External contamination of antineoplastic drug containers from a Canadian wholesaler

2019 ◽  
Vol 26 (2) ◽  
pp. 423-427
Author(s):  
D Hilliquin ◽  
JF Bussières
Keyword(s):  
External Surface ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Antineoplastic Drug ◽  
Antineoplastic Drugs ◽  
Pharmacy Staff ◽  
Cross Sectional ◽  
Liquid Chromatography Tandem Mass ◽  
Handling Practices ◽  
Single Batch

Introduction Contamination of hospitals’ surfaces with antineoplastic drugs is documented despite safe handling practices. The exterior of commercial containers is often contaminated during the manufacturing process and can cross-contaminate hospitals’ surfaces. The aim was to investigate the contamination of the exterior of antineoplastic drug vials available in Canada in 2018. Methods Cross-sectional study. All available antineoplastic drugs vials from a single wholesaler were targeted. Containers were sampled upon their receipt by the pharmacy staff, before they were cleaned. One wipe was used to sample the external surface of five vials from a single batch from the same manufacturer. Nine antineoplastic drugs were quantified by ultra-performance liquid chromatography–tandem mass spectrometer: cyclophosphamide, docetaxel, 5-fluorouracil, gemcitabine, ifosfamide, irinotecan, methotrexate, paclitaxel, vinorelbine. Results Twenty-one samplings were done (105 containers from nine different manufacturers): cyclophosphamide = 2, docetaxel = 1, gemcitabine = 2, 5-fluorouracil = 2, ifosfamide = 2, irinotecan = 3, methotrexate = 6, paclitaxel = 2, vinorelbine = 1. One of these samplings was done on blister packaging, the remainder were done on glass vials. A total of 15/21 samples (71%) were positive to at least one drug (docetaxel, 5-fluorouracil, ifosfamide, and vinorelbine). A maximum of 272 ng/vial was quantified (gemcitabine). Cross contamination with other antineoplastic drugs was detected on 16/21 (76%) samples. Conclusion The majority of samples were positive to at least one antineoplastic drug, confirming that the exterior of antineoplastic drugs containers is still an important source of contamination. Manufacturers should reduce this contamination. Vials should be washed upon receipt, before they are stored in pharmacy. Gloves must be worn at all times to avoid occupational exposure.

Association of CYP2D6*10 (c. 100 C>T) Genotype with Z-END Concentration in Patients with Breast Cancer Receiving Tamoxifen Therapy in Indonesian Population

2019 ◽  
Vol 19 (8) ◽  
pp. 1198-1206 ◽  
Author(s):  
Yenny ◽  
Sonar S. Panigoro ◽  
Denni J. Purwanto ◽  
Adi Hidayat ◽  
Melva Louisa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Steady State ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Threshold Concentration ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Significant Difference ◽  
Pcr Rflp ◽  
Liquid Chromatography Tandem Mass

Background: Tamoxifen (TAM) is a frequently used hormonal prodrug for patients with breast cancer that needs to be activated by cytochrome P450 2D6 (CYP2D6) into Zusammen-endoxifen (Z-END). Objective: The purpose of the study was to determine the association between CYP2D6*10 (c.100C>T) genotype and attainment of the plasma steady-state Z-END minimal threshold concentration (MTC) in Indonesian women with breast cancer. Methods: A cross-sectional study was performed in 125 ambulatory patients with breast cancer consuming TAM at 20 mg/day for at least 4 months. The frequency distribution of CYP2D6*10 (c.100C>T) genotypes (C/C: wild type; C/T: heterozygous mutant; T/T: homozygous mutant) was detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), the results of which were subsequently confirmed by sequencing. The genotypes were categorized into plasma Z- END concentrations of <5.9 ng/mL and ≥5.9 ng/mL, which were measured using ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Results: Percentages of C/C, CT, and T/T genotypes were 22.4%, 29.6%, and 48.8%, respectively. Median (25-75%) Z-END concentrations in C/C, C/T, and T/T genotypes were 9.58 (0.7-6.0), 9.86 (0.7-26.6), and 3.76 (0.9-26.6) ng/mL, respectively. Statistical analysis showed a significant difference in median Z-END concentration between patients with T/T genotype and those with C/C or C/T genotypes (p<0.001). There was a significant association between CYP2D6*10 (c.100C>T) genotypes and attainment of plasma steady-state Z-END MTC (p<0.001). Conclusion: There was a significant association between CYP2D6*10 (c.100C>T) and attainment of plasma steady-state Z-END MTC in Indonesian breast cancer patients receiving TAM at a dose of 20 mg/day.

