Pharmacy is an important subfield of the medical sciences,and its development is inseparable from pharmacy education.Pharmacy education outputs indispensable professionals and expertise for the healthcare industry,pro...Pharmacy is an important subfield of the medical sciences,and its development is inseparable from pharmacy education.Pharmacy education outputs indispensable professionals and expertise for the healthcare industry,promotes the development of pharmacy skills,and supports the development of the pharmaceutical and health sectors.To this end,many insightful studies have been carried out to promote the development and progress of pharmacy education.These studies have been published in high-quality pharmacy education journals indexed in the Web of Science Core Collection(WoSCC),and the two journals with the largest number of published articles are the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning.The 200 most-cited papers historically in these two journals have a significant impact on the research paradigm and future directions in the field of pharmacy education.Therefore,this paper summarizes the knowledge domains of these 200 papers and uses the scientometric method to study their basic information,authorship distribution,citation performance,publishing paradigm and hotspot mining.The era of Holistic Integrative Pharmacy(HIP),in which the focus has shifted from isolated pharmacological interventions to more collaborative,patient-centered,and interdisciplinary approaches,underscores the importance of evolving educational methodologies.In this context,understanding the scientometric trends in pharmacy education becomes even more crucial.This study aims to explore the current development status of pharmacy education,develop more innovative and effective educational models,and promote the widespread application of HIP in pharmacy education.The goal is to enhance the overall quality of pharmacy education and provide guidance and insights for the future development of pharmacy education.展开更多
Pharmacy clinics,staffed by clinical pharmacists who interact directly with patients,encompass services such as medication reconciliation,education,follow-up visits,and lifestyle guidance.Their primary goal is to enha...Pharmacy clinics,staffed by clinical pharmacists who interact directly with patients,encompass services such as medication reconciliation,education,follow-up visits,and lifestyle guidance.Their primary goal is to enhance patients’quality of life.Numerous studies,both domestic and international,have highlighted the benefits of pharmacy clinics in optimizing drug therapy quality and reducing treatment costs,particularly for long-term medication management in organ transplant recipients and similar patient groups.Despite these benefits,pharmacy clinics are still in the early stages of development in China.There remains a lack of clarity regarding the specific development and service content of pharmacy clinics tailored for transplant patients.Therefore,this study aimed to assess the current status of pharmacy clinic development for transplant patients in China and provide insights to hospitals for advancing and strengthening transplant pharmacy clinic initiatives.展开更多
Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated ne...Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated neuroprotective properties,yet a comprehensive systematic review assessing its efficacy remains absent.This study aims to evaluate the efficacy of Boswellia extract in treating NDs,with a particular focus on its effects in AD and its potential for long-term neurorestoration,thereby supporting further investigation into Boswellia’s therapeutic role in ND management.Methods:A systematic literature search was performed in PubMed,Web of Science,ScienceDirect,and Google Scholar for English-language studies published up to March 2024.Eighteen studies met the inclusion criteria and were included in the meta-analysis.The study protocol was registered on PROSPERO(CRD42024524386).Eligible studies involved rodent models of IS,PD,or AD with post-operative interventions using Boswellia extract.Data extraction focused on mechanisms of action,dosages,treatment durations,and therapeutic outcomes.Studies were excluded if they involved non-ND models,combined treatments,or had incomplete data.Two researchers independently conducted literature screening and data extraction.Statistical analyses were conducted using Stata(version 17)and RevMan(version 5.4),employing fixed or random-effects models based on heterogeneity assessments.Result s:Boswellia extract significantly improved the mean effect size for NDs(ES=1.28,95%CI(1.05,1.51),P<0.001).Specifically,it reduced cerebral infarct volume in IS(SMD=−2.87,95%CI(−3.42,−2.32))and enhanced behavioral outcomes in AD(SMD=3.26,95%CI(2.07,5.14))and PD(SMD=5.37,95%CI(3.93,6.80)).Subgroup analyses revealed that Boswellia extract exhibited superior efficacy in AD when administered orally and via intra-cerebroventricular injection.Long-term treatment with Boswellia extract suggested potential neurorestorative effects.Additionally,Boswellia extract was more effective than its monomeric constituents,highlighting its promising role in ND treatment.Conclusion:Boswellia extract demonstrates significant neuroprotective effects across various NDs,particularly in AD and in promoting long-term neurorestoration.These findings support the need for further research into Boswellia’s potential as a therapeutic agent in the management of neurological disorders.展开更多
Macrophages in the brain barrier system include microglia in the brain parenchyma,border-associated macrophages at the brain’s borders,and recruited macrophages.They are responsible for neural development,maintenance...Macrophages in the brain barrier system include microglia in the brain parenchyma,border-associated macrophages at the brain’s borders,and recruited macrophages.They are responsible for neural development,maintenance of homeostasis,and orchestrating immune responses.With the rapid exploitation and development of new technologies,there is a deeper understanding of macrophages in the brain barrier system.Here we review the origin,development,important molecules,and functions of macrophages,mainly focusing on microglia and border-associated macrophages.We also highlight some advances in single-cell sequencing and significant cell markers.We anticipate that more advanced methods will emerge to study resident and recruited macrophages in the future,opening new horizons for neuroimmunology and related peripheral immune fields.展开更多
Single-atom nanozymes(SAzymes)exhibit exceptional catalytic efficiency due to their maximized atom utilization and precisely modulated metalcarrier interactions,which have attracted significant attention in the biomed...Single-atom nanozymes(SAzymes)exhibit exceptional catalytic efficiency due to their maximized atom utilization and precisely modulated metalcarrier interactions,which have attracted significant attention in the biomedical field.However,stability issues may impede the clinical translation of SAzymes.This review provides a comprehensive overview of the applications of SAzymes in various biomedical fields,including disease diagnosis(e.g.,biosensors and diagnostic imaging),antitumor therapy(e.g.,photothermal therapy,photodynamic therapy,sonodynamic therapy,and immunotherapy),antimicrobial therapy,and anti-oxidative stress therapy.More importantly,the existing challenges of SAzymes are discussed,such as metal atom clustering and active site loss,ligand bond breakage at high temperature,insufficient environment tolerance,biosecurity risks,and limited catalytic long-term stability.Finally,several innovative strategies to address these stability concerns are proposed—synthesis process optimization(space-limited strategy,coordination site design,bimetallic synergistic strategy,defect engineering strategy,atom stripping-capture),surface modification,and dynamic responsive design—that collectively pave the way for robust,clinically viable SAzymes.展开更多
