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The chronic effect of pulsed 1800 MHz electromagnetic radiation on amino acid neurotransmitters in three different areas of juvenile and young adult rat brain
No full textThe extensive use of mobile phones worldwide has raised increasing concerns about the effects of electromagnetic radiation (EMR) on the brain due to the proximity of the mobile phone to the head and the appearance of several adverse neurological effects after mobile phone use. It has been hypothesized that the EMR-induced neurological effects may be mediated by amino acid neurotransmitters. Thus, the present study investigated the effect of EMR (frequency 1800 MHz, specific absorption rate 0.843 W/kg, power density 0.02 mW/cm2, modulated at 217 Hz) on the concentrations of amino acid neurotransmitters (glutamic acid, aspartic acid, gamma aminobutyric acid, glycine, taurine, and the amide glutamine) in the hippocampus, striatum, and hypothalamus of juvenile and young adult rats. The juvenile and young adult animals were each divided into two groups: control rats and rats exposed to EMR 1 h daily for 1, 2, and 4 months. A subgroup of rats were exposed daily to EMR for 4 months and then left without exposure for 1 month to study the recovery from EMR exposure. Amino acid neurotransmitters were measured in the hippocampus, striatum, and hypothalamus using high-performance liquid chromatography. Exposure to EMR induced significant changes in amino acid neurotransmitters in the studied brain areas of juvenile and young adult rats, being more prominent in juvenile animals. It could be concluded that the alterations in amino acid neurotransmitters induced by EMR exposure of juvenile and young adult rats may underlie many of the neurological effects reported after EMR exposure including cognitive and memory impairment and sleep disorders. Some of these effects may persist for some time after stopping exposure
Cellulose-based lateral flow device for low-cost point-of-care blood coagulation monitoring
No full text1. Introduction to no-reaction lateral flow assay (nrLFA) device • Consists of sample pad, analytical membrane and wicking pad; paper-based and low-cost 2. Properties of various analytical membranes, SEM images of nitrocellulose membranes 3. Reproducibility of nrLFA device using various body fluids (whole blood, plasma, artificial sweat, etc.) • t ≥ 60 s, CV \u3c 7% for ail fluids; t ≥ 80 s, CV ∼1.5% for RBC component in whole blood 4. Effect of hematocrit (Hct) and sample volume on fluid transport in nrLFA device • Larger Hct results in shorter RBC distance in nrLFA (monotonie); minimum sample volume: 20 μL 5. nrLFA device for blood coagulation monitoring • Stronger coagulation results in shorter RBC distance in nrLFA (monotonie); better detection range and linearity than fibrintimer 6. Clinical trial of nrLFA device with patients on anticoagulation therapy • nrLFA capable to statistically distinguish blood coagulation between patients with different INR 7. Blood coagulation nrLFA in veterinary applications
Evaluation of an academic-community partnership to implement MTM services in rural communities to improve pharmaceutical care for patients with diabetes and/or hypertension
No full textBACKGROUND: Although the current methods of medication therapy management (MTM) delivery have demonstrably improved therapeutic, safety, economic, and humanistic health outcomes, patient- and prescriber-level barriers persist, limiting its reach and effectiveness. OBJECTIVE: To assess telephonic- and community-based clinical pharmacy services in improving health indicators for rural, underserved patients. METHODS: In 2014, an established MTM provider created a novel, collaborative pilot program with independent retail and community health center pharmacies to provide comprehensive, telephonic MTM services to rural Arizonans. This pilot program used a combined telephonic- and community- based pharmacist approach in the provision of MTM services for rural, underserved Arizona populations. Adults with diabetes mellitus and/or hypertension, seen by a prescriber or who filled prescriptions at a contracted, rural facility in 2014, were eligible to participate. Initial MTM telephonic consultations were conducted, and recommendations were communicated to patients\u27 prescribers and/or pharmacists. Patients received a follow-up telephone call at standard intervals, depending on risk severity. RESULTS: A total of 517 patients participated, and 237 medication-related and 1,102 health promotion interventions were completed. Positive trends were observed in fasting blood glucose, postprandial glucose, and diastolic blood pressure. Broad variation in prescriber acceptance of pharmacist recommendations was observed (27%-60%). CONCLUSIONS: Study results provide initial evidence to support the efficacy of collaborative efforts in the provision of MTM services for improving health indicators and safety measures while potentially reducing health care disparities. While the results are encouraging, future research is warranted in more diverse populations and settings
