Behavioral and biochemical adjustments of the zebrafish Danio rerio exposed to the ß-blocker propranolol.

Propranolol (PROP) is a ß-blocker prescribed mainly to treat human cardiovascular diseases and as a result of its wide usage and persistence, it is reported in aquatic environments. This study examined whether PROP alters developmental patterns and catecholamine (CA)-regulated processes in the zebrafish (Danio rerio) and if exposure during early life alters the stress response and behaviors of adults. The calculated 48h larva LC50 was 21.6mg/L, well above reported environmental levels (0.01-0.59µg/L). Stressed and PROP-exposed adult zebrafish had reduced testosterone and estradiol levels and exhibited behaviors indicating less anxiety than control fish. Furthermore, adults previously PROP-exposed as embryos/larvae had decreased growth in terms of body length and mass. Finally, these adults showed increased cholesterol and a dose-dependent decrease in testosterone levels compared with unexposed zebrafish. Thus PROP-exposure of zebrafish embryos/larvae alters developmental patterns and CA-regulated processes that may affect normal behaviors and responses to stressors, and at least some of these changes persist in the adult zebrafish.

Translating evidence to practice for mechanical venous thromboembolism prophylaxis.

Perioperative staff nurses at Aurora Health Care, Milwaukee, Wisconsin, questioned variations in the use of mechanical venous thromboembolism prophylaxis and sought to improve the consistency of prophylaxis care and ensure use of evidence-based practices. A work group consisting of perioperative clinical nurse specialists, a nurse clinician, and a staff nurse performed a systematic literature review to determine best practices for the implementation of mechanical venous thromboembolism prevention in the perioperative period. Key practices identified included optimal application times for initiating mechanical prophylaxis before the surgical procedure and the use of unilateral mechanical prophylaxis for some orthopedic procedures. We found no published consensus regarding a cumulative benefit from combining sequential compression devices and graduated compression stockings and no clinical evidence to support the use of alternative configurations for specialty procedural tables to prevent venous thromboembolism. We disseminated the best practices that we identified within our hospital and to the greater nursing community through posters and presentations.