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Rational use of medicine

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https://www.readbyqxmd.com/read/28736501/design-of-radioiodinated-pharmaceuticals-structural-features-affecting-metabolic-stability-towards-in-vivo-deiodination
#1
REVIEW
Lorenzo Cavina, Dion van der Born, Peter H M Klaren, Martin C Feiters, Otto C Boerman, Floris P J T Rutjes
Radioiodinated pharmaceuticals are convenient tracers for clinical and research investigations because of the relatively long half-lives of radioactive iodine isotopes (i.e., (123)I, (124)I, and (131)I) and the ease of their chemical insertion. Their application in radionuclide imaging and therapy may, however, be hampered by poor in vivo stability of the C-I bond. After an overview of the use of iodine in biology and nuclear medicine, we present here a survey of the catabolic pathways for iodinated xenobiotics, including their biodistribution, accumulation, and biostability...
June 30, 2017: European Journal of Organic Chemistry
https://www.readbyqxmd.com/read/28731962/polymorphisms-in-cytochrome-p450-oxidoreductase-and-its-effect-on-drug-metabolism-and-efficacy
#2
Liang Gong, Cong-Min Zhang, Jin-Feng Lv, Hong-Hao Zhou, Lan Fan
Cytochrome P450 oxidoreductase (POR) has played a potential role in the metabolism of drugs and steroids by supplying electrons to microsomal cytochrome P450 (CYP) enzymes. More than 200 different POR mutations and polymorphisms causing more than 130 amino acid changes in the POR protein have been reported since 2004. A503V is a common amino acid sequence variant encoded by POR*28, whereas A287P and R457H are the most common disease-causing mutations in Europeans and Asians, respectively. Polymorphisms in the POR gene can affect POR activity, CYP-mediated drug metabolism activities, and the efficacy of several clinically used drugs...
July 20, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#3
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28724036/clinical-pharmacology-profile-of-care-in-hepatology-clinic
#4
Talita Rocha Passos, Fabiana Silva Santos, Maria Cleusa Martins, Vanusa Barbosa Pinto, Flair José Carrilho, Suzane Kioko Ono
Since 2010, the Clinical Gastroenterology and Hepatology Division of the Central Institute of Hospital das Clínicas of the University of São Paulo Medical School (HC-FMUSP, in the Portuguese acronym) has been developing specialized electives assistance activities in the Outpatient Specialty Clinic, Secondary Level, in São Paulo NGA-63 Várzea do Carmo. The objective of this study was to analyze the pharmacotherapeutic profile of patients. This is a cross-sectional and retrospective study in which patients were seen at the Hepatology sector and the results were submitted to descriptive statistics...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28712182/trend-of-irrational-medication-among-the-students-of-department-of-pharmacy-abbottabad-university-of-science-and-technology-in-common-cold-and-flu
#5
Mujeeb Ur Rehman, Saif Ullah Mehsud, Sartaj Ali, Muhammad Ishaq, Mumtaz Ali Khan
BACKGROUND: Common cold and flu are mostly of viral pathogenesis with symptoms in upper respiratory tract. It is highly contagious and close inter-individual contact in winter season increase the spread spectrum. Mis-interpretation with bacterial cause leads to irrationality in its medication. METHODS: A cross-sectional study was conducted among pharmacy department students in February-March 2016. Data were collected through self-administered questionnaire and expressed as percentage frequency...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710372/phthalide-derivatives-from-angelica-sinensis-decrease-hemoglobin-oxygen-affinity-a-new-allosteric-modulating-mechanism-and-potential-use-as-2-3-bpg-functional-substitutes
#6
Wei-Ren Chen, Youqing Yu, Muhammad Zulfajri, Ping-Cheng Lin, Chia C Wang
Angelica sinensis (AS), one of the most versatile herbal medicines remains widely used due to its multi-faceted pharmacologic activities. Besides its traditional use as the blood-nourishing tonic, its anti-hypertensive, anti-cardiovascular, neuroprotective and anti-cancer effects have been reported. Albeit the significant therapeutic effects, how AS exerts such diverse efficacies from the molecular level remains elusive. Here we investigate the influences of AS and four representative phthalide derivatives from AS on the structure and function of hemoglobin (Hb)...
July 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28699158/precision-medicine-in-inflammatory-bowel-diseases
#7
Sarah Fischer, Markus F Neurath
Inflammatory bowel diseases (IBD) are a lifelong condition of chronic, recurrent inflammation in the gut. The introduction of immunomodulators and biologic agents markedly improved the treatment of IBD. Therefore the use of biologics became an essential element in the rational therapy of IBD. Various substances are currently evaluated in clinical trials, addressing different target structures and offering further approaches in the field of IBD. Regarding the growing number of treatment options, the need for prediction of therapy response became a necessity and is subject of present research...
