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Drug utilisation

James W Hindley, Yuval Elani, Catriona M McGilvery, Simak Ali, Charlotte L Bevan, Robert V Law, Oscar Ces
Cell-sized vesicles have tremendous potential both as miniaturised pL reaction vessels and in bottom-up synthetic biology as chassis for artificial cells. In both these areas the introduction of light-responsive modules affords increased functionality, for example, to initiate enzymatic reactions in the vesicle interior with spatiotemporal control. Here we report a system composed of nested vesicles where the inner compartments act as phototransducers, responding to ultraviolet irradiation through diacetylene polymerisation-induced pore formation to initiate enzymatic reactions...
March 15, 2018: Nature Communications
Neill J Liptrott, Marco Giardiello, Tom O McDonald, Steve P Rannard, Andrew Owen
BACKGROUND: Recent work has developed solid drug nanoparticles (SDNs) of efavirenz that have been demonstrated, preclinically, improved oral bioavailability and the potential to enable up to a 50% dose reduction, and is currently being studied in a healthy volunteer clinical trial. Other SDN formulations are being studied for parenteral administration, either as intramuscular long-acting formulations, or for direct administration intravenously. The interaction of nanoparticles with the immunological and haematological systems can be a major barrier to successful translation but has been understudied for SDN formulations...
March 15, 2018: Journal of Nanobiotechnology
James Baker, Andrew Dickman, Stephen Mason, John Ellershaw
BACKGROUND: A continuous subcutaneous infusion (CSCI) is an effective method of multiple drug administration commonly encountered in end of life care when the oral route is compromised. At present, current practice is to limit syringe driver infusion time to a maximum of 24 hours as dictated by available chemical stability data. However, the ability to deliver prescribed medication by a CSCI over 48 hours may have numerous benefits in both patient care and health service resource utilisation...
2018: PloS One
V N Vakharia, J S Duncan, J-A Witt, C E Elger, R Staba, J Engel
Neurosurgery is an under-utilised treatment that can potentially cure drug-refractory epilepsy. Careful, multidisciplinary pre-surgical evaluation is vital for selecting patients and ensure optimal outcomes. Advances in neuroimaging have improved diagnosis and guide surgical intervention. Invasive electroencephalography allows the evaluation of complex patients who would otherwise not be candidates for neurosurgery. We review the current state of the assessment and selection of patients and consider established and novel surgical procedures, and associated outcome data...
March 13, 2018: Annals of Neurology
Naila Ismayilova, Mary-Anne Leung, Ravi Kumar, Martin Smith, Ruth E Williams
PURPOSE: The Ketogenic Diet (KD) is a well-established treatment for epilepsy in children and adults. We describe our 10-year KD experience in children less than two years of age diagnosed with medically refractory epilepsy. METHODS: We conducted a retrospective case-note review of infants managed with KD at our centre between 2006 and 2016. RESULTS: Twenty-nine children between 2½ weeks and 23 months of age were identified, with mixed epilepsy aetiologies...
March 2, 2018: Seizure: the Journal of the British Epilepsy Association
S Torvinen-Kiiskinen, A-M Tolppanen, M Koponen, A Tanskanen, J Tiihonen, S Hartikainen, H Taipale
BACKGROUND: Hip fractures are a major health concern among older persons with Alzheimer's disease, who usually use many concomitant drugs for several diseases. Evidence of the association between proton pump inhibitor use and risk of hip fracture is contradictory. AIM: To investigate whether the long-term use of proton pump inhibitor is associated with risk of hip fractures among community-dwelling persons with Alzheimer's disease. METHODS: In this nested case-control study, the nationwide MEDALZ data were utilised...
March 6, 2018: Alimentary Pharmacology & Therapeutics
Olga V Saik, Pavel S Demenkov, Timofey V Ivanisenko, Elena Yu Bragina, Maxim B Freidin, Irina A Goncharova, Victor E Dosenko, Olga I Zolotareva, Ralf Hofestaedt, Inna N Lavrik, Evgeny I Rogaev, Vladimir A Ivanisenko
BACKGROUND: Hypertension and bronchial asthma are a major issue for people's health. As of 2014, approximately one billion adults, or ~ 22% of the world population, have had hypertension. As of 2011, 235-330 million people globally have been affected by asthma and approximately 250,000-345,000 people have died each year from the disease. The development of the effective treatment therapies against these diseases is complicated by their comorbidity features. This is often a major problem in diagnosis and their treatment...
