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Purpose: Gabapentin is a widely prescribed analgesic with increased popularity over recent years. Previous studies have characterized use of gabapentin in the outpatient setting, but minimal data exist for its initiation in the inpatient setting. The objective of this study was to characterize the prescribing patterns of gabapentin when it was initiated in the inpatient setting., Methods: This was a retrospective cohort study of a random sample of adult patients who received new-start gabapentin during hospital admission. Patients for whom gabapentin was prescribed as a home medication, with one-time, on-call, or as-needed orders, or who died during hospital admission were excluded. The primary outcome was characterization of the gabapentin indication; secondary outcomes included the starting and discharge doses, the number of dose titrations, the rate of concomitant opioid prescribing, and pain clinic follow-up. Patients were stratified by surgical vs nonsurgical status., Results: A total of 464 patients were included, 283 (61.0%) of whom were surgical and 181 (39.0%) of whom were nonsurgical. The cohort was 60% male with a mean (SD) age of 56 (18) years; surgical patients were younger and included more women. The most common indications for surgical patients were multimodal analgesia (161; 56.9%), postoperative pain (53; 18.7%), and neuropathic pain (26; 9.2%), while those for nonsurgical patients were neuropathic pain (72; 39.8%) and multimodal analgesia (53; 29.3%). The mean starting dose was similar between the subgroups (613 mg for surgical patients vs 560 mg for nonsurgical patients; P = 0.196). A total of 51.6% vs 81.8% of patients received gabapentin at discharge (P < 0.0001), while referral/follow-up to a pain clinic was minimal and similar between the subgroups (1.1% vs 3.9%; P = 0.210)., Conclusion: Inpatients were commonly initiated on gabapentin for generalized indications, with approximately half discharged on gabapentin. Further studies are needed to assess the impact of this prescribing on chronic utilization., (© American Society of Health-System Pharmacists 2022. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The goal of this study was to determine the concentrations of Mg, Ca and K ions required for the formation of metabolically active population of phosphate (P)-accumulating bacterium Acinetobacter junii. The availability of Mg, Ca and K originating from natural minerals in the conditions of severe shortage of these cations was tested. In the case of shortage of Mg, Ca and K ions in wastewater the P removal was absent due to the decay of A. junii. In the cases of Mg or K shortage in wastewater the P removal was negligible due to the decay of A. junii, while Ca was not essential for the examined bacterium. The minimal required concentrations of Mg and K in synthetic wastewater were 0.64 mg Mg/mg P and 0.50 mg K/mg P. The natural zeolitized tuffs and bentonite, either in Mg, Ca or K form, successfully replaced the lack of Mg, Ca, K and trace metals in wastewater. The requirement of A. junii for examined cations was in the order: Mg>K>Ca., (Copyright 2010 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.)

C1q nephropathy is an uncommon glomerular disease with characteristic features on immunofluorescence microscopy. In this report, clinicopathologic correlations and outcomes are presented for 72 patients with C1q nephropathy. The study comprised 82 kidney biopsies from 28 children and 54 adults with male preponderance (68%). Immunofluorescence microscopy showed dominant or co-dominant staining for C1q in the mesangium and occasional glomerular capillary walls. Electron-dense deposits were observed in 48 of 53 cases. Light microscopy revealed no lesions (n = 27), focal segmental glomerulosclerosis (FSGS; n = 11), proliferative glomerulonephritis (n = 20), or various other lesions (n = 14). Clinical presentations in the patients who had no lesions histology were normal urine examination (7%), asymptomatic hematuria and/or proteinuria (22%), and nephrotic syndrome (minimal change-like lesion; 63%), which frequently relapsed. All patients with FSGS presented with nephrotic syndrome. Those with proliferative glomerulonephritis usually presented with chronic kidney disease (75%) or asymptomatic urine abnormalities (20%). Of the patients with sufficient follow-up data, complete remission of the nephrotic syndrome occurred in 77% of those with a minimal change-like lesion, progression to end-stage renal disease occurred in 33% of those with FSGS, and renal disease remained stable in 57% of those with proliferative glomerulonephritis. In conclusion, this study identified two predominant clinicopathologic subsets of C1q nephropathy: (1) Podocytopathy with a minimal change-like lesion or FSGS, which typically presents with nephrotic syndrome, and (2) a typical immune complex-mediated glomerular disease that varies from no glomerular lesions to diverse forms of glomerular proliferation, which typically presents as chronic kidney disease. Clinical presentation, histology, outcomes, and presumably pathogenesis of C1q nephropathy are heterogeneous.

This study was undertaken to investigate the suitability of applying the conventional method of chemical deinking flotation of digital offset prints and ecological implications of the disposal of digital offset prints, with special emphasis on the content of heavy metal cations. The EDXRF method was used to determine the concentrations of Pb, Zr, Sr, As, Co, Zn, Cu, Ni, Fe, Mn, Cr, V, Ti, Ca, and K cations in handsheet ashes after flotation as well as in ashes of foams separated from cellulose suspension in the flotation phase. The same method was applied to determine the concentrations of Pb, Cr, Mn, Fe, Ni, Cu, Zn, and Co in process water filtrates obtained from the cellulose suspension after flotation and in foam filtrates. Centrifuging and coagulation previously treated flotation process water, while foam filtrates were centrifuged. Concentrations of Pb, As, Sr, Zr, K, Ca, Ti, V, Cr, Mn, Fe, Cu, and Zn were determined in the sediments obtained by centrifuging process water. The trials were done with unprinted substrates without deinking chemicals, with unprinted substrates in the presence of deinking chemicals and with printed substrates in the presence of deinking chemicals. Cation analysis revealed that deinking chemicals facilitate release of cations from the substrate and their transition into process water. Concentrations of most cations in the flotation process water, in foam water as well as in the sediment of the process water of printed substrate flotation deinking were lower than those obtained by flotation of unprinted substrate suspension. Polymer particles of ElectroInk incompletely separated from cellulose fibers prevent release of cations from cellulose fibers into process water. Deinking chemicals do not affect release of cations from ElectroInk particles, so the substrate is the main source of increased concentration of cations in the water of digital offset print deinking. The major part of cations in process water is bound to the colloid particles of the filler (CaCO3) released by substrate disintegration and to particles of fine fibers.