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Hospitals Around the World Are Running Out of Saline. We Can’t Just Switch to Other Intravenous Fluids – Here’s Why

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Last week Australian Therapeutic Goods Administration added intravenous (IV) fluids to the growing list of drugs briefly supply. The shortage is due to higher-than-expected demand and production issues.

Two specific intravenous fluids are affected: normal saline and complicated sodium lactate (also called Hartmann’s solution). Both fluids are made of salt.

There are IV fluids that use other ingredients, corresponding to sugar, as an alternative of salt. However, relatively than switch patients to these fluids, the government has decided to approve salt-based solutions from other foreign brands.

So why do IV fluids contain different chemicals? And why cannot you simply swap them out when one runs out?

We cannot just inject water right into a vein

Medicines are at all times injected into the veins in a water-based solution. But we will not do it with pure water, we now have to add other chemicals. This is because of a scientific principle called osmosis.

Osmosis occurs when water moves rapidly into and out of cells in the bloodstream, in response to changes in the concentration of chemicals dissolved in the blood plasma. Think salts, sugars, nutrients, drugs, and proteins.

Too much of the chemicals and proteins in the blood causes it to be in a “hypertonic” state, which causes the blood cells to shrink. Too little of the chemicals and proteins in the blood causes the blood cells to expand. The correct amount known as “isotonic”.

Mixing the medicine with the correct amount of chemicals by injection or infusionensures that the concentration inside the syringe or drip bag stays close to isotonic.

There is currently a shortage of two saline-based intravenous fluids in Australia.
sirnength88/Shutterstock

What types of intravenous fluids are there?

There are a number of intravenous fluids available for administering medications. The two hottest are:

  • 0.9% saline, which is an isotonic solution of table salt. This is one of the intravenous fluids which might be missing

  • 5% glucose sugar solution/glucose. There is not any shortage of this fluid.

There are also intravenous fluids that mix saline and glucose, in addition to intravenous fluids containing other salts:

  • Ringer’s solution is an intravenous fluid containing sodium, potassium and calcium salts

  • Plasma-Lyte has various sodium and magnesium salts

  • Hartmann’s solution (sodium lactate complex) incorporates a number of different salts. It is often used to treat a condition called metabolic acidosis, where patients have an increased amount of acid of their blood. It is low.

What when you use the fallacious solution?

Some medications are only stable in specific intravenous fluids, for instance only in saline-based intravenous fluids or only in glucose.

Putting the medication in the fallacious IV fluid could potentially cause the medication to “run out” of solution, meaning patients is not going to receive the full dose.

The drug may break down: not only will it not work, but it will possibly also cause serious uncomfortable side effects.

An example of a situation where a drug can turn into something toxic is a drug utilized in cancer chemotherapy. cisplatin. It is secure when administered in saline, but when administered in pure glucose it might cause life-threatening damage to the patient’s kidneys.

What can hospitals use as an alternative?

The IV fluids briefly supply are saline and Hartmann’s solution. These are supplied by three approved Australian suppliers: Baxter Healthcare, B.Braun and Fresenius Kabi.

The government’s solution is to approve a number of overseas-registered alternative brands of saline solutions, which is permitted under applicable rules without going through the normal Australian quality control and approval process. They will receive approval in the country of manufacture.

The government is taking this approach since it might not be effective or secure to formulate drugs which might be intended to be in saline into different intravenous fluids. And we wouldn’t have the manufacturing capability to produce saline intravenous fluids here in Australia.

The Australian Association of Hospital Pharmacists provides guidance to other healthcare professionals on which medicines ought to be administered with which intravenous fluids. Australian Injectable Drugs Manual. If physiological saline or Hartmann’s solution is missing and supplies of other foreign brands haven’t arrived, you should utilize the following tips to select one other suitable intravenous fluid.

Why don’t we produce it locally?

The current shortage of intravenous fluids is one other example of the problems Australia is facing because it becomes almost entirely depending on overseas manufacturers for key medicines.

Fortunately, we now have workarounds to cope with the current shortage. However, Australia is probably going to face ongoing shortages, not only of IV fluids but of all the medicines we depend on overseas manufacturers to manufacture. Shortages like these put Australian lives in danger.

In the past, each I and othersThey called on the Federal Government to develop or support the development of Australian drug manufacturing. This could include off-patent drug manufacturing, with a concentrate on the mostly used drugs in Australia.