February 13, 2018: BMC Medical Genomics
Joanna Y Huang, Paul Monagle, M Patricia Massicotte, Christina J VanderPluym
INTRODUCTION: Ventricular Assist Devices (VADs) are increasingly utilised in children with end-stage heart failure, and experience high bleeding and clotting rates. In particular, pediatric VAD patients are more challenging than adults to anticoagulate due to developmental hemostasis, lack of suitable drug preparations, and difficult anticoagulation monitoring often due to poor vascular access; in addition to difficulties of VAD design in smaller children. This review aims to summarize the current evidence related to antithrombotic therapy in pediatric VAD patients...
February 28, 2018: Thrombosis Research
Juanita Westbury, Peter Gee, Tristan Ling, Alex Kitsos, Gregory Peterson
OBJECTIVE: For at least two decades, concerns have been raised about inappropriate psychotropic prescribing in Australian residential aged care facilities, due to their modest therapeutic benefit and increased risk of falls and mortality. To date, the majority of prevalence data has been collected in Sydney exclusively and it is not known if recent initiatives to promote appropriate psychotropic prescribing have impacted utilisation. Thus, we aimed to comprehensively analyse psychotropic use in a large national sample of residential aged care facility residents...
February 1, 2018: Australian and New Zealand Journal of Psychiatry
Mathias Ried-Larsen, Christopher S MacDonald, Mette Y Johansen, Katrine B Hansen, Robin Christensen, Thomas P Almdal, Bente K Pedersen, Kristian Karstoft
The majority of T2D cases are preventable through a healthy lifestyle, leaving little room for questions that lifestyle should be the first line of defense in the fight against the development of T2D. However, when it comes to the clinical care of T2D, the potential efficacy of lifestyle is much less clear-cut, both in terms of impacting the pathological metabolic biomarkers of the disease, and long-term complications. A healthy diet, high leisure-time physical activity and exercise are considered to be cornerstones albeit adjunct to drug therapy in the management of T2D...
February 28, 2018: Diabetes/metabolism Research and Reviews
Natsuki Abe-Fukasawa, Keiichiro Otsuka, Ayako Aihara, Nobue Itasaki, Taito Nishino
Cells grown in three-dimensional (3D) cultures are more likely to have native cell-cell and cell-matrix interactions than in 2D cultures that impose mechanical constraints to cells. However, most 3D cultures utilise gel matrix which, while serving as a scaffold, limits application due to its solid and opaque nature and inconsistency in cell exposure to exogenous signals. In 3D culture without gel matrix, cells tend to adhere to each other and form clumps with necrotic zone at the centre, making them unsuitable for analyses...
February 26, 2018: Scientific Reports
Christopher D Spicer, Coline Jumeaux, Bakul Gupta, Molly M Stevens
Peptide- and protein-nanoparticle conjugates have emerged as powerful tools for biomedical applications, enabling the treatment, diagnosis, and prevention of disease. In this review, we focus on the key roles played by peptides and proteins in improving, controlling, and defining the performance of nanotechnologies. Within this framework, we provide a comprehensive overview of the key sequences and structures utilised to provide biological and physical stability to nano-constructs, direct particles to their target and influence their cellular and tissue distribution, induce and control biological responses, and form polypeptide self-assembled nanoparticles...
February 26, 2018: Chemical Society Reviews
R Schroeder
Biocompatible materials that can encapsulate large amounts of nutrients while protecting them from degrading environmental influences are highly desired for extended manned spaceflight. In this study, alkaline-degradable microgels based on poly(N-vinylcaprolactam) (PVCL) were prepared and analysed with their regard to stabilise retinol which acts as a model vitamin (vitamin A1 ). It was investigated whether the secondary crosslinking of the particles with a polyphenol can prevent the isomerisation of biologically active all-trans retinol to biologically inactive cis-trans retinol...
February 2018: Life Sciences in Space Research
M Kreuter, U Ochmann, D Koschel, J Behr, F Bonella, M Claussen, U Costabel, S Jungmann, M Kolb, D Nowak, F Petermann, M Pfeiffer, M Polke, A Prasse, J Schreiber, J Wälscher, H Wirtz, D Kirsten
BACKGROUND:  Interstitial lung diseases (ILD) encompass different heterogeneous, mainly chronic diseases of the pulmonary interstitium and/or alveoli with known and unknown reasons. The diagnostic of ILD is challenging and should be performed interdisciplinary. The medical history is of major importance and therefore, in German-speaking countries the Frankfurter Bogen (published in 1985) was utilised to scrutinise the medical history of the patient. This by now more than 30-years-old questionnaire requires a revision with regard to content and language...