Increased levels of bisphenol A (BPA) in Thai girls with precocious puberty

2016 ◽  
Vol 0 (0) ◽  
Author(s):  
Vichit Supornsilchai ◽  
Chutima Jantarat ◽  
Wichit Nosoognoen ◽  
Sopon Pornkunwilai ◽  
Suttipong Wacharasindhu ◽  
...  
Keyword(s):  
Bisphenol A ◽  
Estrogenic Activity ◽  
Age At Onset ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Control Groups ◽  
Limit Of Quantification ◽  
Cross Sectional ◽  
Liquid Chromatography Tandem Mass

AbstractReports on the secular trend of pubertal onset indicate a recent earlier start especially in girls. Bisphenol A (BPA), which posses estrogenic activity, might be a cause of advanced puberty. The objective of the study was to determine the association between BPA and advanced puberty.A cross-sectional study was conducted in patients with advanced puberty (n=41) compared to age-matched controls (n=47). Anthropometric measurements, estradiol, basal and gonadotropin releasing hormone (GnRH)-stimulated follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels, uterine sizes, ovarian diameters and bone ages were obtained. Urinary BPA concentrations were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC/MSMS) with the lower limit of quantification (LLOQ) of 0.05 ng/mL.The median adjust-BPA concentration in advanced puberty group was higher than in control groups [1.44 vs. 0.59 μg/g creatinine (Cr): p<0.05]. We also found that the median adjust-BPA concentration in girls with advanced puberty who were overweight/obese, was greater than in the normal pubertal overweight/obese girls (1.74 vs. 0.59 μg/g Cr: p<0.05), and was in the same trend among normal weight girls with advanced and normal puberty (0.83 vs. 0.49 μg/g Cr: p=0.09), but not statistically significant.The present findings suggest that BPA exposure appears to be related to an earlier age at onset of puberty especially in obese girls.

Cross-sectional evaluation of surface contamination with 9 antineoplastic drugs in 93 Canadian healthcare centers: 2019 results

2020 ◽  
Vol 26 (8) ◽  
pp. 1921-1930
Author(s):  
Marie Palamini ◽  
Sébastien Gagné ◽  
Nicolas Caron ◽  
Jean-François Bussières
Keyword(s):  
Occupational Safety ◽  
Ultra Performance Liquid Chromatography ◽  
Primary Objective ◽  
Outpatient Clinics ◽  
Antineoplastic Drugs ◽  
Cross Sectional ◽  
Health Group ◽  
Liquid Chromatography Tandem Mass ◽  
Kolmogorov Smirnov ◽  
The Impact

Introduction The primary objective was to describe environmental contamination with National Institute for Occupational Safety and Health Group 1 hazardous drugs in oncology pharmacies and outpatient clinics in Canada in 2019, as part of an annual surveillance project. Methods In each participating center, 12 standardized sites (6 in the oncology pharmacy and 6 in outpatient clinic) were sampled. Each sample was prepared to allow quantification of six antineoplastic drugs (cyclophosphamide, ifosfamide, methotrexate, gemcitabine, 5-fluorouracil, and irinotecan) by ultra-performance liquid chromatography-tandem mass spectrometry. Samples were also tested for three additional antineoplastic drugs (docetaxel, paclitaxel, and vinorelbine) without quantification. The impact of certain characteristics of the sampling sites was evaluated with a Kolmogorov–Smirnov test for independent samples. Results Ninety-three Canadian centers participated in 2019, with a total of 1045 surfaces sampled. Cyclophosphamide was the drug most often found in the surface samples (32.4% of samples with positive result), followed by gemcitabine (20.3%). The front grille inside the biological safety cabinet (81.5% of samples positive for at least one antineoplastic drug) and the armrest of a treatment chair (75.8%) were the most frequently contaminated surfaces. Centers with more oncology inpatient and outpatient beds, those that prepared more antineoplastic drugs each year, and those that used more cyclophosphamide each year had higher concentrations of cyclophosphamide contamination on the surfaces tested ( p <  0.0001). Conclusion Traces of dangerous drugs were found in oncology pharmacies and oncology outpatient clinics in 93 Canadian hospitals in 2019. However, the quantities measured were very small. Every healthcare worker should consider these work areas to be contaminated and should wear appropriate protective equipment.

