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Abu Kassim NL, Mohd Bakri SK, Nusrat F, Salim E, Manjurul Karim M, Rahman MT. Time-based changes in authorship trend in research-intensive universities in Malaysia. Account Res 2024; 31:56-71. [PMID: 35758245 DOI: 10.1080/08989621.2022.2094256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Considering the fact that publications serve as an important criterion to evaluate the scientific accomplishments of an individual within respective fields in academia, there has been an increasing trend to publish scientific articles whereby multiple authors are defined as primary, co-, or corresponding authors according to the roles performed. This article analyzes the authorship pattern in 4,561 papers (including 60 single-authored papers) from 1990 till 2020 of 94 academics who hold a position as professors and are affiliated with the Faculty of Medicine at three different research universities in Malaysia. Only 708 papers (15.5% of 4,561 papers) were authored by less than three authors. In 3,080 papers (67.5% of 4,561 papers), those academics appeared as coauthors. Using different years as cutoff periods, it was observed that the appearance as coauthor in the papers had steeply risen around the years: 2006, 2007, 2008 and onwards. The increased number of authors in the multi-author papers and the appearance of the selected academics as coauthors reflect the extent of boosting of collaborative research in that period which corresponds to the adoption of the "publish or perish policy" by the Ministry of Higher Education in Malaysia.
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Affiliation(s)
- Noor Lide Abu Kassim
- Faculty of Education, International Islamic University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Fariha Nusrat
- Department of Mathematics and Natural Sciences, BRAC University, Dhaka, Bangladesh
| | - Elnaz Salim
- Faculty of Dentistry, University of Malaysia, Kuala Lumpur, Malaysia
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Matrook KA, Cowman S, Pertl M, Whitford D. Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2323060. [PMID: 38446054 PMCID: PMC10919304 DOI: 10.1080/17482631.2024.2323060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. METHODS Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. RESULTS Three main themes emerged includes: (1) nurses' experiences with current diabetes care practices, (2) stakeholders' views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. CONCLUSION The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses' advanced roles and family inclusion in healthcare.
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Affiliation(s)
- Khadija A. Matrook
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Bahrain
| | - Seamus Cowman
- School of Nursing and Midwifery, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - Maria Pertl
- Department of Health Psychology, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - David Whitford
- Department of General Practice, RCSI & UCD Malaysia Campus, George Town, Pulau Pinang, Malaysia
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Moiz A, Zolotarova T, Eisenberg MJ. Outpatient management of essential hypertension: a review based on the latest clinical guidelines. Ann Med 2024; 56:2338242. [PMID: 38604225 PMCID: PMC11011233 DOI: 10.1080/07853890.2024.2338242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 03/15/2024] [Indexed: 04/13/2024] Open
Abstract
Background: Essential hypertension, a prevalent cardiovascular condition, poses a significant health burden worldwide. Based on the latest American clinical guidelines, half of adults in the United States have hypertension. Of these, only about a half are treated and about a quarter are adequately controlled for hypertension. Given its impact on morbidity and mortality, ensuring effective management of high blood pressure is crucial to reduce associated risks and improve patient outcomes.Objective: This review aims to provide a comprehensive and up-to-date summary of the latest cardiology guidelines and evidence-based research on essential hypertension, with a focus on guiding outpatient clinical practice.Methods: The review evaluates both non-pharmacological approaches and pharmacological interventions to offer clinicians practical insights. Notably, it emphasizes the importance of individualized treatment plans tailored to patients' specific risk profiles and comorbidities.Results: By consolidating the latest advancements in hypertension management, this review provides clinicians with an up-to-date reference, offering a nuanced understanding of treatment goals and strategies.Conclusion: Through the incorporation of evidence-based recommendations, healthcare practitioners can optimize patient care, mitigate potential complications, and improve overall outcomes in essential hypertension.
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Affiliation(s)
- Areesha Moiz
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Tetiana Zolotarova
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
| | - Mark J. Eisenberg
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Canada
- Department of Medicine and Health Sciences, McGill University, Montreal, Canada
- Departments of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
- Division of Cardiology, Jewish General Hospital, McGill University, Montreal, Canada
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Park WH. Propyl gallate induces human pulmonary fibroblast cell death through the regulation of Bax and caspase-3. Ann Med 2024; 56:2319853. [PMID: 38373208 PMCID: PMC10878342 DOI: 10.1080/07853890.2024.2319853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/11/2024] [Indexed: 02/21/2024] Open
Abstract
Propyl gallate (PG) has been found to exert an inhibitory effect on the growth of different cell types, including lung cancer cells. However, little is known about the cytotoxicological effects of PG specifically on normal primary lung cells. The current study examined the cellular effects and cell death resulting from PG treatment in human pulmonary fibroblast (HPF) cells. DNA flow cytometry results demonstrated that PG (100-1,600 μM) had a significant impact on the cell cycle, leading to G1 phase arrest. Notably, 1,600 μM PG slightly increased the number of sub-G1 cells. Additionally, PG (400-1,600 μM) resulted in the initiation of cell death, a process that coincided with a loss of mitochondrial membrane potential (MMP; ΔΨm). This loss of MMP (ΔΨm) was evaluated using a FACS cytometer. In PG-treated HPF cells, inhibitors targeting pan-caspase, caspase-3, caspase-8, and caspase-9 showed no significant impact on the quantity of annexin V-positive and MMP (ΔΨm) loss cells. The administration of siRNA targeting Bax or caspase-3 demonstrated a significant attenuation of PG-induced cell death in HPF cells. However, the use of siRNAs targeting p53, Bcl-2, or caspase-8 did not exhibit any notable effect on cell death. Furthermore, none of the tested MAPK inhibitors, including MEK, c-Jun N-terminal kinase (JNK), and p38, showed any impact on PG-induced cell death or the loss of MMP (ΔΨm) in HPF cells. In conclusion, PG induces G1 phase arrest of the cell cycle and cell death in HPF cells through apoptosis and/or necrosis. The observed HPF cell death is mediated by the modulation of Bax and caspase-3. These findings offer insights into the cytotoxic and molecular effects of PG on normal HPF cells.
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Affiliation(s)
- Woo Hyun Park
- Department of Physiology, Medical School, Jeonbuk National University, Jeonju, Jeollabuk, Republic of Korea
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Ameline A, Gheddar L, Arbouche N, Blanchot A, Raul JS, Kintz P. Testing for Kratom alkaloids in fingernail clippings - not only mitragynine. J Pharm Biomed Anal 2024; 243:116078. [PMID: 38489958 DOI: 10.1016/j.jpba.2024.116078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/20/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024]
Abstract
Kratom (Mitragyna speciosa) is a species of large tree that grows in Southeast Asia and is part of the Rubiaceae family. Its fresh leaves are harvested for their medicinal properties and used for their psychoactive effects. Kratom contains many biologically active alkaloids, including mitragynine and 7-OH-mitragynine, which are considered the two most important psychoactive components and constitute approximately 66% and 2% of the total alkaloid content. Other alkaloids are present in the plant, such as speciogynine, speciociliatine and paynantheine, but have less psychoactive activity. Over the past decade, the sale of kratom powder has increased on the Internet. This led to a significant increase in forensic cases. Given the lack of data existing in the literature, and the total absence of data in nails, the authors report a study to determine the best target alkaloids for documenting kratom consumption in this matrix. Fingernail clippings from a supposed kratom powder user were analyzed after liquid-liquid extraction, chromatography separation using a HSS C18 column and performed on an ultra-high performance liquid chromatography coupled to a tandem mass spectrometer. In the specimen, mitragynine was quantified at 229 pg/mg, speciogynine and paynantheine were both quantified at 2 pg/mg, and speciociliatine was quantified at 19 pg/mg. 7-OH-mitragynine was not detected. The interpretation of these concentrations is complex, since there is currently no reference in the literature, as this is the first identification of mitragynine and other kratom alkaloids in nails. Nevertheless, in view of the high concentration of mitragynine, the subject seems to be a repetitive user of kratom. According to the measured concentrations, it seems that mitragynine remains the best target to document kratom consumption, but the identification of the other alkaloids would enhance the specificity of the test.
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Bai X, Wang S, Shu L, Cao Q, Hu H, Zhu Y, Chen C. Hawthorn leaf flavonoids alleviate the deterioration of atherosclerosis by inhibiting SCAP-SREBP2-LDLR pathway through sPLA2-ⅡA signaling in macrophages in mice. J Ethnopharmacol 2024; 327:118006. [PMID: 38442806 DOI: 10.1016/j.jep.2024.118006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/07/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Hawthorn leaves are a combination of the dried leaves of the Rosaceae plants, i.e., Crataegus pinnatifida Bge. or Crataegus pinnatifida Bge. var. major N. E. Br., is primarily cultivated in East Asia, North America, and Europe. hawthorn leaf flavonoids (HLF) are the main part of extraction. The HLF have demonstrated potential in preventing hypertension, inflammation, hyperlipidemia, and atherosclerosis. However, the potential pharmacological mechanism behind its anti-atherosclerotic effect has yet to be explored. AIM OF THE STUDY The in vivo and in vitro effects of HLF on lipid-mediated foam cell formation were investigated, with a specific focus on the levels of secreted phospholipase A2 type IIA (sPLA2-II A) in macrophage cells. MATERIALS AND METHODS The primary constituents of HLF were analyzed using ultra-high performance liquid chromatography and liquid chromatography-tandem mass spectrometry. In vivo, HLF, at concentrations of 5 mg/kg, 20 mg/kg, and 40 mg/kg, were administered to apolipoprotein E knockout mice (ApoE-/-) fed by high-fat diet (HFD) for 16 weeks. Aorta and serum samples were collected to identify lesion areas and lipids through mass spectrometry analysis to dissect the pathological process. RAW264.7 cells were incubated with oxidized low-density lipoprotein (ox-LDL) alone, or ox-LDL combined with different doses of HLF (100, 50, and 25 μg/ml), or ox-LDL plus 24-h sPLA2-IIA inhibitors, for cell biology analysis. Lipids and inflammatory cytokines were detected using biochemical analyzers and ELISA, while plaque size and collagen content of plaque were assessed by HE and the Masson staining of the aorta. The lipid deposition in macrophages was observed by Oil Red O staining. The expression of sPLA2-IIA and SCAP-SREBP2-LDLR was determined by RT-qPCR and Western blot analysis. RESULTS The chemical profile of HLF was studied using UPLC-Q-TOF-MS/MS, allowing the tentative identification of 20 compounds, comprising 1 phenolic acid, 9 flavonols and 10 flavones, including isovitexin, vitexin-4″-O-glucoside, quercetin-3-O-robibioside, rutin, vitexin-2″-O-rhamnoside, quercetin, etc. HLF decreased total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) levels in ApoE-/- mice (P < 0.05), reduced ox-LDL uptake, inhibited level of inflammatory factors, such as IL-6, IL-8, TNF-α, and IL-1ꞵ (P < 0.001), and alleviated aortic plaques with a thicker fibrous cap. HLF effectively attenuated foam cell formation in ox-LDL-treated RAW264.7 macrophages, and reduced levels of intracellular TC, free cholesterol (FC), cholesteryl ester (CE), IL-6, TNF-α, and IL-1β (P < 0.001). In both in vivo and in vitro experiments, HLF significantly downregulated the expression of sPLA2-IIA, SCAP, SREBP2, LDLR, HMGCR, and LOX-1 (P < 0.05). Furthermore, sPLA2-IIA inhibitor effectively mitigated inflammatory release in RAW264.7 macrophages and regulated SCAP-SREBP2-LDLR signaling pathway by inhibiting sPLA2-IIA secretion (P < 0.05). CONCLUSION HLF exerted a protective effect against atherosclerosis through inhibiting sPLA2-IIA to diminish SCAP-SREBP2-LDLR signaling pathway, to reduce LDL uptake caused foam cell formation, and to slow down the progression of atherosclerosis in mice.
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Affiliation(s)
- Xufeng Bai
- College of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, 330004, China
| | - Shuwen Wang
- College of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, 330004, China
| | - Limei Shu
- College of Pharmacy, Jiangxi University of Chinese Medicine, Nanchang, 330004, China
| | - Qingyu Cao
- College of Pharmacy, Nanchang Medical College, Nanchang, Jiangxi, 330052, China
| | - Huiming Hu
- College of Pharmacy, Nanchang Medical College, Nanchang, Jiangxi, 330052, China; Key Laboratory of Pharmacodynamics and Quality Evaluation on Anti-Inflammatory Chinese Herbs, Jiangxi Administration of Traditional Chinese Medicine, Jiangxi, 330052, China; School of Biomedical Sciences, University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia.
| | - Yanchen Zhu
- College of Computer Science, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, 330004, China.
| | - Chen Chen
- School of Biomedical Sciences, University of Queensland, St Lucia, Brisbane, Queensland, 4072, Australia.
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Murphy ZR, Muzaffar AF, Massih SA, Klein EY, Dispenza MC, Fabre V, Hensley NB, Blumenthal KG, Alvarez-Arango S. Examining cefazolin utilization and perioperative anaphylaxis in patients with and without a penicillin allergy label: A cross-sectional study. J Clin Anesth 2024; 94:111377. [PMID: 38241788 PMCID: PMC10939842 DOI: 10.1016/j.jclinane.2024.111377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
STUDY OBJECTIVE To compare the occurrence of cefazolin perioperative anaphylaxis (POA) in patients with and without a penicillin allergy label (PAL) to determine whether the prevalence of cefazolin POA differs based on the presence of a PAL. DESIGN Cross-sectional study. SETTING A large U.S. healthcare system in the Baltimore-D.C. region, July 2017 to July 2020. PATIENTS 112,817 surgical encounters across inpatient and outpatient settings in various specialties, involving 90,089 patients. Of these, 4876 (4.3%) encounters had a PAL. INTERVENTIONS Perioperative cefazolin administration within 4 h before surgery to 4 h after the procedure began. MEASUREMENTS The primary outcome was cefazolin POA in patients with and without PALs. Potential POA cases were identified based on tryptase orders or diphenhydramine administrations within the initial cefazolin administration to 6 h postoperatively. Verification included two validation steps. The first checked for hypersensitivity reaction (HSR) documentation, and the second, led by Allergy specialists, identified POA and the probable culprit. The secondary outcome looked at cefazolin use trends in patients with a PAL, stratified by setting and specialty. MAIN RESULTS Of 112,817 encounters, 1421 (1.3%) had possible cefazolin HSRs. Of these, 22 (1.5%) had POA, resulting in a 0.02% prevalence. Of these, 13 (59.1%) were linked to cefazolin and 9 (40.9%) attributed to other drugs. Only one cefazolin POA case had a PAL, indicating no significant difference in cefazolin POA prevalence between patients with and without PALs (p = 0.437). Perioperative cefazolin use in patients with PALs steadily increased from 2.6% to 6.0% between 2017 and 2020, specifically in academic settings. CONCLUSIONS The prevalence of cefazolin POA does not exhibit significant differences between patients with and without PALs, and notably, the incidence remains remarkably low. Based on these findings, it is advisable to view cefazolin as an acceptable choice for prophylaxis in patients carrying a PAL.
