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Rational use of medicine

Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Ellen L Mintz, Juliana A Passipieri, Daniel Y Lovell, George J Christ
Despite the regenerative capacity of skeletal muscle, permanent functional and/or cosmetic deficits (e.g., volumetric muscle loss (VML) resulting from traumatic injury, disease and various congenital, genetic and acquired conditions are quite common. Tissue engineering and regenerative medicine technologies have enormous potential to provide a therapeutic solution. However, utilization of biologically relevant animal models in combination with longitudinal assessments of pertinent functional measures are critical to the development of improved regenerative therapeutics for treatment of VML-like injuries...
October 7, 2016: Journal of Visualized Experiments: JoVE
Dwijen Kumar Choudhury, Babul Kumar Bezbaruah
OBJECTIVES: The aim of this study is to evaluate the prescribing pattern of analgesics and analyze the rational use of analgesic in orthopedic in-patient department of tertiary care teaching hospital, Guwahati, Assam. SUBJECTS AND METHODS: An observational and cross-sectional study was carried out for 1 month from April to May 2014. Collected data included age, sex, diagnosis and line of management during the study. The generic name and the average cost of treatment per patient were evaluated using Indian Drug Review, 2014...
July 2016: Indian Journal of Pharmacology
R Soumya, Vijayalakshmi Devarashetty, C R Jayanthi, M Sushma
OBJECTIVES: Pharmacists are one of the crucial focal points for health care in the community. They have tremendous outreach to the public as pharmacies are often the first-port-of-call. With the increase of ready-to-use drugs, the main health-related activity of a pharmacist today is to assure the quality of dispensing, a key element to promote rational medicine use. MATERIALS AND METHODS: A cross-sectional study of 200 pharmacies, 100 each in various residential (R) and commercial (C) areas of Bengaluru, was conducted using a prevalidated questionnaire administered to the chief pharmacist or the person-in-charge by the investigators...
July 2016: Indian Journal of Pharmacology
(no author information available yet)
Pharmacovigilance is the science and activity relating to the collection, detection, assessment, monitoring, and prevention of adverse effects with pharmaceutical products. Pharmacovigilance basically targets safety of medicine. Pharmacists have crucial role in health systems to maintain the rational and safe use of medicine for they are drug experts who are specifically trained in this field. Effective use of pharmacists' workforce will improve the outcome of the pharmacotherapy as well as decrease global health costs...
2016: Online Journal of Public Health Informatics
Bashir Mohamed Elmahi Yousif, Siripen Supakankunti
BACKGROUND: The appropriate use of medicines is essential for the provision of quality health services, patient safety, and the rational use of health resources. In Sudan, general practitioners (GPs) provide 80 % of insured patients' health services. Pharmaceutical service costs have been increasing since 2010. OBJECTIVES: We aimed to use the World Health Organization (WHO) and International Network for the Rational Use of Drugs prescribing indicators to assess prescription quality among GPs in different types of primary healthcare centers (PHCCs) within the National Health Insurance Fund (NHIF) in Gezira State, Sudan...
September 2016: Drugs—Real World Outcomes
Adam S Cheifetz, Robert Gianotti, Raphael Luber, Peter R Gibson
Patients and physicians often have many questions regarding the role of complementary and alternative medicines (CAMs), or non-allopathic therapies, for inflammatory bowel diseases (IBD). CAMs of various forms are used by more than half of patients with IBD during some point in their disease course. We summarize the available evidence for the most commonly used and discussed CAMs. We discuss evidence for the effects of herbs (such as cannabis and curcumin), probiotics, acupuncture, exercise, and mind-body therapy...
October 12, 2016: Gastroenterology
S N Thiyahiny, M G Sathiadas, K Sanchayan, C Vamadevan, R Balasubramaniam, S Sri Ranganathan
INTRODUCTION: Challenges in rational use of medicines (RUM) in children are different from that of adults. In Sri Lanka, data on RUM in children are limited. OBJECTIVE: To assess the current status and to investigate effectiveness of an intervention in improving RUM in children. METHODS: Non-randomised controlled before and after study design was employed. Study settings were one paediatric unit in two Teaching Hospitals one for intervention (IU) and the other as a control (CU) unit...
