The process during meiosis that contributes to the gamete having a material that is unique is the anaphase. This step splits the chromosomes into two separate chromatids. The resulting gametes contain 50% of the chromosomes and this 50% is not the same for the other gametes.
Critically ill patients admitted to the intensive care unit (ICU) are at risk of developing gastrointestinal (GI) bleeding owing to stress ulcers, which is associated with a prolonged length of stay (LOS) in the ICU and an increased risk of death.
- To prevent GI bleeding in these critically ill patients, ICU doctors frequently prescribe stress ulcers prophylaxis (SUP).
- Proton pump inhibitors (PPIs) and histamine type 2 receptor blockers (H2Bs) are the most commonly used SUP agents.
- Sepsis has been considered a risk factor for the development of stress ulceration and GI bleeding for many years, and SUP is recommended by the Surviving Sepsis Campaign guidelines for patients with sepsis or septic shock who have risk factors for GI bleeding.
- Although these guidelines further recommend either H2Bs or PPIs when SUP is indicated, there is limited evidence of the effects of H2Bs in comparison with PPIs when used as SUP in critically ill patients with sepsis.
- A recent meta-analysis of a general population of patients in the ICU suggested that PPIs are the most effective agents in preventing clinically important GI bleeding. However, two retrospective studies found that PPIs were associated with a higher rate of GI bleeding than H2Bs.
- In clinical practice, PPIs are more commonly prescribed by critical care providers, possibly because of their superior acid suppression capability in comparison with H2Bs.
- However, PPI use is not without risk. Some studies have shown that patients receiving PPIs have a higher risk of nosocomial pneumonia, Clostridium difficile infection(CDI), and myocardial infarction.
- Accordingly, it is reasonable to evaluate the comparative effects of SUP using PPIs and H2Bs on important outcomes in patients with severe sepsis or septic shock.
- A retrospective cohort study compares two strategies for SUP among adult patients with sepsis or septic shock who have risk factors for GI bleeding.
- Specifically, hypothesized that PPIs are associated with a lower occurrence of GI bleeding and in-hospital mortality than H2Bs but may increase the risk of pneumonia and CDI.
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The mechanism of action of Bordetella pertussis is to stop the cilia of epithelial cells from beating.
<em>Bordetella pertussis</em> is a pathogenic, gram-negative bacteria. It is the causative agent of highly communicable respiratory disease known as pertussis or whooping cough.
The mechanism of action of Bordetella pertussis:
- This bacterium colonizes the ciliated epithelial cells of the respiratory airways of the host.
- A surface protein on the bacteria called filamentous haemagglutinin adhesin binds to sulfatides on the cilia of epithelial cells. When the bacterium is anchored, it releases tracheal cytotoxin, which prevents the cilia from beating.
- As a result, the cilia in an organism's lungs are unable to sweep out foreign material, and the body reacts by causing the host to cough. When people cough, bacteria are released into the air, where they might spread to other hosts.
- Another toxin called the pertussis toxin, often known as PTx, prevents adenylate cyclase from using ATP to convert to cyclic AMP. This results in over-conversion of ATP to cyclic AMP, which may interfere with cellular signaling systems. As a result, phagocytes are unable to respond to an infection effectively.
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