Not only would this create sustainable high-tech jobs in Australia, it will also positively impact our economy and make us less vulnerable to future global medicine supply issues.

This article was originally published on : theconversation.com
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Health and Wellness

More than half of party drug users take ADHD medication without a prescription, new study finds

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Each 12 months, the National Drug and Alcohol Research Centre on the University of New South Wales in Sydney surveys a whole bunch of regular drug users in Australia to seek out out understand trends within the use of psychoactive substances throughout the country.

Today we published Report 2024during which 740 people from Australian capital cities who usually use ecstasy or other illegal stimulants were surveyed.

While the first focus of our research is illicit drugs and markets, we also monitor trends within the over-the-counter use of pharmaceutical stimulants, resembling ADHD medications.

This 12 months, 54% of people we spoke to had used pharmaceutical stimulants previously six months after they weren’t prescribed them, the best percentage now we have seen since we began asking people about this kind of drug use in 2007.

What are pharmaceutical stimulants?

Pharmaceutical stimulants include the drug methylphenidate (trade names Concerta and Ritalin), in addition to dexamfetamine and lisdexamfetamine (Vyvanse).

These medications are commonly prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsya chronic neurological disorder that causes excessive sleepiness and sudden sleep attacks through the day.

These drugs work in other ways depending on the kind. However, they treat ADHD by increasing levels of necessary chemicals (neurotransmitters) within the brain, including dopamine and norepinephrine.

However, as with many pharmaceutical substances, people also use these stimulants after they should not prescribed. There is range of reasons someone may select to make use of these medications without a prescription.

Tests University students have shown that these substances are sometimes used to extend alertness, concentration and memory. Studies conducted amongst wider populations have shown that they may also be used experimentor to get high.

All over the world, including in Australiawere significant increases within the prescription of ADHD medications lately, likely on account of increased identification and diagnosis of ADHD. As prescriptions increase, the danger of these substances being diverted to illegal drug markets increases.

Some people may seek pharmaceutical stimulants to extend alertness and concentration.
Ground Photo/Shutterstock

What we found

The percentage of people using stimulants without a prescription has tripled since monitoring began – from 17% of respondents in 2007 to 54% in 2024. It has remained at a similar level lately (52% in 2022 and 47% in 2023).

Frequency of use remained relatively low. Respondents typically reported using non-prescribed pharmaceutical stimulants monthly or less continuously.

In this study, participants most continuously reported using dexamfetamine, followed by methylphenidate and lisdexamfetamine. Most (79%) said it was “easy” or “very easy” to acquire these substances, just like 2022 and 2023.

Of course, provided that our study focused on regular drug users, the over-the-counter use of pharmaceutical stimulants doesn’t reflect their use in the final population.

In 2022–2023 National Household Drug Strategy Surveygeneral population survey of Australians aged 14 years and over, 2.1% of the population (comparable to about 400,000 people) reported using pharmaceutical stimulants for non-medical purposes within the previous 12 months. This was just like the proportion of people reporting using ecstasy.

What are the risks?

Pharmaceutical stimulants are considered to have a relatively secure toxicity profile. However, like all stimulants, these substances increase activity sympathetic nervous systemwhich controls various functions within the body during times of stress. This in turn increases heart rate, blood pressure and respiration rate.

These changes may cause acute cardiac events (resembling arrhythmias or irregular heartbeats) and, with repeated use of high doses, chronic changes in heart work.

Recent Australian research has documented increase in poisoning involving these substances, although a significant proportion of these seem like intentional poisonings. In the poisonings that involved only pharmaceutical stimulants, the drugs were mostly taken orally, with the median dose being more than ten times the everyday prescribed dose. The commonest symptoms were hypertension (hypertension), tachycardia (fast heart rate), and agitation.

In our study, individuals who took pharmaceutical stimulants most frequently took them in pill form, taking a dose barely higher than that typically prescribed.

However, about one in 4 people reported snorting as a route of administration. This can lead to physical harm, resembling damage to the sinuses, and will increase the potential risks of the drug because it will possibly come into effect faster within the body.

A hand holds a bag of white powder.
Snorting stimulants could also be more dangerous.
Author: DedMityay/Shutterstock

Some pharmaceutical stimulants are “long-acting,” released into the body throughout the day. So there may additionally be a risk of premature re-dosing if people unknowingly use these preparations more than once a day. That is, if people don’t experience desired effects They may take one other dose on the expected time, which can increase the danger of uncomfortable side effects.