Background:Human skin is affected by ultraviolet rays on a daily basis,and excessive ultraviolet radiation(UVR)can lead to sunburn erythema,tanning,photoaging,and skin tumors.The combination of Astragali Radix(AR)and ...Background:Human skin is affected by ultraviolet rays on a daily basis,and excessive ultraviolet radiation(UVR)can lead to sunburn erythema,tanning,photoaging,and skin tumors.The combination of Astragali Radix(AR)and Anemarrhenae Rhizoma(AAR)is a common pairing in traditional Chinese medicine(TCM).According to earlier studies,they possess properties capable of alleviating the adverse impacts of UVR on the skin.However,the specific actions and underlying mechanisms require further investigation.The study aims to analyze the efficacy of AR-AAR in preventing UVR-induced skin damage and to clarify the associated molecular mechanisms.Methods:Potential signaling pathways by which AR and AAR may protect against UVR-induced skin damage were identified with network pharmacology,molecular docking techniques and molecular dynamics(MD)simulation.Except the normal group,the back skin of SD rats was exposed to 1.1 mW/cm^(2) UVA combined with 0.1 mW/cm^(2) UVB daily,and the UVR skin damage model was established.Morphological features of skin tissues of different groups were discovered through Hematoxylin and Eosin(HE)staining,Masson staining,Weigert staining.ELISA was utilized to measure the levels of reactive oxygen species(ROS),Interleukin 6(IL-6),Interleukin 1β(IL-1β)and Tumor necrosis factos-α(TNF-α)in skin tissues.RT-PCR and Western blot were employed to quantify the mRNA and protein contents of PI3K,AKT,and MMP-9.Results:Network pharmacology analysis predicts that AR-AAR may improve skin damage induced by UVR through the PI3K/AKT signaling pathway.Histological staining shows that AR-AAR can significantly reduce inflammatory infiltration and fibrosis in damaged skin.Treatment with AR-AAR(2:1)significantly reduced the expression levels of IL-1β,IL-6,TNF-αand ROS in UVR-damaged rat skin.After treatment with AR-AAR(2:1),not only did the relative mRNA expression levels of PI3K and AKT and the protein expression levels of PI3K,AKT,P-PI3K,and P-AKT increase,but the mRNA and protein expression levels of MMP-9 decreased.Conclusion:The study indicate that the AR-AAR combination and its active components may mitigate UVR skin damage by modulating the PI3K/AKT signaling pathway.展开更多
Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance pati...Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.展开更多
Objective: to explore the transformation of drug management mode in pharmacy department under the situation of new medical reform. Methods: the hospital pharmacy department implemented the traditional management mode ...Objective: to explore the transformation of drug management mode in pharmacy department under the situation of new medical reform. Methods: the hospital pharmacy department implemented the traditional management mode from March to October 2018, changed the management mode in November 2018, and selected November 2018 to June 2019 as the later implementation period. Results: after the implementation, the coverage rate of rechecked prescriptions, administration rate, monthly per capita prescription quantity of pharmacists, clear destination rate and drug use rate were higher than those before the implementation (P < 0.05). After the implementation, the drug expiration rate, drug abuse rate, drug damage rate and audit error rate were lower than those before the implementation (P < 0.05). Conclusion: under the new medical reform situation, the transformation of drug management mode has become an inevitable trend. The new management mode can further strengthen the management of pharmacy department, improve the professional quality and professional ability of pharmacy staff, and provide medication services for patients.展开更多
It is challenging to characterize the drug-related problems(DRPs)of patients treated by Integrated Traditional Chinese and Western Medicine(ITCWM),both locally and globally.In the present study,we aimed to assess DRPs...It is challenging to characterize the drug-related problems(DRPs)of patients treated by Integrated Traditional Chinese and Western Medicine(ITCWM),both locally and globally.In the present study,we aimed to assess DRPs and factors associated with their occurrence among inpatients of the ITCWM department in China.We retrospectively examined medication use in the ITCWM department,documented in Intelligent Management System Software for Critical Rational Administration of Drug.Various types of DRPs classification were performed based on the Pharmaceutical Care Network Europe(PCNE)classification tool V9.0,and associations of patient’s characteristics were analyzed.A total of 1606 DRPs were identified in 687 inpatients in this study.Problems and causes of DRPs,intervention,acceptance,and outcome of that were classified.PPI(21.7%),endogenous supplements(15.4%),and traditional Chinese medicine(8.7%)contributed to the significant proportion of drug categories associated with DRPs.Approximately half of the patients(47.6%)had at least one DRP.The top four categories of causes were“drug administered via the wrong route”(18.4%),“inappropriate combination”(16.7%),“too long duration of the treatment”(13.0%),and“inappropriate drug form”(12.1%).Total 63.6%of intervention was accepted and fully implemented.“EPP”and“hospital stay days≥10 d”characteristics were most likely to be significantly associated with DRPs.As a necessary review item,DRP was highly performed among inpatients of the ITCWM department.The work provided a benchmark for this population through the PCNE strategy.展开更多
Ischemic stroke is a secondary cause of mortality worldwide,imposing considerable medical and economic burdens on society.Extracellular vesicles,serving as natural nanocarriers for drug delivery,exhibit excellent bioc...Ischemic stroke is a secondary cause of mortality worldwide,imposing considerable medical and economic burdens on society.Extracellular vesicles,serving as natural nanocarriers for drug delivery,exhibit excellent biocompatibility in vivo and have significant advantages in the management of ischemic stroke.However,the uncertain distribution and rapid clearance of extracellular vesicles impede their delivery efficiency.By utilizing membrane decoration or by encapsulating therapeutic cargo within extracellular vesicles,their delivery efficacy may be greatly improved.Furthermore,previous studies have indicated that microvesicles,a subset of large-sized extracellular vesicles,can transport mitochondria to neighboring cells,thereby aiding in the restoration of mitochondrial function post-ischemic stroke.Small extracellular vesicles have also demonstrated the capability to transfer mitochondrial components,such as proteins or deoxyribonucleic acid,or their sub-components,for extracellular vesicle-based ischemic stroke therapy.In this review,we undertake a comparative analysis of the isolation techniques employed for extracellular vesicles and present an overview of the current dominant extracellular vesicle modification methodologies.Given the complex facets of treating ischemic stroke,we also delineate various extracellular vesicle modification approaches which are suited to different facets of the treatment process.Moreover,given the burgeoning interest in mitochondrial delivery,we delved into the feasibility and existing research findings on the transportation of mitochondrial fractions or intact mitochondria through small extracellular vesicles and microvesicles to offer a fresh perspective on ischemic stroke therapy.展开更多
Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hyp...Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.展开更多
[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual m...[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual measures against exposure to ACDs differ between hospitals, and no surveillance data regarding the conditions of each hospital in relation to performing chemotherapy in Japan are available. [Methods] To understand current measures against exposure to ACDs and problems related to cancer chemotherapy at outpatient departments, we conducted a questionnaire survey on doctors, pharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in Japan. [Results] Responses were received from all 10 institutions. The hospital pharmacists prepared all ACDs for outpatients in each institution. All hospitals took basic measures against ACD exposure, such as using personal protective equipment and penetration-resistant waste containers. Conditions against exposure to ACDs generally improved between 2012 and 2015, especially in terms of conveyance of ACDs and use of a closed-system drug transfer device. However, no measures linking ACDs with administration routes or injection sites were commonly taken in any of the hospitals in 2015. [Conclusions] Conditions against ACD exposure improved between 2012 and 2015, possibly because new guidelines were issued. To improve measures for ACD exposure in Japan, preparing more appropriate manuals and offering more opportunities to medical staff for continuing education are considered important.展开更多
Background: Etomidate is the standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Etomidate shortages require providers to utilize alternative agents. The purpose of t...Background: Etomidate is the standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Etomidate shortages require providers to utilize alternative agents. The purpose of this study is to compare the safety and procedural outcomes of propofol and etomidate for RSI in the ED. Methods: This was a retrospective chart review of adult patients in the ED who received propofol or etomidate for induction during RSI. The main endpoint was hypotension, defined as a systolic blood pressure < 90 mmHg or diastolic blood pressure < 60 mmHg, within the first hour of intubation. Time to intubation, intensive care unit length of stay, hospital length of stay, and in-hospital mortality were also evaluated. Results: Two hundred and seventy five patient charts were reviewed. Of the 98 patients included, 43 patients received propofol and 55 patients received etomidate. Propofol was associated with an increased incidence of hypotension within the first hour of intubation (65.1% vs. 25.5%, p < 0.001). No difference was found in the time to intubation: ≤5 minutes (51.2% vs. 34.6%, p = 0.83). The mortality rate was 11.6% in the propofol group and 27.3% in the etomidate group (p = 0.004). There was no difference in hospital or intensive care unit length of stay between the propofol and etomidate groups (7.7 vs. 9.2 days, p = 0.23;4.2 vs. 6.3 days, p = 0.31). Conclusion: Propofol was a safe and procedurally effective induction agent for RSI. Compared to etomidate, it was associated with an increased rate of hypotension within the first hour of intubation, with no difference in the percent of patients that required an intervention.展开更多
Stress during tertiary educational period has significant negative effect on the performance of a student. Mental distress is increasing among students and is one of the important public health concerns. This study wa...Stress during tertiary educational period has significant negative effect on the performance of a student. Mental distress is increasing among students and is one of the important public health concerns. This study was carried out to investigate the socio demographic characteristics of students, level of their stress feeling, and status of mental health and to find out the co-relation of different factors associated with the level of stress feelings. A cross sectional study was conducted among the students of the Department of Pharmacy of UAP. A total of 504 students (181 male students and 323 female students) participated in this study. Feeling of severe stress was almost equal to both sexes. But, moderate level of stress was more associated with female students (N = 253, F = 78.33%) and overall female students were more stressful than male. Thought towards future career ranked one among many reasons of stress in students (59.67% for male students and 37.46% for female students). In terms of academic achievements, feeling of stress was higher in female students compared to male students (34.98% for female students vs. 15.47% for male students). Other factors such as unrealistic expectations, family relationship and affairs, socio economic condition, being of too busy also significantly participate in the development of stress in young mind. Mental health status was estimated by considering some facts such as state of shock due to unwanted life events, lacking of expression of emotions, reduced feeling of pleasure, unusual thinking, fear of any specific objects, short term memory loss, self identity disorder and lack of self confidence. We co-related different risk factors like age, gender, socio-economic condition, unrealistic thought patter to different levels of stress feeling. Feelings of stress were most among the student of 21 - 25 years of age. Socio-economic condition is always a great factor of stress, middle class society has more stress compared to other socio-economic classes. Psychological counseling is required in educational institution to detect and prevent mental distress and stress among students.展开更多
Background: The present study was undertaken to evaluate the correct interpretation by university students of internationally available pictograms and to assess the ability of the pictograms to convey the intended mes...Background: The present study was undertaken to evaluate the correct interpretation by university students of internationally available pictograms and to assess the ability of the pictograms to convey the intended messages. Aim: To compare the ability of pharmacy and non-pharmacy students to comprehend pharmaceutical pictograms. Method: Twenty eight internationally available (United States Pharmacopoeial Convention Inc. USP) pictograms were used throughout this study, which was conducted with 300 pharmacy and non-pharmacy students. Questionnaires included relevant questions, and participants were instructed to study the pictograms and write their interpretations. The American National Standards Institute requirement of 85% correctness criterion was used for correct interpretation. Differences between responses of the two groups were calculated using SPSS version 18 and p < 0.05 was considered significant. Results: The majority of pharmacy (98%) and non-pharmacy (86%) students stated that pictograms should be included in medicine leaflet and they were helpful for all patients. Out of the 28 pictograms 7 (25%) and 2 (7.1%) of them achieved the ANSI requirement of 85% correctness criterion by pharmacy and non-pharmacy students respectively. Conclusion: Interventions to increase public awareness of the usefulness of pharmaceutical pictograms are needed.展开更多
Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is ...Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is commonly utilized and recommended in guidelines. Objective: We sought to assess clinical and safety outcomes associated with various insulin infusion starting doses in patients diagnosed with DKA in the emergency department in an effort to help guide prescribing. Methods: A retrospective cohort study was conducted within an academic emergency department and included patients who received continuous infusion regular insulin with an ICD-10 code for DKA between January 2016 and January 2019. A predictive regression model was applied to test if predefined lab values influenced the starting insulin infusion rates. Clinical and safety outcomes were evaluated by starting insulin infusion rate. Data was analyzed based on starting insulin infusion rates. Results: 347 patients met inclusion criteria with 92 (26.5%) patients receiving Conclusion: Glucose levels significantly influenced the insulin starting infusion rate, with no identified differences in adverse effects or clinical outcomes.展开更多
Paederia scandens(Lour.)Merr.is a traditional Chinese medicine,which mainly has the functions of analgesia,detoxification,anti-inflammatory and anticonvulsant.Modern studies show that the main chemical constituents of...Paederia scandens(Lour.)Merr.is a traditional Chinese medicine,which mainly has the functions of analgesia,detoxification,anti-inflammatory and anticonvulsant.Modern studies show that the main chemical constituents of this plant are iridoids and volatile oil,which have biological activities such as analgesia,anti-inflammatory,hepatoprotection,renoprotection and antibacterial.This review highlights the chemical constituents and biological activities of P.scandens based on studies published in last decades and provides the references for the further development and utilization of this medicinal plant.展开更多
Background: One of the key drivers for the emergence and spread of antimicrobial resistance (AMR) is non-prudent antibiotic use, which results in selection pressure toward relevant bacteria. Pharmacy staffs have pivot...Background: One of the key drivers for the emergence and spread of antimicrobial resistance (AMR) is non-prudent antibiotic use, which results in selection pressure toward relevant bacteria. Pharmacy staffs have pivotal roles in facilitating the prudent use of antibiotics through antimicrobial stewardship programs. Due to limited information in Benin, this study assessed the knowledge and attitudes of pharmacy staffs on antibiotic use and resistance. Materials and Methods: This cross-sectional study was conducted among 159 pharmacy staffs using a structured questionnaire from August 2018 to December 2018 in Benin. Data analysis was done by using Stata version 13.0. Results: Of the 159 participants, 54.8% knew the definition of antibiotic therapy and 66.9% knew the definition of probabilistic antibiotic therapy. The majority (88.1%) of the participants thought that the choice of antibiotics was made according to the pathology, while 60.4% thought that it depended on the pathology and the germ involved. 49.02% of dispensers in pharmacies stated that half of the patients had requested treatment without providing a prescription at the pharmacy. The top three antibiotics that were dispensed without a prescription include amoxicillin (98.1%), cloxacillin (76.7%) and metronidazole (57.2%), all from the Access group of antibiotics. Conclusion: These results underscore the need for educational and training interventions targeting specific professional groups. There is an urgent need for regulatory measures and public awareness through improved antimicrobial stewardship to limit this practice.展开更多
Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine...Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine is a beneficial analgesic agent in the emergency department (ED), particularly in patients with opioid-resistant pain or polytrauma patients who are hemodynamically unstable. Purpose: The purpose of this study was to evaluate current practice and describe clinical outcomes associated with the use of low-dose ketamine for acute pain in the ED. Methods: Adult patients receiving ketamine were retrospectively evaluated between March 1, 2012 and March 31, 2013. Patients were included if they were ordered for ketamine in the ED to treat acute pain. Outcomes included dose administered, cumulative doses, concurrent opioid administration, and any efficacy or adverse events documented after the administration of ketamine. Continuous variables are reported as mean (standard deviation [SD]) or median (interquartile range [IQR]). Results: A total of 46 patients were evaluated for inclusion. Of the 25 patients included, 38 doses of ketamine were documented. The mean age was 41 years old with 64% of the patients being female. The average initial ketamine dose was 0.12 ± 0.06 mg/kg and 8 (32%) patients received multiple doses of ketamine (1.5 ± 0.8 doses per patient). Ketamine was added to opioid therapy in 23 (92%) patients. Pain scores decreased post administration of ketamine from 10 (9 - 10) to 5 (4 - 7). Adequate pain relief was documented in 11 (44%) patients (felt comfortable going home);partial pain relief was noted in 5 (20%) patients;3 (12%) patients reported no pain relief;3 (12%) patients were able to have a procedure done, and efficacy was not documented in 3 (12%) patients. Anxiety and agitation were documented in 2 (8%) patients. No adverse outcomes were documented in 84% of patients. Conclusion: Administration of low-dose ketamine for acute pain in the ED demonstrated improvement in patients’ pain scores with minimal documented adverse outcomes.展开更多
Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the c...Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.展开更多
基金National Natural Science Foundation of China(grant No.82373800)Guangzhou Science and Technology Plan Project(grant No.202201010589).
文摘Pharmacy is an important subfield of the medical sciences,and its development is inseparable from pharmacy education.Pharmacy education outputs indispensable professionals and expertise for the healthcare industry,promotes the development of pharmacy skills,and supports the development of the pharmaceutical and health sectors.To this end,many insightful studies have been carried out to promote the development and progress of pharmacy education.These studies have been published in high-quality pharmacy education journals indexed in the Web of Science Core Collection(WoSCC),and the two journals with the largest number of published articles are the American Journal of Pharmaceutical Education and Currents in Pharmacy Teaching and Learning.The 200 most-cited papers historically in these two journals have a significant impact on the research paradigm and future directions in the field of pharmacy education.Therefore,this paper summarizes the knowledge domains of these 200 papers and uses the scientometric method to study their basic information,authorship distribution,citation performance,publishing paradigm and hotspot mining.The era of Holistic Integrative Pharmacy(HIP),in which the focus has shifted from isolated pharmacological interventions to more collaborative,patient-centered,and interdisciplinary approaches,underscores the importance of evolving educational methodologies.In this context,understanding the scientometric trends in pharmacy education becomes even more crucial.This study aims to explore the current development status of pharmacy education,develop more innovative and effective educational models,and promote the widespread application of HIP in pharmacy education.The goal is to enhance the overall quality of pharmacy education and provide guidance and insights for the future development of pharmacy education.
