Drug seekers have often sought narcotics and benzodiazepines through subjective reports of severe pain. We report 2 patients who claimed repeated envenomation to receive narcotic administration; 1 claimed black widow bite on 8 occasions at 7 separate healthcare facilities, the other claimed to have been bitten by a copperhead snake on 7 occasions at 4 separate healthcare facilities. A 3rd patient complained of lionfish envenomation with no tissue reaction and was refused analgesia. Inconsistent clinical presentations of envenomations may signal drug-seeking behaviors.
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Ther Clin Risk Manag
January 2025
Department of Otolaryngology Head & Neck Surgery, Monash Health, Melbourne, Australia.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is often severe, debilitating and difficult to treat. Recent randomised control trials (RCTs) of biologics that target key inflammatory pathways have demonstrated clinical efficacy in treating CRSwNP. Such RCTs must facilitate meta-analysis.
View Article and Find Full Text PDFJ Clin Endocrinol Metab
January 2025
Adelaide Medical School, University of Adelaide, Adelaide, Australia.
Context: In males of normal weight, intraduodenal administration of calcium enhances the effects of the amino acid, L-tryptophan (Trp), to suppress energy intake, associated with greater stimulation of cholecystokinin (CCK), glucagon-like peptide-1 (GLP-1) and peptide tyrosine-tyrosine (PYY) secretion (key mechanisms underlying the regulation of pyloric motility and gastric emptying), but not gastrin or glucose-dependent insulinotropic polypeptide (GIP).
Objective: Given the implications for the management of obesity, the current study evaluated the effects of calcium, when administered alone and in combination with Trp, on gut hormone secretion, antropyloroduodenal motility and energy intake in males with obesity.
Methods: Fifteen males with obesity and without type 2 diabetes (mean±SD; age: 27±8 years; body mass index: 30±2 kg/m2; HbA1c: 5.
Clin Transl Sci
January 2025
Department of Clinical Pharmacology, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Exercise increases blood and lymph flow in working muscles, potentially affecting the bioavailability and effect of subcutaneously administered drugs. The aim of this study was to assess the influence of a single exercise session on pharmacokinetics and pharmacodynamics of a single dose of subcutaneously administered unfractionated heparin. In a crossover design, 15 healthy males underwent four experimental days where 15,000 IU of unfractionated heparin was injected subcutaneously into the thigh of the non-dominant leg.
View Article and Find Full Text PDFExp Physiol
January 2025
Division of Sport, Health and Exercise Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
Assessment of diaphragm function and fatigue typically relies on the measurement of transdiaphragmatic pressure (P). Although P serves as an index of diaphragm force output, it provides limited information regarding the ability of the muscle to shorten and generate power. We asked whether ultrasonography, combined with P, could be used to quantify changes in diaphragm function attributable to fatigue.
View Article and Find Full Text PDFSociol Health Illn
January 2025
Department of Global Health and Social Medicine, King's College London, London, UK.
The National Institute for Health and Care Excellence (NICE) was established a quarter of a century ago in 1999 to regulate the cost-effectiveness of pharmaceuticals (and other health technologies) for the NHS. Drawing on medical sociology theories of corporate bias, neoliberalism, pluralism/polycentricity and regulatory capture, the purpose of this article is to examine the applicability of those theories to NICE as a key regulatory agency in the UK health system. Based on approximately 7 years of documentary research, interviews with expert informants and observations of NICE-related meetings, this paper focuses particularly on NICE's relationship with the interests of the pharmaceutical industry compared with other stakeholder interests at the meso-organisational level.
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