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Drug shortage

Fauzia A Khan, Alan F Merry
The safety of anesthesia characteristic of high-income countries today is not matched in low-resource settings with poor infrastructure, shortages of anesthesia providers, essential drugs, equipment, and supplies. Health care is delivered through complex systems. Achieving sustainable widespread improvement globally will require an understanding of how to influence such systems. Health outcomes depend not only on a country's income, but also on how resources are allocated, and both vary substantially, between and within countries...
April 2018: Anesthesia and Analgesia
Ali Ahmed, Maria Tanveer, Adeel Siddiqui, Gul Majid Khan
Clinical pharmacists should be increasingly important members of the healthcare team in developing countries such as Pakistan. Survey of literature was conducted to identify the determinants of clinical pharmacy in Pakistan. Lack of trained human capital, shortage of resources, patient overburden, inefficient pharmacy education curriculum, and limited job opportunities are some of the determinants of clinical pharmacy profession in developing countries. The underutilization of clinical pharmacists paves the way for an increased incidence of medication errors, adverse drug events, irrational prescribing, and suboptimal therapeutic outcomes...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Nicanor I Moldovan
Biofabrication of tissue analogues is aspiring to become a disruptive technology capable to solve standing biomedical problems, from generation of improved tissue models for drug testing to alleviation of the shortage of organs for transplantation. Arguably, the most powerful tool of this revolution is bioprinting, understood as the assembling of cells with biomaterials in three-dimensional structures. It is less appreciated, however, that bioprinting is not a uniform methodology, but comprises a variety of approaches...
March 13, 2018: Journal of Cellular and Molecular Medicine
Jane Goudge, Tobias Chirwa, Sandra Eldridge, Francesc Xavier F Gómez-Olivé, Chodziwadziwa Kabudula, Felix Limbani, Eustasius Musenge, Margaret Thorogood
Introduction: In low/middle-income countries with substantial HIV and tuberculosis epidemics, health services often neglect other highly prevalent chronic conditions, such as hypertension, which as a result are poorly managed. This paper reports on a study to assess the effect on hypertension management of lay health workers (LHW) working in South African rural primary healthcare clinics to support the provision of integrated chronic care. Methods: A pragmatic cluster randomised trial with a process evaluation in eight rural clinics assessed the effect of adding two LHWs supporting nurses in providing chronic disease care in each intervention clinic over 18 months...
2018: BMJ Global Health
Kate Traynor
No abstract text is available yet for this article.
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
Afework Mulugeta, Gebremedhin Berhe Gebregergs, Selamawit Asfaw, Dejen Yemane, Mengistu Mitiku, Beyene Meresa, Goitom Gigar, Amanuel Kidane
BACKGROUND: The antibiotic treatment of people with trachoma helps to prevent transmission the disease in a community. Currently, Zithromax is the drug recommended for mass drug administration (MDA). MDA should be carried out annually for three to five years in trachoma endemic areas. Coverage survey is essential to track progress towards program goals and to identify communities with poor coverage in order to permit timely and appropriate actions. We assessed mass Zithromax administration coverage, social mobilization and campaign challenges in south and southeast zones of Tigray, Ethiopia...
February 26, 2018: PLoS Neglected Tropical Diseases
Sylvain P Chantepie, Sylvain Garciaz, Emmanuelle Tchernonog, Frederic Peyrade, Marie-Virginie Larcher, Momar Diouf, Luc Mathieu Fornecker, Roch Houot, Thomas Gastinne, Carole Soussain, Sandra Malak, Richard Lemal, Caroline Delette, Ahmad Ibrahim, Anne-Claire Gac, E Reboursière, Jean-Pierre Vilque, Mohamed Amine Bekadja, Rene-Olivier Casasnovas, Remy Gressin, Stéphanie Guidez, Diane Coso, Charles Herbaux, Krimo Bouabdallah, Eric Durot, Gandhi Damaj
Carmustine shortage has led to an increase use of alternative conditioning regimens prior to autologous stem cell transplantation for the treatment of lymphoma, including Bendamustine-based (BeEAM). The aim of this study was to evaluate the safety of the BeEAM regimen in a large cohort of patients. A total of 474 patients with a median age of 56 years were analyzed. The majority of patients had diffuse large B-cell lymphoma (43.5%). Bendamustine was administered at a median dose of 197 mg/m2 /day (50-250) on days -7 and -6...
