Effects of inhaled JAK inhibitor GDC-4379 on exhaled nitric oxide and peripheral biomarkers of inflammation.

Background: Janus Kinases (JAKs) mediate activity of many asthma-relevant cytokines. GDC-0214, an inhaled small molecule JAK1 inhibitor, has previously been shown to reduce fractional exhaled nitric oxide (FeNO) in patients with mild asthma, but required an excessive number of inhalations.

Aim: To assess whether GDC-4379, a new inhaled JAK inhibitor, reduces FeNO and peripheral biomarkers of inflammation.

Butanediol Conversion to Gamma-Hydroxybutyrate Markedly Reduced by the Alcohol Dehydrogenase Blocker Fomepizole.

1,4-Butanediol (BDO)-used as solvent and abused for its euphoric effects-is converted to gamma-hydroxybutyrate (GHB) by the enzyme alcohol dehydrogenase. This double-blind, placebo-controlled crossover study with six healthy volunteers is the first to date investigating the role of the ADH inhibitor fomepizole (4-methylpyrazole (4MP)) in moderating this conversion in humans. Participants received on two different days either intravenous placebo or 15 mg/kg 4MP followed by oral administration of 25 mg/kg BDO.

Snakebites and climate change in California, 1997-2017.

Background: Climate change effect on flora and fauna has been scientifically documented, but the effect on North American venomous snakebites is unknown. The objectives were to examine Californian snakebite incidence and correlate with weather patterns and climate changes.

Methods: A retrospective analysis of snakebites reported to the Californian Poison Control System from 1 September 1997 to 30 September 2017.

Racial disparities across provider specialties in opioid prescriptions dispensed to medicaid beneficiaries with chronic noncancer pain.

Objective: Chronic pain affects both psychological and physical functioning, and is responsible for more than $60 billion in lost productivity annually in the United States. Although previous studies have demonstrated racial disparities in opioid treatment, there is little evidence regarding disparities in treatment of chronic noncancer pain (CNCP) and the role played by physician specialty in these disparities.

Design: A retrospective cohort study.

Beau's Lines After Cardiac Arrest.

A 34-year-old man with uncontrolled hypertension suffered a ventricular fibrillation cardiac arrest from an obstructive left anterior descending artery occlusion. He was defibrillated more than 10 times before achieving return of spontaneous circulation. He was comatose after his arrest and was treated with therapeutic hypothermia, and a bare metal stent was placed in his obstructed coronary artery with restoration of excellent postobstruction blood flow.

Differential prescribing of opioid analgesics according to physician specialty for Medicaid patients with chronic noncancer pain diagnoses.

Background: Despite >20 years of studies investigating the characteristics of patients seeking or receiving opioid analgesics, research characterizing factors associated with physicians' opioid prescribing practices has been inconclusive, and the role of practitioner specialty in opioid prescribing practices remains largely unknown.

Objective: To examine the relationships between physicians' and other providers' primary specialties and their opioid prescribing practices among patients with chronic noncancer pain (CNCP).

Methods: Prescriptions for opioids filled by 81,459 Medicaid patients with CNCP in North Carolina (USA), 18 to 64 years of age, enrolled at any point during a one-year study period were examined.

Multidisciplinary intervention decreases the use of opioid medication discharge packs from 2 urban EDs.

Introduction: Prescription opioid overdoses and deaths constitute a public health epidemic, and recent studies show that emergency department (ED) prescribers may contribute to this crisis. We hypothesized that a multidisciplinary educational intervention would decrease ED opioid packs dispensed at discharge.

Methods: This prospective study implemented a "bundle" of interdisciplinary educational modalities: lectures, journal clubs, case discussions, and an electronic medical record decision support tool.

Windmills and pill mills: can PDMPs tilt the prescription drug epidemic?

Prescription drug monitoring programs (PDMPs) are state-based registries of prescriptions for specific controlled substances. This overview will describe the history and funding of these databases, address those characteristics thought to be of greatest utility for PDMPs and review current literature regarding PDMP effectiveness and their potential limitations. Although more extensive research on PDMP outcomes is needed, these databases are an essential component in ongoing efforts to establish safe and compassionate prescription opioid stewardship.