Guidance for Prescribing Oral Antihypertensive Medications in the Emergency Department.

Purpose Of Review: To review the most current recommendations regarding assessment and treatment of asymptomatic hypertension treatment in the emergency department (ED) and to provide guidance for prescribing oral antihypertensive therapy for ED providers.

Recent Findings: There are varying management strategies for the treatment of asymptomatic hypertension in the ED likely due to a lack of direct guidelines for treatment. There is an increasing body of evidence for the safety of initiating therapy to treat chronic asymptomatic hypertension in the ED.

Left ventromedial prefrontal cortex inhibitory rTMS as an anti-stress intervention in opioid use disorder: Trial design.

Background: In people with substance use disorders (SUDs), stress-exposure can impair executive function, and increase craving and likelihood of drug-use recurrence. Research shows that acute stressors increase drug-seeking behavior; however, mechanisms underlying this effect are incompletely understood. The Competing Neurobehavioral Decisions System theory posits that persons with SUDs may have hyperactive limbic reward circuitry and hypoactive executive control circuitry.

Incidence of surgical infection in cefazolin 3 g versus 2 g for colorectal surgery in obese patients.

Objective: To compare the incidence of surgical site infection (SSI) between cefazolin 3 g and 2 g surgical prophylaxis in patients weighing ≥120 kg that undergo elective colorectal surgery.

Methods: A multicenter, retrospective cohort study was performed utilizing a validated database of elective colorectal surgeries in Michigan acute care hospitals. Adults weighing ≥120 kg who received cefazolin and metronidazole for surgical prophylaxis between 7/2012 and 6/2021 were included.

Late-Life Alcohol Exposure Does Not Exacerbate Age-Dependent Reductions in Mouse Spatial Memory and Brain TFEB Activity.

Alcohol consumption is believed to affect Alzheimer's disease (AD) risk, but the contributing mechanisms are not well understood. A potential mediator of the proposed alcohol-AD connection is autophagy, a degradation pathway that maintains organelle and protein homeostasis. Autophagy is regulated through the activity of Transcription factor EB (TFEB), which promotes lysosome and autophagy-related gene expression.

Enhanced safety and efficacy profile of CD40 antibody upon encapsulation in pHe-triggered membrane-adhesive nanoliposomes.

Aim: To develop pH (pHe)-triggered membrane adhesive nanoliposome (pHTANL) of CD40a to enhance anti-tumor activity in pancreatic cancer while reducing systemic toxicity.

Materials And Methods: A small library of nanoliposomes (NL) with various lipid compositions were synthesized to prepare pH (pHe)-triggered membrane adhesive nanoliposome (pHTANL). Physical and functional characterization of pHTANL-CD40a was performed via dynamic light scattering (DLS), Transmission Electron Microscopy (TEM), confocal microscopy, and flow cytometry.

Navigating performance measures for ambulatory antimicrobial stewardship: a review of HEDIS® and other metrics the steward should know.

Ambulatory antimicrobial stewardship can be challenging due to disparities in resource allocation across the care continuum, competing priorities for ambulatory prescribers, ineffective communication strategies, and lack of incentive to prioritize antimicrobial stewardship program (ASP) initiatives. Efforts to monitor and compare outpatient antibiotic usage metrics have been implemented through quality measures (QM). Healthcare Effectiveness Data and Information Set (HEDIS®) represent standardized measures that examine the quality of antibiotic prescribing by region and across insurance health plans.

Fostering Advocacy in Student Pharmacists: Strategies for Curricular Integration and Assessment.

Objectives: This study aimed to discuss teaching and assessment of advocacy skills in student pharmacists as called for in the American Association of Colleges of Pharmacy 2022 Curriculum Outcomes and Entrustable Professional Activities.

Findings: The American Association of Colleges of Pharmacy 2022 Curriculum Outcomes and Entrustable Professional Activities categorize advocacy as a skill that should be developed to advance patient care and the profession. This is a change from the 2013 Center for Advancement of Pharmacy Education outcomes, in which the focus was on advocating for patients.