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Affiliation(s)
- Zachary R Murphy
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States of America
| | - Anum F Muzaffar
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Sandra A Massih
- Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Eili Y Klein
- Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
| | - Melanie C Dispenza
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Valeria Fabre
- Division of Infectious Disease, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Nadia B Hensley
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Kimberly G Blumenthal
- Harvard Medical School, Boston, MA, United States of America; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States of America; The Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Santiago Alvarez-Arango
- Division of Clinical Pharmacology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America; Department of Pharmacology and Molecular Science, Johns Hopkins School of Medicine, Baltimore, MD, United States of America.
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Feng Y, Chang P, Liu J, Zhang WS. Effects and mechanisms of perioperative medications on the hypothalamic pituitary adrenal response to surgical injury: A narrative review. J Clin Anesth 2024; 94:111367. [PMID: 38232466 DOI: 10.1016/j.jclinane.2023.111367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/30/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024]
Abstract
The adrenal gland is a vital endocrine organ, and adrenal steroid synthesis and secretion are closely regulated by the hypothalamic-pituitary-adrenal (HPA) axis in response to various stimuli. Surgery or trauma can activate the HPA axis and induce the secretion of cortisol. Different cortisol responses vary with the grade of surgery. Perioperative medications have the potential to decrease the cortisol level in the body, and both excessive and insufficient cortisol levels after surgery are disadvantageous. The effect of perioperative medications on the HPA response to surgery can be divided into three levels: "adrenal insufficiency (AI)", "stress response inhibition", and "uncertainty". The clinical presentation of AI includes fatigue, nausea, vomiting, abdominal pain, muscle cramps, hypotension, hypovolemic shock and prerenal failure, which may result in fatal consequences. Stress response inhibition can reduce postoperative complications, such as pain and cognitive dysfunction. This is protective to patients during perioperative and postoperative periods. The aim of the present review is to shed light on current evidence regarding the exact effects and mechanisms of perioperative medications on the HPA response to surgical injury and provide the applicable guidance on clinical anesthesia.
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Affiliation(s)
- Yan Feng
- Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, China; Department of Anesthesiology, West China Hospital, Sichuan University, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, China
| | - Pan Chang
- Department of Anesthesiology, West China Hospital, Sichuan University, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, China
| | - Wen-Sheng Zhang
- Department of Anesthesiology, West China Hospital, Sichuan University, China; Laboratory of Anesthesia and Critical Care Medicine, National-Local Joint Engineering Research Centre of Translational Medicine of Anesthesiology, West China Hospital, Sichuan University, China.
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Yaribeygi H, Maleki M, Jamialahmadi T, Sahebkar A. Anti-inflammatory benefits of semaglutide: State of the art. J Clin Transl Endocrinol 2024; 36:100340. [PMID: 38576822 PMCID: PMC10992717 DOI: 10.1016/j.jcte.2024.100340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Abstract
Individuals with diabetes often have chronic inflammation and high levels of inflammatory cytokines, leading to insulin resistance and complications. Anti-inflammatory agents are proposed to prevent these issues, including using antidiabetic medications with anti-inflammatory properties like semaglutide, a GLP-1 analogue. Semaglutide not only lowers glucose but also shows potential anti-inflammatory effects. Studies suggest it can modulate inflammatory responses and benefit those with diabetes. However, the exact mechanisms of its anti-inflammatory effects are not fully understood. This review aims to discuss the latest findings on semaglutide's anti-inflammatory effects and the potential pathways involved.
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Affiliation(s)
- Habib Yaribeygi
- Research Center of Physiology, Semnan University of Medical Sciences, Semnan, Iran
| | - Mina Maleki
- Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
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Boitano TK, Virk A, Michael Straughn Jr J, Dowdy SC. Quality corner: Safely using cephalosporins in almost all patients with penicillin allergies: Mini-review and suggested protocol to improve efficacy and surgical outcomes. Gynecol Oncol Rep 2024; 53:101389. [PMID: 38623269 PMCID: PMC11016857 DOI: 10.1016/j.gore.2024.101389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
Surgical site infections (SSI) are one of the most common gynecologic oncology postoperative complications and they have a significant deleterious impact on the healthcare system and in patients' outcomes. Cefazolin is the recommended antibiotic in women undergoing gynecologic surgical procedures that require that require prophylaxis. However, 10-20% of patients may report a penicillin allergy which can result in administration of a less effective antibiotic. This quality review evaluated the literature around this common perioperative issue and demonstrated that healthcare teams should consider the implementation of a protocol to safely use cefazolin in most patients with a penicillin allergy. Overall, literature shows this is a safe adjustment and would improve antimicrobial stewardship, decrease SSI rates, avoid acute kidney injury, and increase cost savings.
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Affiliation(s)
- Teresa K.L. Boitano
- Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Abinash Virk
- Division of Public Health, Infectious Diseases, and Occupational Medicine, Mayo Clinic, Rochester, MN, USA
| | - J. Michael Straughn Jr
- Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sean C. Dowdy
- Division of Gynecologic Oncology, Mayo Clinic, Rochester, MN, USA
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Dilawri A, Muir J, Brodie D, Abrams D, Agerstrand C, Madahar P, Dzierba AL. Practices surrounding antimicrobial use in patients managed with extracorporeal membrane oxygenation: An international survey. J Crit Care 2024; 81:154534. [PMID: 38367526 DOI: 10.1016/j.jcrc.2024.154534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE This study aimed to survey critical care clinicians and characterize their perception of antimicrobial dosing strategies in patients receiving extracorporeal membrane oxygenation (ECMO). METHODS International, cross-sectional survey distributed to members of the Society of Critical Care Medicine in October 2022. RESULTS Respondents were primarily physicians (45%), with 92% practicing in North America. Ninety-seven percent of respondents reported antimicrobial dosing in critically ill patients to be challenging, due to physiological derangements seen in the patient population. Eighty-seven percent reported consideration of physicochemical drug properties when dosing antimicrobials in ECMO-supported patients, with lipophilicity (83%) and degree of protein binding (74%) being the two most common. Respondents' approach to antimicrobial dosing strategies did not significantly differ in critically ill ECMO-supported patients, compared to patients with equal severity of illness not receiving ECMO support. CONCLUSION Approaches to antimicrobial dosing strategies do not significantly differ among respondents between critically ill patients on ECMO support, compared to patients with equal severity of illness not receiving ECMO support. These findings were unexpected considering the added physiologic complexity of the ECMO circuit to critically ill adult patients and the need for well designed and adequately powered studies to inform empiric dosing guidance for ECMO-supported patients.
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Affiliation(s)
- Atul Dilawri
- Department of Pharmacy, NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Justin Muir
- Department of Pharmacy, NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Daniel Brodie
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States of America
| | - Darryl Abrams
- Division of Pulmonary and Critical Care Medicine, Columbia College of Physicians and Surgeons/NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Cara Agerstrand
- Division of Pulmonary and Critical Care Medicine, Columbia College of Physicians and Surgeons/NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Purnema Madahar
- Division of Pulmonary and Critical Care Medicine, Columbia College of Physicians and Surgeons/NewYork-Presbyterian Hospital, New York, NY, United States of America
| | - Amy L Dzierba
- Department of Pharmacy, NewYork-Presbyterian Hospital, New York, NY, United States of America; Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons and NewYork-Presbyterian Hospital, New York, NY, United States of America.
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12
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Hetland LH, Maguire J, Debono D, Wright H. Scholarly literature on nurses and pharmacogenomics: A scoping review. Nurse Educ Today 2024; 137:106153. [PMID: 38484442 DOI: 10.1016/j.nedt.2024.106153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/18/2024] [Accepted: 03/05/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Pharmacogenomics is the bioscience investigating how genes affect medication responses. Nurses are instrumental in medication safety. Pharmacogenomics is slowly being integrated into healthcare, and knowledge and understanding of it is now pertinent to nursing practice. PURPOSE This paper aims to map the scholarly literature on pharmacogenomics in relation to nurses. METHODS A scoping review was conducted in four databases: CINAHL, Embase (Ovid), ProQuest Health and Medicine and PubMed using the search terms pharmacogenomic*, pharmacogenetic*, PGx*, and nurs*, resulting in 263 articles of which 77 articles met the inclusion criteria. FINDINGS Most articles (85 %, n = 65) were non-empirical and 12 presented empirical data (15 %, n = 12). The articles were USA-centric (81 %, n = 62) and represented a broad range of nursing specialties. CONCLUSION The majority of scholarly literature on nurses and pharmacogenomics is narrative reviews. Further empirical research is warranted to investigate nurses' current knowledge levels and potential involvement with pharmacogenomics in clinical practice.
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Affiliation(s)
- Linn Helen Hetland
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia.
| | - Jane Maguire
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Deborah Debono
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
| | - Helen Wright
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, NSW, Australia; Nursing and Midwifery, College of Healthcare Sciences, James Cook University, QLD, Australia; School of Public Health, Faculty of Health, University of Technology Sydney, NSW, Australia
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13
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Zhao Y, Li Y, Du J, Fang C, Li W, Lv M, Wu Y, Wang K, Wu T, Tian Y, Zhang J. Modulation of hemispheric asymmetry in executive control of attention in schizophrenia with atypical antipsychotic treatment: Potential benefits of olanzapine. Schizophr Res Cogn 2024; 36:100306. [PMID: 38469136 PMCID: PMC10926294 DOI: 10.1016/j.scog.2024.100306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
Deficits in executive control of attention have been reported in schizophrenia patients, but can be ameliorated by treatment of atypical antipsychotics along with the symptoms. However, it remains unclear whether this effect is related to a modulation of hemispheric asymmetry in executive control by the medicine. In this behavioral study, we employed a lateralized version of the attention network test to examine the hemispheric asymmetry of executive control in schizophrenia patients before and after olanzapine treatment, compared to matched healthy controls. Executive control was measured as a conflict effect, indexed as the response time (RT) difference between incongruent versus congruent flanker conditions, and was compared between stimuli presented in the left and the right visual field (i.e., processed by right versus left hemisphere of the brain). Results showed that pre-treatment schizophrenia patients revealed a right hemisphere superiority in conflict effect (i.e., a smaller effect in the right hemisphere than in the left hemisphere), driven by the incongruent condition. Olanzapine treatment reduced this right hemisphere superiority by improving the efficiency of the left hemisphere in the incongruent condition. These results suggested that olanzapine treatment may improve the efficiency of executive control in the left hemisphere in schizophrenia patients.
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Affiliation(s)
- Yong Zhao
- The Sixth People's Hospital of Anqing, Anqing 246000, Anhui, China
| | - Yifan Li
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
| | - Jing Du
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
| | - Chuanlong Fang
- The Sixth People's Hospital of Anqing, Anqing 246000, Anhui, China
| | - Wansheng Li
- The Sixth People's Hospital of Anqing, Anqing 246000, Anhui, China
| | - Mengyu Lv
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100048, Beijing, China
| | - Yue Wu
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230000, Anhui, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230000, Anhui, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230000, Anhui, China
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230000, Anhui, China
| | - Tingting Wu
- Beijing Key Lab of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100048, Beijing, China
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230000, Anhui, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230000, Anhui, China
| | - Juanjuan Zhang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230000, Anhui, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230000, Anhui, China
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14
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Blakeney EAR, Chu F, White AA, Randy Smith G, Woodward K, Lavallee DC, Salas RME, Beaird G, Willgerodt MA, Dang D, Dent JM, Tanner E“I, Summerside N, Zierler BK, O’Brien KD, Weiner BJ. A scoping review of new implementations of interprofessional bedside rounding models to improve teamwork, care, and outcomes in hospitals. J Interprof Care 2024; 38:411-426. [PMID: 34632913 PMCID: PMC8994791 DOI: 10.1080/13561820.2021.1980379] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/13/2021] [Accepted: 08/29/2021] [Indexed: 01/22/2023]
Abstract
Poor communication within healthcare teams occurs commonly, contributing to inefficiency, medical errors, conflict, and other adverse outcomes. Interprofessional bedside rounds (IBR) are a promising model that brings two or more health professions together with patients and families as part of a consistent, team-based routine to share information and collaboratively arrive at a daily plan of care. The purpose of this systematic scoping review was to investigate the breadth and quality of IBR literature to identify and describe gaps and opportunities for future research. We followed an adapted Arksey and O'Malley Framework and PRISMA scoping review guidelines. PubMed, CINAHL, PsycINFO, and Embase were systematically searched for key IBR words and concepts through June 2020. Seventy-nine articles met inclusion criteria and underwent data abstraction. Study quality was assessed using the Mixed Methods Assessment Tool. Publications in this field have increased since 2014, and the majority of studies reported positive impacts of IBR implementation across an array of team, patient, and care quality/delivery outcomes. Despite the preponderance of positive findings, great heterogeneity, and a reliance on quantitative non-randomized study designs remain in the extant research. A growing number of interventions to improve safety, quality, and care experiences in hospital settings focus on redesigning daily inpatient rounds. Limited information on IBR characteristics and implementation strategies coupled with widespread variation in terminology, study quality, and design create challenges in assessing the effectiveness of models of rounds and optimal implementation strategies. This scoping review highlights the need for additional studies of rounding models, implementation strategies, and outcomes that facilitate comparative research.