An evaluation of a potential calcium channel blocker–lower-extremity edema–loop diuretic prescribing cascade
No full textObjectives: Dihydropyridine calcium channel blockers (DH-CCB) are associated with lower-extremity edema (LEE). Loop diuretics have been used inappropriately to treat DH-CCB–associated LEE, constituting a prescribing cascade (PC). The aim of this work was to identify the prevalence and factors associated with potential DH-CCB–LEE–loop diuretic PC. Methods: The 2014 National Ambulatory Medical Care Survey was used to identify patient visits in which a DH-CCB was continued. The definition of a potential PC was the continuation or initiation of a loop diuretic in the absence of congestive heart failure, cancer, obstructive sleep apnea, chronic kidney disease or end-stage renal disease, obesity, or resistant hypertension. Multivariable logistic regression was used to identify factors related to a potential PC, including demographic information, number of medications, number of patient visits in the previous 12 months, and comorbid conditions. Results: Among the estimated 47.5 million patient visits in which a DH-CCB was continued, 4.6% had a potential PC. Visits in patients 65 to 84 years of age (odds ratio [OR] 2.56, 95% CI 1.20–5.43) and 85 years of age and older (OR 3.89, 95% CI 1.76–8.61) were more likely to have potential PC compared with patients 18 to 64 years of age. Visits in patients with 5 to 7 (OR 3.75, 95% CI 1.72–8.19), 8 to 11 (OR 2.20, 95% CI 1.09–4.44), and 12 or more (OR 5.23, 95% CI 2.29–11.94) medications were more likely to have potential PC compared with patients with 4 or fewer medications. Conclusion: A potential DH-CCB–associated LEE loop diuretic PC was present in approximately 2.2 million patient visits in which DH-CCB was continued. Older age and an increasing number of concomitant medications were associated with this potential PC
Documenting stage 1 and 2 meaningful use criteria: A comparison of clinical pharmacists with other healthcare providers
No full textPurpose. Documentation of Stage 1 and Stage 2 Meaningful Use (MU) criteria for patients with type 2 diabetes mellitus between clinical pharmacists and other healthcare providers was compared. Methods. Patients seen at 8 clinics in a federally qualified health center who had type 2 diabetes mellitus and were seen by clinical pharmacists or other healthcare providers were randomly selected for inclusion in this retrospective study. Approximately half of the encounters were evaluated for Stage 1 MU compliance (encounters from October through December 2014), and half were evaluated for Stage 2 MU compliance (encounters from January through March 2015). Categorical and descriptive variables were analyzed by calculating frequencies and percentages. Chi-square tests were used to compare groups with an a priori level of significance set at 0.05. Results. A total of 790 patients were seen by 46 providers, 8 (18%) of whom were clinical pharmacists. The study also included 24 medical doctors, 8 family nurse practitioners, 1 physician assistant, and 5 doctors of osteopathic medicine. Other healthcare providers more consistently documented 5 Stage 1 MU criteria than did clinical pharmacists. Clinical pharmacists more consistently documented 2 core objectives than did other healthcare providers. Otherwise, no significant differences in documentation were detected. Conclusion. Other healthcare providers more consistently documented 5 Stage 1 MU criteria than did clinical pharmacists. Clinical pharmacists more consistently documented 2 core objectives than did other healthcare providers
Minors in Laboratories Policy
No full textThe University of Health Sciences and Pharmacy in St. Louis Office of Environmental Health and Safety is committed to providing a safe and healthful educational and employment environment for its entire community through collaboration, support and best practice integration into the campus culture. This policy specifically applies to minors who are involved in laboratory activities on the University of Health Sciences and Pharmacy in St. Louis campus. To assure the health and wellness of minors visiting the University of Health Sciences and Pharmacy in St. Louis, the Minors in Laboratories Policy has been established.