Effectiveness of traditional non-carbapenem β-lactams vs. novel β-lactams for the treatment of carbapenem-resistant Pseudomonas aeruginosa: a retrospective cohort study.

Background: The World Health Organization (WHO) has identified carbapenem-resistant Pseudomonas aeruginosa (CRPA) as one of the three critical priority pathogens. There is scarce literature evaluating the treatment outcomes in patients with CRPA infections treated with traditional non-carbapenem β-lactam (NCBL) agents. Thus, this study aims to assess the effectiveness of traditional NCBL compared to novel β-lactam agents (NVL) for treating non-carbapenem β-lactam -susceptible CRPA.

Effectiveness of ceftazidime-avibactam versus ceftolozane-tazobactam for multidrug-resistant Pseudomonas aeruginosa infections in the USA (CACTUS): a multicentre, retrospective, observational study.

Background: Ceftolozane-tazobactam and ceftazidime-avibactam are preferred treatment options for multidrug-resistant Pseudomonas aeruginosa infections; however, real-world comparative effectiveness studies are scarce. Pharmacokinetic and pharmacodynamic differences between the agents might affect clinical response rates. We aimed to compare the effectiveness of ceftolozane-tazobactam and ceftazidime-avibactam for treatment of invasive multidrug-resistant P aeruginosa infections.

Interactions of VMAT2 with CDCrel-1 and Parkin in Methamphetamine Neurotoxicity.

In recent years, methamphetamine (METH) misuse in the US has been rapidly increasing, and there is no FDA-approved pharmacotherapy for METH use disorder (MUD). In addition to being dependent on the drug, people with MUD develop a variety of neurological problems related to the toxicity of this drug. A variety of molecular mechanisms underlying METH neurotoxicity has been identified, including the dysfunction of the neuroprotective protein parkin.

Current and emerging PCSK9-directed therapies to reduce LDL-C and ASCVD risk: A state-of-the-art review.

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death worldwide. Lowering low-density lipoprotein cholesterol (LDL-C) levels is a primary strategy to reduce ASCVD risk. Although statin therapy remains the initial therapy of choice to reduce LDL-C and ASCVD risk, statin intolerance and suboptimal LDL-C lowering response prompts the need for additional non-statin therapies.

Ceftobiprole Medocaril: A New Fifth-Generation Cephalosporin.

Objective: The objective was to review the pharmacology, efficacy, and safety of intravenous ceftobiprole in the treatment of bloodstream infections, acute bacterial skin and skin structure infections (ABSSSIs), community-acquired pneumonia (CAP), and hospital-acquired pneumonia (HAP), or ventilator-associated pneumonia (VAP).

Data Sources: PubMed and ClinicalTrials.gov were searched using the following terms: ceftobiprole, ceftobiprole medocaril, ceftobiprole medocaril sodium, Zevtera, and BAL5788.

Characterisation, management, and outcomes of New Delhi metallo-β-lactamase-producing Escherichia coli: A case series.

Objective: New Delhi metallo-β-lactamase (NDM)-producing carbapenem-resistant Enterobacterales (CRE) is a globally growing threat. We sought to describe the microbiology, management and outcomes of patients with this infection at our facility.

Methods: This is a descriptive case series of patients with NDM-producing Escherichia coli isolated from culture in Detroit between July 2021 and February 2023.

Say it ain't : a microbiology nudge comment leads to less treatment of respiratory colonization.

Objective: To describe the effect of a (SM) respiratory culture nudge on antibiotic use in colonized patients.

Design: IRB-approved quasi-experiment.

Setting: Five acute-care hospitals in Michigan.

Inhalation exposure to airborne PM attenuates hepatic metabolic pathways through -nitrosylation of the primary ER stress sensor.

Inhalation exposure to airborne fine particulate matter (aerodynamic diameter: <2.5 µm, PM) is known to cause metabolic dysfunction-associated steatohepatitis (MASH) and the associated metabolic syndrome. Hepatic lipid accumulation and inflammation are the key characteristics of MASH.

