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medicines optimisation

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https://www.readbyqxmd.com/read/29334913/identifying-enablers-and-barriers-to-individually-tailored-prescribing-a-survey-of-healthcare-professionals-in-the-uk
#1
Joanne Reeve, Nicky Britten, Richard Byng, Jo Fleming, Janet Heaton, Janet Krska
BACKGROUND: Many people now take multiple medications on a long-term basis to manage health conditions. Optimising the benefit of such polypharmacy requires tailoring of medicines use to the needs and circumstances of individuals. However, professionals report barriers to achieving this in practice. In this study, we examined health professionals' perceptions of enablers and barriers to delivering individually tailored prescribing. METHODS: Normalisation Process Theory (NPT) informed an on-line survey of health professionals' views of enablers and barriers to implementation of Individually Tailored Prescribing (ITP) of medicines...
January 15, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29334141/characterization-of-macromolecular-baseline-of-human-brain-using-metabolite-cycled-semi-laser-at-9-4t
#2
Ioannis-Angelos Giapitzakis, Nikolai Avdievich, Anke Henning
PURPOSE: Macromolecular resonances (MM) arise mainly from cytosolic proteins and overlap with metabolites, influencing metabolite quantification. Macromolecules can serve as valuable biomarkers for diseases and pathologies. The objectives of this study were to characterize MM at 9.4T in the human brain (occipital and left parietal lobe) and to describe the RF coil setup used for MM acquisition in the two regions. METHODS: An adiabatic inversion pulse was optimised for metabolite nulling at 9...
January 15, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29325555/the-readiness-of-hospital-pharmacists-in-kuwait-to-practise-evidence-based-medicine-a-cross-sectional-study
#3
Ali Jasem Buabbas, Fatemah Mohammad Alsaleh, Hamza Mohamad Al-Shawaf, Ali Abdullah, Abdullah Almajran
BACKGROUND: The evolving role of pharmacists in providing pharmaceutical care, as part of the healthcare team, challenges them to acquire up-to-date knowledge of medicines to make the best clinical decisions. The volume of medical literature is on the increase, and it is important to utilise these resources to optimise patients' therapeutic outcomes. This study aimed at assessing the readiness of government hospital pharmacists in practising evidence-based medicine (EBM) in Kuwait in regards to their attitude, knowledge and skills, as well as the perceived barriers and facilitators...
January 11, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29322348/optimisation-of-a-potency-assay-for-the-assessment-of-immunomodulative-potential-of-clinical-grade-multipotent-mesenchymal-stromal-cells
#4
Irene Oliver-Vila, Carmen Ramírez-Moncayo, Marta Grau-Vorster, Sílvia Marín-Gallén, Marta Caminal, Joaquim Vives
Clinical use of multipotent Mesenchymal Stromal Cell (MSC)-based medicinal products requires their production in compliance with Good Manufacturing Practices, thus ensuring that the final drug product meets specifications consistently from batch to batch in terms of cell viability, identity, purity and potency. Potency relates to the efficacy of the medicine in its target clinical indication, so adequate release tests need to be defined and validated as quality controls. Herein we report the design and optimisation of parameters affecting the performance of an in vitro cell-based assay for assessing immunomodulatory potential of clinical grade MSC for human use, based on their capacity to inhibit proliferation of T lymphocytes under strong polyclonal stimuli...
January 10, 2018: Cytotechnology
https://www.readbyqxmd.com/read/29318694/public-risk-perception-of-non-prescription-medicines-and-information-disclosure-during-consultations-a-suitable-target-for-intervention
#5
Shona Fielding, Paul Slovic, Marie Johnston, Amanda J Lee, Christine M Bond, Margaret C Watson
OBJECTIVE: Optimisation of non-prescription medicine (NPM) supply from community pharmacies could reduce demand on other healthcare providers, including general practitioners and emergency department personnel. Outcomes can be maximised if patients disclose relevant information, for example concomitant medication, during pharmacy-based consultations. Strategies to promote information disclosure are needed. This study used the psychometric paradigm of risk to explore whether the public's risk perception of NPMs was associated with information disclosure...
January 10, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29314430/reducing-medication-errors-in-critical-care-patients-pharmacist-key-resources-and-relationship-with-medicines-optimisation
#6
Richard S Bourne, Rob Shulman, Jennifer K Jennings
BACKGROUND: Medication errors are the most common type of medical errors critical care patients experience. Critical care units utilise a variety of resources to reduce medication errors; it is unknown which resources or combinations thereof are most effective in improving medication safety. OBJECTIVES: To obtain UK critical care pharmacist group consensus on the most important interventions/resources that reduce medication errors. To then classify units that participated in the PROTECTED UK study to investigate if there were significant differences in the reported pharmacist prescription intervention type, clinical impact and rates according to unit resource classification...
