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2022 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sajad Moradi ◽  
Dinyar Khazaeli ◽  
Mohammadreza Dadfar ◽  
Nima Bakhtiari

Background: We aimed to evaluate the safety and efficacy of 50-unit dose against 100-unit dose of intracavernosal injection (ICI) of AbobotulinumtoxinA (BTX-A) (Masport®) in patients with vascular erectile dysfunction (ED) resistant to first-line therapies, including phosphodiesterase type 5 inhibitors (PDE5I). Methods: In this double-blind randomized controlled trial (RCT), 40 patients with ED resistant to PDE5I were randomly divided into two groups: ICI of a single dose of Masport® 50 units and single dose of 100 units. Peak systolic velocity (PSV) confirmed arterial insufficiency vascular disorder. For all patients, IIEF (International Index of Erectile Function), SHIM (Sexual Health Inventory for Men), and EHS (Erection Hardness Score) questionnaires were completed. Six weeks after the treatment, the subjects were re-examined. Results: Our results showed an acceptable clinical efficacy and safety of ICI of Masport® six weeks after injection. No systemic complications in patients were seen. Three patients complained of brief penile pain shortly after injection, but there were no other local complications. The increase in mean PSV in the 100-unit group due to treatment was significant (P-value < 0.0001). Also, there was a significant difference between the two groups of 50- and 100-unit (P-value < 0.0001). In addition, the increase in mean IIEF-EF, SHIM score, and EHS due to treatment was significant between the two groups. For the 100-unit group, P-value < 0.0001 and the difference between the two groups was also significant (P-value < 0.0001), which indicated a better response to treatment in the 100-unit group. The mean increase of IIEF score (EF domain) was 4.3 (mean IIEF: 9.4 and 13.7 after and before, respectively) in the 100-unit group and (mean IIEF: 8.1 and 9.1 after and before, respectively) in the 50-unit group. Conclusions: The results of this study showed that ICI of AbobotulinumtoxinA, especially at a dose of 100 units, in patients with refractory vasculogenic ED is safe and effective in improving sexual function and ultrasound indices.


Pharmaceutics ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 91
Author(s):  
Shu-Hsin Chen ◽  
Hsiu-Chu Chang ◽  
Ming-Yi Chien ◽  
Jinxiang Xi ◽  
Hui-Ling Lin

This study aimed to evaluate optimal aerosol and oxygen delivery with a hood on an infant model and a paediatric model. A facemask and a hood with three inlets, with or without a front cover, were used. A small-volume nebuliser with a unit-dose of salbutamol was used for drug delivery and an air entrainment nebuliser was used to deliver oxygen at 35%. Infant and paediatric breathing patterns were mimicked; a bacterial filter was connected to the end of a manikin trachea for aerosol drug collection, and an oxygen analyser was used to measure the oxygen concentration. For the infant model, inhaled drug dose was significantly higher when the nebuliser was placed in the back of the hood and with a front cover. This was verified by complementary computational simulations in a comparable infant-hood model. For the paediatric model, the inhaled dose was greater with a facemask than with a hood. Oxygen delivery with a facemask and a hood with a front cover achieved a set concentration in both models, yet a hood without a front cover delivered oxygen at far lower concentrations than the set concentration.


2021 ◽  
pp. 001857872110613
Author(s):  
James A. M. Rhodes ◽  
Bryan C. McCarthy ◽  
Anthony C. Scott

Background: Automated dispensing cabinets have the potential to create technology-induced errors that can arise during controlled substance medication dispensing. Despite enhancements made to the medication use process, the impact of ADC functionality on technology-induced controlled substance discrepancies have yet to be described. Objective: To evaluate the impact of ADC functionality expansion on technology-induced errors such as controlled substance discrepancies created during “blind inventory counts” and cassette dispensing errors. Methods: This quasi-experimental study was conducted over 18 months that evaluated the expanded use of dispensing cassettes within 8 ADCs at the University of Chicago Medicine. Unit-dose controlled substances with high usage were directed for inventory reassignment to cassettes. Controlled substance dispenses, blind inventory counts discrepancies and cassette dispensing errors were evaluated before and after cassette expansion. ADC discrepancy and Cassette Dispensing Error rates were calculated using 1-week segments across the study period. Results: Of the 64 040 dispenses during the study period, the proportion of cassette dispenses increased from 16% to 72% after cassette expansion. Controlled substance discrepancies decreased from 11 to 7 discrepancies for every 1000 dispenses ( P < .0001). After cassette expansion, cassette dispensing errors increased to roughly 28 errors for every 1000 dispenses ( P < .0001). Conclusion: Expansion of ADC functionality created opportunities for reduced technology-induced controlled substance discrepancy rates at the expense of increased cassette dispensing errors.


