Performance of the efferent limb of a rapid response system: an observational study of medical emergency team calls.

AIM: To determine the distribution of outcomes following a medical emergency team (MET) call using a modified version of the multidisciplinary audit and evaluation of outcomes of rapid response (MAELOR) tool, and to evaluate its usefulness in monitoring the performance of the efferent limb of the rapid response system (RRS) at our institution. METHOD: An observational study of prospectively collected data including all MET calls at our institution during the 36 weeks study period (23 December 2013 - 31 august 2014). Outcomes of MET calls were registered 24 h after the call occurred and categorized according to the MAELOR tool. RESULTS: Fifty-five of a total of 308 MET calls were excluded due to prior limitations in treatment. Of the remaining cases 66 % had positive outcomes. Thirty two percent of the calls resulted in transfer to the ICU, of these 73 % occurred within 4 h. Patients remained on the ward in 53 % of the cases, and 56 % of these were no longer triggering at follow up. Nine patients had died at follow-up, three without a DNAR order. Three patients were lost to follow-up, two patients were discharged from the hospital and 25 remained alive on the ward with a DNAR as a consequence of the MET call. CONCLUSIONS: ICU transfer was implemented rapidly in most cases once the decision was made, but a disturbingly large number of patients, who remained on the ward were still triggering at 24 h follow-up. We found the MAELOR-tool useful to evaluate RRS efferent limb performance.

Hyperactivity and lack of social discrimination in the adolescent Fmr1 knockout mouse.

The aims of this study were to investigate behaviour relevant to human autism spectrum disorder (ASD) and the fragile X syndrome in adolescent Fmr1 knockout (KO) mice and to evaluate the tissue levels of striatal monoamines. Fmr1 KO mice were evaluated in the open field, marble burying and three-chamber test for the presence of hyperactivity, anxiety, repetitive behaviour, sociability and observation of social novelty compared with wild-type (WT) mice. The Fmr1 KO mice expressed anxiety and hyperactivity in the open field compared with WT mice. This increased level of hyperactivity was confirmed in the three-chamber test. Fmr1 KO mice spent more time with stranger mice compared with the WT. However, after a correction for hyperactivity, their apparent increase in sociability became identical to that of the WT. Furthermore, the Fmr1 KO mice could not differentiate between a familiar or a novel mouse. Monoamines were measured by HPLC: Fmr1 KO mice showed an increase in the striatal dopamine level. We conclude that the fragile X syndrome model seems to be useful for understanding certain aspects of ASD and may have translational interest for studies of social behaviour when hyperactivity coexists in ASD patients.

Direct RNA sequencing mediated identification of mRNA localized in protrusions of human MDA-MB-231 metastatic breast cancer cells.

BACKGROUND: Protrusions of cancer cells conferrers a vital function for cell migration and metastasis. Protein and RNA localization mechanisms have been extensively examined and shown to play pivotal roles for the functional presence of specific protein components in cancer cell protrusions. METHODS: To describe genome wide RNA localized in protrusions of the metastatic human breast cancer cell line MDA-MB-231 we used Boyden chamber based methodology followed by direct mRNA sequencing. RESULTS: In the hereby identified group of protrusion localized mRNA some previously were described to be localized exemplified by mRNA for Ras-Related protein 13 (RAB13) and p0071 (Plakophilin-4/PKP4). For other transcripts, exemplified by mRNA for SH3PXD2A/TKS5 and PPFIA1/Liprin-α1, only the corresponding proteins previously were described to have protrusion localization. Finally, a cohort of MDA-MB-231 protrusion localized transcripts represents novel candidates to mediate cancer cell subcellular region specific functions through mRNA direction to protrusions. We included a further characterization of p0071, an armadillo repeat protein of adherence junctions and desmosomes, in MDA-MB-231 and non-metastatic MCF7 cells including analysis of novel identified alternative spliced p0071 mRNA isoforms. The results showed isoform and cell type specific p0071 mRNA localization. CONCLUSIONS: Altogether, the presented data represents a genome wide and gene specific descriptive and functional analyses of RNA localization in protrusions of MDA-MB-231 metastatic cancer cells.