Genetically, modern broilers are fast-growing birds which attain the market age at the age of 5 weeks. To maintain optimum production, antibiotics have been commonly included in the diets as growth promoters. However, due to the increase in antimicrobial resistance, their uses have been banned worldwide. To keep the optimum level of production and health in broiler industry, the use of alternative growth promoters such as probiotics, prebiotics, enzymes, and organic acids has been proposed. Chemically, organic acids are weak acids and only partially dissociate. They are considered safe and have been used for preservation of food for centuries. Nowadays, organic acids have been reported for antibacterial, immune potentiating, and growth promoters in broilers. In this review, the effects of dietary inclusion of organic acids on growth, nutrient digestibility, intestinal integrity, immune system, and antibacterial activity in broilers are discussed.

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This case report illustrates the rare occurrence of an implantable port becoming infected, forming septic pulmonary emboli (SPE), and eventually a secondary spontaneous pneumothorax (SSP). A 43-year-old male presented to the emergency department for a five-day duration of fevers, generalized malaise, difficulty in breathing, non-productive cough, and left chest pain. Past history revealed right carotid body paraganglioma that required resection, adjuvant chemotherapy via a port in the left subclavian vein, and radiation. The cancer was in remission for one year prior to this admission and the port had not been used in six months, but had not been removed. Chest computed tomography demonstrated bilateral pleural cavitations and parenchymal ground-glass opacities. Blood cultures and subsequent sensitivities grew methicillin sensitive Staphylococcus aureus (MSSA). We initiated empiric broad spectrum coverage and later switched to cefazolin. A left shoulder ultrasound illustrated a subclavian vein thrombus, so the port was removed. Culture of the catheter tip also grew MSSA. Four days later the patient developed acute dyspnea. Repeat imaging showed a new right-sided spontaneous hydropneumothorax with loculated pleural effusions along with progression of the bilateral opacities and cavitations. Therefore, chest tubes were placed with pleural fluid cultures growing MSSA. Additionally, video-assisted thoracoscopic surgery with decortication was performed. The patient was discharged home on six weeks of intravenous cefazolin via a peripherally inserted central catheter (PICC). This case demonstrates that the physicians should be aware of the lethal complications of a port and should attempt to remove them once they are no longer required.

withdrawal psychotic disorder by the usage of brexpiprazole. This case could serve as a reminder that brexpiprazole could be considered as a balance between the therapeutic effects and safety for the patient with cannabis withdrawal psychotic disorder.

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Dexmedetomidine is an α2-adrenergic used as an adjunct therapy for sedation in the intensive care unit. While it is known to cause polyuria exclusively in perioperative conditions, not many cases are known in the intensive care unit, thus making the diagnosis challenging. We present the case of a 61-year-old male who had developed polyuria secondary to central diabetes insipidus after receiving dexmedetomidine intravenous infusion in the medical ICU. Increased awareness of this uncommon side effect of dexmedetomidine will help clinicians recognize and address it early.