Glucocorticoid treatment increases cholesterol availability during critical illness: effect on adrenal and muscle function.

Background: Hypocholesterolemia hallmarks critical illness though the underlying pathophysiology is incompletely understood. As low circulating cholesterol levels could partly be due to an increased conversion to cortisol/corticosterone, we hypothesized that glucocorticoid treatment, via reduced de novo adrenal cortisol/corticosterone synthesis, might improve cholesterol availability and as such affect adrenal gland and skeletal muscle function.

Methods: In a matched set of prolonged critically ill patients (n = 324) included in the EPaNIC RCT, a secondary analysis was performed to assess the association between glucocorticoid treatment and plasma cholesterol from ICU admission to day five.

Impact of critical illness on cholesterol and fatty acids: insights into pathophysiology and therapeutic targets.

Critical illness is characterized by a hypercatabolic response encompassing endocrine and metabolic alterations. Not only the uptake, synthesis and metabolism of glucose and amino acids is majorly affected, but also the homeostasis of lipids and cholesterol is altered during acute and prolonged critical illness. Patients who suffer from critically ill conditions such as sepsis, major trauma, surgery or burn wounds display an immediate and sustained reduction in low plasma LDL-, HDL- and total cholesterol concentrations, together with a, less pronounced, increase in plasma free fatty acids.

Dissecting the costs of a facultative symbiosis in an isopod living with ants.

The balance between costs and benefits is expected to drive associations between species. While these balances are well understood for strict associations, we have no insights to which extent they determine facultative associations between species. Here, we quantified the costs of living in a facultative association, by studying the effects of red wood ants on the facultatively associated isopod Porcellio scaber.

Impact of Hydrocortisone and of CRH Infusion on the Hypothalamus-Pituitary-Adrenocortical Axis of Septic Male Mice.

Purpose: Sepsis is hallmarked by high plasma cortisol/corticosterone (CORT), low adrenocorticotropic hormone (ACTH), and high pro-opiomelanocortin (POMC). While corticotropin-releasing hormone-(CRH) and arginine-vasopressin (AVP)-driven pituitary POMC expression remains active, POMC processing into ACTH becomes impaired. Low ACTH is accompanied by loss of adrenocortical structure, although steroidogenic enzymes remain expressed.

CanMEDS Competencies in Family Medicine Residents: Can Criterion-Based Assessment Improve the Quality of Teacher Feedback?

This article was migrated. The article was marked as recommended. The Université Laval family medicine program has developed an innovative computerized tool called the criterion-based Competency Assessment Tool (CAT), currently undergoing validity assessment.