Record Setting Temperatures in the Setting of SARS-CoV-2 Suggests Dexmedetomidine Drug-Induced Fever: A Case Report.

Patients infected with COVID-19 can develop coinfections or acute respiratory disorder that result in ventilation. Dexmedetomidine is a common medication used to sedate ventilated patients in the intensive care unit and for nonintubated patients prior to a surgical procedure. As a highly selective alpha-2 agonist, dexmedetomidine provides sedation while reducing the need for anxiolytics or opioids. However, previous case reports suggest dexmedetomidine can induce fever in a variety of conditions. The purpose of this case report is to describe a patient who acquired a fever of 42.6°C in the setting of COVID-19 after administration of dexmedetomidine.

Consumer's Opinion on a Pharmacist's Role in Nutritional Counseling.

BACKGROUND: Nutrition has become an increasing health concern. From fad diets to exercise programs, the consumer seems to be consulting multiple resources that all provide a different answer in the process of obtaining optimal health. Easily accessible pharmacists may be the sources to answer crucial nutritional issues facing society today. METHODS: Using the results of a previous study about food perceptions among lean and non-lean populations, interview questions were created to determine the populations' nutrition and pharmacist's role knowledge. Nutrition knowledge among lean vs. non-lean consumers was assessed by determining experience with pharmacist nutritional counseling, how experience perceptions differed, and how these perceptions can shape a pharmacist's role. Audio recorded interviews were conducted in a rural setting. Seventy-two English speaking, ambulatory, lean (BMI ≤ 24) and non-lean (BMI ≥ 25) residents between the ages 25-71 years participated in the study in a small western United States town. RESULTS: 26.3% of consumers obtained nutrition information from the internet; however, the internet and healthcare providers were considered the most trustworthy. When asked about the pharmacist's role in nutrition counseling, 32.7% believed that pharmacists were not a reliable source based on education background. Another 10.2% thought pharmacists were too busy for counseling. DISCUSSION: This study indicates the consumers' knowledge on pharmacists' education, willingness to seek out nutrition knowledge, and a pharmacist's ability to provide nutrition counseling can differ between lean and non-lean consumers. Lean consumers tend to have more interaction with a pharmacist whereas non-lean consumers do not. CONCLUSION: As a profession, pharmacists should educate consumers on reliable nutrition resources, a pharmacist's education, and how they use their role to provide consumers with nutrition knowledge.

Yoga and other meditative movement therapies to reduce chronic pain.

CLINICAL QUESTION: In adults with chronic pain, do yoga and other meditative movement therapies to improvement in chronic pain symptoms? ANSWER: Yes. However, in each of the studies reviewed, yoga classes were included as part of the pain management regime, sometimes alone and sometimes in tandem with DVDs or audiotapes. We feel that no exercise therapy program should be undertaken without professional coaching from certified, registered and qualified instructors. DATE ANSWER WAS DETERMINED: August 2014, June, 2015, August 2015. LEVEL OF EVIDENCE FOR THE ANSWER: A. SEARCH TERMS: chronic pain, yoga, exercise therapy, meditative movement therapy. INCLUSION CRITERIA: Adults; meta-analyses; systematic reviews; cohort studies; randomized controlled trials; practice guidelines; articles from 2010 to present. EXCLUSION CRITERIA: Children younger than 18 years of age, Pilates.

Rostral spinal cord segments are sufficient to generate a rhythm for both locomotion and scratching but affect their hip extensor phases differently.

Rostral segments of the spinal cord hindlimb enlargement are more important than caudal segments for generating locomotion and scratching rhythms in limbed vertebrates, but the adequacy of rostral segments has not been directly compared between locomotion and scratching. We separated caudal segments from immobilized low-spinal turtles by sequential spinal cord transections. After separation of the caudal four segments of the five-segment hindlimb enlargement, the remaining enlargement segment and five preenlargement segments still produced rhythms for forward swimming and both rostral and pocket scratching. The swimming rhythm frequency was usually maintained. Some animals continued to generate swimming and scratching rhythms even with no enlargement segments remaining, using only preenlargement segments. The preenlargement segments and rostral-most enlargement segment were also sufficient to maintain hip flexor (HF) motoneuron quiescence between HF bursts [which normally occurs during each hip extensor (HE) phase] during swimming. In contrast, the HF-quiescent phase was increasingly absent (i.e., HE-phase deletions) during rostral and pocket scratching. Moreover, respiratory motoneurons that normally burst during HE bursts continued to burst during the HF quiescence of swimming even with the caudal segments separated. Thus the same segments are sufficient to generate the basic rhythms for both locomotion and scratching. These segments are also sufficient to produce a reliable HE phase during locomotion but not during rostral or pocket scratching. We hypothesize that the rostral HE-phase interneurons that rhythmically inhibit HF motoneurons and interneurons are sufficient to generate HF quiescence during HE-biased swimming but not during the more HF-biased rostral and pocket scratching.