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Affiliation(s)
- Erin Abu-Rish Blakeney
- Department of Biobehavioral Nursing and Health Informatics,
School of Nursing, University of Washington
| | | | - Andrew A. White
- Department of Medicine, University of Washington School of
Medicine
| | | | | | | | | | | | - Mayumi A. Willgerodt
- Department of Family and Child Nursing, School of Nursing,
University of Washington
| | | | | | | | | | - Brenda K. Zierler
- Department of Biobehavioral Nursing and Health
Informatics, School of Nursing, University of Washington
| | | | - Bryan J. Weiner
- Departments of Global Health and Health Services, School
of Public Health, University of Washington
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15
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Walpola RL, Issakhany D, Gisev N, Hopkins RE. The accessibility of pharmacist prescribing and impacts on medicines access: A systematic review. Res Social Adm Pharm 2024; 20:475-486. [PMID: 38326207 DOI: 10.1016/j.sapharm.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Pharmacist prescribing has been introduced in several countries as a strategy to improve access to health care and medicines. However, the direct impacts of pharmacist prescribing on medicines access, and the overall accessibility of pharmacist prescribing services, are not well known. OBJECTIVES This systematic review aimed to assess the direct impacts of pharmacist prescribing on medicines access, and the accessibility of pharmacist prescribing services, in community and primary care settings. METHODS PubMed, Embase, and CINAHL were searched for studies published in English between 01 January 2003 to 15 June 2023. Both quantitative and qualitative primary studies were included if they described pharmacist prescribing in a primary care setting. Outcomes included findings related to access to medicines as a result of pharmacist prescribing (primary outcome), and access to pharmacist prescribing services overall (secondary outcome). Narrative synthesis of outcomes was undertaken. RESULTS A total of 47 studies were included from four countries (United States, United Kingdom, Canada, New Zealand). Thirteen studies provided evidence that pharmacist prescribing may improve medicines access in several ways, including: increasing the proportion of eligible people receiving medicines, increasing the number of overall dispensed prescriptions, or reducing time to receipt of treatment. The remainder of the included studies reported on the accessibility of pharmacist prescribing services. Published studies highlight that pharmacist prescribers practicing in community settings are generally accessible, with pharmacist prescribers viewed by patients as easy and convenient to consult. There was limited evidence about the affordability of pharmacy prescribing services, and a number of potential equity issues were observed, including reduced access to pharmacist prescribers in more socioeconomically disadvantaged areas and those with greater proportions of populations at risk of health inequities, such as culturally and linguistically diverse communities. CONCLUSIONS This systematic review found that pharmacist prescribing services were both highly accessible and beneficial in improving access to medicines. However, measures of medicines access varied, and few studies included direct measures of medicines access as an outcome of pharmacist prescribing, highlighting a need for future studies to incorporate direct measures of medicines access when assessing the impact of pharmacist prescribing services.
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Affiliation(s)
- Ramesh L Walpola
- School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia; School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia.
| | - Dabrina Issakhany
- School of Population Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Ria E Hopkins
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
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16
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Chen T, Spiegel T, Zhang H, Celmins L, Bickley D, Scarpelli D. Evaluating the impact of a discharge pharmacy in the emergency department on emergency department revisits and admissions. Am J Emerg Med 2024; 79:116-121. [PMID: 38422752 DOI: 10.1016/j.ajem.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/04/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
IMPORTANCE Medication nonadherence leads to worse health outcomes, increased healthcare service utilization, and increased overall healthcare costs. OBJECTIVE To determine whether a discharge pharmacy located in the Emergency Department (ED) reduces ED revisits and hospitalizations. DESIGN This is a cohort study where we extracted data from our electronic medical records with adult encounters between 12/2019-10/2021. For the purpose of this study, we defined a revisit to the ED as within 7 days and an admission within 30 days from prior initial ED visit. SETTING The University of Chicago Medicine is an academic medical center located in Chicago's South Side. PARTICIPANTS Between dates of 12/2019-11/2021, we had 78,660 adult distinct encounters. We created 5 different groups: no medications prescribed, ED discharge pharmacy only, e-prescriptions to outside pharmacies, combination of ED pharmacy and e-prescription sent elsewhere, and printed prescriptions with or without any e-prescriptions. EXPOSURE Our ED pharmacy is located within the adult ED, serving only patients seen and discharged from the adult ED. MAIN OUTCOME(S) AND MEASURE(S) Our primary endpoint is to evaluate if prescribing and dispensing prescriptions from only our ED pharmacy is associated with decreased ED revisits within 7 days and reduced hospitalizations within 30 days of initial ED visit. RESULTS When comparing patients who received prescriptions only from the ED discharge pharmacy, patients who received no prescriptions were 31.6% (P < 0.001) more likely to revisit our ED, and patients who received e-prescriptions sent to other pharmacies were 10.4% (P = 0.017) more likely to revisit. Patients who received e-prescriptions from other pharmacies were 29.2% (P < 0.001) more likely to be hospitalized and mixture of e-prescriptions were 59.5% (P < 0.001) more likely to be hospitalized compared to the ED pharmacy only group. CONCLUSIONS AND RELEVANCE We believe having a pharmacy providing medications to patients being discharged from the ED reduces barriers like cost, transportation, and pharmacy access patients face trying to fill prescriptions at their local pharmacy. All of these reductions in barriers provides an easier and more convenient method for patients to obtain their medications at discharge from the ED, reducing the risk of a repeat ED visit and subsequent hospital admission.
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Affiliation(s)
- Thomas Chen
- Department of Medicine, Section of Hospital Medicine, University of Chicago.
| | - Thomas Spiegel
- Department of Medicine, Section of Emergency Medicine, University of Chicago
| | - Hui Zhang
- Center for Health and the Social Sciences, University of Chicago
| | | | - Daniel Bickley
- Department of Medicine, Section of Emergency Medicine, University of Chicago; Center for Health and the Social Sciences, University of Chicago
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17
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Feltes J, Popova M, Hussein Y, Pierce A, Yamane D. Thrombolytics in Cardiac Arrest from Pulmonary Embolism: A Systematic Review and Meta Analysis. J Intensive Care Med 2024; 39:477-483. [PMID: 38037310 DOI: 10.1177/08850666231214754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
BACKGROUND During cardiopulmonary resuscitation, intravenous thrombolytics are commonly used for patients whose underlying etiology of cardiac arrest is presumed to be related to pulmonary embolism (PE). METHODS We performed a systematic review and meta-analysis of the existing literature that focused on the use of thrombolytics for cardiac arrest due to presumed or confirmed PE. Outcomes of interest were return of spontaneous circulation (ROSC), survival to hospital discharge, neurologically-intact survival, and bleeding complications. RESULTS Thirteen studies with a total of 803 patients were included in this review. Most studies included were single-armed and retrospective. Thrombolytic agent and dose were heterogeneous between studies. Among those with control groups, intravenous thrombolysis was associated with higher rates of ROSC (OR 2.55, 95% CI = 1.50-4.34), but without a significant difference in survival to hospital discharge (OR 1.41, 95% CI = 0.79-2.41) or bleeding complications (OR 2.21, 0.95-5.17). CONCLUSIONS Use of intravenous thrombolytics in cardiac arrest due to confirmed or presumed PE is associated with increased ROSC but not survival to hospital discharge or change in bleeding complications. Larger randomized studies are needed. Currently, we recommend continuing to follow existing consensus guidelines which support use of thrombolytics for this indication.
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Affiliation(s)
- Jordan Feltes
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Margarita Popova
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Yasir Hussein
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Ayal Pierce
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - David Yamane
- Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
- Department of Anesthesiology and Critical Care Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
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18
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Killam-Worrall L, Brand R, Castro JR, Patel DS, Huynh K, Lindley B, Torres BP. Baclofen and Tizanidine Adverse Effects Observed Among Community-Dwelling Adults Above the Age of 50 Years: A Systematic Review. Ann Pharmacother 2024; 58:523-532. [PMID: 37589096 DOI: 10.1177/10600280231193080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE This review highlights adverse effects of baclofen and tizanidine in older community-dwelling adults. DATA SOURCES A literature search was conducted, including search terms of "adverse effect," "baclofen," "elderly," "falls," "fractures," and "tizanidine." Studies were included if they described community-dwelling adults aged 50 years and older who received oral baclofen or tizanidine. The Federal Drug Administration Adverse Event Reporting System (FAERS) data were compiled for adverse effect incidence. STUDY SELECTION AND DATA EXTRACTION The literature search was completed in July 2019 and updated in June 2023. Reviews performed by 2 independent reviewers yielded 15 records. FAERS identified 486 (baclofen) and 305 (tizanidine) adverse effects of interest. DATA SYNTHESIS Two retrospective cohort studies evaluating baclofen use in older adults showed increased hospitalizations for encephalopathy in chronic kidney disease (7.2% vs 0.1%) and end-stage renal disease (daily dose 20 mg or more; relative risk [RR] 19.8, 95% CI = [14.0-28.0]). Other articles were case reports; 10 articles reported dyskinesias, encephalopathy or disorientation, and drowsiness associated with baclofen, and 5 articles reported bradycardia and/or hypotension with tizanidine. The FAERS Public Dashboard revealed 12.1% and 28.7% overall incidence of adverse effects of interest, with a 27.8% and 29.2% incidence of falls for baclofen and tizanidine, respectively. Baclofen and tizanidine are associated with concerning adverse effects in older adults. Alternative agents should be considered, but, if necessary, providers should start at lower doses and increase slowly. CONCLUSIONS This review highlights the importance of using baclofen and tizanidine with caution in older adults.
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Affiliation(s)
- Lisa Killam-Worrall
- Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | - Romana Brand
- Wise Regional Health System Emergency Department, Decatur, TX, USA
| | | | | | | | - Bryn Lindley
- Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | - Brittany Palasik Torres
- Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Sciences Center, Fort Worth, TX, USA
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19
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Covington EW, Watkins AM. Agreement Between Two-Concentration and One-Concentration Area Under the Curve (AUC) Estimates When Using Bayesian Modeling to Dose Vancomycin in Patients With Obesity. Ann Pharmacother 2024; 58:501-505. [PMID: 37542419 DOI: 10.1177/10600280231190910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Vancomycin Bayesian modeling provides 24-hour area under the curve (AUC24) estimations. However, the agreement between two-concentration and one-concentration Bayesian estimates in patients with obesity is unknown. OBJECTIVE The purpose of this study was to determine the agreement between two-concentration and one-concentration Bayesian AUC24 estimates in patients with obesity receiving vancomycin. METHODS This retrospective within-subjects cohort study included patients with obesity and two vancomycin concentrations. The first concentration was hidden from dosing software to record the one-concentration AUC24. AUC24 estimates were categorized into 1 of 3 groups: <400, 400 to 600, or >600 mg*h/L. Patients were excluded for vancomycin duration less than 48 hours or renal dysfunction. The primary outcome was AUC24 agreement with two versus one concentration. Secondary outcomes included the AUC24 category, matching of AUC24 categorization, and correlation between two-concentration versus one-concentration AUC24. AUC24 estimate agreement was assessed by Bland Altman plot and bias via linear regression. Statistical analyses were performed using SPSS (version 20.0). RESULTS A total of 31 patients were included. The mean difference in AUC24 between two versus one concentration was 11.4 mg*h/L (95% limits of agreement = -72 to 95 mg*h/L). Linear regression indicated the presence of proportional bias at higher AUC24 values (β = 0.16; P = 0.015). Matching of AUC24 categorization with two versus one concentration was 87% (27/31 patients). CONCLUSION AND RELEVANCE This study demonstrated overall agreement between AUC24 estimates when using two versus one vancomycin concentration in patients with obesity, though proportional bias was detected at higher AUC24. Future studies with larger sample sizes are needed to confirm these results.
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Affiliation(s)
- Elizabeth W Covington
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL, USA
| | - Addison M Watkins
- McWhorter School of Pharmacy, Samford University, Birmingham, AL, USA
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20
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Zeng J, Deng Q, Chen Z, Yan S, Dong Q, Zhang Y, Cui Y, Li L, He Y, Shi J. Recent development of VEGFR small molecule inhibitors as anticancer agents: A patent review (2021-2023). Bioorg Chem 2024; 146:107278. [PMID: 38484586 DOI: 10.1016/j.bioorg.2024.107278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/15/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024]
Abstract
VEGFR, a receptor tyrosine kinase inhibitor (TKI), is an important regulatory factor that promotes angiogenesis and vascular permeability. It plays a significant role in processes such as tumor angiogenesis, tumor cell invasion, and metastasis. VEGFR is mainly composed of three subtypes: VEGFR-1, VEGFR-2, and VEGFR-3. Among them, VEGFR-2 is the crucial signaling receptor for VEGF, which is involved in various pathological and physiological functions. At present, VEGFR-2 is closely related to a variety of cancers, such as non-small cell lung cancer (NSCLC), Hepatocellular carcinoma, Renal cell carcinoma, breast cancer, gastric cancer, glioma, etc. Consequently, VEGFR-2 serves as a crucial target for various cancer treatments. An increasing number of VEGFR inhibitors have been discovered to treat cancer, and they have achieved tremendous success in the clinic. Nevertheless, VEGFR inhibitors often exhibit severe cytotoxicity, resistance, and limitations in indications, which weaken the clinical therapeutic effect. In recent years, many small molecule inhibitors targeting VEGFR have been identified with anti-drug resistance, lower cytotoxicity, and better affinity. Here, we provide an overview of the structure and physiological functions of VEGFR, as well as some VEGFR inhibitors currently in clinical use. Also, we summarize the in vivo and in vitro activities, selectivity, structure-activity relationship, and therapeutic or preventive use of VEGFR small molecule inhibitors reported in patents in the past three years (2021-2023), thereby presenting the prospects and insights for the future development of targeted VEGFR inhibitors.