February 21, 2018: Pneumologie
Tim Kirkpatrick, Charlotte Lennox, Rod Taylor, Rob Anderson, Michael Maguire, Mark Haddad, Susan Michie, Christabel Owens, Graham Durcan, Alex Stirzaker, William Henley, Caroline Stevenson, Lauren Carroll, Cath Quinn, Sarah Louise Brand, Tirril Harris, Amy Stewart, Roxanne Todd, Sarah Rybczynska-Bunt, Rebecca Greer, Mark Pearson, Jenny Shaw, Richard Byng
INTRODUCTION: The 'Engager' programme is a 'through-the-gate' intervention designed to support prisoners with common mental health problems as they transition from prison back into the community. The trial will evaluate the clinical and cost-effectiveness of the Engager intervention. METHODS AND ANALYSIS: The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either: (a) the Engager intervention plus standard care (intervention group) or (b) standard care alone (control group) across two investigation centres (South West and North West of England)...
February 20, 2018: BMJ Open
Lisa Gillinder, Alexander Lehn, Helen Brown, Sasha Dionisio
OBJECTIVE: The present study aims to determine qualitative outcomes of presentations with acute recurrent seizures or status epilepticus to the emergency department of our institution after the introduction of a new seizure management protocol METHODS: We performed a retrospective analysis on two cohorts of patients for all presentation to the emergency department of our institution. Presentations were reviewed from January to July pre protocol introduction and the same period post protocol...
February 20, 2018: Internal Medicine Journal
Andrea Marcellusi, Gianluca Fabiano, Raffaella Viti, Pier Cesare Francesa Morel, Giuseppe Nicolò, Alberto Siracusano, Francesco Saverio Mennini
OBJECTIVES: Schizophrenia is a chronic, debilitating psychiatric disease with highly variable treatment pathways and consequent economic impacts on resource utilisation. The aim of the study was to estimate the economic burden of schizophrenia in Italy for both the societal and Italian National Healthcare perspective. METHODS: A probabilistic cost of illness model was applied. A systematic literature review was carried out to identify epidemiological and economic data...
February 8, 2018: BMJ Open
Roland C Merchant, Zhongli Zhang, Zihao Zhang, Tao Liu, Janette R Baird
OBJECTIVES: Assess the 12-month efficacy of a brief intervention (BI) on reducing drug use and increasing drug treatment services utilisation among adult emergency department (ED) patients. METHODS: This randomised, controlled trial enrolled 18-64-year-old ED patients needing a drug use intervention. Treatment arm participants received a tailored BI while control arm participants only completed the study questionnaires. Self-reported past 3-month drug use and engagement in drug treatment services were compared by study arm at 3-month intervals over 1 year...
February 2, 2018: Emergency Medicine Journal: EMJ
Caleb J Banta-Green, Phillip O Coffin, Joseph O Merrill, Jeanne M Sears, Chris Dunn, Anthony S Floyd, Lauren K Whiteside, Norbert D Yanez, Dennis M Donovan
BACKGROUND: Opioid overdose is a major and increasing cause of injury and death. There is an urgent need for interventions to reduce overdose events among high-risk persons. METHODS: Adults at elevated risk for opioid overdose involving heroin or pharmaceutical opioids who had been cared for in an emergency department (ED) were randomised to overdose education combined with a brief behavioural intervention and take-home naloxone or usual care. Outcomes included: (1) time to first opioid overdose-related event resulting in medical attention or death using competing risks survival analysis; and (2) ED visit and hospitalisation rates, using negative binomial regression and adjusting for time at risk...
February 7, 2018: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Rowan P Ogeil, Jeremy Dwyer, Lyndal Bugeja, Cherie Heilbronn, Dan I Lubman, Belinda Lloyd
BACKGROUND: In the past two decades, rates of pharmaceutical opioid use and harms resulting from their use (including death) have risen. The present study identified a series of fatal opioid overdoses where there was evidence that witnesses had noted symptoms consistent with overdose, and examined associated contextual factors. METHODS: A retrospective review was undertaken utilising the Coroners Court of Victoria's Overdose Deaths Register for pharmaceutical opioid overdose deaths between 2011 and 2013...
February 9, 2018: International Journal on Drug Policy
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