文摘Pharmacy clinics,staffed by clinical pharmacists who interact directly with patients,encompass services such as medication reconciliation,education,follow-up visits,and lifestyle guidance.Their primary goal is to enhance patients’quality of life.Numerous studies,both domestic and international,have highlighted the benefits of pharmacy clinics in optimizing drug therapy quality and reducing treatment costs,particularly for long-term medication management in organ transplant recipients and similar patient groups.Despite these benefits,pharmacy clinics are still in the early stages of development in China.There remains a lack of clarity regarding the specific development and service content of pharmacy clinics tailored for transplant patients.Therefore,this study aimed to assess the current status of pharmacy clinic development for transplant patients in China and provide insights to hospitals for advancing and strengthening transplant pharmacy clinic initiatives.
基金supported by the National Natural Science Foundation of China,specifically through grants(No.8227431382304947)Key Research and Development Project of Shaanxi Province(2023GHZD43).Peer re v iew information。
文摘Background:Neurological disorders(NDs),including ischemic stroke(IS),Parkinson’s disease(PD),and Alzheimer’s disease(AD),are major contributors to global morbidity and mortality.Boswellia extract has demonstrated neuroprotective properties,yet a comprehensive systematic review assessing its efficacy remains absent.This study aims to evaluate the efficacy of Boswellia extract in treating NDs,with a particular focus on its effects in AD and its potential for long-term neurorestoration,thereby supporting further investigation into Boswellia’s therapeutic role in ND management.Methods:A systematic literature search was performed in PubMed,Web of Science,ScienceDirect,and Google Scholar for English-language studies published up to March 2024.Eighteen studies met the inclusion criteria and were included in the meta-analysis.The study protocol was registered on PROSPERO(CRD42024524386).Eligible studies involved rodent models of IS,PD,or AD with post-operative interventions using Boswellia extract.Data extraction focused on mechanisms of action,dosages,treatment durations,and therapeutic outcomes.Studies were excluded if they involved non-ND models,combined treatments,or had incomplete data.Two researchers independently conducted literature screening and data extraction.Statistical analyses were conducted using Stata(version 17)and RevMan(version 5.4),employing fixed or random-effects models based on heterogeneity assessments.Result s:Boswellia extract significantly improved the mean effect size for NDs(ES=1.28,95%CI(1.05,1.51),P<0.001).Specifically,it reduced cerebral infarct volume in IS(SMD=−2.87,95%CI(−3.42,−2.32))and enhanced behavioral outcomes in AD(SMD=3.26,95%CI(2.07,5.14))and PD(SMD=5.37,95%CI(3.93,6.80)).Subgroup analyses revealed that Boswellia extract exhibited superior efficacy in AD when administered orally and via intra-cerebroventricular injection.Long-term treatment with Boswellia extract suggested potential neurorestorative effects.Additionally,Boswellia extract was more effective than its monomeric constituents,highlighting its promising role in ND treatment.Conclusion:Boswellia extract demonstrates significant neuroprotective effects across various NDs,particularly in AD and in promoting long-term neurorestoration.These findings support the need for further research into Boswellia’s potential as a therapeutic agent in the management of neurological disorders.
基金supported by Ministry of Science and Technology China Brain Initiative Grant,No.2022ZD0204702(to ZY)the National Natural Science Foundation of China,No.82371357(to LC)+2 种基金Foundation for Military Medicine,No.16QNP085(to ZY)Navy Medical University Basic Medical College“Yi Zhang”Basic Medical Talent Development and Support Program,Nos.JCYZRC-D-022(to TC)and JCYZRC-D-024(to HD)Science and Technology Innovation Special Fund of Shanghai Baoshan District,No.2023-E-05(to YW).
文摘Macrophages in the brain barrier system include microglia in the brain parenchyma,border-associated macrophages at the brain’s borders,and recruited macrophages.They are responsible for neural development,maintenance of homeostasis,and orchestrating immune responses.With the rapid exploitation and development of new technologies,there is a deeper understanding of macrophages in the brain barrier system.Here we review the origin,development,important molecules,and functions of macrophages,mainly focusing on microglia and border-associated macrophages.We also highlight some advances in single-cell sequencing and significant cell markers.We anticipate that more advanced methods will emerge to study resident and recruited macrophages in the future,opening new horizons for neuroimmunology and related peripheral immune fields.
基金supported by the National Natural Science Foundation of China[82003956]the National Key Research and Development Program of China[No.2022YFA1205802]+2 种基金financially supported by Henan Province Health Science and Technology Innovation Youth Talent Project(YQRC2023013 and YQRC2024013)the Key Project of Medical Science and Technology of Henan Province(SBGJ202302072)the Science and Technology Research Project of Henan Province(252102311236).
文摘Single-atom nanozymes(SAzymes)exhibit exceptional catalytic efficiency due to their maximized atom utilization and precisely modulated metalcarrier interactions,which have attracted significant attention in the biomedical field.However,stability issues may impede the clinical translation of SAzymes.This review provides a comprehensive overview of the applications of SAzymes in various biomedical fields,including disease diagnosis(e.g.,biosensors and diagnostic imaging),antitumor therapy(e.g.,photothermal therapy,photodynamic therapy,sonodynamic therapy,and immunotherapy),antimicrobial therapy,and anti-oxidative stress therapy.More importantly,the existing challenges of SAzymes are discussed,such as metal atom clustering and active site loss,ligand bond breakage at high temperature,insufficient environment tolerance,biosecurity risks,and limited catalytic long-term stability.Finally,several innovative strategies to address these stability concerns are proposed—synthesis process optimization(space-limited strategy,coordination site design,bimetallic synergistic strategy,defect engineering strategy,atom stripping-capture),surface modification,and dynamic responsive design—that collectively pave the way for robust,clinically viable SAzymes.