Prescription in Locker Box (PILBOX): Remodeling of the Medication Collection Process (Preprint)

2020 ◽  
Author(s):  
Lim Jit Fan Christina ◽  
Goh Boon Kwang ◽  
Chee Wing Ling Vivian ◽  
Tang Woh Peng ◽  
Goh Qiuling Bandy
Keyword(s):  
Cross Sectional Study ◽  
Ease Of Use ◽  
Prescription Medications ◽  
Pharmacy Staff ◽  
Cross Sectional ◽  
Team Members ◽  
Face To Face ◽  
Ranking Score ◽  
Study Team ◽  
Willingness To Use

BACKGROUND Traditionally, patients wishing to obtain their prescription medications have had to present themselves physically at pharmacy counters and collect their medications via face-to-face interactions with pharmacy staff. Prescription in Locker Box (PILBOX) is a new innovation which allows patients and their caregivers to collect their medication asynchronously, 24/7 at their convenience, from medication lockers instead of from pharmacy staff and at any time convenient to them instead of being restricted to pharmacy operating hours. OBJECTIVE This study aimed to determine the willingness by patients/caregivers to use this new innovation and factors that affect their willingness. METHODS This prospective cross-sectional study was conducted over 2 months at 2 public primary healthcare centres in Singapore. Patients or caregivers who were at least 21 yo and turned up at the pharmacies to collect medications were administered a self-developed 3-part questionnaire face-to-face by trained study team members, if they gave their consent to participate in the study. RESULTS A total of 222 participants completed the study. About 40% of them participants were willing to use the PILBOX to collect their medications. Amongst the participants who were keen to use the PILBOX service, slightly more than half (i.e. 52.8%) of them were willing to pay for the PILBOX service. The participants felt that the ease of use (3.46±1.21 i.e. mean of ranking score ± standard deviation) of the PILBOX was the most important factor that would affect their willingness to use the medication pick up service. This was followed by “waiting time” (3.37±1.33), cost of using the medication pick up service (2.96±1.44) and 24/7 accessibility (2.62±1.35). This study also found that age (p=0.006), language literacy (p=0.000), education level (p=0.000), working status (p=0.011) and personal monthly income (p=0.009) were factors that affected the willingness of the patients or caregivers to use the PILBOX. CONCLUSIONS Patients and caregivers are keen to use PILBOX to collect their medications for its convenience and the opportunity to save time, if it is easy to use and not costly.

scholarly journals Association of Human Plasma Metabolomics with Delayed Dark Adaptation in Age-Related Macular Degeneration

Metabolites ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 183
Author(s):  
Kevin M Mendez ◽  
Janice Kim ◽  
Inês Laíns ◽  
Archana Nigalye ◽  
Raviv Katz ◽  
...  
Keyword(s):  
Amino Acids ◽  
Fatty Acid ◽  
Macular Degeneration ◽  
Dark Adaptation ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Age Related ◽  
Vitreoretinal Disease