February 23, 2018: American Journal of Hematology
Sanford P C Hsu, John S Kuo, Hsin-Chien Chiang, Hsin-Ell Wang, Yu-Shan Wang, Cheng-Chung Huang, Yi-Chun Huang, Mau-Shin Chi, Minesh P Mehta, Kwan-Hwa Chi
Glioblastoma (GBM) cells are characterized by high phagocytosis, lipogenesis, exocytosis activities, low autophagy capacity and high lysosomal demand are necessary for survival and invasion. The lysosome stands at the cross roads of lipid biosynthesis, transporting, sorting between exogenous and endogenous cholesterol. We hypothesized that three already approved drugs, the autophagy inducer, sirolimus (rapamycin, Rapa), the autophagy inhibitor, chloroquine (CQ), and DNA alkylating chemotherapy, temozolomide (TMZ) could synergize against GBM...
January 23, 2018: Oncotarget
Gertruud Haitsma, Himanshu Patel, Parthasarathi Gurumurthy, Maarten J Postma
BACKGROUND: The aim of this study was to examine the access of Indian cancer patients to optimum cancer care under selected government schemes by reviewing reimbursement schemes for cancer care in India. METHODS: All cancer care reimbursement schemes in India were identified and three highly utilized schemes (VAS, RAS, CMCHS) were selected. Quality of breast, colorectal, lung, head & neck, and gastric cancer care was reviewed with respect to NCCN guidelines...
February 22, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
Ricardo Castro, Nicolas Nin, Fernando Ríos, Leyla Alegría, Elisa Estenssoro, Gastón Murias, Gilberto Friedman, Manuel Jibaja, Gustavo Ospina-Tascon, Javier Hurtado, María Del Carmen Marín, Flavia R Machado, Alexandre Biasi Cavalcanti, Arnaldo Dubin, Luciano Azevedo, Maurizio Cecconi, Jan Bakker, Glenn Hernandez
BACKGROUND: Intensive care medicine is a relatively young discipline that has rapidly grown into a full-fledged medical subspecialty. Intensivists are responsible for managing an ever-increasing number of patients with complex, life-threatening diseases. Several factors may influence their performance, including age, training, experience, workload, and socioeconomic context. The aim of this study was to examine individual- and work-related aspects of the Latin American intensivist workforce, mainly with academic appointments, which might influence the quality of care provided...
February 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
Gorka Orive, Dwaine Emerich, Ali Khademhosseini, Shinichi Matsumoto, R M Hernández, J L Pedraz, Tejal Desai, Riccardo Calafiore, Paul de Vos
Encapsulating, or immunoisolating, insulin-secreting cells within implantable, semipermeable membranes is an emerging treatment for type 1 diabetes. This approach can eliminate the need for immunosuppressive drug treatments to prevent transplant rejection and overcome the shortage of donor tissues by utilizing cells derived from allogeneic or xenogeneic sources. Encapsulation device designs are being optimized alongside the development of clinically viable, replenishable, insulin-producing stem cells, for the first time creating the possibility of widespread therapeutic use of this technology...
February 15, 2018: Trends in Biotechnology
Zhan Wang, Sang Jin Lee, Heng-Jie Cheng, James J Yoo, Anthony Atala
Bioengineering of a functional cardiac tissue composed of primary cardiomyocytes has great potential for myocardial regeneration and in vitro tissue modeling. However, its applications remain limited because the cardiac tissue is a highly organized structure with unique physiologic, biomechanical, and electrical properties. In this study, we undertook a proof-of-concept study to develop a contractile cardiac tissue with cellular organization, uniformity, and scalability by using three-dimensional (3D) bioprinting strategy...
February 13, 2018: Acta Biomaterialia
Nicole Ide, James P LoGerfo, Biraj Karmacharya
For the past three decades, the burden of diabetes in Nepal has been steadily increasing, with an estimated 3% annual increase since the year 2000. Although the burden is increasing, the methods of addressing the challenge have remained largely unchanged. This study sought to assess the current state of diabetes services provided by health facilities and to identify the major barriers that people with diabetes commonly face in Nepal. For this qualitative study, we selected five health facilities of varying levels and locations...
February 13, 2018: Health Policy and Planning
Michelle F Richter, Paul J Hergenrother
Multidrug resistant Gram-negative bacterial infections are on the rise, and there is a lack of new classes of drugs to treat these pathogens. This drug shortage is largely due to the challenge of finding antibiotics that can permeate and persist inside Gram-negative species. Efforts to understand the molecular properties that enable certain compounds to accumulate in Gram-negative bacteria based on retrospective studies of known antibiotics have not been generally actionable in the development of new antibiotics...
