When the COVID-19 pandemic collides with the obesity epidemic in the United States: a national survey.

BACKGROUND: COVID-19 has disrupted life and put a spotlight on obesity as a risk factor for severe COVID-19 outcomes. Five years ago, we performed a survey exploring ways Americans view obesity and its treatment. We repeated the survey in the COVID-19 era to explore the impact of this once-in-a-century public health crisis on public perception and behavior surrounding obesity. OBJECTIVE: To explore if America's views on obesity have changed after more than 2 years of living through COVID-19. SETTING: The national survey was conducted by the National Opinion Research Center (NORC) from December 10 to 28, 2021. METHODS: We revisited some of the questions posed in a survey 5 years ago and added questions asking whether COVID-19 has changed views on obesity. We surveyed 1714 Americans sampled from a probability-based, nationally representative panel. Responses of Americans to questions about obesity were compared with the same or similar questions asked 5 years ago. RESULTS: COVID-19 has led to a change in how Americans view risks of obesity and benefits of treatment. Nearly one third (29%) of Americans became more worried about having obesity, and this is more pervasive among Black and Hispanic Americans (45%). This heightened concern led an estimated 28 million people to explore treatments not considered before the pandemic, including 6.4 million who thought about bariatric surgery or taking prescription obesity drugs. CONCLUSIONS: COVID-19 may have heightened Americans' worry about obesity. This may present an opportunity for conversations about treatments, including metabolic surgery.

Impact of Transfusing Packed Red Blood Cells Through a Rapid Infuser on Potassium Levels.

BACKGROUND: Hyperkalemia is associated with the rapid transfusion of packed red blood cells in trauma patients. Rapid infusers can infuse blood up to 500 ml/min. OBJECTIVE: This study aimed to determine whether infusing packed red blood cells through a rapid infuser impacts the potassium levels of the infused blood. METHODS: Two baseline samples were obtained to measure potassium and hemolysis scores in 12 units of expired blood prior to infusion. The blood was then infused via the Belmont Rapid Infuser into collection bags at varying infusion rates (50, 100, 250, and 500 ml/min) utilizing different gauge catheter sizes (18-gauge, 16-gauge, and Cordis catheter). Two postinfusion blood samples were collected and tested for potassium and hemolysis scores and compared with preinfusion values. This process was then repeated with fresh blood. RESULTS: The potassium levels of the samples taken from each unit prior to infusion (average difference 0.245) and after infusion (average difference 0.08) correlated well. There was no difference in potassium levels pre- and postinfusion at any infusion rate after accounting for catheter size and age of blood. The median potassium level of the fresh blood was 5.025 prior to infusion and 4.875 after infusion. The median potassium level of the expired blood was 16.05 prior to infusion and 16.4 postinfusion. There was no significant difference in the hemolysis scores between the preinfusion and postinfusion samples. CONCLUSIONS: Hyperkalemia in trauma patients undergoing massive transfusions is not a result of mechanical hemolysis from the high rates of blood infusion.

Cardiopulmonary responses of intratracheally instilled tire particles and constituent metal components.

Tire and brake wear particles contain transition metals, and contribute to near-road PM. We hypothesized that acute cardiopulmonary injury from respirable tire particles (TP) will depend on the amount of soluble metals. Respirable fractions of two types of TP (TP1 and TP2) were analyzed for water and acid-leachable metals using ICP-AES. Both TP types contained a variety of transition metals, including zinc (Zn), copper (Cu), aluminum, and iron. Zn and Cu were detected at high levels in water-soluble fractions (TP2 > TP1). Male Wistar Kyoto rats (12-14 wk) were intratracheally instilled, in the first study, with saline, TP1 or TP2 (5 mg/kg), and in the second study, with soluble Zn, Cu (0.5 micromol/kg), or both. Pulmonary toxicity and cardiac mitochondrial enzymes were analyzed 1 d, 1 wk, or 4 wk later for TP and 4 or 24 h later for metals. Increases in lavage fluid markers of inflammation and injury were observed at d 1 (TP2 > TP1), but these changes reversed by wk 1. No effects on cardiac enzymes were noted with either TP. Exposure of rats to soluble Zn and Cu caused marked pulmonary inflammation and injury but temporal differences were apparent (Cu effects peaked at 4 h and Zn at 24 h). Instillation of Zn, Cu, and Zn + Cu decreased the activity of cardiac aconitase, isocitrate dehydrogenase, succinate dehydrogenase, cytochrome-c-oxidase and superoxide dismutase suggesting mitochondrial oxidative stress. The observed acute pulmonary toxicity of TP could be due to the presence of water soluble Zn and Cu. At high concentrations these metals may induce cardiac oxidative stress.