Although studies are scarce, review and meta-analysis of the available literature does not provide convincing evidence that lithium is less effective when treatment is discontinued and restarted, compared to uninterrupted treatment.

Debate about the pharmaceutical industry's involvement with medical education has reached new levels of acrimony, fuelled by intensified scrutiny of industryphysician relationships. This heightened concern makes apparent the need for clearly articulated standards and vigilant adherence to them among funders, sponsors, faculty and recipients of medical education. The best practice of medicine requires collaboration between the pharmaceutical industry, which develops and brings new medicines to the market; the practitioners who prescribe the medicines to better serve their patients; and those who develop educational activities. Adoption of and adherence to, defined recommendations will maintain this essential channel of communication and help achieve the shared goal of benefiting patients and enhancing the practice of medicine. This paper examines the methods by which medical advances are adopted by practitioners, exploring the key role played by opinion leaders. The authors also discuss the rules and regulations affecting US and European medical education activities and differentiate between promotional and independently accredited educational activities.Recommendations are included to stimulate discussion of best practices in medical education in order to improve patient care.

Hyperglycaemia is recognized as a marker of adverse clinical outcomes for hospitalized patients with and without diabetes, including mortality, morbidity, increased length of stay, infections and overall complications. In some cases, intravenous (IV) insulin infusions are the optimal intervention and, to date, these have been compounded in hospital pharmacy departments or, alternatively, at the point of care, when timeliness is a concern or the pharmacy is closed. However, in-house compounding of high-risk medications such as IV insulin poses risks both for patients and institutions. The critical nature of certain high-risk therapies has led to the development of ready-to-administer products to improve the safety, timeliness, efficacy and efficiency of critical infusions. Recently, IV insulin, a high-alert therapy, has been added to the ready-to-use armamentarium. This narrative review explores the expanding indications, risks and opportunities associated with insulin infusions and potential options for improved safety.