The purpose of this study was to analyze the association between plasma metabolite levels and dark adaptation (DA) in age-related macular degeneration (AMD). This was a cross-sectional study including patients with AMD (early, intermediate, and late) and control subjects older than 50 years without any vitreoretinal disease. Fasting blood samples were collected and used for metabolomic profiling with ultra-performance liquid chromatography–mass spectrometry (LC-MS). Patients were also tested with the AdaptDx (MacuLogix, Middletown, PA, USA) DA extended protocol (20 min). Two measures of dark adaptation were calculated and used: rod-intercept time (RIT) and area under the dark adaptation curve (AUDAC). Associations between dark adaption and metabolite levels were tested using multilevel mixed-effects linear modelling, adjusting for age, gender, body mass index (BMI), smoking, race, AMD stage, and Age-Related Eye Disease Study (AREDS) formulation supplementation. We included a total of 71 subjects: 53 with AMD (13 early AMD, 31 intermediate AMD, and 9 late AMD) and 18 controls. Our results revealed that fatty acid-related lipids and amino acids related to glutamate and leucine, isoleucine and valine metabolism were associated with RIT (p < 0.01). Similar results were found when AUDAC was used as the outcome. Fatty acid-related lipids and amino acids are associated with DA, thus suggesting that oxidative stress and mitochondrial dysfunction likely play a role in AMD and visual impairment in this condition.

scholarly journals Pesticide Use and Self-Reported Symptoms of Acute Pesticide Poisoning among Aquatic Farmers in Phnom Penh, Cambodia

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Hanne Klith Jensen ◽  
Flemming Konradsen ◽  
Erik Jørs ◽  
Jørgen Holm Petersen ◽  
Anders Dalsgaard
Keyword(s):  
Management Practices ◽  
Cross Sectional Study ◽  
Protective Measure ◽  
Pesticide Poisoning ◽  
Sectional Study ◽  
Cross Sectional ◽  
Phnom Penh ◽  
Pesticide Management ◽  
Handling Practices ◽  
Acute Pesticide Poisoning

Organophosphates and carbamates (OPs/CMs) are known for their acetylcholinesterase inhibiting character. A cross-sectional study of pesticide handling practices and self-perceived symptoms of acute pesticide poisoning was conducted using questionnaire-based interviews with 89 pesticide sprayers in Boeung Cheung Ek (BCE) Lake, Phnom Penh, Cambodia. The study showed that 50% of the pesticides used belonged to WHO class I + II and personal protection among the farmers were inadequate. A majority of the farmers (88%) had experienced symptoms of acute pesticide poisoning, and this was significantly associated with the number of hours spent spraying with OPs/CMs (OR = 1.14, CI 95%: 1.02–1.28). The higher educated farmers reduced their risk of poisoning by 55% for each extra personal protective measure they adapted (OR = 0.45, CI 95%: 0.22–0.91). These findings suggest that improving safe pesticide management practices among the farmers and enforcing the effective banning of the most toxic pesticides will considerably reduce the number of acute pesticide poisoning episodes.

scholarly journals Serum Metabolomics Analysis of Asthma in Different Inflammatory Phenotypes: A Cross-Sectional Study in Northeast China

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Zhiqiang Pang ◽  
Guoqiang Wang ◽  
Cuizhu Wang ◽  
Weijie Zhang ◽  
Jinping Liu ◽  
...  
Keyword(s):  
Metabolic Profile ◽  
Ultra Performance Liquid Chromatography ◽  
Cross Sectional Study ◽  
Sphingolipid Metabolism ◽  
Cross Sectional ◽  
Asthma Phenotypes ◽  
Novel Approach ◽  
Retinol Metabolism ◽  
Inflammatory Phenotypes ◽  
Serum Metabolomics

Background and Objective. Asthma as a chronic heterogeneous disease seriously affects the quality of life. Incorrect identification for its clinical phenotypes lead to a huge waste of medical resources. Metabolomic technique as a novel approach to explore the pathogenesis of diseases have not been used to study asthma based on their clear defined inflammatory phenotypes. This study is aimed to distinguish the divergent metabolic profile in different asthma phenotypes and clarify the pathogenesis of them.Methods. Participants including eosinophilic asthmatics (EA, n=13), noneosinophilic asthmatics (NEA, n=16), and healthy controls (HC, n=15) were enrolled. A global profile of untargeted serum metabolomics was identified with Ultra Performance Liquid Chromatography–Mass Spectrometry technique.Results. Multivariate analysis was performed and showed a clear distinction between EA, NEA, and HC. A total of 18 different metabolites were recognized between the three groups based on OPLS-DA model and involved in 10 perturbed metabolic pathways. Glycerophospholipid metabolism, retinol metabolism, and sphingolipid metabolism were identified as the most significant changed three pathways (impact > 0.1 and -log(P) > 4) between the phenotypes.Conclusions. We showed that the different inflammatory phenotypes of asthma involve the immune regulation, energy, and nutrients metabolism. The clarified metabolic profile contributes to understanding the pathophysiology of asthma phenotypes and optimizing the therapeutic strategy against asthma heterogeneity.

