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Albin CSW, Cunha CB, Glaser TP, Schachter M, Snow JW, Oto B. The Approach to Altered Mental Status in the Intensive Care Unit. Semin Neurol 2024. [PMID: 39137901 DOI: 10.1055/s-0044-1788894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
Altered mental status (AMS) is a syndrome posing substantial burden to patients in the intensive care unit (ICU) in both prevalence and intensity. Unfortunately, ICU patients are often diagnosed merely with syndromic labels, particularly the duo of toxic-metabolic encephalopathy (TME) and delirium. Before applying a nonspecific diagnostic label, every patient with AMS should be evaluated for specific, treatable diseases affecting the central nervous system. This review offers a structured approach to increase the probability of identifying specific causal etiologies of AMS in the critically ill. We provide tips for bedside assessment in the challenging ICU environment and review the role and yield of common neurodiagnostic procedures, including specialized bedside modalities of diagnostic utility in unstable patients. We briefly review two common etiologies of TME (uremic and septic encephalopathies), and then review a selection of high-yield toxicologic, neurologic, and infectious causes of AMS in the ICU, with an emphasis on those that require deliberate consideration as they elude routine screening. The final section lays out an approach to the various etiologies of AMS in the critically ill.
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Affiliation(s)
| | - Cheston B Cunha
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Rhode Island Hospital, Providence, Rhode Island
| | - Timlin P Glaser
- University of Arizona College of Medicine, Phoenix, Arizona
- Banner University Medical Center, Phoenix, Arizona
| | | | - Jerry W Snow
- University of Arizona College of Medicine, Phoenix, Arizona
- Banner University Medical Center, Phoenix, Arizona
| | - Brandon Oto
- sBridgeport Hospital, Yale New Haven Health, Bridgeport, Connecticut
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2
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Alqarni M, Iqbal M, Foudah AI, Aljarba TM, Abdel Bar F, Alshehri S, Shakeel F, Alam P. Quantification of Suvorexant in Human Urine Using a Validated HPTLC Bioanalytical Method. ACS OMEGA 2023; 8:39928-39935. [PMID: 37901579 PMCID: PMC10601068 DOI: 10.1021/acsomega.3c07123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
Suvorexant (SUV) is a new sedative/hypnotic medicine that is recommended to treat insomnia. It is an important medicine from a forensic point of view due to its sedative/hypnotic and depressant effects. To the best of our knowledge, high-performance thin-layer chromatography (HPTLC) bioanalytical methods have not been published to measure SUV in human urine and pharmaceutical samples. Accordingly, this study was designed and validated a sensitive and rapid bioanalytical HPTLC method to determine SUV in human urine samples for the very first time. The densitometric measurement of SUV and the internal standard (IS; sildenafil) was performed on glass-coated silica gel normal-phase-60F254S TLC plates using a mixture of chloroform and methanol (97.5:2.5 v/v) as the eluent system. Both the SUV and IS were detected at a wavelength of 254 nm. Both analytes were extracted using the protein precipitation technique utilizing methanol as the solvent. For the IS and SUV, the Rf values were 0.09 and 0.45, respectively. The proposed bioanalytical method for SUV was linear in the 50-1600 ng/band range. The current bioanalytical technique was linear, precise (% RSD = 3.28-4.20), accurate (% recovery = 97.58-103.80), robust (% recovery = 95.31-102.34 and % RSD = 2.81-3.15), rapid, and sensitive (LOD = 3.73 ng/band and LOQ = 11.20 ng/band). These findings suggested that the current bioanalytical method can be regularly used to determine SUV in wide varieties of urine samples.
