An in-depth survey of the oil spill literature since 1968: Long term trends and changes since Deepwater Horizon.

In order to characterize the state of oil spill research and describe how the field has changed since its inception in the 1960s and since the Deepwater Horizon spill in 2010, we examined approximately 10% of oil spill literature (1255 of over 11,000 publications) published from 1968 to 2015. We find that, despite its episodic nature, oil spill research is a rapidly expanding field with a growth rate faster than that of science as a whole. There is a massive post-Deepwater Horizon shift of research attention to the Gulf of Mexico, from 2% of studies in 2004-2008 to 61% in 2014-2015, thus ranking Deepwater Horizon as the most studied oil spill. There is, however, a longstanding gap in research in that only 1% of studies deal with the effects of oil spills on human health. These results provide a better understanding of the current trends and gaps within the field.

Influence of UVB radiation on the lethal and sublethal toxicity of dispersed crude oil to planktonic copepod nauplii.

Toxic effects of petroleum to marine zooplankton have been generally investigated using dissolved petroleum hydrocarbons and in the absence of sunlight. In this study, we determined the influence of natural ultraviolet B (UVB) radiation on the lethal and sublethal toxicity of dispersed crude oil to naupliar stages of the planktonic copepods Acartia tonsa, Temora turbinata and Pseudodiaptomus pelagicus. Low concentrations of dispersed crude oil (1 µL L(-1)) caused a significant reduction in survival, growth and swimming activity of copepod nauplii after 48 h of exposure. UVB radiation increased toxicity of dispersed crude oil by 1.3-3.8 times, depending on the experiment and measured variables. Ingestion of crude oil droplets may increase photoenhanced toxicity of crude oil to copepod nauplii by enhancing photosensitization. Photoenhanced sublethal toxicity was significantly higher when T. turbinata nauplii were exposed to dispersant-treated oil than crude oil alone, suggesting that chemical dispersion of crude oil may promote photoenhanced toxicity to marine zooplankton. Our results demonstrate that acute exposure to concentrations of dispersed crude oil and dispersant (Corexit 9500) commonly found in the sea after oil spills are highly toxic to copepod nauplii and that natural levels of UVB radiation substantially increase the toxicity of crude oil to these planktonic organisms. Overall, this study emphasizes the importance of considering sunlight in petroleum toxicological studies and models to better estimate the impact of crude oil spills on marine zooplankton.

Pharmacist Pain E-Consults That Result in a Therapy Change.

Pain specialty pharmacists can provide support to prescribing primary care providers and enable changes in therapy.

Measured density and calculated baricity of custom-compounded drugs for chronic intrathecal infusion.

BACKGROUND AND OBJECTIVES: To minimize the frequency that intrathecal pumps require refilling, drugs are custom compounded at very high concentrations. Unfortunately, the baricity of these custom solutions is unknown, which is problematic, given baricity's importance in determining the spread of intrathecally administered drugs. Consequently, we measured the density and calculated the baricity of clinically relevant concentrations of multiple drugs used for intrathecal infusion. METHODS: Morphine, clonidine, bupivacaine, and baclofen were weighed to within 0.0001 g and diluted in volumetric flasks to produce solutions of known concentrations (morphine 1, 10, 25, and 50 mg/mL; clonidine 0.05, 0.5, 1, and 3 mg/mL; bupivacaine 2.5, 5, 10, and 20 mg/mL; baclofen 1, 1.5, 2, and 4 mg/mL). The densities of the solutions were measured at 37°C using the mechanical oscillation method. A "best-fit" curve was calculated for plots of concentration versus density for each drug. RESULTS: All prepared solutions of clonidine and baclofen were hypobaric. Higher concentrations of morphine and bupivacaine were hyperbaric, whereas lower concentrations were hypobaric. The relationship between concentration and density is linear for morphine (r > 0.99) and bupivacaine (r > 0.99) and logarithmic for baclofen (r = 0.96) and clonidine (r = 0.98). CONCLUSIONS: This is the first study to examine the relationship between concentration and density for custom drug concentrations commonly used in implanted intrathecal pumps. We calculated an equation that defines the relationship between concentration and density for each drug. Using these equations, clinicians can calculate the density of any solution made from the drugs studied here.

Countercurve placement of conchal cartilage grafts used for correction of nasal tip deformities.

A novel, straightforward technique which we have used in 7 patients and developed over the past 2 years is presented for help with the correction of nasal tip deformities, lack of nasal tip projection, and dome symmetry using conchal cartilage. Procedures to correct these problems include, but are not limited to, early open rhinoplasties with direct suturing techniques, grafting with cartilage, mobilization of the nasal cartilage, and nasoalveolar molding. We present a simple technique utilizing mature conchal cartilage as a columella strut with a lateral extension that curves over the misshapen side. Using the graft in a unique countercurve placement takes advantage of the structural memory intrinsic to mature cartilage and uses this springlike property to enhance tip projection and support lower lateral cartilage. The keys are (1) adequate mobilization of the nasal cartilage, (2) careful dissection of the pocket, (3) countercurve placement of the conchal cartilage.