2016: Ceylon Medical Journal
İbrahim Ömer Barlas, Orhan Sezgin, Collet Dandara, Gözde Türköz, Emre Yengel, Zinhle Cindi, Handan Ankaralı, Semra Şardaş
Pharmacogenomics harnesses the utility of a patient's genome (n = 1) in decisions on which therapeutic drugs and in what amounts should be administered. Often, patients with shared ancestry present with comparable genetic profiles that predict drug response. However, populations are not static, thus, often, population mobility through migration, especially enmasse as is seen for refugees, changes the pharmacogenetic profiles of resultant populations and therefore observed responses to commonly used therapeutic drugs...
October 2016: Omics: a Journal of Integrative Biology
J A Van Heerden, J R Burger, J J Gerber
BACKGROUND: Prescribing for older patients is a well-recognised problem, and inappropriate items are prescribed frequently. Several tools and criteria are available to promote rational prescribing in older patients. OBJECTIVE: To determine the prevalence of potentially inappropriate prescriptions (PIPs) in older South African patients. METHODS: A retrospective drug utilisation review was conducted using medicine claims data over a 1-year period...
September 9, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Rebecca Llewellyn, Chrystal Jaye, Richard Egan, Wayne Cunningham, Jessica Young, Peter Radue
The prevalence of metaphors in medicine is widely acknowledged. In a qualitative study exploring expectations of longevity, we observed repeated recourse to the imaginative rationality provided by metaphors to express perspectives on longevity and death. Bafflement, acceptance, uncertainty and distress were conveyed through metaphors, providing valuable insight into the internal healthcare frameworks of participants. Skilful use of imaginative rationality in the healthcare setting may illuminate the elusive and often eschewed topic of death in a way that fosters clarity and new understandings, and pave the way towards a better life, and death for patients...
October 5, 2016: Medical Humanities
Elisa Biondi, Joshua D Lane, Debasis Das, Saurja Dasgupta, Joseph A Piccirilli, Shuichi Hoshika, Kevin M Bradley, Bryan A Krantz, Steven A Benner
Reported here is a laboratory in vitro evolution (LIVE) experiment based on an artificially expanded genetic information system (AEGIS). This experiment delivers the first example of an AEGIS aptamer that binds to an isolated protein target, the first whose structural contact with its target has been outlined and the first to inhibit biologically important activities of its target, the protective antigen from Bacillus anthracis We show how rational design based on secondary structure predictions can also direct the use of AEGIS to improve the stability and binding of the aptamer to its target...
October 3, 2016: Nucleic Acids Research
Ming-Liang Zhou, Zhigang Qian, Liang Chen, David L Kaplan, Xiaoxia Xia
Protein hydrogels are an important class of materials for applications in biotechnology and medicine. The fine tuning of their sequence, molecular weight, and stereochemistry offers unique opportunities to engineer biofunctionality, biocompatibility, and biodegradability into these materials. Here we report a new family of redox-sensitive protein hydrogels with controllable mechanical properties, composed of recombinant silk-elastin-like protein polymers (SELPs). The SELPs were designed and synthesized SELPs with different ratios of silk-to-elastin blocks that incorporated periodic cysteine residues...
October 4, 2016: Biomacromolecules
Simon Rj Maxwell
Prescribing is the most important tool used by physicians to cure illness, relieve symptoms and prevent future disease. It is also a complex intellectual task that requires formulation of an appropriate treatment regimen from the many thousands available, taking into account the infinite variation in the patients they encounter. Unfortunately, the selection of a medicine and dosage regimen is sometimes suboptimal, leading to poor patient outcomes (eg treatment failure, avoidable adverse reactions). This article will highlight some of the common prescribing errors and will develop a rational approach that includes making a diagnosis, estimating prognosis, establishing the goals of therapy, selecting the most appropriate treatment and monitoring the effects of the treatment...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Azizeh Abdolmalekia, Jahan B Ghasemi
Finding high quality beginning compounds is a critical job at the start of the lead generation stage for multi-target drug discovery (MTDD). Designing hybrid compounds as a selective multi-target chemical entity is a challenge, opportunity, and new idea to better act against specific multiple targets. One hybrid molecule is formed by two (or more) pharmacophore group's participation. So, these new compounds often exhibit two or more activities going about as multi-target drugs (mt-drugs) and may have superior safety or efficacy...