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Affiliation(s)
- Mohammed
H. Alqarni
- Department
of Pharmacognosy, College of Pharmacy, Prince
Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Muzaffar Iqbal
- Department
of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Ahmed I. Foudah
- Department
of Pharmacognosy, College of Pharmacy, Prince
Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Tariq M. Aljarba
- Department
of Pharmacognosy, College of Pharmacy, Prince
Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Fatma Abdel Bar
- Department
of Pharmacognosy, College of Pharmacy, Prince
Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Sultan Alshehri
- Department
of Pharmaceutical Sciences, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia
| | - Faiyaz Shakeel
- Department
of Pharmaceutics, College of Pharmacy, King
Saud University, Riyadh 11451, Saudi Arabia
| | - Prawez Alam
- Department
of Pharmacognosy, College of Pharmacy, Prince
Sattam bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
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Qi H, Liu R, Zhou J, Feng Y, Feng L, Feng Z, Yan F. Investigating sleep quality and sleep hygiene awareness among Chinese adults: an association and network analysis study. Sleep Breath 2023; 27:2049-2058. [PMID: 36869169 PMCID: PMC9984285 DOI: 10.1007/s11325-023-02798-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE The relationships between sleep quality and sleep hygiene awareness in the Chinese population were unclear. We aimed to investigate the associations and related factors between sleep quality and sleep hygiene awareness in adults and to identify the most central domain for sleep quality using network analysis. METHODS A cross-sectional survey was conducted from April 22 to May 5, 2020. Adults (18 years old or above) who had access to smartphones were invited to participate in this survey. The Pittsburg Sleep Quality Index (PSQI) and the Sleep Hygiene Awareness and Practice Scale (SHAPS) were used to evaluate the sleep quality and sleep hygiene awareness of the participants. Propensity score matching (PSM) was used as sensitivity analysis to reduce the confounding effects. Multiple logistic regression was performed to evaluate the associations. The R packages "bootnet" and "qgraph" were used to estimate the connection and calculate the network centrality indices between good and poor sleepers. RESULTS In total, 939 respondents were included in the analysis. Of them, 48.8% (95% CI: 45.6-52.0%) were identified as poor sleepers. Participants with nervous system diseases, psychiatric diseases, and psychological problems were more likely to have poor sleep quality. The notion that using sleep medication regularly was beneficial to sleep was associated with poor sleep quality. Similarly, the notion that waking up at the same time each day disrupted sleep was also associated with poor sleep quality. The findings were consistent before and after PSM. Subjective sleep quality was the most central domain for sleep quality in good and poor sleepers. CONCLUSION Poor sleep quality was positively associated with certain sleep hygiene notions in Chinese adults. Effective measures such as self-relief, sleep hygiene education, and cognitive behavioral treatment may have been needed to improve sleep quality, especially during the COVID-19 outbreak.
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Affiliation(s)
- Han Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
- Department of Epidemiology and Health Statistics, School of Public Health, and Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Rui Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Jia Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Lei Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Zizhao Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China
| | - Fang Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China.
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Yence M, Cetinkaya A, Kaya SI, Ozkan SA. Recent Developments in the Sensitive Electrochemical Assay of Common Opioid Drugs. Crit Rev Anal Chem 2022; 54:882-895. [PMID: 35853096 DOI: 10.1080/10408347.2022.2099732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Opioids are a class of drugs used to treat moderate to severe pain and have short-term adverse effects. Nevertheless, they are considered necessary for pain management. However, well-known hazards are connected with an opioid prescription, such as overuse, addiction, and overdose deaths. For example, the death rate from opioid analgesic poisoning in the USA approximately doubled, owing to the overuse and addiction of opioid analgesics. Also, opioids are a very important group of analytes in forensic chemistry, so it is necessary to use reliable, fast, and sensitive analytical tools to determine opioid analgesics. This review focuses on the opioid overdose crisis, the properties of commonly used opioid drugs, their mechanism, effects, and some chromatographic and spectroscopic detection methods are explained briefly. Then most essentially recent developments covering the last ten years in the sensitive electrochemical methods of common opioid analgesics, their innovations and features, and future research directions are presented.
