Articles: ninos.
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Editorial Review
Blunt Talk on "Blunts": The Increasingly Popular Tobacco Product That Is Potentially Exacerbating Tobacco-Related Health Disparities.
A "blunt" is a hollowed-out cigar/cigarillo from which much of the loose tobacco has been removed, and the remaining tobacco wrapper filled with cannabis. Although blunts contain significant levels of tobacco/nicotine, they are often treated as if they were exclusive cannabis products and omitted from surveys of tobacco products. Whereas the prevalence of virtually all other tobacco products is on the decline in the USA, available data suggest that the prevalence of blunt smoking is not - and in fact, it may be increasing. ⋯ Co-use of tobacco and cannabis has been reported to have additive and even synergistic adverse health effects. Lack of investigations into the health effects of tobacco products most frequently used by Black people may contribute to tobacco-related health disparities. We argue that the scientific and public health communities must treat blunts as the potentially lethal tobacco product that they are, studying their prevalence and use patterns, and investigating their adverse health effects, both short and long term.
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Accurate assessment of kidney function is essential for diagnosing and managing chronic kidney disease (CKD) and acute kidney injury (AKI), adjusting drug dosages, and predicting clinical outcomes. Despite its ubiquitous use, serum creatinine has significant limitations, necessitating the exploration of alternative and complementary biomarkers and technologies. ⋯ Furthermore, it highlights innovations in real-time glomerular filtration rate (GFR) measurement, such as transdermal monitoring using MB-102 and dual fluorescent tracers. We conclude with a discussion on the development, validation, and clinical integration of these advancements, which may redefine renal function assessment in the years to come.
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This paper provides an overview of the efficacy of vitamin C for preventing and treating respiratory infections. Studies in a wide variety of animals have shown vitamin C to be protective against infections. In controlled trials in the general human population, vitamin C at a dose greater than 1 g/day did not prevent common colds. ⋯ It is unlikely that vitamin C would reduce the risk of pneumonia in the general population; however, 4 trials reported a treatment benefit for pneumonia patients, although the findings encourage further research rather than providing firm evidence of efficacy. Vitamin C has been tested for efficacy in COVID‑19 and sepsis with conflicting results. Given the evidence that vitamin C reduces the severity and duration of the common cold, paired with its good safety profile and low cost, it is not unreasonable for patients to test whether therapeutic vitamin C supplementation at a dose of 6-8 g/day is beneficial at the individual level.
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Pol. Arch. Med. Wewn. · Jan 2025
ReviewAnticoagulation in patients with a history of heparin-induced thrombocytopenia who require cardiovascular surgery: is it okay to use heparin?
Heparin‑induced thrombocytopenia (HIT) is an adverse drug reaction with significant thromboembolic risk. Though there are models for use of nonheparin anticoagulants, heparin remains the preferred anticoagulant in many operative settings, especially cardiovascular surgery and percutaneous cardiac intervention. ⋯ If procedures cannot be delayed, approaches include intraoperative bivalirudin or intraoperative heparin with pre- or intraoperative plasma exchange or a potent antiplatelet agent, sometimes in combination with intravenous immunoglobulin. In subacute HIT B (immunoassay positive, functional assay negative) and remote HIT (immunoassay negative, functional assay negative), brief exposure to heparin in the intraoperative setting with close monitoring postoperatively is suggested due to the low risk of recurrent HIT.
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In the US, approximately 10.55 million adults have atrial fibrillation (AF). AF is associated with significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality. ⋯ AF is associated with increased rates of stroke, heart failure, and mortality. Lifestyle and risk factor modification are recommended to prevent AF onset, recurrence, and complications, and oral anticoagulants are recommended for those with an estimated risk of stroke or thromboembolic events of 2% or greater per year. Early rhythm control using antiarrhythmic drugs or catheter ablation is recommended in select patients with AF experiencing symptomatic paroxysmal AF or HFrEF.