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Affiliation(s)
- Jing Zeng
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China
| | - Qichuan Deng
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Zheng Chen
- School of Life Science and Engineering, Southwest Jiaotong University, Chengdu 610031, China
| | - Shuang Yan
- Sichuan University of Arts and Science, DaZhou 635000, China
| | - Qin Dong
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China
| | - Yuyu Zhang
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China
| | - Yuan Cui
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China
| | - Ling Li
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China; Chengdu University of Traditional Chinese Medicine State Key Laboratory of Southwestern Chinese Medicine Resources, Sichuan 611137, China.
| | - Yuxin He
- School of Food and Bioengineering, Xihua University, Chengdu, Sichuan 610039, China.
| | - Jianyou Shi
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province, Sichuan Academy of Medical Science & Sichuan Provincial People's Hospital, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China.
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21
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Ibekwe SO, Everett L, Mondal S. Methadone Should Not Be Used in Cardiac Surgery as Part of Enhanced Recovery After Cardiac Surgery Protocol. J Cardiothorac Vasc Anesth 2024; 38:1272-1274. [PMID: 38503627 DOI: 10.1053/j.jvca.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 02/14/2024] [Indexed: 03/21/2024]
Affiliation(s)
| | - Lauren Everett
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD
| | - Samhati Mondal
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD.
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22
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Qu L, Ma XP, Simayi A, Wang XL, Xu GP. Comparative efficacy of various pharmacologic treatments for alcohol withdrawal syndrome: a systematic review and network meta-analysis. Int Clin Psychopharmacol 2024; 39:148-162. [PMID: 38170803 DOI: 10.1097/yic.0000000000000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
This study was to compare multiple classes of medications and medication combinations to find alternatives or additives for patients not applicable to benzodiazepines (BZDs). We performed a network meta-analysis to assess the comparative effect of 11 pharmacologic treatments in patients with alcohol withdrawal syndrome. Forty-one studies were included, comprising a total sample size of 4187 participants. The pooled results from the randomized controlled trials showed that there was no significant difference in the Clinical Institute Withdrawal Assessment-Alcohol, revised (CIWA-Ar) reduction with other medications or medication combinations compared to BZDs. Compared to BZDs, the mean difference in ICU length of stay of anticonvulsants + BZDs was -1.71 days (95% CI = -2.82, -0.59). Efficacy rankings from cohort studies showed that anticonvulsant + BZDs were superior to other treatments in reducing CIWA-Ar scores and reducing the length of stay in the ICU. Synthesis results from randomized controlled trials indicate that there are currently no data suggesting that other medications or medication combinations can fully replace BZDs. However, synthetic results from observational studies have shown that BZDs are effective in the context of adjuvant anticonvulsant therapy, particularly with early use of gabapentin in combination with BZDs in the treatment of alcohol withdrawal syndrome, which represents a promising treatment option.
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Affiliation(s)
- Li Qu
- Department of Anesthesia, People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang, China
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Moore EL, Kuhn AK, Leung JG, Myhre LJ. Striving for health equity: Stigmatizing language in inpatient pharmacy notes - A pilot study. Res Social Adm Pharm 2024; 20:553-556. [PMID: 38365520 DOI: 10.1016/j.sapharm.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/06/2023] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND As pharmacy evolves, pharmacists have an increasing role in documentation. Publications examining the actions of other health professionals show that negative perception in written notes translates to patients receiving lower quality of care, resulting in worse health outcomes, suggesting that the use of stigmatizing language towards patients has concerning consequences. OBJECTIVES To identify the prevalence of stigmatizing language in inpatient pharmacy progress. notes based on patient specific characteristics and diagnoses. METHODS This retrospective pilot study reviewed inpatient pharmacy progress notes of a Midwestern (United States) tertiary academic institution from May to June 2023. Stigmatizing words and phrases associated with specified disease states were separated into the categories of general language, substance use disorders, and mental health. Notes of patients on internal medicine, family medicine, kidney/pancreas transplant, liver transplant, and gastroenterology services were included. RESULTS Stigmatizing language was found in 22% (n = 43) of notes. The words "abuse" and "dependence" had the highest prevalence. Patients diagnosed with substance use disorders experienced stigmatizing language at a high rate, exaggerated further if their note lacked a documented diagnosis. CONCLUSIONS This study demonstrated that stigmatizing language is present in pharmacy documentation. Providing context and resources of the proper documentation to reflect equitable healthcare is crucial for patient care.
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Affiliation(s)
- Elise L Moore
- Department of Pharmacy Services, Mayo Clinic, 1216 2nd St SW, Rochester, MN, 55902, United States.
| | - Alyssa K Kuhn
- Department of Pharmacy Services, Mayo Clinic, 1216 2nd St SW, Rochester, MN, 55902, United States.
| | - Jonathan G Leung
- Department of Pharmacy Services, Mayo Clinic, 1216 2nd St SW, Rochester, MN, 55902, United States.
| | - Laura J Myhre
- Department of Pharmacy Services, Mayo Clinic, 1216 2nd St SW, Rochester, MN, 55902, United States.
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24
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Cho J, Ra Lee A, Koo D, Kim K, Mi Jeong Y, Lee HY, Euni Lee E. Development of machine-learning models using pharmacy inquiry database for predicting dose-related inquiries in a tertiary teaching hospital. Int J Med Inform 2024; 185:105398. [PMID: 38452610 DOI: 10.1016/j.ijmedinf.2024.105398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/09/2023] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Drug-related problems (DRPs) are a significant concern in healthcare. Pharmacists play a vital role in detecting and resolving DRPs to improve patient safety. A pharmacy inquiry program was established in a tertiary teaching hospital to document inquiries about physicians' orders, aimed at preventing potential DRPs or providing medication information during order reviews. OBJECTIVE We aimed to develop machine-learning models using a pharmacy inquiry database to predict dose-related inquiries based on prescriptions and patient information. METHODS This retrospective study analyzed 20,393 pharmacy inquiries collected between January 2018 and February 2023. Data included prescription information (drug ingredient, dose, unit, and frequency), patient characteristics (age, sex, weight, and department), and renal function. The inquiries were categorized into two classes: dose-related inquiries (e.g., wrong dose and inappropriate regimen) and non-dose-related inquiries (e.g., inappropriate drug form and administration route). Six machine-learning models were developed: logistic regression, support vector classifier, decision tree, random forest, extreme gradient boosting, and categorical boosting. To evaluate the performance of the models, the area under the receiver operating characteristic curve and the accuracy were compared. RESULTS The CatBoost model achieved the highest performance (sensitivity: 0.92; accuracy: 0.79). The SHapley Additive exPlanations values highlighted the importance of features in the model predictions, drug ingredients, units, and renal function, in that order. Notably, lower renal function positively contributed to the prediction of dose-related inquiries. Additionally, the subsequent feature importance among drug ingredients showed that drugs such as acetylsalicylic acid, famotidine, metformin, and spironolactone strongly influenced the prediction of dose-related inquiries. CONCLUSION Machine-learning models that use pharmacy inquiry data can effectively predict dose-related inquiries. Further external validation and refinement of the models are required for broader applications in healthcare settings. These findings provide valuable guidance for healthcare professionals and highlight the potential of machine learning in pharmacists' decision-making.
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Affiliation(s)
- Jungwon Cho
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea; Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Ah Ra Lee
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Dongjun Koo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; Interdisciplinary Program in Bioengineering, College of Engineering, Seoul National University, Seoul, South Korea
| | - Koenhee Kim
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Young Mi Jeong
- Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - Ho-Young Lee
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea; Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine Gyeonggi-do, Republic of Korea.
| | - Eunkyung Euni Lee
- College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea; Department of Pharmacy, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
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Lin E, Gandhi D, Volk M. Preventing Readmissions of Hepatic Encephalopathy: Strategies in the Acute Inpatient, Immediate Postdischarge, and Longitudinal Outpatient Setting. Clin Liver Dis 2024; 28:359-367. [PMID: 38548445 DOI: 10.1016/j.cld.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Hepatic encephalopathy (HE) is a strong predictor of early hospital readmission in patients with cirrhosis. Early hospital readmission increases health care costs and is associated with worse survival. Herein we provide an overview of strategies to prevent hospital readmissions in patients with HE, divided into 3 contexts: (a) acute inpatient, (b) immediate postdischarge, and (c) longitudinal outpatient setting.
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Affiliation(s)
- Emily Lin
- Department of Gastroenterology, Loma Linda University, Loma Linda, CA, USA
| | - Devika Gandhi
- Department of Gastroenterology, Loma Linda University, Loma Linda, CA, USA.
| | - Michael Volk
- Department of Medicine, Baylor Scott and White, Central Texas Region, Temple, TX, USA
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Irwin AN, Gray M, Ventricelli D, Boggis JS, Bratberg J, Floyd AS, Silcox J, Hartung DM, Green TC. "I go out of my way to give them an extra smile now:" A study of pharmacists who participated in Respond to Prevent, a community pharmacy intervention to accelerate provision of harm reduction materials. Res Social Adm Pharm 2024; 20:512-519. [PMID: 38395644 PMCID: PMC10981567 DOI: 10.1016/j.sapharm.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Community pharmacies are well-positioned to improve the health of people with opioid use disorder and who use drugs by providing naloxone and other essential public health supplies. Respond to Prevent (R2P) is a clinical trial which sought to accelerate provision of harm reduction materials through a multicomponent intervention that included in-store materials, online training, and academic detailing. OBJECTIVES The objective of this study was to explore pharmacists' attitudes, knowledge, and experiences in providing naloxone, dispensing buprenorphine, and selling nonprescription syringes following participation in the R2P program. METHODS Two online asynchronous focus groups were conducted with community-based chain pharmacists across Massachusetts, New Hampshire, Oregon, and Washington who had participated in the R2P program. Participants accessed an online repository of group interview items and responded to questions over a short period. Each pharmacist participated anonymously for approximately 30 min over 2 ½ days. Pharmacists answered questions on experiences with pharmacy-based harm reduction care and R2P intervention implementation barriers and facilitators. Qualitative data analysis was conducted by a multidisciplinary team using an immersion-crystallization approach. RESULTS A total of 32 pharmacists participated in the two focus groups. Most participants were female (n = 18, 56%), non-Hispanic (n = 29, 91%), and white (n = 17, 53%). Four major themes were identified related to (1) addressing bias and stigma toward people with opioid use disorder and who use drugs, (2) familiarity and comfort with naloxone provision, (3) perspective and practice shifts in nonprescription syringe sales, (4) structural challenges to harm reduction care in the pharmacy. CONCLUSIONS Community pharmacists across the four states identified attitudes, knowledge, and experiences that create barriers to providing care to people with opioid use disorder and who use drugs. R2P approaches and tools were effective at reducing stigma and changing attitudes but were less effective at addressing structural challenges from the pharmacists' perspective.
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Affiliation(s)
- Adriane N Irwin
- Department of Pharmacy Practice, Oregon State University College of Pharmacy, Corvallis, OR, USA
| | | | - Daniel Ventricelli
- Indivior, Inc., North Chesterfield, VA, USA; Department of Clinical Pharmacy, Philadelphia College of Pharmacy at University of the Sciences, Philadelphia, PA, USA
| | - Jesse S Boggis
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA; Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA
| | - Jeffrey Bratberg
- Department of Pharmacy Practice and Clinical Research, University of Rhode Island College of Pharmacy, Kingston, RI, USA
| | - Anthony S Floyd
- Department of Psychiatry and Behavioral Sciences, Addictions, Drug & Alcohol Institute, University of Washington School of Medicine, Seattle, WA, USA
| | - Joseph Silcox
- Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; Department of Sociology, University of Massachusetts, Boston, MA, USA
| | - Daniel M Hartung
- Department of Pharmacy Practice, Oregon State University College of Pharmacy, Corvallis, OR, USA
| | - Traci C Green
- Opioid Policy Research Collaborative, Heller School for Social Policy & Management at Brandeis University, Waltham, MA, USA; Departments of Emergency Medicine and Epidemiology, Brown Schools of Medicine and Public Health, Providence, RI, USA.
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Yan S, Song X, Hu X, Yao K, Qu S. A novel intraocular pressure predicting method based on hyperelastic mechanical model of cornea. J Mech Behav Biomed Mater 2024; 153:106475. [PMID: 38430796 DOI: 10.1016/j.jmbbm.2024.106475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/15/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Measuring intraocular pressure (IOP) is crucial and remains challenging in diagnosing glaucoma, as it is associated with cornea deformation during inflation. In this study, a three-dimensional analytical model based on hyperelastic constitutive relationship to predict correlation between cornea vertex displacement and the IOP is proposed. The analytical model is validated by rigorous experiments. Rabbit corneas were selected for this study and their mechanical properties were obtained using uniaxial tensile tests. To mimic the environment in which the cornea exists, an artificial anterior chamber equipped with water-injection pipelines was constructed to study the relationship between the corneal vertex displacement with IOP value in practical situation. The experimental results of rabbits corneas prove that the IOP can be deduced based on the measured corneal vertex displacement by the analytical model. Furthermore, subtle difference occurs when comparing the calculated human IOPs with those measured by medical equipment, demonstrating that the proposed method is suitable for monitoring the IOP of human. This novel IOP predicting method provides new inspiration for the design of eyepieces, as well as the preoperative preparation for laser surgery and evaluation of corneal damage.
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Affiliation(s)
- Shi Yan
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, PR China; State Key Laboratory of Fluid Power & Mechatronic System, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, and Department of Engineering Mechanics, Zhejiang University, Hangzhou, 310027, PR China
| | - Xiaohui Song
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, PR China
| | - Xiaocheng Hu
- State Key Laboratory of Fluid Power & Mechatronic System, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, and Department of Engineering Mechanics, Zhejiang University, Hangzhou, 310027, PR China; China Academy of Space Technology (Xi'an), Xi'an, 710100, PR China.
| | - Ke Yao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, PR China.
| | - Shaoxing Qu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, PR China; State Key Laboratory of Fluid Power & Mechatronic System, Key Laboratory of Soft Machines and Smart Devices of Zhejiang Province, and Department of Engineering Mechanics, Zhejiang University, Hangzhou, 310027, PR China.
