: 3.38; 95% confidence interval: 1.48 to 7.72; p = 0.004) independently of hemoglobin. Nonanemic iron-deficient patients had a 2-fold greater risk for death than anemic iron-replete subjects.



B. Describe the technological tools you would utilize to assess and treat the patient?

Disruption of meiosis in humans has been linked to a number of genetic disorders such as Down and Turners syndrome, and abnormal fat homeostasis is thought to be an underlying cause of obesity and related diseases. This high-throughput screening method identifies whether a compound has a toxic effect on these important biological processes. Samples, such as drug candidates, agrochemicals, industrial chemicals, soil and water samples, may be used to evaluate:

Safety of pre-clinical drug candidates. Toxicity screening in C. elegans may be used to rapidly and inexpensively test compounds earlier in the pipeline.

Safety of household and industrial chemicals.

Environmental effects of compounds. By testing samples of soil and water, the effects of agrochemicals and industrial chemicals can be analyzed in high-throughput manner.

Molecular toxicology of compounds. Localization of GFP-tagged proteins combined with the powerful genetic approaches available in C. elegans make it possible to identify the mechanism of action of any known or newly discovered toxins.

Innovations and Advantages

Despite the devastating outcomes of genetic anomalies stemming from problems during the cell division program meiosis, screening of environmental toxicants for their ability to disrupt meiosis has revealed to be very challenging. Meiosis is a complex process that cannot be recapitulated in a tissue culture setting, and occurs at specific stages of development over a period of several months to years. Time, cost, and experimental constraints therefore limit in vivo screening of environmental toxicants that disrupt biological processes such as meiosis.

These screens have a number of important advantages over current screening ...