February 15, 2018: Annals of the New York Academy of Sciences
Abdullah Al Nahain, Vera Ignjatovic, Paul Monagle, John Tsanaktsidis, Vito Ferro
Heparin, a sulfated polysaccharide belonging to the glycosaminoglycan family, has been widely used as an anticoagulant drug for decades and remains the most commonly used parenteral anticoagulant in adults and children. However, heparin has important clinical limitations and is derived from animal sources which pose significant safety and supply problems. The ever growing shortage of the raw material for heparin manufacturing may become a very significant issue in the future. These global limitations have prompted much research, especially following the recent well-publicized contamination scandal, into the development of alternative anticoagulants derived from non-animal and/or totally synthetic sources that mimic the structural features and properties of heparin...
February 15, 2018: Medicinal Research Reviews
N Pinder, L H Pelzl, G Walther, J Backhaus, O Kurzai, T Hoppe-Tichy
BACKGROUND: Ready to use caspofungin infusion bags are centrally prepared in the Hospital Pharmacy, University Hospital of Heidelberg, for economic reasons and possibly occurring problems with drug shortages. The aim of this study was a quality control of the in-house preparation of caspofungin infusion bags and the preparation process. Caspofungin concentration with regard to chemical stability and antifungal activity of caspofungin preparations were defined as quality parameters. METHODS: Three caspofungin infusion bags (50 mg in 100 mL 0...
April 1, 2017: Die Pharmazie
Xiaobei Luo, Kapish Gupta, Abhishek Ananthanarayanan, Zenan Wang, Lei Xia, Aimin Li, Rashidah Binte Sakban, Side Liu, Hanry Yu
Shortage of functional hepatocytes hampers drug safety testing and therapeutic applications because mature hepatocytes cannot be expanded and maintain functions in vitro. Recent studies have reported that liver progenitor cells can originate from mature hepatocytes in vivo. Derivation of proliferating progenitor cells from mature hepatocytes, and re-differentiation into functional hepatocytes in vitro has not been successful. Here we report the derivation of novel mesenchymal-like stem cells (arHMSCs) from adult rat hepatocytes...
February 12, 2018: Scientific Reports
Donald G Ahearn, R Doyle Stulting
Recent (2012) grave but rare outbreaks of fungal meningitis and endophthalmitis associated with drugs contaminated with select environmental moulds (Exserohilum and Fusarium, respectively) have exacerbated mycology concerns for formulation, good laboratory practices (GLP), and use of the final drug product. Intensified investigations (2013-2015) by the Food and Drug Administration (FDA) that included added responsibilities for specialty compounding laboratories have prompted at least nine voluntary mould-related drug recalls during 2014-2015...
October 9, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Milan Hano, Lenka Tomášová, Mário Šereš, Lucia Pavlíková, Albert Breier, Zdena Sulová
Multidrug resistance (MDR) is a phenotype of cancer cells with reduced sensitivity to a wide range of unrelated drugs. P-glycoprotein (P-gp)-a drug efflux pump (ABCB1 member of the ABC transporter gene family)-is frequently observed to be a molecular cause of MDR. The drug-efflux activity of P-gp is considered as the underlying mechanism of drug resistance against P-gp substrates and results in failure of cancer chemotherapy. Several pathological impulses such as shortages of oxygen and glucose supply, alterations of calcium storage mechanisms and/or processes of protein N-glycosylation in the endoplasmic reticulum (ER) leads to ER stress (ERS), characterized by elevation of unfolded protein cell content and activation of the unfolded protein response (UPR)...
February 6, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Tessa M Raams, Joyce L Browne, Verena J M M Festen-Schrier, Kerstin Klipstein-Grobusch, Marcus J Rijken
BACKGROUND: Active management of the third stage of labor (AMTSL) describes interventions with the common goal to prevent postpartum hemorrhage (PPH). In low- and middle-income countries, implementation of AMTSL is hampered by shortage of skilled birth attendants and a high percentage of home deliveries. Task shifting of specific AMTSL components to unskilled birth attendants or self-administration could be a strategy to increase access to potentially life-saving interventions. This study was designed to evaluate the effect, acceptance and safety of task shifting of specific aspects of AMTSL to unskilled birth attendants...
February 6, 2018: BMC Pregnancy and Childbirth
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