基金supported by the Shaanxi Qinchuang Yuan“scientist+engineer”team construction(No.2023KXJ-080)Shaanxi Chiral Drug Engineering Technology Research Center(Department of Science and Technology of Shaanxi Province.No.[2011]-251).
文摘Background:Human skin is affected by ultraviolet rays on a daily basis,and excessive ultraviolet radiation(UVR)can lead to sunburn erythema,tanning,photoaging,and skin tumors.The combination of Astragali Radix(AR)and Anemarrhenae Rhizoma(AAR)is a common pairing in traditional Chinese medicine(TCM).According to earlier studies,they possess properties capable of alleviating the adverse impacts of UVR on the skin.However,the specific actions and underlying mechanisms require further investigation.The study aims to analyze the efficacy of AR-AAR in preventing UVR-induced skin damage and to clarify the associated molecular mechanisms.Methods:Potential signaling pathways by which AR and AAR may protect against UVR-induced skin damage were identified with network pharmacology,molecular docking techniques and molecular dynamics(MD)simulation.Except the normal group,the back skin of SD rats was exposed to 1.1 mW/cm^(2) UVA combined with 0.1 mW/cm^(2) UVB daily,and the UVR skin damage model was established.Morphological features of skin tissues of different groups were discovered through Hematoxylin and Eosin(HE)staining,Masson staining,Weigert staining.ELISA was utilized to measure the levels of reactive oxygen species(ROS),Interleukin 6(IL-6),Interleukin 1β(IL-1β)and Tumor necrosis factos-α(TNF-α)in skin tissues.RT-PCR and Western blot were employed to quantify the mRNA and protein contents of PI3K,AKT,and MMP-9.Results:Network pharmacology analysis predicts that AR-AAR may improve skin damage induced by UVR through the PI3K/AKT signaling pathway.Histological staining shows that AR-AAR can significantly reduce inflammatory infiltration and fibrosis in damaged skin.Treatment with AR-AAR(2:1)significantly reduced the expression levels of IL-1β,IL-6,TNF-αand ROS in UVR-damaged rat skin.After treatment with AR-AAR(2:1),not only did the relative mRNA expression levels of PI3K and AKT and the protein expression levels of PI3K,AKT,P-PI3K,and P-AKT increase,but the mRNA and protein expression levels of MMP-9 decreased.Conclusion:The study indicate that the AR-AAR combination and its active components may mitigate UVR skin damage by modulating the PI3K/AKT signaling pathway.
文摘Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.
文摘Objective: to explore the transformation of drug management mode in pharmacy department under the situation of new medical reform. Methods: the hospital pharmacy department implemented the traditional management mode from March to October 2018, changed the management mode in November 2018, and selected November 2018 to June 2019 as the later implementation period. Results: after the implementation, the coverage rate of rechecked prescriptions, administration rate, monthly per capita prescription quantity of pharmacists, clear destination rate and drug use rate were higher than those before the implementation (P < 0.05). After the implementation, the drug expiration rate, drug abuse rate, drug damage rate and audit error rate were lower than those before the implementation (P < 0.05). Conclusion: under the new medical reform situation, the transformation of drug management mode has become an inevitable trend. The new management mode can further strengthen the management of pharmacy department, improve the professional quality and professional ability of pharmacy staff, and provide medication services for patients.
基金National Major New Drug Creation Project of China(Grant No.2020ZX09201-009)。
文摘It is challenging to characterize the drug-related problems(DRPs)of patients treated by Integrated Traditional Chinese and Western Medicine(ITCWM),both locally and globally.In the present study,we aimed to assess DRPs and factors associated with their occurrence among inpatients of the ITCWM department in China.We retrospectively examined medication use in the ITCWM department,documented in Intelligent Management System Software for Critical Rational Administration of Drug.Various types of DRPs classification were performed based on the Pharmaceutical Care Network Europe(PCNE)classification tool V9.0,and associations of patient’s characteristics were analyzed.A total of 1606 DRPs were identified in 687 inpatients in this study.Problems and causes of DRPs,intervention,acceptance,and outcome of that were classified.PPI(21.7%),endogenous supplements(15.4%),and traditional Chinese medicine(8.7%)contributed to the significant proportion of drug categories associated with DRPs.Approximately half of the patients(47.6%)had at least one DRP.The top four categories of causes were“drug administered via the wrong route”(18.4%),“inappropriate combination”(16.7%),“too long duration of the treatment”(13.0%),and“inappropriate drug form”(12.1%).Total 63.6%of intervention was accepted and fully implemented.“EPP”and“hospital stay days≥10 d”characteristics were most likely to be significantly associated with DRPs.As a necessary review item,DRP was highly performed among inpatients of the ITCWM department.The work provided a benchmark for this population through the PCNE strategy.
基金supported by the grants from University of Macao,China,Nos.MYRG2022-00221-ICMS(to YZ)and MYRG-CRG2022-00011-ICMS(to RW)the Natural Science Foundation of Guangdong Province,No.2023A1515010034(to YZ)。
文摘Ischemic stroke is a secondary cause of mortality worldwide,imposing considerable medical and economic burdens on society.Extracellular vesicles,serving as natural nanocarriers for drug delivery,exhibit excellent biocompatibility in vivo and have significant advantages in the management of ischemic stroke.However,the uncertain distribution and rapid clearance of extracellular vesicles impede their delivery efficiency.By utilizing membrane decoration or by encapsulating therapeutic cargo within extracellular vesicles,their delivery efficacy may be greatly improved.Furthermore,previous studies have indicated that microvesicles,a subset of large-sized extracellular vesicles,can transport mitochondria to neighboring cells,thereby aiding in the restoration of mitochondrial function post-ischemic stroke.Small extracellular vesicles have also demonstrated the capability to transfer mitochondrial components,such as proteins or deoxyribonucleic acid,or their sub-components,for extracellular vesicle-based ischemic stroke therapy.In this review,we undertake a comparative analysis of the isolation techniques employed for extracellular vesicles and present an overview of the current dominant extracellular vesicle modification methodologies.Given the complex facets of treating ischemic stroke,we also delineate various extracellular vesicle modification approaches which are suited to different facets of the treatment process.Moreover,given the burgeoning interest in mitochondrial delivery,we delved into the feasibility and existing research findings on the transportation of mitochondrial fractions or intact mitochondria through small extracellular vesicles and microvesicles to offer a fresh perspective on ischemic stroke therapy.