September 27, 2016: Current Topics in Medicinal Chemistry
Michelle de Oliveira Pedrosa, Rayssa Marques Duarte da Cruz, Jéssika Oliveira Viana, Ricardo Olímpio de Moura, Hamilton Mitsugu Ishiki, José Maria Barbosa Filho, Margareth F F M Diniz, Marcus Tullius Scotti, Luciana Scotti, Francisco Jaime Bezerra Mendonça
Molecular Hybridization is an approach in rational drug design where new chemical entities are obtained by combining two or more pharmacophoric units from different bioactive compounds into a single molecule. Through this approach, medicinal chemists hope that the new hybrid derivative presents: better affinity and efficacy when compared to the parent drugs; a modified selectivity profile with improvement over pharmacokinetic and pharmacodynamic restrictions; dual or multiple modes of action; reduction of undesirable side effects; decreases in drug-drug interactions; reduced emergence or spread of drug resistance in microorganisms and protozoans; and lower cost...
September 27, 2016: Current Topics in Medicinal Chemistry
Jiachun Liu, Yan-Ling Wu, Huri Piao, Xiaoyin Zhao, Wen Zhang, Yanli Wang, Minrui Liu
At present, diseases resulting from various reasons have been causing deadly fears to humans and previously incogitable losses to health. Meanwhile, the patient compliance has been weakening because of drug resistance and serious drug adverse effects. There is therefore an urgent need for the development of novel structural agents. Rhodanine derivatives have represented wide biological activities, as well as significant industrial applications, which suggests that rhodanine heterocycle represents a key structural motif in heterocyclic chemistry and occupies a prominent position in drug discovery...
September 28, 2016: Mini Reviews in Medicinal Chemistry
Vojtěch Mornstein, Jiří Beneš, Zdeněk Mrozek, Štěpán Svačina
This article gives information on selected alternative medicine methods (AMM) under conditions of the Czech health care system. They can be defined as contemporaneous diagnostic and therapeutic methods which differ in their theoretical fundaments as well as practices from the evidence based medicine. This definition is controversial because these methods are an intrinsically incompatible aggregate of modalities acting as a placebo above all. We can encounter many "therapeutic" and "examination" methods which are practiced namely by healers without formal medical education, and connected closely with esotericism...
2016: Casopís Lékar̆ů C̆eských
Jakaria Shawon, Akib Mahmud Khan, Adhip Rahman, Mohammad Mazharol Hoque, Mohammad Abdul Kader Khan, Mohammed G Sarwar, Mohammad A Halim
Molecular recognition has central role on the development of rational drug design. Binding affinity and interactions are two key components which aid to understand the molecular recognition in drug-receptor complex and crucial for structure-based drug design in medicinal chemistry. Herein, we report the binding affinity and the nonbonding interactions of azelaic acid and related compounds with the receptor DNA polymerase I (2KFN). Quantum mechanical calculation was employed to optimize the modified drugs using B3LYP/6-31G(d,p) level of theory...
October 1, 2016: Interdisciplinary Sciences, Computational Life Sciences
Yasser Riazalhosseini, Mark Lathrop
Genomics is revolutionizing our understanding of the molecular basis of renal cell carcinoma (RCC). The advent of unbiased genome-wide association studies has led to the discovery of previously unrecognized genetic predisposing factors that impact an individual's risk of developing RCC. Moreover, large-scale investigations of somatic alterations of the genomic and transcriptomic landscapes in tumours using next-generation sequencing technology have revealed new information on the molecular pathways that are characteristically disrupted in various RCC subtypes...
November 2016: Nature Reviews. Nephrology
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