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Broccard SP, Edwards MA, Brennan ER, Spaulding AC, DeLeon MF, Mishra N, Casler JD, Colibaseanu DT. Room for Improvement: The Impact of Guideline-Recommended Extended Thromboprophylaxis in Patients Undergoing Abdominal Surgery for Colorectal and Anal Cancer at a Tertiary Referral Center. Dis Colon Rectum 2024; 67:714-722. [PMID: 38335005 DOI: 10.1097/dcr.0000000000003158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND Venous thromboembolism occurs in approximately 2% of patients undergoing abdominal and pelvic surgery for cancers of the colon, rectum, and anus and is considered preventable. The American Society of Colon and Rectal Surgeons recommends extended prophylaxis in high-risk patients, but there is low adherence to the guidelines. OBJECTIVE This study aims to analyze the impact of venous thromboembolism risk-guided prophylaxis in patients undergoing elective abdominal and pelvic surgeries for colorectal and anal cancers from 2016 to 2021. DESIGN This was a retrospective analysis. SETTING The study was conducted at a multisite tertiary referral academic health care system. PATIENTS Patients who underwent elective abdominal or pelvic surgery for colon, rectal, or anal cancer. MAIN OUTCOME MEASURES Receipt of Caprini-guided venous thromboembolism prophylaxis, 90-day postoperative rate of deep vein thrombosis, pulmonary embolism, venous thromboembolism, and bleeding events. RESULTS A total of 3504 patients underwent elective operations, of whom 2224 (63%) received appropriate thromboprophylaxis in the inpatient setting. In the postdischarged cohort of 2769 patients, only 2% received appropriate thromboprophylaxis and no thromboembolic events were observed. In the group receiving inappropriate thromboprophylaxis, at 90 days postdischarge, the deep vein thrombosis, pulmonary embolism, and venous thromboembolism rates were 0.60%, 0.40%, and 0.88%, respectively. Postoperative bleeding was not different between the 2 groups. LIMITATIONS Limitations to our study include its retrospective nature, use of aggregated electronic medical records, and single health care system experience. CONCLUSION Most patients in our health care system undergoing abdominal or pelvic surgery for cancers of the colon, rectum, and anus were discharged without appropriate Caprini-guided venous thromboembolism prophylaxis. Risk-guided prophylaxis was associated with decreased rates of inhospital and postdischarge venous thromboembolism without increased bleeding complications. See Video Abstract . MARGEN DE MEJORA EL IMPACTO DE LA TROMBOPROFILAXIS RECOMENDADA POR LAS DIRECTRICES EN PACIENTES SOMETIDOS A CIRUGA ABDOMINAL POR CNCER COLORRECTAL Y ANAL EN UN CENTRO DE REFERENCIA TERCIARIO ANTECEDENTES:El tromboembolismo venoso ocurre en aproximadamente el 2% de los pacientes sometidos a cirugía abdominal y pélvica por cánceres de colon, recto y ano, y se considera prevenible. La Sociedad Estadounidense de Cirujanos de Colon y Recto recomienda una profilaxis prolongada en pacientes de alto riesgo, pero el cumplimiento de las directrices es bajo.OBJETIVO:Este estudio tiene como objetivo analizar el impacto de la profilaxis guiada por el riesgo de tromboembolismo venoso (TEV) en pacientes sometidos a cirugías abdominales y pélvicas electivas por cáncer colorrectal y anal entre 2016 y 2021.DISEÑO:Este fue un análisis retrospectivo.AJUSTE:El estudio se llevó a cabo en un sistema de salud académico de referencia terciaria de múltiples sitios.PACIENTES:Pacientes sometidos a cirugía abdominal o pélvica electiva por cáncer de colon, recto o ano.PRINCIPALES MEDIDAS DE RESULTADO:Recepción de profilaxis de tromboembolismo venoso guiada por Caprini, tasa postoperatoria de 90 días de trombosis venosa profunda, embolia pulmonar, tromboembolismo venoso y eventos de sangrado.RESULTADOS:Un total de 3.504 pacientes se sometieron a operaciones electivas, de los cuales 2.224 (63%) recibieron tromboprofilaxis adecuada en el ámbito hospitalario. En el cohorte de 2.769 pacientes después del alta, solo el 2% recibió tromboprofilaxis adecuada en la que no se observaron eventos tromboembólicos. En el grupo que recibió tromboprofilaxis inadecuada, a los 90 días después del alta, las tasas de trombosis venosa profunda, embolia pulmonar y tromboembolia venosa fueron del 0,60%, 0,40% y 0,88%, respectivamente. El sangrado posoperatorio no fue diferente entre los dos grupos.LIMITACIONES:Las limitaciones de nuestro estudio incluyen su naturaleza retrospectiva, el uso de registros médicos electrónicos agregados y la experiencia de un solo sistema de atención médica.CONCLUSIÓN:La mayoría de los pacientes en nuestro sistema de salud sometidos a cirugía abdominal o pélvica por cánceres de colon, recto y ano fueron dados de alta sin una profilaxis adecuada de TEV guiada por Caprini. La profilaxis guiada por el riesgo se asoció con menores tasas de tromboembolismo venoso hospitalario y dado de alta sin un aumento de las complicaciones de sangrado. (Traducción-Dr. Aurian Garcia Gonzalez ).
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Affiliation(s)
| | - Michael A Edwards
- Division of Advanced GI and Bariatric Surgery, Mayo Clinic, Jacksonville, Florida
| | - Emily R Brennan
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center, Mayo Clinic, Jacksonville, Florida
| | - Aaron C Spaulding
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center, Mayo Clinic, Jacksonville, Florida
| | - Michelle F DeLeon
- Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida
| | - Nitin Mishra
- Division of Colon and Rectal Surgery, Mayo Clinic, Phoenix, Arizona
| | - John D Casler
- Department of Otorhinolaryngology, Mayo Clinic, Phoenix, Arizona
| | - Dorin T Colibaseanu
- Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center, Mayo Clinic, Jacksonville, Florida
- Division of Colon and Rectal Surgery, Mayo Clinic, Jacksonville, Florida
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Ware LR, Kim CS, Szumita PM, DeGrado JR. A Narrative Review on the Administration of Inhaled Prostaglandins in Critically Ill Adult Patients With Acute Respiratory Distress Syndrome. Ann Pharmacother 2024; 58:533-548. [PMID: 37589097 DOI: 10.1177/10600280231194539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
OBJECTIVE To describe the effect of inhaled prostaglandins on both oxygenation and mortality in critically ill patients with acute respiratory distress syndrome (ARDS), with a focus on safety and efficacy in coronavirus disease 2019 (COVID-19)-associated ARDS and non-COVID-19 ARDS. DATA SOURCES A literature search of MEDLINE was performed using the following search terms: inhaled prostaglandins, inhaled epoprostenol, inhaled nitric oxide, ARDS, critically ill. All abstracts were reviewed. STUDY SELECTION AND DATA EXTRACTION Relevant English-language reports and studies conducted in humans between 1980 and June 2023 were considered. DATA SYNTHESIS Data regarding inhaled prostaglandins and their effect on oxygenation are limited but show a benefit in patients who respond to therapy, and data pertaining to their effect on mortality is scarce. Concerns exist regarding the formulation of inhaled epoprostenol (iEPO) utilized in addition to modes of medication delivery; however, the limited data surrounding their use have shown a reasonable safety profile. Other avenues and beneficial effects may exist with inhaled prostaglandins, such as use in COVID-19-associated ARDS or non-COVID-19 ARDS patients undergoing noninvasive mechanical ventilation or during patient transport. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE The use of inhaled prostaglandins can be considered in critically ill patients with COVID-19-associated ARDS or non-COVID-19 ARDS who are experiencing difficulties with oxygenation refractory to nonpharmacologic strategies. CONCLUSIONS The use of iEPO and other inhaled prostaglandins requires further investigation to fully elucidate their effects on clinical outcomes, but it appears these medications may have a potential benefit in COVID-19-associated ARDS and non-COVID-19 ARDS patients with refractory hypoxemia but with little effect on mortality.
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Affiliation(s)
- Lydia R Ware
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - Christine S Kim
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - Paul M Szumita
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
| | - Jeremy R DeGrado
- Department of Pharmacy, Brigham and Women's Hospital, Boston, MA, USA
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Hu J, Chen C, Li X, Zang X, Ke J, Zhou S, Mai H, Gong C. Risk of Systemic Inflammatory Response Syndrome Following Preoperative Glucocorticoids Administration in Patients After Percutaneous Nephrolithotomy: A Retrospective Cohort Study. Drug Saf 2024; 47:465-474. [PMID: 38441749 DOI: 10.1007/s40264-024-01402-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Systemic inflammatory response syndrome (SIRS) is one of the most serious complications in patients undergoing percutaneous nephrolithotomy (PCNL). Although glucocorticoids are increasingly used during PCNL, few studies have been concerned about the association between glucocorticoids and postoperative SIRS. The study aims to explore whether preoperative use of glucocorticoids is associated with SIRS after PCNL. METHODS A total of 1259 patients who underwent PCNL between January 2015 and April 2021 were enrolled in the retrospective cohort study. Risk factors for post-PCNL SIRS were identified by univariate and multivariate regression analysis. To further explore the association between preoperative administration of glucocorticoids and SIRS, 113 pairs of patients were matched for the confounding factors using propensity score matching (PSM) analysis. The odds ratios (OR) and 95 % confidence intervals (CI) for the above variables were analyzed. RESULTS The incidence of SIRS after PCNL was 9.6 % (121/1259) and the patients who suffered from postoperative SIRS had longer hospital stays and higher hospital costs (all p < 0.05). Multivariate logistic regression analysis indicated that female, preoperative leukocyte count, insertion of central vein catheter, serum albumin, preoperative high-sensitive C-reactive protein/albumin ratio, preoperative transfusion, preoperative administration of glucocorticoids were independent risk factors for SIRS (all p < 0.05). After minimization, the effects of confounding factors by PSM, preoperative administration of glucocorticoids was significantly correlated with SIRS in patients after PCNL (OR=2.44, 95 %CI: 1.31-4.55, p = 0.005). CONCLUSION Preoperative administration of glucocorticoids is an independent risk factor for SIRS in patients undergoing PCNL.
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Affiliation(s)
- Jingping Hu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Chaojin Chen
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Xiaoyue Li
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Xiangyang Zang
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China
| | - Jie Ke
- Guangzhou AID Cloud Technology Co., Ltd, Guangzhou, 510000, China
| | - Shaoli Zhou
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
| | - Haiyan Mai
- Department of Pharmacy, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
| | - Chulian Gong
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630, China.
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Fentie AM, Huluka SA, Gebremariam GT, Gebretekle GB, Abebe E, Fenta TG. Impact of pharmacist-led interventions on medication-related problems among patients treated for cancer: A systematic review and meta-analysis of randomized control trials. Res Social Adm Pharm 2024; 20:487-497. [PMID: 38368123 DOI: 10.1016/j.sapharm.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Medication-related problems (MRPs) continue to impose a voluminous health impact, particularly among patients on anti-cancer therapy, due to the nature and complexity of the care. Pharmacists have a pivotal role in ensuring the safe, effective, and rational use of medicines in this group of patients. OBJECTIVES To examine the impact of pharmacist-led interventions in resolving MRPs among patients treated for cancer. METHODS This systematic review and meta-analysis was conducted and reported following the PRISMA protocol and registered in PROSPERO (Registration number: CRD42022311535). Four database searches, PubMed, EMBASE, Cochrane, and International Pharmaceuticals Abstracts, were systematically searched from August 2022 to January 2023. Only randomized control trials (RCTs) were included. The Cochrane risk of bias assessment tool was used to check the quality of the included studies. The outcome measures were overall MRPs, adherence, medication errors, and adverse drug events (ADEs). Data for meta-analysis were analyzed used using STATA version 17 and standardized mean difference effect sizes were calculated for continuous outcomes and odds ratio for categorical outcomes. RESULTS Out of the 90 studies screened for eligibility, 20 RCT studies were included for the systematic review and 15 for the meta-analysis. Close to two-thirds of the studies were from Europe (n = 7) and Asia (n = 6). A combination of educational and behavioral intervention strategies were used for a period ranged from 8 days to 12 months. The pharmacist-led intervention improved adherence to treatment by 4.79 times (AOR = 4.79; 95%CI = 2.64, 8.68; p-value<0.0001), reduced the occurrence of ADEs by 1.28 (SMD = -1.28; 95%CI = -0.04-2.52; p-value = 0.04) and decreased the overall MRPs by 0.53 (SMD = -0.53; 95%CI = -0.79, -0.28; p-value<0.0001) compared to control groups. CONCLUSION This study found out that pharmacist-led interventions can significantly lower MRPs among patients treated for cancer. Hence, a global concerted effort has to be made to integrate pharmacists in a multidisciplinary direct cancer care.