文摘Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.
文摘[Background] Medical staff have many occasions to be exposed to anticancer drugs (ACDs) in the process of performing cancer chemotherapy. Although guidelines for the safe handling of ACDs have been published, actual measures against exposure to ACDs differ between hospitals, and no surveillance data regarding the conditions of each hospital in relation to performing chemotherapy in Japan are available. [Methods] To understand current measures against exposure to ACDs and problems related to cancer chemotherapy at outpatient departments, we conducted a questionnaire survey on doctors, pharmacists, and nurses in 10 leading hospitals for cancer chemotherapy in Japan. [Results] Responses were received from all 10 institutions. The hospital pharmacists prepared all ACDs for outpatients in each institution. All hospitals took basic measures against ACD exposure, such as using personal protective equipment and penetration-resistant waste containers. Conditions against exposure to ACDs generally improved between 2012 and 2015, especially in terms of conveyance of ACDs and use of a closed-system drug transfer device. However, no measures linking ACDs with administration routes or injection sites were commonly taken in any of the hospitals in 2015. [Conclusions] Conditions against ACD exposure improved between 2012 and 2015, possibly because new guidelines were issued. To improve measures for ACD exposure in Japan, preparing more appropriate manuals and offering more opportunities to medical staff for continuing education are considered important.
文摘Background: Etomidate is the standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Etomidate shortages require providers to utilize alternative agents. The purpose of this study is to compare the safety and procedural outcomes of propofol and etomidate for RSI in the ED. Methods: This was a retrospective chart review of adult patients in the ED who received propofol or etomidate for induction during RSI. The main endpoint was hypotension, defined as a systolic blood pressure < 90 mmHg or diastolic blood pressure < 60 mmHg, within the first hour of intubation. Time to intubation, intensive care unit length of stay, hospital length of stay, and in-hospital mortality were also evaluated. Results: Two hundred and seventy five patient charts were reviewed. Of the 98 patients included, 43 patients received propofol and 55 patients received etomidate. Propofol was associated with an increased incidence of hypotension within the first hour of intubation (65.1% vs. 25.5%, p < 0.001). No difference was found in the time to intubation: ≤5 minutes (51.2% vs. 34.6%, p = 0.83). The mortality rate was 11.6% in the propofol group and 27.3% in the etomidate group (p = 0.004). There was no difference in hospital or intensive care unit length of stay between the propofol and etomidate groups (7.7 vs. 9.2 days, p = 0.23;4.2 vs. 6.3 days, p = 0.31). Conclusion: Propofol was a safe and procedurally effective induction agent for RSI. Compared to etomidate, it was associated with an increased rate of hypotension within the first hour of intubation, with no difference in the percent of patients that required an intervention.
文摘Stress during tertiary educational period has significant negative effect on the performance of a student. Mental distress is increasing among students and is one of the important public health concerns. This study was carried out to investigate the socio demographic characteristics of students, level of their stress feeling, and status of mental health and to find out the co-relation of different factors associated with the level of stress feelings. A cross sectional study was conducted among the students of the Department of Pharmacy of UAP. A total of 504 students (181 male students and 323 female students) participated in this study. Feeling of severe stress was almost equal to both sexes. But, moderate level of stress was more associated with female students (N = 253, F = 78.33%) and overall female students were more stressful than male. Thought towards future career ranked one among many reasons of stress in students (59.67% for male students and 37.46% for female students). In terms of academic achievements, feeling of stress was higher in female students compared to male students (34.98% for female students vs. 15.47% for male students). Other factors such as unrealistic expectations, family relationship and affairs, socio economic condition, being of too busy also significantly participate in the development of stress in young mind. Mental health status was estimated by considering some facts such as state of shock due to unwanted life events, lacking of expression of emotions, reduced feeling of pleasure, unusual thinking, fear of any specific objects, short term memory loss, self identity disorder and lack of self confidence. We co-related different risk factors like age, gender, socio-economic condition, unrealistic thought patter to different levels of stress feeling. Feelings of stress were most among the student of 21 - 25 years of age. Socio-economic condition is always a great factor of stress, middle class society has more stress compared to other socio-economic classes. Psychological counseling is required in educational institution to detect and prevent mental distress and stress among students.
文摘Background: The present study was undertaken to evaluate the correct interpretation by university students of internationally available pictograms and to assess the ability of the pictograms to convey the intended messages. Aim: To compare the ability of pharmacy and non-pharmacy students to comprehend pharmaceutical pictograms. Method: Twenty eight internationally available (United States Pharmacopoeial Convention Inc. USP) pictograms were used throughout this study, which was conducted with 300 pharmacy and non-pharmacy students. Questionnaires included relevant questions, and participants were instructed to study the pictograms and write their interpretations. The American National Standards Institute requirement of 85% correctness criterion was used for correct interpretation. Differences between responses of the two groups were calculated using SPSS version 18 and p < 0.05 was considered significant. Results: The majority of pharmacy (98%) and non-pharmacy (86%) students stated that pictograms should be included in medicine leaflet and they were helpful for all patients. Out of the 28 pictograms 7 (25%) and 2 (7.1%) of them achieved the ANSI requirement of 85% correctness criterion by pharmacy and non-pharmacy students respectively. Conclusion: Interventions to increase public awareness of the usefulness of pharmaceutical pictograms are needed.
