The Second Wave of COVID-19: Clinical Pharmacy Services During a Field Hospital Operation

The second wave of COVID-19 emerged in the late fall months in the state of Massachusetts and inadvertently caused a rise in the number of cases requiring hospitalization. With a field hospital previously opened in central Massachusetts during the Spring of 2020, the governor decided to reimplement the field hospital. Although operations were effectively accomplished during the first wave, the reimplementation of the field hospital came with its new set of challenges for operating a satellite pharmacy. Experiences gathered include new pharmacy operation workflows, the clinical role of pharmacy services, introduction of remdesivir treatment, and pharmacy involvement in newly diagnosed diabetes patients requiring insulin teaching. Pharmacy services were successful in adapting to the rapidly growing number in patients with a total of over 600 patients served in a course of 2 months.     

The anti-diabetic properties of Guazuma ulmifolia Lam are mediated by the stimulation of glucose uptake in normal and diabetic adipocytes without inducing adipogenesis

ETHNOPHARMACOLOGICAL IMPORTANCE: Guazuma ulmifolia Lam (Sterculiaceae) is a plant extensively used in México for the empirical treatment of type 2 diabetes. AIM OF THE STUDY: To investigate the anti-diabetic mechanisms of Guazuma ulmifolia. MATERIALS AND METHODS: Non-toxic concentrations of Guazuma ulmifolia aqueous extracts (GAE) were assayed on adipogenesis and 2-NBDglucose uptake in the murine 3T3-F442A preadipose cell line. RESULTS: GAE added to adipogenic medium (AM) did not affect adipogenesis at any of the tested concentrations (1-70 microg/ml), whereas in AM lacking insulin GAE 70 microg/ml induced triglyceride accumulation by 23%. On the other hand, GAE 70 microg/ml stimulated 2-NBDG uptake by 40% in insulin-sensitive 3T3-F442A adipocytes and by 24% in insulin-resistant adipocytes, with respect to the incorporation showed by insulin-sensitive adipocytes stimulated with the hormone. CONCLUSION: Guazuma ulmifolia exerts its anti-diabetic effects by stimulating glucose uptake in both insulin-sensitive and insulin-resistant adipocytes without inducing adipogenesis.     

Role of Surface Topography in the Superhydrophobic Effect—Experimental and Numerical Studies

Within these studies, the effect of surface topography for hydrophobic coatings was studied both numerically and experimentally. Chemically modified polyurethane coating was patterned by application of a laser beam. A set of patterns with variously distant linear peaks and grooves was obtained. The cross section of the pattern showed that the edges of the peaks and grooves were not sharp, instead forming a rounded, rectangle-like shape. For such surfaces, experimental studies were performed, and in particular the static contact angle (SCA), contact angle hysteresis (CAH), and roll-off angle (ROA) were measured. Profilometry was used to create a numerical representation of the surface. Finite volume method was then applied to simulate the behavior of the water droplets. The model developed herewith enabled us to reproduce the experimental results with good accuracy. Based on the verified model, the calculation was extended to study the behavior of the water droplet on the simulated patterns, both spiked and rectangular. These two cases, despite a similar SCA of the water droplet, have shown extremely different ROA. Thus, more detailed studies were dedicated to other geometrical features of such topography, such as the size and distance of the surface elements. Based on the results obtained herewith, the future design of superhydrophobic and/or icephobic topography is discussed.     

Translumbar retroperitoneal endoscopy: an alternative in the follow-up and management of drained infected pancreatic necrosis

BACKGROUND: The follow-up of drained infected pancreatic necrosis (IPN) is usually done with data on the patient's clinical evolution and information obtained from serial helical computed tomographic scans. Management often requires necrosectomies and periodic debridements. HYPOTHESIS: Translumbar retroperitoneal endoscopy is effective in the management of drained IPN. DESIGN: A prospective observational study. SETTING: University tertiary care hospital. PATIENTS: A series of 11 consecutive patients with drained IPN undergoing postoperative follow-up with translumbar retroperitoneal endoscopy. INTERVENTIONS: Initially, the IPN was drained via the posterior extraperitoneal translumbar approach; then, a superficial necrosectomy was performed during the same surgical intervention by flushing and endoscopic aspiration; and, finally, a lavage and drainage system was fitted. In the immediate postoperative period, for management of the IPN, we removed the drainage tube and inserted a flexible endoscope as far as the pancreatic area to eliminate the infected necrotic material by flushing and aspiration. MAIN OUTCOME MEASURES: In these patients, we studied control of the infection of the pancreatic area, quantification variables of the necrosectomy, technique-related morbidity and mortality, and the need for subsequent operations. RESULTS: The 11 patients studied showed good results regarding the control and complete elimination of the infected necrosis. There was no technique-related morbidity or mortality or need for subsequent operations. CONCLUSION: Translumbar retroperitoneal endoscopy allows exploration of the retroperitoneal space under direct visual guidance, facilitates lavage and aspiration, avoids subsequent surgical operations for debridement, decreases the need for repeated computed tomographic scans to evaluate the evolution of the IPN, and has no added morbidity or mortality.