Evaluation of Insulin Dosing Strategies for Hyperkalemia Management at an Academic Medical Center.

Purpose: While intravenous (IV) insulin is often administered at a fixed dose of 10 units for acute hyperkalemia, optimal dosing for minimizing hypoglycemia while effectively reversing hyperkalemia has not been established. The purpose of this analysis was to evaluate the effect of insulin dosing strategies on hypoglycemia in patients with hyperkalemia.

Methods: Adult patients presenting to an academic medical center who received IV insulin for hyperkalemia between 2016 and 2020 were retrospectively identified.

Prevalence, risk factors, and outcomes associated with delayed second doses of antibiotics in sepsis at a large academic medical center.

Objective: To evaluate the prevalence, risk factors, and clinical impact of delays in second doses of antibiotics in patients with sepsis.

Design: Single-center, retrospective, observational study.

Setting: Large teaching hospital.

Analgesic Outcomes in Opioid Use Disorder Patients Receiving Spinal Anesthesia with or without Intrathecal Clonidine for Cesarean Delivery: A Retrospective Investigation.

Background: Intrathecal (IT) clonidine has been observed to reduce 24-hour opioid requirements and time to first analgesic request after cesarean delivery, but has not been specifically studied in patients with opioid use disorder (OUD).

Methods: Patients with OUD undergoing cesarean delivery under spinal or combined spinal-epidural (CSE) anesthesia at our institution from 2011 to 2020 were identified, and only patients with OUD were included in this study. Subjects that received IT clonidine were compared to a control group that did not receive IT clonidine to observe potential differences in analgesic outcomes (24-hour opioid requirements, pain scores and time to first post-operative pain medication) or side-effects (hypotension, vasopressor dosing and bradycardia).

Event-Based Surveillance of Poisonings and Potentially Hazardous Exposures over 12 Months of the COVID-19 Pandemic.

The COVID-19 pandemic has seen people and governments utilise an array of chemical and pharmaceutical substances in an attempt to prevent and treat COVID-19 infections. The Centre for Radiation, Chemicals and Environmental Hazards (CRCE) at Public Health England (PHE) routinely undertakes Event-Based Surveillance (EBS) to monitor public health threats and incidents related to chemicals and poisons. From April 2020, EBS functions were expanded to screen international media for potentially hazardous exposures associated with the COVID-19 pandemic.

Cesarean Delivery in a Patient With Body Mass Index Over 100: Continuous Spinal Anesthesia in Two Consecutive Deliveries.

Anesthetic implications for morbidly obese parturients have been well described; however, the literature has not yet clarified whether there are additional or unique concerns if the body mass index (BMI) rises farther above the so-called super morbid obesity level: BMI >50 kg/m. There have only been a few case reports focusing on patients with BMI close to or above 100. Parturients with BMI significantly greater than 50 are uncommon, but they represent an increasing proportion among the morbidly obese.

Systematic Review of Human Poisoning and Toxic Exposures in Myanmar.

The International Health Regulations (2005) promote national capacity in core institutions so that countries can better detect, respond to and recover from public health emergencies. In accordance with the 'all hazards' approach to public health risk, this systematic review examines poisoning and toxic exposures in Myanmar. A systematic literature search was undertaken to find articles pertaining to poisoning in Myanmar published between 1998 and 2020.

Understanding Antibiotic Residues and Pathogens Flow in Wastewater from Smallholder Pig Farms to Agriculture Field in Ha Nam Province, Vietnam.

Background: Contact with livestock wastewater on farms and in communities can pose a risk to human and animal health.

Methods: This cross-sectional study was conducted in 180 households and 24 pig farms (96 wastewater samples) to explore information about pig production, livestock waste management, antibiotic use, and to analyze antibiotic residues and microbial contamination, respectively.

Results: Of the 120 households raising pigs, biogas systems were the most commonly used to treat animal waste (70%), followed by compositing (19%), and the remaining respondents discharged waste directly into drains or ponds (11%).

'Safe sex': evaluation of sex education and sexual risk by young adults in Sydney.

In this qualitative study, 28 young adults (18-29-year-olds) living in Sydney define 'safe sex', report on their experiences of sex education, and reflect on the relationship between the sex education received in school and the reality of sexual activity. Participants had a broadly neoliberal understanding of health and risk as something individuals should manage through an ideal of rational decision-making. Yet regardless of how comprehensive or limited their sex education experiences, most noted a wide gulf between safe sex as taught in the classroom and the reality of actual sexual encounters, arguing that sexual decision-making was rarely rational, and shaped by age and experience, drug use, sexual desire, and complicated interpersonal dynamics.

Knowledge, attitudes and practices of livestock and aquaculture producers regarding antimicrobial use and resistance in Vietnam.

The use of antibiotics in livestock production is considered a major driver of antibiotic resistance on a global scale. In Vietnam, small- and medium-scale livestock producers dominate the domestic market and regulatory pushes have done little to decrease antibiotic use. In order to inform future policy directions, this study aims to explore knowledge, attitudes, and practices amongst livestock producers to identify their perspectives on antibiotic use and resistance.

A Rare Case of C2 Sensory Blockade with Preserved Phrenic Nerve Function in an Obstetric Patient.

High neuraxial blockade is a serious complication in obstetric patients and requires prompt recognition and management in order to optimize patient outcomes. In cases of high neuroblockade, patients may present with significant hypotension, dyspnea, agitation, difficulty speaking or inability to speak, or even loss of consciousness. We report the unusual presentation of an obstetric patient that remained hemodynamically stable and had the preserved ability to initiate breaths despite sensory blockade up to C2.

Case Report: Perioperative management of a pregnant poly trauma patient for spine fixation surgery.

Trauma is estimated to complicate approximately one in twelve pregnancies, and is currently a leading non-obstetric cause of maternal death. Pregnant trauma patients requiring non-obstetric surgery pose a number of challenges for anesthesiologists. Here we present the successful perioperative management of a pregnant trauma patient with multiple injuries including occult pneumothorax who underwent T9 to L1 fusion in prone position, and address the pertinent perioperative anesthetic considerations and management.

An unusual ectopic location of a parathyroid carcinoma arising within the thyroid gland.

Introduction: Parathyroid carcinomas are very rare tumors and may arise in the normally located or ectopic gland. The latter present certain diagnostic difficulties, and there are no specific guidelines on their management. We present a case of parathyroid carcinoma arising within an ectopically located intrathyroid gland and discuss the diagnosis, management, and difficulties encountered.

Post-transcriptional suppression of pathogenic prion protein expression in Drosophila neurons.

A wealth of evidence supports the view that conformational change of the prion protein, PrPC, into a pathogenic isoform, PrPSc, is the hallmark of sporadic, infectious, and inherited forms of prion disease. Although the central role played by PrPSc in the pathogenesis of prion disease is appreciated, the cellular mechanisms that recognize PrPSc and modulate its production, clearance, and neural toxicity have not been elucidated. To address these questions, we used a tissue-specific expression system to express wild-type and disease-associated PrP molecules heterologously in Drosophila melanogaster.