Sharps Disposal Practices Among People With Diabetes in a Community Care Clinic.

Objectives: The primary objective of this study was to determine sharps disposal practices among people with diabetes in a community care clinic. Secondary objectives were to identify patterns of sharps use and barriers to proper use. Methods: Surveys were distributed to patients at a community care clinic in person and via mail. Survey questions focused on how sharps are used and disposed of, the frequency of sharps changes, sharps disposal training, sharps identification, and confidence in sharps disposal. Participant demographics and diabetes profiles were also collected. Findings: Among 89 respondents, mean age was 60 years (range 29-93 years), 61.8% were Caucasian, 88.8% had type 2 diabetes, and 60.7% had had a diabetes diagnosis for ≤10 years, with diverse diabetes management methods; 57.3% did not receive or were unsure of sharps training, 25.8% discarded used sharps without a designated sharps container, and 37.1% properly disposed of sharps containers at sharps disposal facilities. Barriers to proper sharps practices included perceived safety of reusing sharps and waste with single use, cost, and the hassle of disposal. Those with prior sharps training were more likely to properly use and discard sharps; however, gaps in knowledge were still evident in this population. Conclusion: Results indicate gaps in proper sharps use and disposal knowledge among people with diabetes. Responses revealed sharps practices that are inconsistent with current federal and state regulations and are potentially dangerous for those handling improperly discarded sharps. Targeted sharps usage and disposal education resources are needed for individuals with and without prior sharps training.

Carbonation dysgeusia associated with topiramate.

PURPOSE: A case of carbonation dysgeusia associated with the use of topiramate is reported in order to bring awareness to a lesser-known adverse effect of the medication so that providers may be able to more effectively counsel patients and provide potential solutions. SUMMARY: A 39-year-old Caucasian woman with longstanding epilepsy was initiated on topiramate therapy after experiencing a generalized seizure (she reported not taking any antiepileptic medication for years). Topiramate was started at a dosage of 25 mg by mouth twice daily and after 3 weeks titrated to a dosage of 100 mg by mouth twice daily for maintenance therapy. After initiation of topiramate therapy, the patient began to experience an immediate change in her carbonation perception when drinking carbonated beverages; all carbonated beverages, including seltzer and beer, tasted "flat." The patient remained on topiramate for the subsequent 12 months without her carbonation perception returning to normal but noted that drinking carbonated beverages through straws slightly mitigated the adverse effect. Case assessment using the adverse drug reaction probability scale of Naranjo et al indicated that topiramate was the probable cause of the patient's carbonation taste perversion. CONCLUSION: A 39-year-old Caucasian woman developed chronic carbonation dysgeusia after initiation of topiramate following a generalized seizure.