2021 ◽  
pp. ejhpharm-2021-003002
Author(s):  
Kaisa Hänninen ◽  
Hanne Katriina Ahtiainen ◽  
Eeva Maria Suvikas-Peltonen ◽  
Ann Marie Tötterman

IUCrJ ◽  
2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Selina L. S. Storm ◽  
Danny Axford ◽  
Robin L. Owen

X-ray-induced radiation damage is a limiting factor for the macromolecular crystallographer and data must often be merged from many crystals to yield complete data sets for the structure solution of challenging samples. Increasing the X-ray energy beyond the typical 10–15 keV range promises to provide an extension of crystal lifetime via an increase in diffraction efficiency. To date, however, hardware limitations have negated any possible gains. Through the first use of a cadmium telluride EIGER2 detector and a beamline optimized for high-energy data collection, it is shown that at higher energies fewer crystals will be required to obtain complete data, as the diffracted intensity per unit dose increases by a factor of more than two between 12.4 and 25 keV. Additionally, these higher energy data can provide more information, as shown by a systematic increase in the high-resolution cutoff of the data collected. Taken together, these gains point to a high-energy future for synchrotron-based macromolecular crystallography.


Author(s):  
V. Rodríguez ◽  
T. Peñafiel ◽  
A. Rincón

Introduction: In Ecuador, many health institutions have not yet migrated to the Unit Dose Dispensation / Distribution System for Medications, which ensures the correct, safe and rational use of medications. Objective: The medication dispensing process in a Riobamba health unit was evaluated as part of the service quality improvement process. Methodology: Information was collected during three months of investigation, from the in-hospital services of hospitalization, intensive care unit, operating room and emergency. The instruments used for the evaluation corresponded to medical prescriptions, medication and medical device request sheets, medication return record sheets and labeling of boxes. Results: In the medical prescriptions as in the record sheets for the return of evaluated drugs, the main drawback was presented in the writing of the pharmaceutical form and the absence of mandatory data for the identification of the patient. In the total of the registers for the return of medications, the absence of the reason for the return of the medications was identified. The medication dispensing process was considered a critical point within the evaluation, since throughout the review period it was observed that the boxes did not have the minimum required labeling, for the correct identification of the patient. Conclusion: It was concluded that the dispensing system presented critical flaws, such as: deficiencies in the supply of medications, dispensing errors, lack of pharmacotherapeutic follow-up and little participation of the pharmaceutical professional. Keywords: dispensing, medication, medication error. Resumen Introducción: En Ecuador, muchas instituciones de salud aún no migran al Sistema de Dispensación/Distribución de Medicamentos por Dosis Unitaria, el cual asegura la correcta, segura y racional utilización de los medicamentos. Objetivo: Se evaluó el proceso de dispensación de medicamentos en una unidad de salud de Riobamba, como parte del proceso de mejoramiento en la calidad del servicio. Metodología: Se recolectó información durante tres meses de investigación, de los servicios de intrahospitalarios de hospitalización, unidad de cuidados intensivos, quirófano y emergencia. Los instrumentos utilizados para la evaluación correspondieron a recetas médicas, hojas de requerimiento de medicamentos y dispositivos médicos, hojas de registro de devolución de medicación y rotulación de cajetines. Resultados: En las recetas médicas como en las hojas de registro de devolución de medicamentos evaluadas, el principal inconveniente se presentó en la escritura de la forma farmacéutica y la ausencia de datos obligatorios para identificación del paciente. En el total de los registros de devolución de medicamentos, se identificó la inexistencia del motivo de la devolución de los medicamentos. El proceso de dispensación de medicación, se consideró un punto crítico dentro de la evaluación, ya que durante todo el período de revisión se observó que los cajetines no contaban con la rotulación mínima requerida, para la identificación correcta del paciente. Conclusión: Se concluyó que el sistema de dispensación presentaba fallas críticas, tales como: deficiencias en el suministro de medicamentos, errores de dispensación, falta de seguimiento farmacoterapéutico y la poca participación del profesional farmacéutico. Palabras clave: dispensación, medicamentos, error de medicación.


2021 ◽  
Author(s):  
Keyword(s):  

Author(s):  
A. Drago ◽  
S. Vettore ◽  
S. Martini ◽  
M. Dutto

Aedes albopictus and Aedes aegypti are two synanthropic, anthropophilic container-breeding mosquitoes. These species are very annoying, but are also vectors of dengue, chikungunya, yellow fever, Zika, and Usutu viruses, and other pathogens. Because these mosquitoes breed very close to humans, cheap homemade methods, as alternatives to commercial insecticides, could be important for their control. Coffee being a very common beverage, the grounds extracted from used coffee capsules have been tested for their larvicidal efficacy. The grounds were extracted with either 30 ml or 70 ml of 65-70 °C water. The content of one capsule was used as a unit dose to treat the quantity of water contained in a medium sized flowerpot tray. The test provided a clear indication that at this dosage, the used coffee capsules were completely ineffective at killing the larvae of Aedes species, so this method cannot be suggested to control these mosquitoes.