scholarly journals A Cross-Sectional Study of Pesticide Use and Knowledge of Smallholder Potato Farmers in Uganda

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Joshua Sikhu Okonya ◽  
Jürgen Kroschel
Keyword(s):  
Disease Incidence ◽  
Household Survey ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Runny Nose ◽  
Regulation Policy ◽  
Agroecological Zones ◽  
Economic Injury ◽  
Handling Practices ◽  
And Storage

In response to increased pest and disease problems, potato farmers use pesticides, which could raise environmental and health concerns. This study sought to promote proper and safe pesticide-handling practices by providing data needed to guide pesticide regulation policy and training for extension staff and farmers. A household survey was conducted in three major potato-growing agroecological zones of Uganda. Two hundred and four potato farmers were interviewed about the type and source of pesticides they use in potato cultivation, the frequency of applications, the use of protective clothing, and cases of pesticide poisoning. The types of pesticides used in potato were fungicides (72%), insecticides (62%), and herbicides (3%). Overall, use of personal protective equipment was low, that is, gumboots (73%), gloves (7%), face masks (16%), and long sleeve shirts (42%). Forty-three percent of farmers who applied pesticides reported having experienced skin itching, 25% skin burning sensation, 43% coughing, 60% a runny nose, 27% teary eyes, and 42% dizziness. An IPM approach involving only moderately to slightly hazardous pesticides when pest and disease incidence has reached economic injury levels and by considering all safety measures during application and storage would be environmentally recommendable and result in reduced health risks.

Life Style Practices And Health Risk Behaviors Of Medical Students: A Cross Sectional Study

2018 ◽  
Vol 08 (04) ◽  
pp. 231-235
Author(s):  
Shireen Jawed ◽  
Sundus Tariq ◽  
Zehra Jamil ◽  
Rabiya Ali ◽  
Rehana Rehman
Keyword(s):  
Medical Students ◽  
Health Risk ◽  
Risk Behaviors ◽  
Life Style ◽  
Health Risk Behaviors ◽  
Cross Sectional Study ◽  
P Value ◽  
Positive Health ◽  
Cross Sectional ◽  
Handling Practices

Objective: A health risk behavior like physical inactivity, unhealthy diet, tobacco use, drug abuse, unprotected sexual practices or harmful use of alcohol is linked with serious ailments like liver cirrhosis, hypertension, abnormal lipid profile and number of cardiovascular diseases. Our study is aimed to explore perception of students about health risk behaviors; eating routines, life style and stress handling practices and compare amongst medical students of first and second year. Subjects and Methods: In this cross-sectional study, 233 female students between 1 8–25 years of age, from first two years of medical college were administered a self-structured questionnaire Response of each item was rated on five-point Likert scale. Maximum points in the scale were five and the minimum was one for each item. Mean score was obtained by adding points of all responses. Degree of health awareness was categorized into low, medium and high on the basis of mean cumulative scores. Independent sample t test was used to compare means between study groups based on academic level (Year I and II medical students) Results: The overall results of the study revealed positive health behaviors among medical students. Year I MBBS had superior acquaintance on healthy eating routines (p-value = 0.001), lifestyle patterns (p-value = 0.002), and stress handling practices (p-value < 0.001) as compared to senior class. Tendency to have anxiety attacks was more in 1st year students (p-value=0.002) while capability to withstand stress was better in senior class (p-value=0.004). Conclusion: Majority of medical students practiced positive health behaviors. These attitudes in terms of selection of life style choices; healthy food and physical activity with avoidance of health risk behaviors and supportive practices was better in Year I students.

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