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The opioid epidemic has renewed debate about how to structure laws, agency policies and hospital protocols for mandatory reporting of illicit substances during pregnancy. This paper analyzes the ethics of Rhode Island's approach to mandatory reporting - in particular, reporting of positive maternal and newborn drug tests at time of delivery. Given that state intervention is generally perceived by pregnant people as punitive and threatening to their family, we consider how four elements often used to justify punitive action by the state - retribution, deterrence, rehabilitation, and incapacitation (societal protection) - apply to Rhode Island's policy and approach to prenatal substance use. In addition, the paper considers the equity implications of Rhode Island's approach. It concludes that, given the potential for the policy to do more harm than good, investment of resources would be better spent on clinical and community services that support substance using parents and their newborns. [ABSTRACT FROM AUTHOR]

We report a case of a patient who first presented with hyperglycemic chorea, and subsequently with hypoglycemic chorea. The patient's hypoglycemia was thought to be iatrogenic, highlighting the importance of careful glucose management following glycemia-related chorea. Presumably secondary to the patient's chorea, the patient also suffered from new onset shoulder pain, which was managed with gabapentin. Unfortunately, due to the patient's renal failure, the gabapentin, combined with infection, led to encephalopathy in this patient. This report presents and offers useful tips on the management of a unique patient who suffered from hyperglycemic chorea, hypoglycemic chorea, and encephalopathy, all within a few weeks. [ABSTRACT FROM AUTHOR]

In some urban areas in Mexico, the use of firewood and charcoal as fuel for meat grills in commercial establishments, has proliferated due to economic and cultural factors. Although this activity satisfies diverse human necessities, it also generates waste that impacts the environment to local and global scales. Such is the case of CO2 emissions produced by biomass burning in grills, whose sources are not recognized in municipal inventories of greenhouse effect gases (GEG) of the State of Veracruz. A theoretical estimation was made based in a census of establishments and an emission parameter, in order to establish a baseline on the amount of gas emitted to the atmosphere by commercial grills in Boca Del Río, Ver. It was concluded that 30 operating grills emit 134.56 tons of CO2 into the atmosphere, equivalent to the annual combustion of 59,016.43 L of gasoline. Hence, these grills must be considered as micro-fixed sources of GEG, which influence local marine acidification and global climate change. It is recommended that it should be included in municipal, state, and national inventories for subsequent professionalization and regulation. [ABSTRACT FROM AUTHOR]

Cerebrospinal fluid (CSF) measures of phosphorylated-tau (P-tau) 231 and P-tau181 are two biomarkers for the identification of tau pathology as related to Alzheimer's disease (AD). While both are pathologically validated, their relative diagnostic performances are not well known. This cross-sectional diagnostic study of 87 normal (NL) subjects and 28 AD subjects compared CSF P-tau231 with CSF P-tau181. Logistic regression modeling demonstrated that the P-tau231 was superior to the P-tau181 in the diagnostic classifications. At a fixed 85% sensitivity cutoff, the ROC analysis shows that P-tau231 has greater overall specificity than P-tau181. While both P-tau analytes demonstrated equivalent negative predictive accuracies, P-tau231 yielded significantly fewer false positives. Moreover, P-tau231, but not P-tau181, demonstrated sensitivity to the E4 genotype. A postmortem validation with 9 AD subjects confirmed the superiority of the CSF P-tau231 specificity. This study suggests that P-tau231 has the potential to improve the CSF tau biomarker diagnosis of AD. [ABSTRACT FROM AUTHOR]