Author(s):  
Sadaf Faisal ◽  
Jessica Ivo ◽  
Tejal Patel

Background: Smart medication adherence products (smart MAPs) capture and transmit real-time medication intake by using various means of connectivity, allowing for remote monitoring. Numerous such products with different features are available to address medication nonadherence. A comparison of the features of these products is needed for clinical decision-making. Therefore, the objective of this review was to compare smart MAPs available for in-home use. Methods: We searched grey and published literature and videos to identify smart MAPs. To be considered smart, products required 2 features: connectivity (the ability for collected data to exist outside the physical device) and automaticity (the ability for data to be analyzed or processed automatically). Products were excluded if product descriptions were not available in English, not for in-home use and unable to dispense medications. Results: Of the 51 products identified, 38 commercially available and 13 prototypes met the definition. Of these, 75% ( n = 38) contained alarms, 24% ( n = 12) were unit-dose, 63% ( n = 32) were multidose, 43% ( n = 22) had locking features, 41% ( n = 21) were portable and 88% ( n = 45) sent notifications to patients. The cost of marketed products, excluding subscriptions, ranged from $10 to $1500 USD. Some products required a monthly ( n = 16) or yearly ( n = 1) subscription ranging from $10 to $100 USD. Discussion: There is a growing market of smart MAPs for in-home patient use with variable features. Clinicians can use these features to identify and recommend products according to the specific needs of their patients to address medication adherence. Can Pharm J (Ott) 2021;154:xx-xx.


2021 ◽  
Author(s):  
Devin Miles ◽  
Ning Cao ◽  
George Sandison ◽  
Robert D Stewart ◽  
Greg Moffitt ◽  
...  

Purpose: Cancer cells produce innate immune signals following radiation damage, with STING pathway signaling as a critical mediator. High linear energy transfer (LET) radiations create larger numbers of DNA double-strand breaks (DSBs) per unit dose than low-LET radiations and may therefore be more immunogenic. We studied the dose response characteristics of pro-immunogenic type-I interferon, interferon-beta (IFNβ), and its reported suppressor signal, three-prime repair exonuclease 1 (TREX1), in vitro with low-LET x-rays and high-LET fast neutrons. Methods: Merkel cell carcinoma cells (MCC) were irradiated by graded doses of x-rays (1-24 Gy) or fast neutrons (1-8 Gy). IFNβ was measured as a function of dose via ELISA assay, and exonuclease TREX1 expression via immunofluorescence microscopy. The Monte Carlo damage simulation (MCDS) was used to model fast neutron relative biological effectiveness for DSB induction (RBEDSB) and compared to laboratory measurements of the RBE for IFNβ production (RBEIFNβ) and TREX1 upregulation (RBETREX1). RBEIFNβ models were also applied to radiation transport simulations to quantify the potential secretion of IFNβ in representative clinical beams. Results: Peak IFNβ secretion occurred at 5.7 Gy for fast neutrons and at 14.0 Gy for x-rays, i.e., an effective RBEIFNβ of 2.5 ± 0.2. The amplitude (peak value) of secreted IFNβ signal did not significantly differ between x-rays and fast neutrons (P > 0.05). TREX1 signal increased linearly with absorbed dose, with a four-fold higher upregulation per unit dose for fast neutrons relative to x-rays (RBETREX1 of 4.0 ± 0.1). Monte Carlo modeling of IFNβ suggests Bragg peak-to-entrance ratios of IFNβ production of 40, 100, and 120 for proton, alpha, and carbon ion beams, respectively, a factor of 10-20-fold higher compared to their corresponding physical dose peak-to-entrance ratios. The spatial width of the Bragg peak for IFNβ production is also a factor of two smaller. Conclusion: High-LET fast neutrons initiate a larger IFNβ response per unit absorbed dose than low-LET x-rays (i.e., RBEIFNβ value of 2.5). The RBE value for IFNβ is quite similar to data reported in the literature for DSB induction and cellular, post-irradiation micronucleation formation for neutrons and x-rays. The increased IFNβ release after high-LET radiation may be a contributing factor in stimulating a systemic anti-tumor, adaptive immune response (abscopal effect). However, our results indicate that TREX1 anti-inflammatory signaling in vitro for MCC cells is larger per unit dose for fast neutrons than for x-rays (RBETREX1 of 4.0). Given these competing effects, additional studies are needed to clarify whether or not high-LET radiations are therapeutically advantageous over low-LET radiation for pro-inflammatory immune signaling in other cell lines in vitro and for in vivo cancer models.


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