A Rare Case of Argatroban-Induced Anaphylaxis in a Patient With Intermediate-High Risk Pulmonary Embolism.

Heparin-induced thrombocytopenia is a rare and potentially devastating complication of heparin therapy. Patients with an absolute indication for anticoagulation, such as those with significant pulmonary embolism, must be switched to a different anticoagulant, such as argatroban, a direct thrombin inhibitor. We report a case of anaphylaxis to argatroban in a patient who was initially on heparin for intermediate-high risk pulmonary embolism but developed suspected type II heparin-induced thrombocytopenia. This case highlights the significance of recognizing and treating anaphylactic reactions and the diagnostic challenges associated with heparin-induced thrombocytopenia.

Nonprescription use of buprenorphine tablets among patients at a tertiary care addictive disorder treatment center in India: Observa-tions and implications.

OBJECTIVE: Nonprescribed use of drugs is a clinical and public health challenge fueled by diversion of controlled opioids like buprenorphine. In this study, we report the nonprescription use of buprenorphine and buprenorphine-naloxone for the first time in India. DESIGN: A cross-sectional observational study utilizing semistructured interviews. SETTING: A tertiary care addictive disorder treatment center in India, which provides inpatient and outpatient medically oriented care that includes agonist treatment (buprenorphine) or detoxification and antagonist treatment (naltrexone). PARTICIPANTS: Patients aged 18-65 years, registered at the center, and who had a history of current (within the past 6 months) nonprescription use of buprenorphine tablets were recruited. MAIN OUTCOME MEASURES: Participants were questioned about demographic and clinical factors and details of nonprescription use of buprenorphine and buprenorphine-naloxone using a structured questionnaire. Since both buprenorphine with naloxone and buprenorphine without naloxone are available and transacted on the street "loose" out of the blister packs, we were unable to differentiate the use of plain buprenorphine and a combination of buprenorphine- naloxone. RESULTS: A majority of the participants used nonprescribed tablets buprenorphine and buprenorphine-naloxone with an intent to control the withdrawal symptoms, and the reason for this use was that other patients shared their prescriptions of these medications. About half of the participants injected the tablets, and liquid pheniramine was most commonly used as the solvent for dissolving the tablets. A "high" was perceived by around half of those who injected. Participants reported knowing, on an average, around 13 peers who injected the tablet buprenorphine or -buprenorphine-naloxone. CONCLUSION: Nonprescription use of tablets buprenorphine and -buprenorphine-naloxone is a clinical concern and also an important public health issue. Geographical and systemic expansions of the availability of buprenorphine may reduce the "demand" for nonprescribed buprenorphine, while the opportunities for diversion from treatment centers can be minimized through more careful clinical prescriptions and monitoring practices.

A Highly Fluorescent Pyrene-Based Sensor for Selective Detection Of Fe3+ Ion in Aqueous Medium: Computational Investigations.

In this work, we introduce a highly selective and sensitive fluorescent sensor based on pyrene derivative for Fe(III) ion sensing in DMSO/water media. 2-(pyrene-2-yl)-1-(pyrene-2-ylmethyl)-1H-benzo[d]imidazole (PEBD) receptor was synthesized via simple condensation reaction and confirmed by spectroscopic techniques. The receptor exhibits fluorescence quenching in the presence of Fe(III) ions at 440 nm. ESI-MS and Job's method were used to confirm the 1:1 molar binding ratio of the receptor PEBD to Fe(III) ions. Using the Benesi-Hildebrand equation the binding constant value was determined as 8.485 × 103 M-1. Furthermore, the limit of detection (LOD, 3σ/K) value was found to be 1.81 µM in DMSO/water (95/5, v/v) media. According to the Environmental Protection Agency (EPA) of the United States, it is lower than the acceptable value of Fe3+ in drinking water (0.3 mg/L). The presence of 14 other metal ions such Co2+, Cr3+, Cu2+, Fe2+, Hg2+, Pb2+, K+, Ni2+, Mg2+, Cd2+, Ca2+, Mn2+, Al3+, and Zn2+ did not interfere with the detection of Fe(III) ions. The fluorescence life-time of the receptor PEBD with and without Fe3+ ion was found to be 1.097 × 10-9 s and 0.9202 × 10-9 s respectively. Similarly, the quantum yield of the receptor PEBD with Fe3+ and without Fe3+ ion was calculated, and found as 0.05 and 0.25 respectively. Computational studies of the receptor PEBD were carried out with density functional theory (DFT) using B3LYP/ 6-311G (d, p), LANL2DZ level of theory.

Initial examination of priming tasks to decrease delay discounting.

Steep discounting of delayed rewards is linked with a variety of unhealthy behaviors that contribute to the major causes of preventable death and disease. Growing evidence suggests that decreases in delay discounting contribute to healthier preferences. This study sought to provide preliminary evidence for the viability of developing a brief priming task to reduce delay discounting in a large, diverse group of individuals. Participants (n=1,122) were randomized to one of three conditions: Future Focus (FF), Present Focus (PF), and Non-Temporal Focus (NTF) intended respectively to decrease, increase, or have no effect on delay discounting. Participants then completed the Monetary Choice Questionnaire, a brief assessment of delay discounting rate. Participants randomized to FF exhibited significantly lower discounting rates than those randomized to PF or NTF conditions. Race, Hispanic background, social self-monitoring, education, and cigarette smoking also accounted for a significant amount of variance in the discounting model. These findings provide support for the development of a brief priming intervention that might be examined in clinical or public health contexts to decrease discounting and support healthy choices.