January 4, 2018: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29261712/mouse-decellularised-liver-scaffold-improves-human-embryonic-and-induced-pluripotent-stem-cells-differentiation-into-hepatocyte-like-cells
#7
Maëlle Lorvellec, Federico Scottoni, Claire Crowley, Rebeca Fiadeiro, Panagiotis Maghsoudlou, Alessandro Filippo Pellegata, Francesca Mazzacuva, Asllan Gjinovci, Anne-Marie Lyne, Justine Zulini, Daniel Little, Olukunbi Mosaku, Deirdre Kelly, Paolo De Coppi, Paul Gissen
Liver transplantation is the definitive treatment of liver failure but donor organ shortage limits its availability. Stem cells are highly expandable and have the potential to differentiate into any specialist cell. Use of patient-derived induced Pluripotent Stem Cells (hiPSCs) has the additional advantage for organ regeneration therapies by removing the need for immunosuppression. We compared hepatocyte differentiation of human embryonic stem cells (hESCs) and hiPSCs in a mouse decellularised liver scaffold (3D) with standard in vitro protocol (2D)...
2017: PloS One
https://www.readbyqxmd.com/read/29244967/diagnosis-and-treatment-of-chronic-wounds-current-standards-of-germany-s-initiative-for-chronic-wounds-e-v
#8
J Dissemond, A Bültemann, V Gerber, B Jäger, K Kröger, C Münter
The diagnosis and treatment of patients with chronic wounds is an enormous challenge in various disciplines of medicine. These very complex processes usually involve several experts of different medical specialties with varying educational backgrounds. A necessary basis for consistent communication and documentation is the use of unambiguous nomenclature. Therefore, the board of the German wound association, Initiative for Chronic Wounds (ICW) e.V., has started to define various terms and procedures. An easy to remember algorithm, in the form of the ABCDE rule, has been developed for the structured diagnosis of chronic wounds...
December 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29235449/evaluation-of-skin-absorbed-doses-during-manipulation-of-radioactive-sources-a-comparison-between-varskin-code-and-monte-carlo-simulations
#9
Ernesto Amato, Antonio Italiano
The evaluation of skin doses during manipulation of radioactive sources can be a critical issue, worth using the most accurate calculation strategies available. The aim of this work was to compare the results of the analytical approach used in VARSKIN with the simulation of radiation transport and interaction by Monte Carlo calculations in GAMOS (GEANT4-based Architecture for Medicine-Oriented Simulations), and to provide an accurate and versatile tool for the evaluation of skin doses from radionuclide sources of any realistic shape (e...
December 13, 2017: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
https://www.readbyqxmd.com/read/29205048/electroconvulsive-therapy-stimulus-titration-not-all-it-seems
#10
Stephen J Rosenman
OBJECTIVE: To examine the provenance and implications of seizure threshold titration in electroconvulsive therapy. BACKGROUND: Titration of seizure threshold has become a virtual standard for electroconvulsive therapy. It is justified as individualisation and optimisation of the balance between efficacy and unwanted effects. RESULT: Present day threshold estimation is significantly different from the 1960 studies of Cronholm and Ottosson that are its usual justification...
December 1, 2017: Australian and New Zealand Journal of Psychiatry
https://www.readbyqxmd.com/read/29200789/pharmacovigilance-a-public-health-priority-for-south-africa
#11
Ushma Mehta, Emma Kalk, Andrew Boulle, Portia Nkambule, Joey Gouws, Helen Rees, Karen Cohen
South Africa has been engaged in pharmacovigilance (PV) activities to assess the impact of adverse drug reactions on public safety and health for 40 years. Activities have evolved from passive regulatory reporting to encompass active surveillance systems. The HIV and AIDS and TB epidemics stimulated pharmacoepidemiological research into the risks associated with medicines used in the standardised regimens of mass treatment programmes. Specific safety concerns, supported by robust local cohort data, have prompted major changes to national and international treatment policies...
2017: South African Health Review
https://www.readbyqxmd.com/read/29182424/bioactivation-of-cyclopropyl-rings-by-p450-an-observation-encountered-during-the-optimisation-of-a-series-of-hepatitis-c-virus-ns5b-inhibitors
#12
Xiaoliang Zhuo, Ying-Zi Wang, Kap-Sun Yeung, Juliang Zhu, Xiaohua Stella Huang, Kyle E Parcella, Kyle J Eastman, John F Kadow, Nicholas A Meanwell, Yue-Zhong Shu, Benjamin M Johnson
1. Due to its unique C-C and C-H bonding properties, conformational preferences and relative hydrophilicity, the cyclopropyl ring has been used as a synthetic building block in drug discovery to modulate potency and drug-like properties. During an effort to discover inhibitors of the hepatitis C virus nonstructural protein 5B with improved potency and genotype-coverage profiles, the use of a pyrimidinylcyclopropylbenzamide moiety linked to a C6-substituted benzofuran or azabenzofuran core scaffold was explored in an effort to balance antiviral potency and metabolic stability...