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Affiliation(s)
- Atalay Mulu Fentie
- Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Ethiopia.
| | - Solomon Assefa Huluka
- Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Ethiopia
| | - Girma Tekle Gebremariam
- Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Pharmacology and Clinical Pharmacy, Ethiopia
| | | | - Ephrem Abebe
- Purdue University, College of Pharmacy, West Lafayette, IN, USA; Indiana University, School of Medicine, Indianapolis, IN, USA
| | - Teferi Gedif Fenta
- Addis Ababa University, College of Health Sciences, School of Pharmacy, Department of Social Pharmacy and Pharmaceutics, Ethiopia
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Şahin S, Azarkan SY, Türksoy VA. Evaluation of the effect of cannabidiol on the THLE-2 liver cell line exposed to lead. Sci Total Environ 2024; 923:170901. [PMID: 38401722 DOI: 10.1016/j.scitotenv.2024.170901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024]
Abstract
Environmental and soil pollution increase the likelihood of human exposure to toxic metals. Therefore, there is a need for new methods and substances to protect individuals against the harmful effects caused by toxic metals. The study is the first to aim at determining the protective effect of cannabidiol (CBD) against oxidative stress and inflammation induced by toxic metal exposure in Transformed Human Liver Epithelial-2 (THLE-2) cell lines representing healthy liver cells. The IC50 value was determined by exposing THLE-2 human liver healthy cell line to different molarities of lead (Pb) using the XTT kit. The protective efficacy of CBD was assessed by adding 5 μM CBD in addition to the Pb doses determined at IC50 levels to the Pb groups created in cell lines. The levels of GSH, MDA, MPO, CAT, TNF-α, IL-1β, and IL-6 in cell lines were determined using ELISA kits. The inhibition of toxic metal entry into the cells by CBD was assessed through ICP-MS analysis. The IC50 value for Pb was determined as 10 μM in 2D cell lines and 25 μM in 3D cell lines. It was observed that the application of 5 μM concentration of CBD, along with the determined IC50 doses for Pb, increased the cell proliferation rate. Furthermore, the decrease in GSH and CAT levels and the increase in MDA, MPO, TNF-α, IL-1β, and IL-6 levels observed in cell lines treated only with Pb were reversed with the application of CBD. The ICP-MS analysis revealed that CBD reduced the cellular uptake of Pb. The reversal of oxidative stress and inflammation induced by Pb, the increase in cell proliferation, and the reduction in the cellular uptake of toxic metals by CBD can be considered as strong evidence for the protective use of CBD in Pb exposures.
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Affiliation(s)
- Serkan Şahin
- Department of Medical Pharmacology, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey.
| | - Serap Yalçın Azarkan
- Department of Medical Pharmacology, Faculty of Medicine, Kırşehir Ahi Evran University, Kırşehir, Turkey.
| | - Vugar Ali Türksoy
- Department of Public Health, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey.
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Garcia S, Mali M, Grewal A. Pro: Methadone Should Be Used as a Part of Enhanced Recovery After Cardiac Surgery Protocol. J Cardiothorac Vasc Anesth 2024; 38:1268-1271. [PMID: 38458828 DOI: 10.1053/j.jvca.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Shelby Garcia
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD
| | - Mitali Mali
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD
| | - Ashanpreet Grewal
- Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD.
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Halonen J, Kärkkäinen J, Jäntti H, Martikainen T, Valtola A, Ellam S, Väliaho E, Santala E, Räsänen J, Juutilainen A, Mahlamäki V, Vasankari S, Vasankari T, Hartikainen J. Prevention of Atrial Fibrillation After Cardiac Surgery: A Review of Literature and Comparison of Different Treatment Modalities. Cardiol Rev 2024; 32:248-256. [PMID: 36729126 DOI: 10.1097/crd.0000000000000499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Atrial fibrillation is the most common arrhythmia to occur after cardiac surgery, with an incidence of 10% to 50%. It is associated with postoperative complications including increased risk of stroke, prolonged hospital stays and increased costs. Despite new insights into the mechanisms of atrial fibrillation, no specific etiologic factor has been identified as the sole perpetrator of the arrhythmia. Current evidence suggests that the pathophysiology of atrial fibrillation in general, as well as after cardiac surgery, is multifactorial. Studies have also shown that new-onset postoperative atrial fibrillation following cardiac surgery is associated with a higher risk of short-term and long-term mortality. Furthermore, it has been demonstrated that prophylactic medical therapy decreases the incidence of postoperative atrial fibrillation after cardiac surgery. Of note, the incidence of postoperative atrial fibrillation has not changed during the last decades despite the numerous preventive strategies and operative techniques proposed, although the perioperative and postoperative care of cardiac patients as such has improved.
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Affiliation(s)
- Jari Halonen
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kärkkäinen
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Helena Jäntti
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
- Centre for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland
| | - Tero Martikainen
- Department of Anesthesiology and Operative Services, Kuopio University Hospital, Kuopio, Finland
| | - Antti Valtola
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - Sten Ellam
- Department of Anesthesiology and Operative Services, Kuopio University Hospital, Kuopio, Finland
| | - Eemu Väliaho
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Elmeri Santala
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jenni Räsänen
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Auni Juutilainen
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Visa Mahlamäki
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sini Vasankari
- Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Tommi Vasankari
- The UKK Institute for Health Promotion Research, Tampere, Finland
- The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Juha Hartikainen
- From the Heart Center, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Usman MA, Donald OU, Salahu D, Akhideno II. Physicochemical Stability of Ketamine After Reconstitution for Injection: A Scoping Review. Anesth Analg 2024; 138:e29-e31. [PMID: 38621287 DOI: 10.1213/ane.0000000000006956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
- Mohammed Adinoyi Usman
- Department of Clinical Pharmacology and Therapeutics, Federal University Dutse, Dutse, Jigawa State, Nigeria, ,
| | - Orshio Uga Donald
- Department of Anaesthesiaßederal Medical Centre, akurdi, Benue State, Nigeria
| | - Dalhat Salahu
- Department of Anaesthesia, Aminu Kano Teaching Hospital, Kano, Nigeria
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Patel H, Raje V, Maczko P, Patel K. Application of 3D printing technology for the development of dose adjustable geriatric and pediatric formulation of celecoxib. Int J Pharm 2024; 655:123941. [PMID: 38403087 DOI: 10.1016/j.ijpharm.2024.123941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 02/27/2024]
Abstract
Developing safe and effective formulations for the geriatric and pediatric population is a challenging task due to issues of swallowability and palatability. The lack of standardized procedures for pediatric formulations further complicates the process. Manipulating adult formulations for children can lead to suboptimal efficacy and safety concerns. To overcome these challenges, minitablets or spinklets are preferred for the geriatric and pediatric population due to their smaller size and flexible dose adjustment. The aim of this study is the development of a 3D printed spinklets formulation of celecoxib, a nonsteroidal anti-inflammatory drug, using hot melt extrusion to address the limitations of traditional manufacturing methods. Three different formulations of celecoxib were prepared using Poly-2-ethyl-tetra-oxazoline (Aquazol) with and without surfactant. Subsequently, the mechanical properties and solubility of the drug-loaded filaments were evaluated. Solid state characterization confirmed the drug conversion into an amorphous form during the extrusion process, Computer-aided design software facilitate sprinklets design for fused deposition modeling and scanning electron microscopy assess the surface morphology. Sophorolipids plasticize better than TPGS, resulting in lowering processing temperatures during melt extrusion. In vitro drug release showed successful enhancements in the dissolution of oral medications for pediatric patients, considering their distinctive physiological characteristics. Overall, this study demonstrates the successful development of PEtOx-based 3D printed celecoxib sprinklets by coupling hot-melt extrusion and 3D printing technology. Future exploration holds the potential to revolutionize pharmaceutical production and advance personalized medication formulations.
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Affiliation(s)
- Henis Patel
- College of Pharmacy and Health Sciences, St. John's University, NY 11432, United States
| | - Vishvesh Raje
- College of Pharmacy and Health Sciences, St. John's University, NY 11432, United States
| | - Paulina Maczko
- College of Pharmacy and Health Sciences, St. John's University, NY 11432, United States
| | - Ketan Patel
- College of Pharmacy and Health Sciences, St. John's University, NY 11432, United States.
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Pavel FBA, Palmer GE, Hevener KE. Biophysical library screening using a Thermo-FMN assay to identify and characterize Clostridioides difficile FabK inhibitors. Biochem Biophys Res Commun 2024; 705:149740. [PMID: 38458032 DOI: 10.1016/j.bbrc.2024.149740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
Clostridioides difficile, a gram-positive anaerobic bacterium, is one of the most frequent causes of nosocomial infections. C. difficile infection (CDI) results in almost a half a million infections and approximately 30,000 deaths in the U.S. each year. Broad-spectrum antibacterial use is a strong risk factor for development of recurring CDI. There is a critical need for narrow-spectrum antibacterials with activity limited to C. difficile. The C. difficile enoyl-acyl carrier protein (ACP) reductase II enzyme (CdFabK), an essential and rate-limiting enzyme in the organism's fatty acid biosynthesis pathway (FAS-2), is an attractive target for narrow-spectrum CDI therapeutics as it is not present in many of the non-pathogenic gut organisms. We have previously characterized inhibitors of the CdFabK enzyme with narrow-spectrum anti-difficile activity and favorable in vivo efficacy, ADME, and low dysbiosis. To expand our knowledge of the structural requirements for CdFabK inhibition, we seek to identify new inhibitors with novel chemical scaffolds. Herein we present the optimization of a thermo-FMN biophysical assay based on the principles of differential scanning fluorimetry, or thermal shift, which leverages the fluorescence signal of the FabK enzyme's FMN prosthetic group. The optimized assay was validated by pilot testing a 10K diversity-based chemical library and novel scaffold hit compounds were identified and biochemically characterized. Additionally, we show that the thermo-FMN assay can be used to determine the thermodynamic dissociation constant, Kd, of CdFabK inhibitors.
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Affiliation(s)
- Fahad Bin Aziz Pavel
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Glen E Palmer
- Department of Clinical Pharmacy and Translational Sciences, College of Pharmacy, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Kirk E Hevener
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN, USA.
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Wongdontree P, Millan-Oropeza A, Upfold J, Lavergne JP, Halpern D, Lambert C, Page A, Kénanian G, Grangeasse C, Henry C, Fouet A, Gloux K, Anba-Mondoloni J, Gruss A. Oxidative stress is intrinsic to staphylococcal adaptation to fatty acid synthesis antibiotics. iScience 2024; 27:109505. [PMID: 38577105 PMCID: PMC10993138 DOI: 10.1016/j.isci.2024.109505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 12/08/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
Antibiotics inhibiting the fatty acid synthesis pathway (FASII) of the major pathogen Staphylococcus aureus reach their enzyme targets, but bacteria continue growth by using environmental fatty acids (eFAs) to produce phospholipids. We assessed the consequences and effectors of FASII-antibiotic (anti-FASII) adaptation. Anti-FASII induced lasting expression changes without genomic rearrangements. Several identified regulators affected the timing of adaptation outgrowth. Adaptation resulted in decreased expression of major virulence factors. Conversely, stress responses were globally increased and adapted bacteria were more resistant to peroxide killing. Importantly, pre-exposure to peroxide led to faster anti-FASII-adaptation by stimulating eFA incorporation. This adaptation differs from reports of peroxide-stimulated antibiotic efflux, which leads to tolerance. In vivo, anti-FASII-adapted S. aureus killed the insect host more slowly but continued multiplying. We conclude that staphylococcal adaptation to FASII antibiotics involves reprogramming, which decreases virulence and increases stress resistance. Peroxide, produced by the host to combat infection, favors anti-FASII adaptation.
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Affiliation(s)
- Paprapach Wongdontree
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Aaron Millan-Oropeza
- PAPPSO Platform, Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | - Jennifer Upfold
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Jean-Pierre Lavergne
- Bacterial Pathogens and Protein Phosphorylation, Molecular Microbiology and Structural Biology, UMR 5086 - CNRS / Université de Lyon, Building IBCP, 7 Passage du Vercors, Lyon, France
| | - David Halpern
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Clara Lambert
- Université Paris Cité, Institut Cochin, INSERM, U1016, CNRS, UMR8104, Paris, France
| | - Adeline Page
- Protein Science Facility, SFR BioSciences, CNRS, UMS3444, INSERM US8, Université de Lyon, Lyon, France
| | - Gérald Kénanian
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Christophe Grangeasse
- Bacterial Pathogens and Protein Phosphorylation, Molecular Microbiology and Structural Biology, UMR 5086 - CNRS / Université de Lyon, Building IBCP, 7 Passage du Vercors, Lyon, France
| | - Céline Henry
- PAPPSO Platform, Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, Jouy-en-Josas, France
| | - Agnès Fouet
- Université Paris Cité, Institut Cochin, INSERM, U1016, CNRS, UMR8104, Paris, France
| | - Karine Gloux
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Jamila Anba-Mondoloni
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
| | - Alexandra Gruss
- Université Paris-Saclay, INRAE, AgroParisTech, Micalis Institute, 78350 Jouy-en-Josas, France
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Pejčić AV, Stefanović SM, Milosavljević MN, Janjić VS, Folić MM, Folić ND, Milosavljević JZ. Outcomes of long-acting injectable antipsychotics use in pregnancy: A literature review. World J Psychiatry 2024; 14:582-599. [DOI: 10.5498/wjp.v14.i4.582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/05/2024] [Accepted: 03/06/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Women with a history of serious psychotic disorders are at increased risk of disease relapse during pregnancy. Long-acting injectable (LAI) antipsychotics have been widely used to improve adherence and prevent relapse in patients with various severe psychotic disorders, but there is a lack of high-quality data from previous research on the safety of LAI antipsychotics during pregnancy.
AIM To summarize relevant data on maternal, pregnancy, neonatal, and developmental outcomes from published cases of LAI antipsychotic use in pregnancy.
METHODS A literature search was performed through November 11, 2023, using three online databases: PubMed/MEDLINE, Scopus, and Web of Science. Case reports or case series that reported information about the outcomes of pregnancy in women who used LAI antipsychotics at any point in pregnancy, with available full texts, were included. Descriptive statistics, narrative summation, and tabulation of the extracted data were performed.
RESULTS A total of 19 publications satisfied the inclusion criteria: 3 case series, 15 case reports, and 1 conference abstract. They reported the outcomes of LAI antipsychotic use in 74 women and 77 pregnancies. The use of second-generation LAI antipsychotics was reported in the majority (n = 47; 61.0%) of pregnancies. First-generation LAI antipsychotics were administered during 30 pregnancies (39.0%). Most of the women (approximately 64%) had either satisfactory control of symptoms or no information about relapse, while approximately 12% of them had developed gestational diabetes mellitus. A minority of cases reported adverse outcomes such as stillbirth, spontaneous abortion, preterm birth, low birth weight, congenital anomalies, and neurological manifestations in newborns. However, there were no reports of negative long-term developmental outcomes.
