RESUMO
Background: Access to emergency contraception is an important consideration in preventing unintended pregnancies. Inconsistent information about emergency contraceptive given to patients at retail pharmacies may limit access. Objective: In this study, we aimed to assess pharmacy students' knowledge of oral emergency contraception. Methods: Students in a Doctor of Pharmacy program completed a confidential survey about their knowledge of and training on oral emergency contraception. Respondents self-reported demographics included age, race, ethnicity, gender, and year in pharmacy school. The survey questions assessed student knowledge of indications, availability, side effects, and mechanisms of action of oral emergency contraception, as well as their training on emergency contraception. Chi-squared and Fisher's exact tests were used to determine if demographics influenced knowledge outcomes. A multivariate logistic regression, including age, gender, ethnicity, religion, year of training, hours of education, and source of knowledge acquisition, was used to adjust for confounding variables. Results: Among 296 pharmacy students, 31% (92/296) completed the survey. Among respondents, 34% (31/92) showed adequate knowledge of oral emergency contraception based on four critical knowledge questions. Third- and fourth-year students were more likely to have adequate knowledge than first- and second-year students (odds ratio [OR], 2.70; confidence interval [95% CI], 1.07-6.80). Students who reported learning about emergency contraception through reading assignments were more likely to have adequate knowledge than students who did not report learning from reading assignments (OR, 2.09; 95% CI, 1.30-3.35). Conclusions: Most pharmacy students at a single academic center did not have adequate knowledge of oral emergency contraception. These findings highlight the need for trainings to improve pharmacy student knowledge of oral emergency contraception.
RESUMO
A 30-year-old female previously diagnosed with C-peptide (CP)-positive, autoantibody-negative type 1 diabetes mellitus (T1DM) at 19 years old presented to the clinic at age 28 for management of diabetes mellitus (DM) that had previously been controlled by insulin since diagnosis. Laboratory results from May 2011 showed low-normal C-peptide of 1 ng/mL (normal range: 0.8-4 ng/mL) with no corresponding glucose, glutamic acid decarboxylase (GAD)-65 antibody (GADA) of <1 U/mL (N<1.1 U/mL at the time of laboratory draw), and HbA1c of 6.4%. Almost 10 years later, in December 2020, laboratory results showed normal C-peptide of 2.1 ng/mL with a glucose of 198 mg/dL, GAD-65 antibody of 38.2 U/mL (current reference range: 0-5 U/mL), negative pancreatic islet antibody (IA), and undetectable zinc transporter 8 (ZnT8) antibody, consistent with a diagnosis of T1DM. This increase in CP indicates the possibility of pancreatic beta cell regeneration and/or increased function. The commonly accepted belief that individuals with T1DM quickly lose all function of pancreatic beta cells has led to academic consequences; many immunotherapy clinical trials' inclusion criteria require participants to have a new diagnosis of T1DM based on the assumption that those with a longer duration of diabetes have unrecoverable cessation of insulin secretion. CP could influence inflammation, microvascular circulation, and endothelial function. Further, it could affect the neuronal and glomerular structure and/or function. These potential functions of CP are seen by the correlation between measurable CP levels and decreased diabetic complication rates.
RESUMO
A 49-year-old female taking lithium for bipolar affective disorder for over 20 years presented with lithium toxicity resulting in declining mentation. Lithium poisoning has been well documented to cause acute gastrointestinal, cardiac, and neurological side effects, along with long-term neurologic sequelae. There has, however, been scant discussion on the potential long-term effects on mentation. The following case report illustrates a possible example.