July 12, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28695833/investigation-on-the-collection-and-economy-of-medicinal-leeches-from-wetlands-around-lake-e%C3%A4-irdir-turkey
#8
Mustafa Ceylan, Osman Çetinkaya
OBJECTIVE: This study aimed to investigate the collection and economy of medicinal leeches from wetlands around Lake Eğirdir, Turkey. METHODS: Data used in this study were based on findings, observations, and face-to-face interviews obtained from a research performed between January 2013 - February 2016 on medicinal leech populations. RESULTS: The leech collecting is carried out without any permission, by both local peoples and others especially who are from Afyonkarahisar...
June 2017: Türkiye Parazitolojii Dergisi
https://www.readbyqxmd.com/read/28694778/north-african-medicinal-plants-traditionally-used-in-cancer-therapy
#9
REVIEW
Jorge M Alves-Silva, Abderrahmane Romane, Thomas Efferth, Lígia Salgueiro
Background: Cancer is a major cause of mortality worldwide with increasing numbers by the years. In North Africa, the number of cancer patients is alarming. Also shocking is that a huge number of cancer patients only have access to traditional medicines due to several factors, e.g., economic difficulties. In fact, medicinal plants are widely used for the treatment of several pathologies, including cancer. Truthfully, herbalists and botanists in North African countries prescribe several plants for cancer treatment...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28694036/-priority-setting-and-rationing-of-pharmaceuticals-an-experimental-analysis-of-discussion-processes
#10
Ines Aumann, Svenja Litzkendorf, Kathrin Damm, J Matthias Graf von der Schulenburg
BACKGROUND/OBJECTIVE: In the face of rising expenditure among statutory sickness funds in Germany it is necessary to start a discussion about priority setting in the healthcare system. For a long time this issue was avoided in healthcare debates. As a result, normative directives are still missing, which can lead to priority setting among healthcare providers in daily healthcare practice. A discussion on priority setting can be conducted at three different levels: at the government (macro), the institutional (meso), and the patient (micro) level...
July 7, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28685674/review-on-anti-cancer-activity-in-wild-plants-of-the-middle-east
#11
Einav Mayzlish-Gati, Marcelo Fridlender, Rameshprabu Nallathambi, Gopinath Selvaraj, Stalin Nadarajan, Hinanit Koltai
Plants have been a source of medicine for thousands of years. In many different cultures they became an integral part of local folklore. Plants have since become a source of well-known drugs and pharmaceuticals that are widely used in modern day medicine. Cancer is among the leading causes of mortality worldwide and the number of new cases is expected to rise over the next 2 decades. Some herbal medicines have a therapeutic effect which inhibits cancer via different mechanisms. The Mediterranean basin is one of the richest biodiversity areas in the world...
July 5, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28684051/patent-foramen-ovale-closure-to-prevent-secondary-neurologic-events
#12
REVIEW
Rosie Jasper, James C Blankenship
In October of 2016 the United States Food and Drug Administration approved the Amplatzer Patent Foramen Ovale (PFO) occluder device for use in patients with cryptogenic stroke, to reduce the risk of recurrent stroke. This event followed 15years of off-label use of atrial septal occluder devices, 3 randomized trials, and enormous controversy over the efficacy of this procedure. While none of the trials reached the primary endpoint needed to prove the efficacy of PFO closure in preventing recurrent stroke, meta-analyses and 5-year follow-up of 1 trial suggest that PFO closure decreases the risk of recurrent stroke, especially in sub-groups with large shunts and atrial septal aneurysms, and especially when the Amplatzer device (rather than other devices) is used...
July 3, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28671618/vascular-mechanobiology-towards-control-of-in-situ-regeneration
#13
REVIEW
Eline E van Haaften, Carlijn V C Bouten, Nicholas A Kurniawan
The paradigm of regenerative medicine has recently shifted from in vitro to in situ tissue engineering: implanting a cell-free, biodegradable, off-the-shelf available scaffold and inducing the development of functional tissue by utilizing the regenerative potential of the body itself. This approach offers a prospect of not only alleviating the clinical demand for autologous vessels but also circumventing the current challenges with synthetic grafts. In order to move towards a hypothesis-driven engineering approach, we review three crucial aspects that need to be taken into account when regenerating vessels: (1) the structure-function relation for attaining mechanical homeostasis of vascular tissues, (2) the environmental cues governing cell function, and (3) the available experimental platforms to test instructive scaffolds for in situ tissue engineering...
