Hypokalemia is common in the emergency department. Severe hypokalemia is often symptomatic and more than two-thirds of patients show ECG changes.

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Background Tablet computers are increasingly being used in hospital patient care and are often colonized with important human pathogens, while the impact of disinfection interventions remains controversial. Method In a prospective hygiene intervention study we consecutively sampled tablet computers exclusively used in a high-resource general internal medicine tertiary care setting with high routine hygiene measures. Our aim was to examine the change in colonizing bacteria on tablet computers before and after the introduction of a mandatory twice daily tablet disinfection intervention. Microbial identification was performed by conventional culture, and the association of bacterial colonization with the intervention was investigated using logistic regression. Results In a total of 168 samples we identified colonizing bacteria in 149 (89%) of samples. While the most commonly identified species were normal skin bacteria, Staphylococcus aureus found in 18 (11%) of samples was the most frequent potential pathogen. We did not detect any Enterococci or Enterobacteriaceae. The disinfection intervention was associated with substantially less overall bacterial colonization (odds ratio 0.16; 95%-CI 0.04–0.56), while specific colonization with Staphylococcus aureus was only slightly decreased (odds ratio 0.46; 95%-CI 0.16–1.29). Conclusion Our results indicate that a twice daily disinfection can still substantially reduce bacterial colonization of in-hospital tablet computers used in a high-resource and high hygiene setting.

Ritalin® (methylphenidate) is an amphetamine-like prescription stimulant commonly used in the treatment of attention deficit hyperactivity disorder in children and adults. Recently, the recreational use of Ritalin has increased, particularly among young adults. Well-known symptoms of intoxication include signs of sympathetic nervous stimulation, such as agitation, anxiety, tachycardia, hypertension, headache, tremor, and dizziness. This case report describes oral dyskinesia as a rare presentation of Ritalin intoxication, with the review of pathophysiology and some epidemiological data.

Background: This study aims to assess postoperative hepatic growth of colorectal adenocarcinoma metastasis and peritumoural macrophage counts after laparoscopy in an experimental animal model.Methods: Thirty male syngenic WAG/Rij rats were randomised into two surgical groups: laparoscopy (LS; n = 15) using CO 2 at 12 mmHg and laparotomy (LT; n = 15; negative control) during an operating time of 90 min. At 45 min after setup, CC531s colon adenocarcinoma cells were injected into two liver lobes. Postoperative tumour volumes were determined by abdominal magnetic resonance imaging (MRI) and computed three-dimensional volumetry. Peritumoural macrophages were counted by local stereology using a confocal laser-scanning fluorescence microscope.Results: The median postoperative tumour volume was significantly higher after LS in both lobes (L): after 10, 15 and 20 days in L2 and L5: 24/12, 54/38, 275/62 mm 3 and 0/0, 15/11, 55/ 24 mm 3 (LS/LT). Significantly fewer peritumoural macrophages were found after LS at all postoperative time points (Mann-Whitney: p < 0.05).Conclusions: Increased hepatic growth of colorectal adenocarcinoma metastasis and impaired cellular antitumoural defence after LS cast doubt on the use of LS in colorectal cancer and needs further clinical investigation.

Contrast-enhanced ultrasonography is well suited for the diagnosis and monitoring of hepatic fascioliasis.

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