November 28, 2017: Xenobiotica; the Fate of Foreign Compounds in Biological Systems
https://www.readbyqxmd.com/read/29177770/interventions-to-improve-medicines-management-for-people-with-dementia-a-systematic-review
#13
REVIEW
Mairead McGrattan, Cristín Ryan, Heather E Barry, Carmel M Hughes
BACKGROUND: The importance of optimising medicines management for people with dementia has been emphasised through research and policy. However, evidence is currently lacking regarding how to achieve this in this patient population. OBJECTIVE: The aim was to assess the effectiveness of medicines management interventions for people with dementia living in their own home or a care home, with or without nursing care. METHODS: A systematic literature search was conducted in February 2016 across six electronic databases and three trial registries...
November 24, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29170312/15%C3%A2-a-clinical-decision-tool-for-prescribing-anti-platelet-medication-for-patients-with-suspected-acute-coronary-syndrome-pam
#14
Charles Reynard, Rick Body
BACKGROUND: The benefit of antiplatelet medication in confirmed acute coronary syndrome (ACS) is well established. In the Emergency Department (ED) diagnostic uncertainty may lead to over-treatment, with consequent risks (e.g., bleeding), or under-treatment, compromising clinical outcomes. Clinicians must subjectively balance the anticipated risks and benefits with their perceived probability of ACS in order to decide whether to prescribe these medications. We aimed to construct a clinical model to optimise and personalise recommendations for anti-platelet prescription in this context...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29158036/paediatric-weight-estimation-by-age-in-the-digital-era-optimising-a-necessary-evil
#15
Nicholas Appelbaum, Jonathan Clarke, Ian Maconochie, Ara Darzi
BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool...
November 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/29153640/-analysis-of-the-use-of-proton-pump-inhibitors-in-primary-health-care
#16
M J Hernández-Arroyo, A Díaz-Madero, E Enríquez-Gutiérrez, M C Teijeiro-Bermejo, E Sáez-Rodríguez, M R Gutiérrez-Martín
OBJECTIVE: The increase in the consumption of anti-ulcer drugs is accompanied by a high rate of incorrect use. The objectives of this study were to analyse the adequacy of repeat prescriptions of proton pump inhibitors (PPIs) in a Medical Centre, and to evaluate the efficacy of an improvement intervention. MATERIAL AND METHOD: A cross-sectional, descriptive and observational study of prevalence was conducted on patients in a medical centre under treatment with PPIs for at least 3consecutive months (November 2016-January 2017)...
November 15, 2017: Semergen
https://www.readbyqxmd.com/read/29152842/cross-sectional-survey-of-patients-need-for-information-and-support-with-medicines-after-discharge-from-hospital
#17
Adam J Mackridge, Ruth Rodgers, Dan Lee, Charles W Morecroft, Janet Krska
BACKGROUND: Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. OBJECTIVES: To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support...
November 20, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29148164/protein-profiling-of-non-model-plant-cuminum-cyminum-by-gel-based-proteomic-approach
#18
Uzma Zaman, Henning Urlaub, Atiya Abbasi
INTRODUCTION: Cumin (Cuminum cyminum), a popular spice has been widely used in traditional medicine to cure various ailments. Despite the existence of scientific literature about its pharmacological properties, no successful proteome profiling has yet been attempted. OBJECTIVE: To optimise extraction of cumin proteins and analyse its profile by shotgun proteomics, using one-dimensional electrophoresis coupled with nano-ESI-LC-MS/MS. METHODOLOGY: As a first step, we have compared three extraction protocols for total proteins extraction from cumin...
November 16, 2017: Phytochemical Analysis: PCA
https://www.readbyqxmd.com/read/29132230/combination-therapy-for-obesity
#19
John Ph Wilding
Obesity is a chronic disease with serious consequences and although lifestyle modification is considered first line treatment, it is often ineffective, especially in the long term. Relatively few people with obesity will undergo the most effective currently available treatment of bariatric surgery. Pharmacotherapy can bridge the gap between lifestyle modification and surgery, but many monotherapies have only modest efficacy or require high doses with unacceptable side effects. As with many other areas of medicine, combination therapy is now becoming accepted as a way of optimising efficacy for weight management, whilst minimising adverse effects...
November 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/29108136/application-and-optimisation-of-the-comparison-on-extreme-laboratory-tests-cert-algorithm-for-detection-of-adverse-drug-reactions-transferability-across-national-boundaries
#20
Mun Yee Tham, Qing Ye, Pei San Ang, Liza Y Fan, Dukyong Yoon, Rae Woong Park, Zheng Jye Ling, James W Yip, Bee Choo Tai, Stephen Jw Evans, Cynthia Sung
PURPOSE: The Singapore regulatory agency for health products (Health Sciences Authority), in performing active surveillance of medicines and their potential harms, is open to new methods to achieve this goal. Laboratory tests are a potential source of data for this purpose. We have examined the performance of the Comparison on Extreme Laboratory Tests (CERT) algorithm, developed by Ajou University, Korea, as a potential tool for adverse drug reaction detection based on the electronic medical records of the Singapore health care system...
November 6, 2017: Pharmacoepidemiology and Drug Safety
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