CONCLUSION Currently available data seem reassuring, but further well-designed studies are required to properly evaluate the risks and benefits of LAI antipsychotic use during pregnancy.
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Affiliation(s)
- Ana V Pejčić
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Srdjan M Stefanović
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
- Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac 34000, Serbia
| | - Miloš N Milosavljević
- Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Vladimir S Janjić
- Department of Psychiatry, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
- Clinic for Psychiatry, University Clinical Center Kragujevac, Kragujevac 34000, Serbia
| | - Marko M Folić
- Department of Clinical Pharmacology, University Clinical Center Kragujevac, Kragujevac 34000, Serbia
- Center for Pharmaceutical and Pharmacological Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
| | - Nevena D Folić
- Department of Pediatrics, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
- Pediatric Clinic, University Clinical Center Kragujevac, Kragujevac 34000, Serbia
| | - Jovana Z Milosavljević
- Department of Anatomy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac 34000, Serbia
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Ratliff HC, Yakusheva O, Boltey EM, Marriott DJ, Costa DK. Patterns of interactions among ICU interprofessional teams: A prospective patient-shift-level survey approach. PLoS One 2024; 19:e0298586. [PMID: 38625976 DOI: 10.1371/journal.pone.0298586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 01/28/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND The Awakening, Breathing Coordination, Delirium monitoring and Early mobility bundle (ABCDE) is associated with lower mortality for intensive care unit (ICU) patients. However, efforts to improve ABCDE are variably successful, possibly due to lack of clarity about who are the team members interacting when caring for each patient, each shift. Lack of patient shift-level information regarding who is interacting with whom limits the ability to tailor interventions to the specific ICU team to improve ABCDE. OBJECTIVE Determine the number and types of individuals (i.e., clinicians and family members) interacting in the care of mechanically ventilated (MV) patients, as reported by the patients' assigned physician, nurse, and respiratory therapist (RT) each shift, using a network science lens. METHODS We conducted a prospective, patient-shift-level survey in 2 medical ICUs. For each patient, we surveyed the assigned physician, nurse, and RT each day and night shift about who they interacted with when providing ABCDE for each patient-shift. We determined the number and types of interactions, reported by physicians, nurses, and RTs and day versus night shift. RESULTS From 1558 surveys from 404 clinicians who cared for 169 patients over 166 shifts (65% response rate), clinicians reported interacting with 2.6 individuals each shift (physicians: 2.65, nurses: 3.33, RTs: 1.86); this was fewer on night shift compared to day shift (1.99 versus 3.02). Most frequent interactions were with the bedside nurse, attending, resident, intern, and RT; family member interactions were reported in less than 1 in 5 surveys (12.2% of physician surveys, 19.7% of nurse surveys, 4.9% of RT surveys). INTERPRETATION Clinicians reported interacting with 3-4 clinicians each shift, and fewer on nights. Nurses interacted with the most clincians and family members. Interventions targeting shift-level teams, focusing on nurses and family members, may be a way to improve ABCDE delivery and ICU teamwork.
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Affiliation(s)
- Hannah C Ratliff
- School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
| | - Olga Yakusheva
- School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
- School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Emily M Boltey
- VA Pittsburgh Healthcare System, Pittsburgh, PA, United States of America
| | - Deanna J Marriott
- School of Nursing, University of Michigan, Ann Arbor, MI, United States of America
| | - Deena Kelly Costa
- School of Nursing, Yale University, West Haven, CT, United States of America
- Section of Pulmonary, Critical Care & Sleep Medicine, School of Medicine, Yale University, New Haven, CT, United States of America
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41
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Li H, Naqvi IA, Strobino K, Malhotra S. Clinical Telepharmacy: Addressing Care Gaps in Diabetes Management for an Underserved Urban Population Using a Collaborative Care Model. Telemed J E Health 2024. [PMID: 38621151 DOI: 10.1089/tmj.2023.0589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Introduction: Optimal chronic care management is limited by low health care access and health literacy among underserved populations. We introduced clinical pharmacy services to enhance our patient-centered home model, which serves mostly Medicare/Medicaid-insured patients. Primary care providers (PCP) refer patients with uncontrolled diabetes to the pharmacist for chronic disease management between PCP appointments to bring A1c to goal under a collaborative agreement. This workflow existed before the COVID-19 pandemic and was primarily in-person visits. Our model transitioned to telehealth, where pharmacy services continued via audio/video visits to avoid disruption in care. Methods: A collaborative scope of practice within care guidelines was developed with PCPs. Established patients with uncontrolled diabetes were referred to the clinical pharmacist. The workflow remained consistent through January 1, 2019 to January 31, 2020 (pre-COVID), and April 1, 2020 to October 31, 2021 (post-COVID). February and March 2020 were excluded due to changing operational processes at the pandemic onset. The pharmacist independently saw patients for medication-related interventions and ordered associated labs within the scope of practice. The program was retrospectively evaluated via process metrics (visit volume and intervention types) and clinical outcome (A1c reduction). Results: A total of 105 patients were referred for diabetes management during the study period. These were in-person pre-COVID (95%) and shifted to entirely audio/video (100%) post-COVID. Impact of pharmacy services was sustained through the change in care model: an A1c reduction of more than 0.5% was observed in 65% (n = 20) and 69% (n = 49) of patients managed by the pharmacist, pre- and post-COVID, respectively. Pharmacy visit volumes were 86 versus 308, respectively. Conclusion: Pharmacy referral and visit volumes increased over the pandemic, made possible via telehealth. The goal attainment rate observed pre-COVID was amplified even with the growth in services over time. Clinical pharmacy services delivered through audio/video telehealth visits may be equally effective compared to face-to-face services.
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Affiliation(s)
- Hanlin Li
- Department of Pharmacy, New York-Presbyterian Hospital, New York, New York, USA
| | - Imama A Naqvi
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Kevin Strobino
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Sujata Malhotra
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
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Li B, Chen XF, Wu HS, Su J, Ding YY, Zhang ZH, Rong M, Dong YJ, He X, Li LZ, Lv GY, Chen SH. The anti-hyperlipidemia effect of Atractylodes macrocephala Rhizome increased HDL via reverse cholesterol transfer. Heliyon 2024; 10:e28019. [PMID: 38560167 PMCID: PMC10979170 DOI: 10.1016/j.heliyon.2024.e28019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
Aim Atractylodes macrocephala Rhizome (AM) has been used to treat hyperlipidemia for centuries, but its functional components and mechanisms are not clear. This research aimed to investigate the active components in AM and the mechanisms that underlie its anti-hyperlipidemia effect. Methods SD rats were fed a high-sucrose high-fat diet in conjunction with alcohol (HSHFDAC) along with different AM extracts (AMW, AMO, AME, and AMP) for 4 weeks. AM's active components were analyzed using multiple databases, and their mechanisms were explored through network pharmacology. The relationship between AM's effect of enhancing serum HDL-c and regulating the expression of reverse cholesterol transport (RCT)-related proteins (Apo-A1, LCAT, and SR-BI) was further validated in the HSHFDAC-induced hyperlipidemic rats. The kidney and liver functions of the rats were measured to evaluate the safety of AM. Results AMO, mainly comprised of volatile and liposoluble components, contributed the most significant anti-hyperlipidemia effect among the four extracts obtained from AM, significantly improving the blood lipid profile. Network pharmacology analysis also suggested that volatile and liposoluble components, comprise AM's main active components and they might act on signaling pathways associated with elevated HDL-c. Validation experiments found that AMO substantially and dose-dependently increased HDL-c levels, upregulated the expression of Apo-A1, SR-BI, and LCAT, improved the pathological changes in the kidney and liver, and significantly reduced the serum creatinine levels in rats with hyperlipidemia. Conclusion The main anti-hyperlipidemia active components of AM are its volatile and liposoluble components, which may enhance serum HDL-c by increasing the expression of the RCT-related proteins Apo-A1, LCAT, and SR-BI.
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Affiliation(s)
- Bo Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou, Zhejiang Province, 313200, PR China
- Zhejiang Synergetic Traditional Chinese Medicine Research and Development Co., Ltd, Huzhou, Zhejiang, 313200, PR China
| | - Xian-fang Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Han-song Wu
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Jie Su
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Yan-yan Ding
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Ze-hua Zhang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Mei Rong
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Ying-jie Dong
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Xinglishang He
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Lin-zi Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
| | - Gui-yuan Lv
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, PR China
| | - Su-hong Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, PR China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, Huzhou, Zhejiang Province, 313200, PR China
- Zhejiang Synergetic Traditional Chinese Medicine Research and Development Co., Ltd, Huzhou, Zhejiang, 313200, PR China
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Hernández-Chico I, Rodríguez-Guerrero E, Expósito-Ruiz M, Navarro-Marí JM, Gutiérrez-Fernández J. Reliability of a Screening Method Using Antibiotic Disks to Detect Carbapenemases in Glucose-Nonfermenting Gram-Negative Microorganisms From Clinical Samples of a Regional Hospital in Southeastern Spain. J Clin Lab Anal 2024:e25036. [PMID: 38619303 DOI: 10.1002/jcla.25036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 03/20/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Infections by glucose-nonfermenting gram-negative bacilli (NFGNB) pose a major public health problem due to multiresistance to beta-lactam antibiotics, especially plasmid-borne carbapenemases. Their detection by microbiology laboratories is challenging, and there is a need for easy-to-use and reliable diagnostic techniques. Our objective was to evaluate an in-house screening method to presumptively detect carbapenemases in NFGNB in a simple and clinically useful manner. METHODS The study included 175 NFGNB isolates from urinary, respiratory, and rectal samples. In a triple assay, isolates were incubated at 37°C for 24 h on three solid-culture media: MacConkey II Agar, 5% Sheep Blood Columbia Agar and Mueller Hinton II Agar; meropenem (MEM) and cefepime (FEP) disks were employed for screening. Studies were then performed on the inhibition halo diameter, scanning effects, and the appearance of mutant colonies, which were compared with those observed using the colorimetric Neo-Rapid CARB Kit and immunochromatography (NG5-Test Carba and K-Set for OXA-23). Receiver operating characteristic curves were constructed for these data. RESULTS Carbapenemases were expressed by 79/175 (45.1%): 19 Pseudomonas aeruginosa and 60 Acinetobacter baumannii. Optimal inhibition halo diameter cutoffs to detect this resistance on 5% sheep blood agar were as follows: 6 mm (MEM) and 6.5 mm (FEP) for P. aeruginosa (in the absence of scanning effects and mutations) and 10.5 mm (MEM) and 16 mm (FEP) for A. baumannii (even in the presence of scanning effects). CONCLUSION The combined utilization of MEM and FEP antibiotic disks in 5% sheep blood agar, measuring their inhibition haloes, offers an effective method to predict the presence of carbapenemases as resistance mechanism in P. aeruginosa and A. baumannii.
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Affiliation(s)
- Itahisa Hernández-Chico
- Departmento de Microbiología, Facultad de Medicina, Universidad de Granada-Instituto de Investigación Biosanitaria, Granada, Spain
| | - Enrique Rodríguez-Guerrero
- Departmento de Microbiología, Hospital Universitario Virgen de las Nieves-Instituto de Investigación Biosanitaria, Granada, Spain
| | - Manuela Expósito-Ruiz
- Departmento de Estadística, Facultad de Medicina, University of Granada-Instituto de Investigación Biosanitaria, Granada, Spain
| | - José María Navarro-Marí
- Departmento de Microbiología, Hospital Universitario Virgen de las Nieves-Instituto de Investigación Biosanitaria, Granada, Spain
| | - José Gutiérrez-Fernández
- Departmento de Microbiología, Facultad de Medicina, Universidad de Granada-Instituto de Investigación Biosanitaria, Granada, Spain
- Departmento de Microbiología, Hospital Universitario Virgen de las Nieves-Instituto de Investigación Biosanitaria, Granada, Spain
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Boroughani M, Tahmasbi Z, Heidari MM, Johari M, Hashempur MH, Heydari M. Potential therapeutic effects of green tea ( Camellia sinensis) in eye diseases, a review. Heliyon 2024; 10:e28829. [PMID: 38601618 PMCID: PMC11004586 DOI: 10.1016/j.heliyon.2024.e28829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/08/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
This review aims to evaluate the therapeutic potential of green tea (GT), scientifically named Camellia sinensis, in treating eye diseases. We provide an overview of the ingredients and traditional use of Camellia sinensis, followed by a detailed discussion of its therapeutic uses in various eye diseases, including ocular surface diseases (allergic diseases, dry eye, pterygium, and infections), cataract, glaucoma, uveitis, retinal diseases, and optic nerve diseases. The pharmacologic activities related to ocular diseases, such as anti-vascular endothelial growth factor, aldose reductase inhibitor activity, anti-bacterial, anti-inflammatory, and antioxidant effects are also explored in this review. The dose and route of administration of GT in various studies are discussed. Safety issues related to the use of GT, such as the side effects associated with high doses and long-term use, are also addressed. The review highlights the potential of GT as a natural therapeutic agent for a variety of ocular diseases. Its various pharmacologic activities make it a promising treatment option. However, more well-designed studies are needed to determine the optimal dose and route of administration and to assess its long-term safety and efficacy. Overall, GT appears to be a promising adjunct therapy for various ocular diseases.
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Affiliation(s)
- Mohadese Boroughani
- Student research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Tahmasbi
- Student research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammadkarim Johari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hashem Hashempur
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Fadl Elmula FEM, Mariampillai JE, Heimark S, Kjeldsen SE, Burnier M. Medical Measures in Hypertensives Considered Resistant. Am J Hypertens 2024; 37:307-317. [PMID: 38124494 PMCID: PMC11016838 DOI: 10.1093/ajh/hpad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Patients with resistant hypertension are the group of hypertensive patients with the highest cardiovascular risk. METHODS All rules and guidelines for treatment of hypertension should be followed strictly to obtain blood pressure (BP) control in resistant hypertension. The mainstay of treatment of hypertension, also for resistant hypertension, is pharmacological treatment, which should be tailored to each patient's specific phenotype. Therefore, it is pivotal to assess nonadherence to pharmacological treatment as this remains the most challenging problem to investigate and manage in the setting of resistant hypertension. RESULTS Once adherence has been confirmed, patients must be thoroughly worked-up for secondary causes of hypertension. Until such possible specific causes have been clarified, the diagnosis is apparent treatment-resistant hypertension (TRH). Surprisingly few patients remain with true TRH when the various secondary causes and adherence problems have been detected and resolved. Refractory hypertension is a term used to characterize the treatment resistance in hypertensive patients using ≥5 antihypertensive drugs. All pressor mechanisms may then need blockage before their BPs are reasonably controlled. CONCLUSIONS Patients with resistant hypertension need careful and sustained follow-up and review of their medications and dosages at each term since medication adherence is a very dynamic process.