Aztreonam-avibactam: The dynamic duo against multidrug-resistant gram-negative pathogens.

Antimicrobial resistance poses a significant public health challenge, particularly with the rise of gram-negative hospital-acquired infections resistant to carbapenems. Aztreonam-avibactam (ATM-AVI) is a promising new combination therapy designed to combat multidrug-resistant (MDR) gram-negative bacteria, including those producing metallo-β-lactamases (MBLs). Aztreonam, a monobactam antibiotic, is resistant to hydrolysis by MBLs but can be degraded by other β-lactamases.

Multidrug Resistant in Clinical Settings: A Review of Resistance Mechanisms and Treatment Strategies.

is causing increasing concern among clinicians due to its high mortality and resistance rates. This bacterium is responsible for various infections, especially in hospital settings, affecting some of the most vulnerable patients. has developed resistance through multiple mechanisms, making treatment challenging.

Optimizing Heparin Quality Assurance Utilizing Electronic Data Abstraction.

Heparin is a high-risk medication with significant variability across patients. Systematic data analysis can help hospitals improve heparin management, ensuring safe and effective anticoagulation. An opportunity exists to create a more efficient data collection process, allowing hospitals to streamline quality assurance programs.

Regulation of mitochondrial oxidative phosphorylation through tight control of cytochrome c oxidase in health and disease - Implications for ischemia/reperfusion injury, inflammatory diseases, diabetes, and cancer.

Mitochondria are essential to cellular function as they generate the majority of cellular ATP, mediated through oxidative phosphorylation, which couples proton pumping of the electron transport chain (ETC) to ATP production. The ETC generates an electrochemical gradient, known as the proton motive force, consisting of the mitochondrial membrane potential (ΔΨ, the major component in mammals) and ΔpH across the inner mitochondrial membrane. Both ATP production and reactive oxygen species (ROS) are linked to ΔΨ, and it has been shown that an imbalance in ΔΨ beyond the physiological optimal intermediate range results in excessive ROS production.

Judicious Use of Benzathine Penicillin G in Response to a Medication Alert During a Critical Drug Shortage.

Purpose: To evaluate judicious antibiotic prescribing of benzathine penicillin G (BPG) after implementation of an electronic health record-based medication shortage alert during a critical drug shortage.

Methods: This was an institutional review board-approved retrospective cohort study of patients aged ≥3 months who received BPG between May 9, 2023, and February 28, 2024. The study included inpatient and outpatient visits after implementing a BPG medication shortage alert; patients with severe penicillin allergy, neurosyphilis, or congenital syphilis were excluded.

NAD(P)-Dependent Glucose Dehydrogenases: Underestimated Multifunctional Biocatalysts.

The last decade has witnessed tremendous progress in the field of biocatalysis. One of the most frequently utilized enzymes in diverse biocatalytic applications is NAD(P)-dependent glucose dehydrogenases (GDHs). Traditionally, these enzymes are employed for their role in regenerating NAD(P)H in various enzymatic reactions utilizing glucose.

Massage prior to exercise delays the onset of the physical working capacity at the fatigue threshold (PWCFT).

Background: Functional massage (FM) is a soft tissue technique that incorporates non-end range joint movement with tissue compression to treat musculotendinous pain and dysfunction. FM has been associated with promoting neural excitability and neuromuscular efficiency. In clinical practice, FM may be used at the beginning of a treatment session to prepare fibers of the target muscle and surrounding soft tissues for functional activity.

Basal cortisol level modulates stress-induced opioid-seeking behavior.

In preclinical studies and our human laboratory, the α-noradrenergic autoreceptor antagonist yohimbine was found to promote drug-seeking behavior. This study evaluated effects of dose-combinations of yohimbine and the glucocorticoid receptor agonist hydrocortisone to model intensity-dependent effects of stimulating each neurochemical system, alone and together, on stress-reactivity and opioid-seeking. Twelve regular heroin-using participants diagnosed with opioid use disorder (OUD) were stabilized on sublingual buprenorphine (8-mg/day), then passed a hydromorphone 18-mg vs.