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Affiliation(s)
- Merve Yence
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - Ahmet Cetinkaya
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
| | - S Irem Kaya
- Department of Analytical Chemistry, Gulhane Faculty of Pharmacy, University of Health Sciences, Ankara, Turkey
| | - Sibel A Ozkan
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkey
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Fu T, Shen J, Meng Y, Wang J, Wang S, Zhang Y, Wang T, Zhang X. Automatic Detoxification Medicine Delivery by Thermo-Sensitive Poly(ethylene glycol)-Based Nanogels. Polymers (Basel) 2022; 14:892. [PMID: 35267715 PMCID: PMC8912541 DOI: 10.3390/polym14050892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
During the medication-assisted treatment of drug abuse, side effects and addiction liabilities are commonly observed. Thus, control of the medication dose is very important. According to body temperature abnormalities in drug abusers, a thermo-sensitive nanogel was synthesized as a drug carrier to automatically deliver detoxification medicines. This nanogel was prepared through the synthesis of polystyrene (PS) core microspheres, followed by coverage with a nonlinear poly(ethylene glycol)-based copolymer shell. The PS core microspheres were found to be an ideal hydrophobic core for loading the detoxification medicines effectively. The nonlinear poly(ethylene glycol)-based copolymer shell layer consisted of 2-(2-methoxyethoxy)ethyl methacrylate (MEO2MA) and oligo(ethylene glycol) methyl ether methacrylates (Mn = 300 g mol-1, MEO5MA). The monomer feeding molar ratio n(MEO2MA)/n(MEO5MA) of 1:3 enabled PS@P(MEO2MA-co-MEO5MA) nanogels to exhibit a distinguished colloidal stability and an adjustable volume phase transition temperature which is within the drug addicts' abnormally fluctuating temperature range. Importantly, it was found that the obtained PS@P(MEO2MA-co-MEO5MA) nanogels displayed good biocompatibility with rat aortic endothelial cells in the given concentration range. The nanogels also exhibited a satisfactory loading efficiency and thermo-sensitive/sustained release characteristics for three detoxification medicines: sinomenine, diltiazem and chlorpromazine.
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Affiliation(s)
- Ting Fu
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Jing Shen
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Yuting Meng
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Jun Wang
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Siping Wang
- Institute of Education, China Democratic League (Yunnan), Kunming 650228, China;
| | - Yuhui Zhang
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Tongwen Wang
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
| | - Xufeng Zhang
- College of Chemistry and Chemical Engineering, Yunnan Normal University, Kunming 650500, China; (T.F.); (Y.M.); (J.W.); (Y.Z.); (T.W.)
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Almeida-González M, Boada LD, Henríquez-Hernández LA, Luzardo OP, Zaragoza E, Burillo-Putze G, Quintana-Montesdeoca MP, Zumbado M. Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain. TOXICS 2022; 10:toxics10020064. [PMID: 35202250 PMCID: PMC8876624 DOI: 10.3390/toxics10020064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 12/21/2022]
Abstract
Medical psychotropics are widely used and prescribed in developed countries. These medications may have an impairing effect on mood or perception and may induce harmful behaviors. Nevertheless, in Europe, studies on their importance from a medico-legal perspective are scarce. To fill this gap, we evaluate the determinants of these drugs in a retrospective study based on data obtained from forensic autopsies. Toxicological analyses were performed on 394 blood samples from compulsory autopsies at the Institute of Legal Medicine of Las Palmas. Of the samples, 41% (159) were positive for at least one psychotropic, with benzodiazepines being the most frequently detected (24.1%), followed by opiates and antidepressants. Benzodiazepines, opiates, and antidepressants were detected more frequently in men who suffered a violent death. More than 30% of the positive samples showed two or more drugs, suggesting a prevalence of polypharmacy among forensic autopsy subjects, with the most frequently combination found being benzodiazepines plus opiates (28.3% of positive samples). A combination of opiates plus antidepressants was also found in subjects involved in violent deaths. Our results suggest that more than 40% of the adult European population involved in medico-legal issues may be under the influence of legal psychotropics. The link between violent deaths and the use of medical psychotropics is particularly worrisome and indicates that these drugs should be carefully monitored in developed countries, in all forensic autopsies, in a similar way to illegal psychotropics.
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Affiliation(s)
- Maira Almeida-González
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Luis D. Boada
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Luis Alberto Henríquez-Hernández
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
- Correspondence: ; Tel.: +34-928-451-461
| | - Octavio P. Luzardo
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Enrique Zaragoza
- Institute of Legal Medicine of Las Palmas, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (M.A.-G.); (L.D.B.); (E.Z.)
| | - Guillermo Burillo-Putze
- Emergency Department, Hospital Universitario de Canarias, Carretera Ofra S/N, 38320 San Cristóbal de La Laguna, Spain;
| | - María P. Quintana-Montesdeoca
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
| | - Manuel Zumbado
- Toxicology Unit, Research Institute of Biomedical and Health Sciences (IUIBS), Universidad de Las Palmas de Gran Canaria, Paseo Blas Cabrera s/n, 35016 Las Palmas de Gran Canaria, Spain; (O.P.L.); (M.P.Q.-M.); (M.Z.)
