A Case of Hyperammonemia Not Attributable to Liver Disease and Treated With IV Ammonia Scavengers.

Hyperammonemia is a serious metabolic condition marked by elevated ammonia levels in the blood, leading to neurological damage and systemic complications if untreated. While often associated with liver dysfunction, inborn metabolic errors such as fatty acid oxidation defects, pyruvate metabolism disorders, urea cycle disorders (UCDs), urea splitting bacterial infections, hemato-oncological disorders, and portosystemic shunts are less commonly recognized but significant causes, particularly outside neonatal populations. These metabolic errors, due to partial enzyme deficiencies, may present later in life with atypical symptoms.

Peripherally mediated opioid combination therapy in mouse and pig.

The concomitant epidemics of chronic pain and opioid misuse in the United States have led to a call for novel analgesics with limited abuse potential. Previously, we have shown that co-delivery of a novel combination targeting both μ- and δ-opioid receptors in the peripheral and central nervous systems can produce synergistic analgesia. Loperamide, a peripherally restricted μ-opioid agonist, and oxymorphindole, a δ-opioid receptor partial agonist, synergize in multiple mouse models of hyperalgesia.

'Hope' is the thing with feathers: Student midwifery outside the system.

Midwifery in Australia, and across other high-income countries with Westernised care arrangements, is reaching crisis point; an overrun, overworked, and underfunded maternity system causing traumatised and disenfranchised midwives to leave the profession in droves. However, there is also an underreported student midwife retention crisis negatively affecting the profession. Student midwives, becoming disempowered and disillusioned after facing the climate of collective trauma within the system, are leaving their studies at unprecedented rates.