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Affiliation(s)
- Fadl Elmula M Fadl Elmula
- Division of Medicine, Ullevaal University Hospital, Cardiorenal Research Centre, Oslo, Norway
- Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, KSA
| | | | - Sondre Heimark
- Division of Medicine, Ullevaal University Hospital, Cardiorenal Research Centre, Oslo, Norway
- Medical Faculty, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nephrology, Ullevaal University Hospital, Oslo, Norway
| | - Sverre E Kjeldsen
- Division of Medicine, Ullevaal University Hospital, Cardiorenal Research Centre, Oslo, Norway
- Medical Faculty, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Ullevaal University Hospital, Oslo, Norway
| | - Michel Burnier
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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Yao Z, Xiao Y, Li W, Kong S, Tu H, Guo S, Liu Z, Ma L, Qiao R, Wang S, Chang M, Zhao X, Zhang Y, Xu L, Sun D, Fu X. FDA-Approved Tedizolid Phosphate Prevents Cisplatin-Induced Hearing Loss Without Decreasing Its Anti-tumor Effect. J Assoc Res Otolaryngol 2024:10.1007/s10162-024-00945-2. [PMID: 38622383 DOI: 10.1007/s10162-024-00945-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/04/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE Cisplatin is a low-cost clinical anti-tumor drug widely used to treat solid tumors. However, its use could damage cochlear hair cells, leading to irreversible hearing loss. Currently, there appears one drug approved in clinic only used for reducing ototoxicity associated with cisplatin in pediatric patients, which needs to further explore other candidate drugs. METHODS Here, by screening 1967 FDA-approved drugs to protect cochlear hair cell line (HEI-OC1) from cisplatin damage, we found that Tedizolid Phosphate (Ted), a drug indicated for the treatment of acute infections, had the best protective effect. Further, we evaluated the protective effect of Ted against ototoxicity in mouse cochlear explants, zebrafish, and adult mice. The mechanism of action of Ted was further explored using RNA sequencing analysis and verified. Meanwhile, we also observed the effect of Ted on the anti-tumor effect of cisplatin. RESULTS Ted had a strong protective effect on hair cell (HC) loss induced by cisplatin in zebrafish and mouse cochlear explants. In addition, when administered systemically, it protected mice from cisplatin-induced hearing loss. Moreover, antitumor studies showed that Ted had no effect on the antitumor activity of cisplatin both in vitro and in vivo. RNA sequencing analysis showed that the otoprotective effect of Ted was mainly achieved by inhibiting phosphorylation of ERK. Consistently, ERK activator aggravated the damage of cisplatin to HCs. CONCLUSION Collectively, these results showed that FDA-approved Ted protected HCs from cisplatin-induced HC loss by inhibiting ERK phosphorylation, indicating its potential as a candidate for preventing cisplatin ototoxicity in clinical settings.
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Affiliation(s)
- Zhiwei Yao
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
| | - Yu Xiao
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
- School of Life Science, Shandong University, Qingdao, 266237, China
| | - Wen Li
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China.
| | - Shuhui Kong
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, 250000, China
| | - Hailong Tu
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
| | - Siwei Guo
- School of Life Science, Shandong University, Qingdao, 266237, China
| | - Ziyi Liu
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
| | - Lushun Ma
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
| | - Ruifeng Qiao
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, 250000, China
| | - Song Wang
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Miao Chang
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China
| | - Xiaoxu Zhao
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Yuan Zhang
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China
| | - Lei Xu
- Department of Otolaryngology-Head and Neck Surgery, Shandong Provincial ENT Hospital, Shandong University, Jinan, 250000, China.
| | - Daqing Sun
- Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin Medical University, No. 154 Anshan Road, Heping District, Tianjin, 300052, China.
| | - Xiaolong Fu
- Medical Science and Technology Innovation Center, Shandong First Medical University, Jinan, 250117, China.
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Yang S, Yang X, Hou Z, Zhu L, Yao Z, Zhang Y, Chen Y, Teng J, Fang C, Chen S, Jia M, Liu Z, Kang S, Chen Y, Li G, Niu Y, Cai Q. Rationale for immune checkpoint inhibitors plus targeted therapy for advanced renal cell carcinoma. Heliyon 2024; 10:e29215. [PMID: 38623200 PMCID: PMC11016731 DOI: 10.1016/j.heliyon.2024.e29215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
Renal cell carcinoma (RCC) is a frequent urological malignancy characterized by a high rate of metastasis and lethality. The treatment strategy for advanced RCC has moved through multiple iterations over the past three decades. Initially, cytokine treatment was the only systemic treatment option for patients with RCC. With the development of medicine, antiangiogenic agents targeting vascular endothelial growth factor and mammalian target of rapamycin and immunotherapy, immune checkpoint inhibitors (ICIs) have emerged and received several achievements in the therapeutics of advanced RCC. However, ICIs have still not brought completely satisfactory results due to drug resistance and undesirable side effects. For the past years, the interests form researchers have been attracted by the combination of ICIs and targeted therapy for advanced RCC and the angiogenesis and immunogenic tumor microenvironmental variations in RCC. Therefore, we emphasize the potential principle and the clinical progress of ICIs combined with targeted treatment of advanced RCC, and summarize the future direction.
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Affiliation(s)
- Siwei Yang
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Xianrui Yang
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zekai Hou
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Liang Zhu
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhili Yao
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | | | - Yanzhuo Chen
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jie Teng
- Affiliated Hospital of Hebei University, Baoding, China
| | - Cheng Fang
- Taihe County People's Hospital, Anhui, China
| | - Songmao Chen
- Department of Urology, Fujian Provincial Hospital, Fujian, China
- Provincial Clinical Medical College of Fujian Medical University, Fujian, China
| | - Mingfei Jia
- Department of Urology, North China University of Science and Technology Affiliated Hospital, Hebei, China
| | - Zhifei Liu
- Department of Urology, Tangshan People's Hospital, Hebei, China
| | - Shaosan Kang
- Department of Urology, North China University of Science and Technology Affiliated Hospital, Hebei, China
| | - Yegang Chen
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Gang Li
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Yuanjie Niu
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiliang Cai
- Department of Urology, Tianjin Institute of Urology, Second Hospital of Tianjin Medical University, Tianjin, China
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Bourneau-Martin D, Grandvuillemin A, Babin M, Mullet C, Said H, Cellier M, Geniaux H, Gautier S, Beurrier M, Veyrac G, Lagarce L, Laroche ML, Briet M. Adverse drug effect in the context of drug shortage: the CIRUPT prospective study from the French pharmacovigilance network. Eur J Hosp Pharm 2024:ejhpharm-2023-004047. [PMID: 38621957 DOI: 10.1136/ejhpharm-2023-004047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVES Drug shortages are of increasing concern to worldwide public health. The consequences of drug shortages for patient safety have been little studied, especially from a pharmacovigilance point of view. In this context, the network of French pharmacovigilance centres conducted the CIRUPT study (Conséquences Iatrogènes des RUPTures de stock/iatrogenic consequences of drug shortages) based on a prospective campaign of adverse effects occurring in the context of drug shortage notifications. METHODS All notifications involving a shortage drug submitted to the French pharmacovigilance centres between 1 January 2020 and 30 June 2021 were collected and registered in the French national pharmacovigilance database with the standardised high level term 'product supply and availability issues' and with predefined keywords in the narrative section. RESULTS 224 cases were included, involving mainly adverse drug reactions (ADRs) (n=131/224, 59%) and medication errors (n=51/224, 23%); 29% of the cases were serious. The most represented classes of shortage drugs were: vaccines (n=78/224, 35%); drugs for acid-related disorders (H2-receptor antagonists) (n=27/224, 12%); antineoplastic agents (n=17/224, 8%); and antiepileptics (n=15/224, 7%). In 82% of cases, the involved shortage drug was the subject of information delivered to health professionals by the National Agency for the Safety of Medicines and Health Products. Drug shortages were associated with an ADR related to replacement drugs in 59% (n=131/224) of the cases, drug inefficacy in 18% (n=41/224), and/or an aggravation of the underlying disease in 11% (n=25/224). CONCLUSIONS From a pharmacovigilance point of view, a large diversity of anatomical therapeutic classes is involved and the risk related to drug shortages is not limited to drugs registered on 'major therapeutic interest or essential drug' lists. Information from health agencies is not sufficient to avoid the risks, and further strategies should be developed.
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Affiliation(s)
- Delphine Bourneau-Martin
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Aurelie Grandvuillemin
- Centre Regional de Pharmacovigilance, University Hospital Centre Dijon Bourgogne, Dijon, Bourgogne-Franche-Comté, France
| | - Marina Babin
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Charlotte Mullet
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Hillary Said
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Morgane Cellier
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Helene Geniaux
- Centre Regional de Pharmacovigilance, University Hospital Centre of Limoges, Limoges, Nouvelle-Aquitaine, France
| | - Sophie Gautier
- Centre Régional de Pharmacovigilance, Lille University Hospital, Lille, Hauts-de-France, France
| | - Mathilde Beurrier
- Centre Régional de Pharmacovigilance, Nancy University Hospital Center, Nancy, Grand Est, France
| | - Gwenaelle Veyrac
- Centre Regional de Pharmacovigilance, University Hospital Centre Nantes, Nantes, Pays de la Loire, France
| | - Laurence Lagarce
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
| | - Marie-Laure Laroche
- Centre Régional de Pharmacovigilance, University Hospital Centre of Limoges, Limoges, Nouvelle-Aquitaine, France
| | - Marie Briet
- Department of Pharmacology-Toxicology and Pharmacovigilance, University Hospital Centre Angers, Angers, Pays de la Loire, France
- UMR CNRS 6015, Inserm U1083, Unité MitoVasc, Team Carme, SFR ICAT, University of Angers, Angers, Pays de la Loire, France
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Poutrain E, Abelé-Naveau M, Baltora M, Villain A, Sakji I, Strobbe G, Marliot G. Securing the oral and enteral oncopediatric chemotherapy process in pediatric oncology: Introduction of the ENFit™ standard in a controlled-atmosphere area and implementation of a dispensing service of medications to outpatients circuit with advice on proper use. J Oncol Pharm Pract 2024:10781552241241062. [PMID: 38613327 DOI: 10.1177/10781552241241062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Oral chemotherapies pediatrics are manufactured from injectable specialties in a controlled-atmosphere area. Packaged in Luer-Lock syringes, the transition to an ENFit™ connector became crucial to enable administration in surveyed patients. In parallel, a study was carried out to optimize and secure patient care by setting up a retrocession circuit. OBJECTIVE To introduce the ENFit™ range of devices into the manufacturing process for oral or enteral chemotherapy syringes. Secondly, establish a retrocession circuit, validate its economic relevance and implement and evaluate efforts to promote proper use. METHODS ENFit™ meeting the specifications were sourced and then evaluated. Research was conducted on the legislative framework governing the retrocession of masterful preparations made from injectable specialties. A 2021 retrospective economic study enabled the assessment of the financial balance generated by a potential retrocession circuit. Meetings to promote the good use of medication were conducted. Satisfaction questionnaires were created for caregivers and medical staff in the pediatric department. RESULTS All ENFit™ ranges have been referenced within the Fresenius laboratory. Retrocession has been set up in accordance with legislation. The economic study highlighted a potential revenue of EUR 69,900 in 2021. Three good-use booklets and a dosage plan were created to promote good use. Ten families and 12 caregivers responded to the questionnaire, with satisfaction rates of 81.1% and 71.9%, respectively. CONCLUSION ENFit™ devices has enabled oral and enteral administration of chemotherapy. The retrocession circuit includes all the good-use elements required for optimal patient care. The results of the satisfaction survey are positive, certain areas for improvement have been identified.
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Affiliation(s)
- Elise Poutrain
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
| | - Marie Abelé-Naveau
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
| | | | - Alexandre Villain
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
| | - Ilyes Sakji
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
| | - Geoffrey Strobbe
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
| | - Guillaume Marliot
- Pôle Produits de Santé, service de Pharmacie, Centre Oscar Lambret, Lille, France
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White CM, Cazares S, Gonzalez-Cortes ED, Driver TG. Iodine(III)-Catalyzed Oxidative Cyclization of Aryl Amines to Construct N-Alkylbenzimidazoles. J Org Chem 2024. [PMID: 38613505 DOI: 10.1021/acs.joc.4c00346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Abstract
An I(III)-catalyzed oxidative cyclization reaction using selectfluor as the oxidant was developed that converts ortho-substituted anilines to benzimidazoles. The mild reaction requires as little as 0.5 mol % of iodobenzene, and its scope is broad: electron-withdrawing or electron-releasing groups on the aniline portion are tolerated, and cyclic or acyclic N-alkylamines are permitted as ortho-substituents. Preliminary mechanistic investigations suggest that benzimidazole formation occurs via cationic reactive intermediates, and an intramolecular kinetic isotope effect of 1.98 ± 0.05 was measured.
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Affiliation(s)
- Carmen Margaret White
- Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, Chicago, Illinois 60607-7061, United States
| | - Sherlyn Cazares
- Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, Chicago, Illinois 60607-7061, United States
| | - Efren D Gonzalez-Cortes
- Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, Chicago, Illinois 60607-7061, United States
| | - Tom G Driver
- Department of Chemistry, University of Illinois at Chicago, 845 West Taylor Street, Chicago, Illinois 60607-7061, United States
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