Finally, non-prescribed stimulants can have negative effects when taken with other medications. This can include a “masking effect” (for instance, a stimulant may mask the symptoms alcohol poisoning).

So what should we do?

Pharmaceutical stimulants are necessary medications within the treatment of ADHD and narcolepsy, and when used as directed, they’re relatively secure. However, there are additional risks when people use these substances without a prescription.

Harm reduction campaigns that highlight these risks, including differences between formulations, will be useful. Ongoing monitoring, alongside more in-depth investigation of associated harms, can also be key.

This article was originally published on : theconversation.com
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Health and Wellness

Usher’s Groomer Shares His Skin Care Routine That Keeps Him in Shape at 45

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Kevin Mazur/Getty Images

Shortly after Labor Day, the consummate entertainer Usher played 4 consecutive sold-out shows in Brooklyn, New York, as a part of his . For two hours each night, he danced, sang, poured drinks for fans (you only needed to be there), and partied with special musical guests, all while his skin glowed. And not simply because he was sweating, although he was sweating loads. But also since the star, who has been around for 3 many years, has flawless skin at age 45. How does he do it?

With proper skincare and the assistance of hairdresser, Lola Okanlawon.

I had the chance, together with a gaggle of journalists and public opinion influencers, to hearken to the speech of Okanlawon, a famous make-up artist and licensed dermatologist DiAnne Davis, MDconcerning the tricks to having an unparalleled skincare routine, and all of it revolves around the suitable products. In addition to dancing with Usher, our presence that evening was also to have a good time the launch of a skincare brand Ceravelatest Eye cream with skin renewing vitamin Cwhich joins their popular Skin Renewing line. Usher uses it, and Davis says it’s best to too.

“Their whole Skin Renewing line really helps target some of the things that you might start to notice as you get a little older,” the plastic surgeon and skincare expert shared. “So maybe you’ve lost a little elasticity, or maybe your skin tone isn’t even, or maybe you’ve noticed a few fine lines and wrinkles here and there. That’s what this Skin Renewing line is all about.”

The key ingredients of the brand new eye cream are hyaluronic acid, which moisturizes, ceramides, which protect and moisturize the skin, caffeine, which reduces puffiness under the eyes, and five percent vitamin C, which brightens the skin across the eyes without irritating it.

(*45*) she says.

Okanlawon visited the artist before ending Usher’s pre-concert styling and opened up about her collaboration with the star, with whom she has been in a relationship for 3 years.

“I take care of all of his skin, from head to toe,” she told us, noting that they’re each fans of Cerave, which she uses often to prep him for the cameras and the massive stage.

“It’s important to have a skin prep routine before you go on stage. This man doesn’t play with his skin or his body,” she shared. “It’s nice to have a man who cares about his skin and cares about his appearance, buys products and asks me about them. ‘Hey, what about this? What about this?'”

The MUA star then delved into the practices and routines that keep her glowing, which include monthly facials (“This is not a game”) and a really, very clean food regimen.

“Of course, we start with a foaming cleanser because I do his stage makeup so that his hairline and certain things stay intact because he sweats a lot,” she says. “If you haven’t seen Usher perform, it’s like a waterfall. So I placed on some makeup that principally won’t come off together with his sweat. Moisturizing foaming cleansing oil It’s amazing since it breaks down product, it breaks down dirt, it breaks down oils, in order that’s definitely where we start.”

Next up is a brand new vitamin C eye cream. Okanlawon received the product ahead of its September launch and has been using it often on the star’s eyes for several months. She says it’s a must have in any skincare routine.

“Usher is a very good, handsome man. But he’s still 45, so eye cream is very important, and eye cream with vitamin C is amazing,” she says. “It’s preventative, so don’t wait until a certain age. Start using eye cream.”

Then they use Vitamin C Serum and finish your pre-makeup workout by moisturizing your body with Cerave Daily Moisturizing Balmwhich apply together.

“We use serum because serum is very important. Vitamin C helps brighten the skin,” she says. “His skin is very elastic because he takes good care of it. It’s easy, he’s easy.”

What Usher does night after night in front of packed audiences is not easy, but with guidance from Okanlawon and Cerave’s Skin Renewing line of beauty products, she all the time looks gorgeous when she does it.