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Crescioli G, Boscia E, Bettiol A, Pagani S, Spada G, Vighi GV, Bonaiuti R, Venegoni M, Vighi GD, Vannacci A, Lombardi N. Risk of Hospitalization for Adverse Drug Events in Women and Men: A Post Hoc Analysis of an Active Pharmacovigilance Study in Italian Emergency Departments. Pharmaceuticals (Basel) 2021; 14:ph14070678. [PMID: 34358104 PMCID: PMC8308702 DOI: 10.3390/ph14070678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 12/30/2022] Open
Abstract
This post hoc analysis of an Italian active pharmacovigilance study describes pharmacological differences of ADEs leading to emergency department (ED) visits and hospitalization in women and men. During the study period (January 2007-December 2018), 61,855 reports of ADEs leading to ED visits were collected. Overall, 30.6% of ADEs resulted in hospitalization (30% in women and 31% in men). Multivariate logistic regression showed that, among women, drug classes significantly associated with an increased risk of hospitalization were heparins (ROR 1.41, CI 1.13-176), antidepressants (ROR 1.12, CI 1.03-1.23) and antidiabetics (ROR 1.13, CI 1.02-1.24). Among men, only vitamin K antagonists (ROR 1.28, CI 1.09-1.50), opioids (ROR 1.30, CI 1.06-1.60) and digitalis glycosides (ROR 1.32, CI 1.09-1.59) were associated with a higher risk of hospitalization. Overall, older age, multiple suspected drugs and the presence of comorbidities were significantly associated with a higher risk of hospitalization. A significantly reduced risk of hospitalization was observed in both women and men experiencing an adverse event following immunization (ROR 0.36, CI 0.27-0.48 and 0.83, 0.42-0.74, respectively) compared to drugs. Results obtained from this real-world analysis highlight important aspects of drug safety between sexes.
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Affiliation(s)
- Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (G.C.); (E.B.); (R.B.); (A.V.)
- Tuscan Regional Center of Pharmacovigilance, 50122 Florence, Italy
| | - Ennio Boscia
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (G.C.); (E.B.); (R.B.); (A.V.)
| | - Alessandra Bettiol
- Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy;
| | - Silvia Pagani
- Internal Medicine, Medical Department, Vimercate Hospital, ASST di Vimercate, 20871 Vimercate, Italy; (S.P.); (G.S.); (G.V.V.); (G.D.V.)
| | - Giulia Spada
- Internal Medicine, Medical Department, Vimercate Hospital, ASST di Vimercate, 20871 Vimercate, Italy; (S.P.); (G.S.); (G.V.V.); (G.D.V.)
| | - Giuditta Violetta Vighi
- Internal Medicine, Medical Department, Vimercate Hospital, ASST di Vimercate, 20871 Vimercate, Italy; (S.P.); (G.S.); (G.V.V.); (G.D.V.)
| | - Roberto Bonaiuti
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (G.C.); (E.B.); (R.B.); (A.V.)
- Joint Laboratory of Technological Solutions for Clinical Pharmacology, Pharmacovigilance and Bioinformatics, University of Florence, 50139 Florence, Italy
| | - Mauro Venegoni
- Pharmacology Unit, Department of Diagnostics and Public Health, University of Verona, 37100 Verona, Italy;
| | - Giuseppe Danilo Vighi
- Internal Medicine, Medical Department, Vimercate Hospital, ASST di Vimercate, 20871 Vimercate, Italy; (S.P.); (G.S.); (G.V.V.); (G.D.V.)
| | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (G.C.); (E.B.); (R.B.); (A.V.)
- Tuscan Regional Center of Pharmacovigilance, 50122 Florence, Italy
- Joint Laboratory of Technological Solutions for Clinical Pharmacology, Pharmacovigilance and Bioinformatics, University of Florence, 50139 Florence, Italy
| | - Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50139 Florence, Italy; (G.C.); (E.B.); (R.B.); (A.V.)
- Tuscan Regional Center of Pharmacovigilance, 50122 Florence, Italy
- Correspondence: ; Tel.: +39-055-27-58-206
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