When Veterinary Drugs Reach Human Hospitals: A Problem-Based Learning Discussion.

The delivery of drugs from the manufacturer to the hospital is a complex process. Despite numerous safeguards, lapses may occur, creating the potential for patient harm. Recently, an urban tertiary care medical center received a shipment of isoflurane bottles labeled for veterinary use. This error was not identified until the veterinary isoflurane reached the operating room automated medication dispensing system. No patients received the anesthetic. This report describes how such an error occurred, explains the differences between veterinary and human medications, and emphasizes the importance of vigilance in the drug supply chain to prevent patient harm.

Targeted Temperature Management After Cardiac Arrest in COVID-19 Patients.

There is a paucity of evidence regarding the utility of targeted temperature management (TTM) in COVID-19 patients who suffer cardiac arrest. This systematic review and meta-analysis aimed to use the available data of how temperature predicts outcomes in COVID-19 patients and the association between active cooling and outcomes in non-COVID-19 cardiac arrest patients to give recommendations for the utility of TTM in COVID-19 survivors of cardiac arrest. The PubMed, Embase, and Web of Science databases were queried in August 2022 for two separate searches: (1) temperature as a predictor of clinical outcomes in COVID-19 and (2) active cooling after return of spontaneous circulation (ROSC) in non-COVID-19. Forest plots were generated to summarize the results. Of the 4209 abstracts screened, none assessed the target population of TTM in COVID-19 victims of cardiac arrest. One retrospective cohort study evaluated hyperthermia in critically ill COVID-19 patients, two retrospective cohort studies evaluated hypothermia in septic COVID-19 patients, and 20 randomized controlled trials evaluated active cooling in non-COVID-19 patients after ROSC. Risk of death was higher in COVID-19 patients who presented with hyperthermia (risk ratio [RR] = 1.87) or hypothermia (RR = 1.77; p < 0.001). In non-COVID-19 victims of cardiac arrest, there was no significant difference in mortality (RR = 0.94; p = 0.098) or favorable neurological outcome (RR = 1.05; p = 0.41) with active cooling after ROSC. Further studies are needed to evaluate TTM in COVID-19 victims of cardiac arrest. However, given the available evidence that hyperthermia or hypothermia in COVID-19 patients is associated with increased mortality as well as our findings suggesting limited utility for active cooling in non-COVID-19 cardiac arrest patients, we posit that TTM to normothermia (core body temperature ∼37°C) would most likely be optimal for the best outcomes in COVID-19 survivors of cardiac arrest.

Descriptive sensory analysis in different classes of orange juice by a robust free-choice profile method.

Free-choice profile (FCP), developed in the 1980s, is a sensory analysis method that can be carried out by untrained panels. The participants need only to be able to use a scale and be consumers of the product under evaluation. The data are analysed by sophisticated statistical methodologies like Generalized Procrustean Analysis (GPA) or STATIS. To facilitate a wider use of the free-choice profiling procedure, different authors have advocated simpler methods based on principal components analysis (PCA) of merged data sets. The purpose of this work was to apply another easy procedure to this type of data by means of a robust PCA. The most important characteristic of the proposed method is that quality responsible managers could use this methodology without any scale evaluation. Only the free terms generated by the assessors are necessary to apply the script, thus avoiding the error associated with scale utilization by inexpert assessors. Also, it is possible to use the application with missing data and with differences in the assessors' attendance at sessions. An example was performed to generate the descriptors from different orange juice types. The results were compared with the STATIS method and with the PCA on the merged data sets. The samples evaluated were fresh orange juices with differences in storage days and pasteurized, concentrated and orange nectar drinks from different brands. Eighteen assessors with a low-level training program were used in a six-session free-choice profile framework. The results proved that this script could be of use in marketing decisions and product quality program development.