A Utilization Review of Patients That Respond to Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution.

Studies have demonstrated the benefits of LDN for various pain indications. This review describes the utilization of and response to LDN in patients with chronic pain within the William S. Middleton Memorial Veterans Hospital (Madison VA). This was a retrospective, single center, chart review of patients that were prescribed LDN for chronic pain. The primary outcome, change in subjective pain report via numeric rating scale (NRS), was analyzed through Wilcoxon Signed Rank Test and descriptive statistics. A total of 136 participants were included. Patients had an average pain score of 7.1 per NRS at baseline. At the initial follow up visit, participants had an average pain of 6.4 (p < 0.001). Additionally, 17.1% of patients had a greater than or equal to 30% pain reduction from baseline. At subsequent follow up, patients reported an average pain of 5.5 (p < 0.0001) per NRS. At the end of the study, 31.6% of patients were maintained on LDN at an average dose of 3.8 mg. This retrospective review demonstrated that LDN may be an effective modality for some chronic pain indications. Reported pain scores were significantly lower at initial follow up compared to baseline for the total population, and for patients with fibromyalgia (FM) specifically.

Immobilization of Diatom Phaeodactylum tricornutum with Filamentous Fungi and Its Kinetics.

Immobilizing microalgae cells in a hyphal matrix can simplify harvest while producing novel mycoalgae products with potential food, feed, biomaterial, and renewable energy applications; however, limited quantitative information to describe the process and its applicability under various conditions leads to difficulties in comparing across studies and scaling-up. Here, we demonstrate the immobilization of both active and heat-deactivated marine diatom Phaeodactylum tricornutum (UTEX 466) using different loadings of fungal pellets (Aspergillus sp.) and model the process through kinetics and equilibrium models. Active P. tricornutum cells were not required for the fungal-assisted immobilization process and the fungal isolate was able to immobilize more than its original mass of microalgae. The Freundlich isotherm model adequately described the equilibrium immobilization characteristics and indicated increased normalized algae immobilization (g algae removed/g fungi loaded) under low fungal pellet loadings. The kinetics of algae immobilization by the fungal pellets were found to be adequately modeled using both a pseudo-second order model and a model previously developed for fungal-assisted algae immobilization. These results provide new insights into the behavior and potential applications of fungal-assisted algae immobilization.

Differentiating probable nitrofurantoin-induced drug fever from antipsychotic-induced hyperthermia in a patient receiving clozapine.

Nitrofurantoin (NIT) is a commonly utilized antibiotic for the treatment of UTIs. Although well tolerated, NIT is not without potential adverse reactions. This case report details the observation of probable NIT-induced drug fever in a patient receiving clozapine. A 61-year-old female with treatment-refractory schizoaffective disorder was admitted to a psychiatric unit with paranoia and auditory hallucinations, prompting clozapine initiation during day 1 of hospitalization. Due to worsening hallucinations and anxiety, antibiotic therapy with NIT for a presumed UTI was initiated 8 days after admission. Febrile episodes were observed beginning on hospital day (HD) 9, leading to concern for possible neuroleptic malignant syndrome (NMS), which led to clozapine discontinuation. The patient received a total of 3 doses of NIT with continued fever until discontinuation on HD 10. No further complications were encountered, and clozapine was safely resumed on HD 13. Although sparsely described in the medical literature, occurrences of drug fever attributable to NIT are previously reported. A review of the medical literature identified only 5 previously published articles specific to NIT-induced drug fever, none of which specified interruptions of psychotropic therapy for a patient with acute psychiatric decompensation. This case highlights the differential diagnosis of fever related to NIT in a patient receiving clozapine when NMS was initially suspected.

Effectiveness of an educational intervention on health risks of vaping for high school-aged adolescents.

OBJECTIVE: The primary objective of this research was to identify if an educational intervention increased the knowledge of high school adolescents on the social and health risks associated with vaping. The secondary objectives included measuring the prevalence of vaping habits and the attitudes of adolescents on the safety of vaping. METHODS: This research was conducted with adolescents at a single high school. An evidence-based educational intervention was provided on the health risks associated with vaping PRODUCTS: Data were collected using a pre- and postsurvey tool. The material presented was targeted on the basis of age and making the information relevant and easy to understand. RESULTS: A total of 235 participants showed a 14% increase in scores from the pre- to postsurvey, indicating an increase in knowledge (P < 0.001). Gender was not a predictor for vaping behavior, but grade level was. A significantly higher proportion of participants who vaped reported vaping being safer than smoking than those who did not vape (χ2 = 13.31, P = 0.001). The most common reason for vaping was stress reduction. For the participants who reported vaping, the most common reason indicated that would motivate them to stop the use of vaping products was concern regarding the negative impact on personal or family health (n = 43). CONCLUSION: An educational intervention was successful in improving high school students' knowledge on the risks associated with vaping. Knowledge on health risk was the most common reported reason for which students would stop vaping.

Combined nitrogen limitation and hydrogen peroxide treatment enhances neutral lipid accumulation in the marine diatom Phaeodactylum tricornutum.

Exogenous application of dilute hydrogen peroxide (H2O2) increases neutral lipid production in Phaeodactylum tricornutum. Exposing early stationary phase cultures of P. tricornutum to 0.25-2mM H2O2 increases the amount of neutral lipids per biomass (mg/mg) by >100% at 24h post H2O2 treatment as determined upon lipid extraction and analysis using a neutral lipid assay. H2O2 treatment increased the total levels of neutral lipids harvested up to 50%, from 64mg/L to 96mg/L, demonstrating its possible effectiveness as a pre-harvest strategy to enhance the biofuel feedstock potential of P. tricornutum. The effects of H2O2 on biomass are concentration dependent; increasing concentrations of H2O2 reduce the levels of isolated biomass. Analysis of combined stressors demonstrates that H2O2 treatment exhibits synergistic effects to enhance neutral lipid production under nitrogen-depleted, but not phosphorus-depleted conditions, suggesting that the effects of hydrogen peroxide on lipid production are influenced by environmental nitrogen levels.