Immediate oral amiodarone re-challenge following the development of parenteral-induced acute liver toxicity

Dear editor,Amiodarone is a class Ⅲ antiarrhythmic medication commonly used in the emergency department (ED) and other critical care settings to treat several types of arrhythmias while also serving as a fixture of the Advanced Cardiac Life Support algorithm.[1] Its mechanism of action primarily involves blocking potassium channel currents during myocyte repolarization with additional effects on betaadrenergic receptors and both sodium and calcium channel blockade.[2] One of amiodarone’s less known complications is the development of acute hepatotoxicity with intravenous(IV) administration.[3] While discontinuation has been recommended, there is limited literature to help guide management when clinical factors warrant its continuation.

Emerging therapeutics in the management of COVID-19

Abstract The severe acute respiratory syndrome coronavirus 2(coronavirus disease 2019,COVID-19)pandemic has placed a tremendous burden on healthcare systems globally.Therapeutics for treatment of the virus are extremely inconsistent due to the lack of time evaluating drug efficacy in clinical trials.Currently,there is a deficiency of published literature that comprehensively discusses all therapeutics being considered for the treatment of COVID-19.A review of the literature was performed for articles related to therapeutics and clinical trials in the context of the current COVID-19 pandemic.We used PubMed,Google Scholar,and Clinicaltrials.gov to search for articles relative to the topic of interest.We used the following keywords:“COVID-19”,“therapeutics”,“clinical trials”,“treatment”,“FDA”,“ICU”,“mortality”,and“management”.In addition,searches through the references of retrieved articles was also performed.In this paper,we have elaborated on the therapeutic strategies that have been hypothesized or trialed todate,the mechanism of action of each therapeutic,the clinical trials finished or inprocess that support the use of each therapeutic,and the adverse effects associated with each therapeutic.Currently,there is no treatment that has been proven to provide significant benefit in reducing morbidity and mortality.There are many clinical trials for numerous different therapeutic agents currently underway.By looking back and measuring successful strategies from previous pandemics in addition to carrying out ongoing research,we provide ourselves with the greatest opportunity to find treatments that are beneficial.

ASSESSMENT OF TISSUE OPTICAL CLEARING AS A FUNCTION OF GLUCOSE CONCENTRATION USING OPTICAL COHERENCE TOMOGRAPHY

One of the major challenges in imaging biological tissues using optical techniques,such as optical coherence tomography(OCT),is the lack of light penetration due to highly turbid structures within the tissue.Optical clearing techniques enable the biological samples to be more optically homogeneous,allowing for deeper penetration of light into the tissue.This study investigates the effect of optical clearing utilizing various concentrations of glucose solution(10%,30%,and 50%)on porcine skin.A gold-plated mirror was imaged beneath the tissue and percentage clearing was determined by monitoring the change in reflected light intensity from the mirror over time.The ratio of percentage clearing per tissue thickness for 10%,30% and 50% glucose was determined to be 4.7±1.6%mm^(−1)(n=6),10.6±2.0%mm^(−1)(n=7)and 21.8±2.2%mm^(−1)(n=5),respectively.It was concluded that while higher glucose concentration has the highest optical clearing effect,a suitable concentration should be chosen for the purpose of clearing,considering the osmotic stress on the tissue sample.