We studied molecular mechanisms of changes in oxidative metabolism under conditions of experimental lipopolysaccharide-induced endotoxemia. Generation of reactive nitrogen and oxygen species in mice increased 18 h after treatment with lipopolysaccharide. These changes contributed to inactivation of enzymes and enzyme complexes (ribonucleotide reductase, NADH-ubiquinone oxidoreductase, and cytochrome c oxidase), dysfunction of the mitochondrial electron transport chain, and development of oxidative stress. Plaferon LB protected mice from the toxic effect of lipopolysaccharide.

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CONCLUSION Episode of care costs beyond the index hospitalization are increasingly important as payers and providers explore new bundled payment approaches. After the index hospitalization, readmissions were the biggest driver of resource utilization in Medicare patients receiving TAVR. Careful consideration of strategies to reduce the risk of readmissions after TAVR may be warranted to reduce resource use and improve quality. These findings may be a helpful benchmark for providers seeking information on the episode of care costs.

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