July 3, 2017: Cells
https://www.readbyqxmd.com/read/28669583/screening-and-identification-of-steroidal-saponins-from-anemarrhena-asphodeloides-employing-uplc-tandem-triple-quadrupole-linear-ion-trap-mass-spectrometry
#14
Yong-Gang Xia, Xin-Dong Guo, Jun Liang, Bing-You Yang, Hai-Xue Kuang
This study presents a practical and valid strategy for the screening and structural characterization of Anemarrhena asphodeloides Bge steroidal saponins (SSs) using ultra-high performance liquid chromatography coupled with triple quadrupole linear ion trap mass spectrometry. The whole analytical protocols integrate four-step procedures in the positive mode: (1) rational deduction of mass fragmentation pathways of A. asphodeloides SSs; (2) untargeted screening of potential A. asphodeloides SSs by multiple-ion monitoring-information-dependent-acquiring- enhanced product ion (MIM-IDA-EPI) scan through reverse phase liquid chromatography; (3) comprehensive construction of an ammoniated precursor ion database by combining untargeted MIM-IDA-EPI scans and data literature; and (4) structural interpretation of targeted A...
June 29, 2017: Steroids
https://www.readbyqxmd.com/read/28666834/a-review-of-traditional-and-current-methods-used-to-potentially-reduce-toxicity-of-aconitum-roots-in-traditional-chinese-medicine
#15
REVIEW
Shuai Liu, Fei Li, Yan Li, Weifei Li, Jinkai Xu, Hong Du
CONTEXT: Aconitum species are well-known for their medicinal value and high lethal toxicity in many Asian countries, notably China, India and Japan. The tubers are only used after processing in Traditional Chinese Medicine (TCM). They can be used safely and effectively with the methods of decoction, rational compatibility, and correct processing based on traditional experiences and new technologies. However, high toxicological risks still remain due to improper preparation and usage in China and other countries...
June 28, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28662649/use-of-generic-and-essential-medicines-for-prevention-and-treatment-of-cardiovascular-diseases-in-portugal
#16
Helena Gama, Carla Torre, José Pedro Guerreiro, Ana Azevedo, Suzete Costa, Nuno Lunet
BACKGROUND: The successful control of cardiovascular diseases at the lowest possible cost requires the use of the most effective and affordable medicines. We aimed to describe the trends in the ambulatory use of medicines for prevention and treatment of cardiovascular diseases [Anatomic Therapeutic Chemical classification system (ATC): C and B01A] in Portugal, between 2004 and 2012, and to estimate the potential for expenditure reduction through changes in patterns of use. METHODS: We analysed sell-out data, expressed as defined daily doses (DDD) and pharmacy retail price (€), from a nationwide database...
June 29, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28658278/antimicrobial-use-surveillance-in-broiler-chicken-flocks-in-canada-2013-2015
#17
Agnes Agunos, David F Léger, Carolee A Carson, Sheryl P Gow, Angelina Bosman, Rebecca J Irwin, Richard J Reid-Smith
There is a paucity of data on the reason for and the quantity of antimicrobials used in broiler chickens in Canada. To address this, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) implemented surveillance of antimicrobial use (AMU) and antimicrobial resistance (AMR) in broiler chicken flocks in 2013. Shortly after this (2014), the poultry industry banned the preventive use of ceftiofur in broiler chickens. The objectives of this analysis were to describe antimicrobial use (AMU) in Canadian broiler chickens between 2013 and 2015 (n = 378 flocks), compare these results to other animal species in Canada, to highlight the utility of farm surveillance data to evaluate the impact of a policy change, and to explore how different antimicrobial use metrics might affect data interpretation and communication...
2017: PloS One
https://www.readbyqxmd.com/read/28654205/driving-toward-precision-medicine-for-acute-leukemias-are-we-there-yet
#18
Clement Chung, Hilary Ma
Despite recent progress in the understanding of the molecular basis of acute leukemias, treatment options for these diseases have not shown significant changes over the last few decades. In this review, we present a nonexhaustive key summary of the current cytogenetic and molecular changes associated with acute leukemias in disease prognostication and potential targeted therapies. An emerging paradigm is that many genetic or molecular alterations target similar signal transduction, transcriptional, and epigenetic pathways...
June 27, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28627841/clinical-decision-making-from-theory-to-practice%C3%A2-and-backward
#19
Lionel De Alencastro, Carole Clair, Isabella Locatelli, Mark H Ebell, Nicolas Senn
Being able to analyze all the successive steps of decision making from the first contact with the patient to the final diagnosis is complex because it refers sometimes to intuitive elements proper to each clinician. However, understanding how they integrate probabilities of diseases into their clinical practice and manage diagnostic uncertainties is crucial. This allows a more rational practice of medicine and identifying factors related to the patient, physician or context that may modify the clinical decision making...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28626850/prescribing-indicators-in-primary-health-care-in-belo-horizonte-brazil-associated-factors
#20
Marina Guimarães Lima, Kátia Reis Dutra, Ursula Carolina Morais Martins
Background The prescription is one of the factors that influences rational use of medicines. The evaluation of prescribing indicators should contribute to organization of primary health care services. Objective The aim of this study was to evaluate prescribing indicators and associated factors in primary health care in the northeast health district, Belo Horizonte, Brazil. Setting Twenty primary health care units in the Northeast Health District, Belo Horizonte, Brazil. Method The study was cross sectional...
June 19, 2017: International Journal of Clinical Pharmacy
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