文摘Introduction: There is minimal literature to support the appropriate dosing for the initiation of IV regular insulin therapy in DKA patients. A 0.1 unit/kg bolus followed by 0.1 units/kg/hour or 0.14 units/kg/hour is commonly utilized and recommended in guidelines. Objective: We sought to assess clinical and safety outcomes associated with various insulin infusion starting doses in patients diagnosed with DKA in the emergency department in an effort to help guide prescribing. Methods: A retrospective cohort study was conducted within an academic emergency department and included patients who received continuous infusion regular insulin with an ICD-10 code for DKA between January 2016 and January 2019. A predictive regression model was applied to test if predefined lab values influenced the starting insulin infusion rates. Clinical and safety outcomes were evaluated by starting insulin infusion rate. Data was analyzed based on starting insulin infusion rates. Results: 347 patients met inclusion criteria with 92 (26.5%) patients receiving Conclusion: Glucose levels significantly influenced the insulin starting infusion rate, with no identified differences in adverse effects or clinical outcomes.
基金Health Industry Research Project of Hainan Province (No.21A200095)Youth Cultivation Fund Project of the First Affiliated Hospital of Hainan Medical College (No.HYYFYPY201909)。
文摘Paederia scandens(Lour.)Merr.is a traditional Chinese medicine,which mainly has the functions of analgesia,detoxification,anti-inflammatory and anticonvulsant.Modern studies show that the main chemical constituents of this plant are iridoids and volatile oil,which have biological activities such as analgesia,anti-inflammatory,hepatoprotection,renoprotection and antibacterial.This review highlights the chemical constituents and biological activities of P.scandens based on studies published in last decades and provides the references for the further development and utilization of this medicinal plant.
文摘Background: One of the key drivers for the emergence and spread of antimicrobial resistance (AMR) is non-prudent antibiotic use, which results in selection pressure toward relevant bacteria. Pharmacy staffs have pivotal roles in facilitating the prudent use of antibiotics through antimicrobial stewardship programs. Due to limited information in Benin, this study assessed the knowledge and attitudes of pharmacy staffs on antibiotic use and resistance. Materials and Methods: This cross-sectional study was conducted among 159 pharmacy staffs using a structured questionnaire from August 2018 to December 2018 in Benin. Data analysis was done by using Stata version 13.0. Results: Of the 159 participants, 54.8% knew the definition of antibiotic therapy and 66.9% knew the definition of probabilistic antibiotic therapy. The majority (88.1%) of the participants thought that the choice of antibiotics was made according to the pathology, while 60.4% thought that it depended on the pathology and the germ involved. 49.02% of dispensers in pharmacies stated that half of the patients had requested treatment without providing a prescription at the pharmacy. The top three antibiotics that were dispensed without a prescription include amoxicillin (98.1%), cloxacillin (76.7%) and metronidazole (57.2%), all from the Access group of antibiotics. Conclusion: These results underscore the need for educational and training interventions targeting specific professional groups. There is an urgent need for regulatory measures and public awareness through improved antimicrobial stewardship to limit this practice.
文摘Introduction: At subdissociative doses of 0.1 - 0.5 mg/kg, ketamine provides effective analgesia when used alone or as an adjunct to opioid analgesics without causing cardiovascular or respiratory compromise. Ketamine is a beneficial analgesic agent in the emergency department (ED), particularly in patients with opioid-resistant pain or polytrauma patients who are hemodynamically unstable. Purpose: The purpose of this study was to evaluate current practice and describe clinical outcomes associated with the use of low-dose ketamine for acute pain in the ED. Methods: Adult patients receiving ketamine were retrospectively evaluated between March 1, 2012 and March 31, 2013. Patients were included if they were ordered for ketamine in the ED to treat acute pain. Outcomes included dose administered, cumulative doses, concurrent opioid administration, and any efficacy or adverse events documented after the administration of ketamine. Continuous variables are reported as mean (standard deviation [SD]) or median (interquartile range [IQR]). Results: A total of 46 patients were evaluated for inclusion. Of the 25 patients included, 38 doses of ketamine were documented. The mean age was 41 years old with 64% of the patients being female. The average initial ketamine dose was 0.12 ± 0.06 mg/kg and 8 (32%) patients received multiple doses of ketamine (1.5 ± 0.8 doses per patient). Ketamine was added to opioid therapy in 23 (92%) patients. Pain scores decreased post administration of ketamine from 10 (9 - 10) to 5 (4 - 7). Adequate pain relief was documented in 11 (44%) patients (felt comfortable going home);partial pain relief was noted in 5 (20%) patients;3 (12%) patients reported no pain relief;3 (12%) patients were able to have a procedure done, and efficacy was not documented in 3 (12%) patients. Anxiety and agitation were documented in 2 (8%) patients. No adverse outcomes were documented in 84% of patients. Conclusion: Administration of low-dose ketamine for acute pain in the ED demonstrated improvement in patients’ pain scores with minimal documented adverse outcomes.
文摘Background: Acute intoxications result from intentionally or accidentally taking a relatively significant amount of a chemical substance which triggers disturbances in the level of psychophysiological functions, the complications of which may lead to mental disorders, physical causalities, and death. Any acute intoxication mostly requires emergency care. Objective: To highlight the prevalence, history, clinical features, emergency treatment, and prediction of acute intoxication cases referred to the emergency services at the Provincial General Reference Hospital in Bukavu, DR-Congo. Methods: A retrospective cross-sectional study was conducted from January 2021 to October 2022 based on an analysis of patients’ medical files. Triage was performed among all-type of patient files recorded in the computerized hospital database Ebale-Sante to sort cases of intoxication. Results: During the observational period, 3966 emergency admissions were counted, of which 321 (8.09%) patients were identified as having acute intoxication. Among these, 100 files that containing sufficient information fit the quality criteria for this study’s analysis. The victims were infants, adolescents and adults aged 1 - 45 years, and 52% were female and 48% were male. Most cases were accidental and, occurred at home, and the victims were driven to the hospital within 2 - 24 hours. The substances consumed included household products, drugs, and herbs. Resuscitation care, antidotes and supportive symptomatic medications ensured that 85% were healed and 10% experienced sequelae;however, 5% died. Conclusion: Acute intoxication occurs in infants mostly accidentally though the ingestion of household products and medicines. Furthermore, suicide cases may occur in traumatized adolescents and discordant couples. People should be informed about how to store hazardous products (e.g.: drugs, household products and pesticides), which should not be available to children, to avoid unintentional poisoning. Special training in clinical toxicology is required to reduce treatment failure.