This article was originally published on : www.essence.com
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Health and Wellness

The Way We Think About “Obesity” and Body Weight Is Changing, Here’s Why

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From doctor’s offices to family gatherings, larger people report being bombarded unsolicited advice about their eating and exercise habits. The underlying message? “They just need to lose weight” to solve almost any health problem.

Society’s give attention to weight has shaped the best way most Australians view health and body weight, which frequently pushes them towards unhealthy thoughts and behaviors in pursuit of the “perfect” figure.

However, the best way society views obesity and body weight is changing, and these changes are being confirmed by science.


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Policymakers and health researchers are increasingly recognizing the harmful effects stigmatizing language and attitude towards individuals with a bigger physique.

Let’s have a look at how attitudes towards obesity have modified through the years and what this implies for public health and healthcare in Australia.

From Personal Responsibility to Complex Chronic Illness

Until recently, weight control was it will likely be considered a private responsibilityObesity was believed to be the results of poor eating regimen and lack of physical activity, coupled with personal and moral failure.

This narrative was reflected in public health policy, which used phrases similar to “he was obese“and the “epidemic of o*c*lness”. It has been shown that such language reinforce negative stereotypes people with larger builds as “lazy” and lacking willpower.

These stereotypes result in stigmatization and weight discrimination, which is still common today. Health professionals similar to dietitians report that Weight stigma (from other people and internally) is a standard and ongoing challenge that ladies need to cope with throughout their careers.

The narrative around personal responsibility has modified lately because it begins to think about broader determinants of health. Research has identified a spread of psychological, social, biological and systemic aspects contribute to rising rates of obesity, similar to socioeconomic status, genetics, medications and environment.

As a result, public health experts consider that is not any longer appropriate use language that refers to obesity as a “lifestyle” issue.

Until recently, weight management was seen as a private responsibility.
World Obesity Federation

Professionals throughout medicine, psychology and dietetics additionally they responded by updating their language standards to prioritize person-first language (for instance, “person living with o*b*lihood”), recognizing a shift away from viewing o*b*lihood as a private failure.

In 2014, the American Medical Association of the United States classified obesity as a chronic diseasecontrary to the recommendations of the Science and Public Health Committee. The decision has sparked widespread dissatisfaction and debate, with claims that it causes unnecessary discrimination and pathologizes normal changes within the human body over time.

The debate continues here in Australiabut no classification has yet been made.

Weight-focused and weight-sensitive narratives

Recent policy documents in Australia similar to National Anti-Obesity Strategy 2022–2032acknowledge the broader perspective of o*b*st. But the policy and practice in Australia remain mainly focused on weight. They encourage weight reduction as a health goal and recommend deliberately avoiding weight gain.

Weight-Focused Approaches to Health They were criticized for the dearth of long-term (longer than five years) evidence of their effectiveness and for causing unintended effects.

Rather than promoting health, weight-focused approaches could cause harm, similar to increased weight stigma and weight cycling (repeated weight reduction and regain). Both weight mark AND weight cycles are related to negative long-term effects on physical and mental health.

Weight-sensitive approaches to health are gaining popularity instead approach that supports people to eat healthily and exercise repeatedly, no matter their desire to shed weight. This approach goals to enhance access to health care and has been shown to enhance overall physical and mental health.

Approaches similar to Health at every size and intuitive eating are key examples of promoting health and wellness without specializing in weight.

Weight-sensitive approaches have he was met with criticismHowever, there are concerns that these approaches will not be supported by empirical evidence and might not be suitable for people needing support with weight management.

What does this mean for us?

While our views on obesity are always changing, it is crucial to hearken to plus-size people and ensure they’ve equal, protected and satisfactory access to healthcare.

Advocates like Size Inclusive Health Australia recommending actions to cut back weight-related stigma and discrimination in order that health is inclusive of all body shapes and sizes.

There are guidelines and recommendations on counter weight stigma and adopt a weight-sensitive approach to health, similar to: Size-sensitive health promotion guidelines and Eating Disorder Safety Guidelines.

Policy, research and practice should proceed to synthesise and understand the evidence surrounding weight-sensitive approaches, in keeping with changing narratives around weight and health. This will support the design, implementation and evaluation of weight-sensitive initiatives in Australia.

This article was originally published on : theconversation.com
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