In the current coronavirus disease 2019 (COVID-19) pandemic, anosmia and dysgeusia have been described as potential symptoms of the disease. On Mar. 21, 2020, a press release from ENT UK (a professional membership body representing ear, nose and throat surgeons in the United Kingdom) and the British Rhinological Society reported anosmia as a symptom in up to 40% of patients in China, South Korea, Germany and Italy. 1 Surprisingly, anosmia and dysgeusia were not reported in the first study describing the clinical characteristics of COVID-19 in China. 2 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) damages primarily the respiratory tract. The most common symptoms of SARS-CoV-2 infection include fever, cough and muscle pain. 3,4 Although most patients generally experience mild to moderate disease, severe or critical disease requiring hospital admission develops in 15%-20% of patients, with an overall fatality rate of 2.3%. 5 A growing body of literature has mentioned anosmia and dysgeusia as potential symptoms of SARS-CoV-2 infection. 1,6,7 Anosmia is associated with other respiratory tract infections, and it is not clear whether this symptom is a consequence of nasal obstruction and congestion, or is a symptom specific to SARS-CoV-2 infection. 8 A better understanding of the association between these symptoms and SARS-CoV-2 infection might update the diagnostic criteria and alert people who experience these symptoms to isolate early and seek testing. Therefore, we aimed to delineate the value of anosmia and dysgeusia as potential specific symptoms of SARS-CoV-2 infection.

Puerarin has multiple pharmacological effects and is widely prescribed for patients with cardiovascular diseases, including hypertension, cerebral ischemia, myocardial ischemia, diabetes mellitus, and arteriosclerosis. While puerarin is a useful therapeutic agent, its mechanisms of action have not been well defined. Understanding puerarin metabolism, in particular its interactions with metabolizing enzymes, will contribute to our understanding of its toxic and therapeutic effects and may help to elucidate potential negative drug-drug interactions. In this study, the major metabolite of puerarin was obtained from the urine of rats administered puerarin, by a semi-preparative high-performance liquid chromatography method. The major metabolite was identified as puerarin-7-O-glucuronide. In vitro, we used a UDP-glucuronosyltransferase (UGT) reaction screening method with 12 recombinant human UGTs to demonstrate that formation of puerarin-7-O-glucuronide was catalyzed by UGT1A1, 1A9, 1A10, 1A3, 1A6, 1A7, and 1A8. UGT1A1, 1A9, and 1A10 significantly catalyzed puerarin-7-O-glucuronide formation, and the activity of UGT1A1 was significantly higher than those of 1A9 and 1A10. The V (max) of UGT1A1 was two- to threefold higher than the levels of UGT1A9 or 1A10, with a lower K ( m ) value and a higher V (max)/K ( m ) value. The kinetics of puerarin-7-O-glucuronide formation catalyzed by UGT1A1 were similar to those of the pooled human liver microsomes (HLMs), with V (max) values of 186.3 and 149.2 pmol/min/mg protein, and K ( m ) values of 811.3 and 838.9 μM, respectively. Furthermore, bilirubin and β-estradiol, probe substrates for UGT1A1, significantly inhibited the formation of puerarin-7-O-glucuronide in HLMs.

BackgroundAttitudes and knowledge about suicide may influence psychiatrists’ management of suicidal patients but there has been little research about this issue in China.MethodsWe used the Scale of Public Attitudes about Suicide (SPAS) – a 47-item scale developed and validated in China – to assess knowledge about suicide and seven specific attitudes about suicide in a sample of 187 psychiatrists from six psychiatric hospitals in Shanghai. The results were compared to those of 548 urban community members (assessed in a previous study).ResultsCompared to urban community members, psychiatrists were more likely to believe that suicide can be prevented and that suicide is an important social problem but they had more stigmatizing beliefs about suicidal individuals and felt less empathy for them. The belief that suicide can be prevented was more common among female psychiatrists than male psychiatrists but male psychiatrists felt more empathy for suicidal individuals. Only 37% of the psychiatrists correctly agreed that talking about suicide-related issues with an individual would not precipitate suicidal behavior and only 41% correctly agreed that those who state that they intend to kill themselves may actually do so.ConclusionsMany psychiatrists in Shanghai harbor negative attitudes about suicidal individuals and are concerned that directly addressing the issue with patients will increase the risk of suicide. Demographic factors, educational status and work experience are associated with psychiatrists’ attitudes about suicide and, thus, need to be considered when training psychiatrists about suicide prevention.

A long-term, observational evaluation of interprofessional Med Rec did not detect a difference in 30- day postdischarge patient hospital visits between patients who received enhanced versus partial Med Rec patient care bundles. In future prospective studies, researchers could focus on evaluating high-risk populations and specific elements of Med Rec services on avoidable, medication-related hospital admissions and postdischarge adverse drug events.