This policy applies to all minors on the University of Health Sciences and Pharmacy in St. Louis campus participating in laboratory activities, observing in laboratories, or touring laboratory facilities
Practical Considerations for the Use of Direct Oral Anticoagulants in Patients with Atrial Fibrillation
No full textAtrial fibrillation (AF) is a significant risk factor for stroke and peripheral thromboembolic events (TEs). Preventing blood clots in the heart to reduce stroke and TE risk is a key goal of AF therapy. Traditional stroke risk assessment tools for patients with nonvalvular AF include the CHADS2 and CHA(2)DS(2)-VASc scores, while long-term outcome data with the newer direct oral anticoagulants (DOACs) are emerging. The goals of this review were to assess traditional therapies and existing treatment guidelines and to discuss key pharmacologic properties of the DOACS, noting how these may benefit at-risk patients with AF. This narrative review was developed on the basis of the authors\u27 clinical knowledge, extensive reading of the literature, and broad pharmacy experience in the management of patients with AF. Limitations of oral vitamin K antagonists (VKAs) include slow onset of action, the need for regular monitoring of their anticoagulation effect, significant food and drug interactions, and unpredictable dose-response properties. Key clinical trial data led to the approvals of apixaban, dabigatran etexilate, edoxaban, and rivaroxaban in the United States to reduce the risk of stroke and systemic embolism in patients with nonvalvular AF. With predictable pharmacologic properties and limited drug and/or dietary interactions, the DOACs offer several benefits over traditional oral anticoagulation therapy with VKA. However, they have limitations, including the absence of immediate reversal agents and limited options for monitoring their anticoagulation effects in clinical practice. As experience with the use of DOACs grows, optimized treatment regimens and improved patient care are expected
Learning human-mobile nearness with multiple sensors data from steady and non-steady spaces
No full textAs mobile devices are becoming equipped with modern sensors, so is the opportunity to develop more intelligent applications in the areas of internetof- things (IoT) and ambient health intelligence using intelligent data analysis techniques. As such, we present the results of our study on recognising nearness of the human body to a mobile device in a three-dimensional space without having any physical contact with the device. The nearness recognition is done by analysing data from several sensors that are available on a mobile device.We show that the human body generates wave patterns that interact with other naturally occurring ambient signals that could be measured by a mobile device, such as, temperature, humidity, magnetic field, acceleration, gravity, and light. This interaction consequentially alters the patterns of the naturally occurring signals in a steady space to form a non-steady space, and thus, exhibits characteristics that could be learned to predict the nearness of the human body to a mobile device with good accuracy
Changes in cytokines, leptin, and IGF-1 levels in overtrained athletes during a prolonged recovery phase: A case-control study
No full textWe investigated how cytokines are implicated with overtraining syndrome (OTS) in athletes during a prolonged period of recovery. Plasma IL-6, IL-10, TNF-α, IL-1β, adipokine leptin, and insulin like growth factor-1 (IGF-1) concentrations were measured in overtrained (OA: 5 men, 2 women) and healthy control athletes (CA: 5 men, 5 women) before and after exercise to volitional exhaustion. Measurements were conducted at baseline and after 6 and 12 months. Inflammatory cytokines did not differ between groups at rest. However, resting leptin concentration was lower in OA than CA at every measurement (P \u3c 0.050) but was not affected by acute exercise. Although IL-6 and TNF-α concentrations increased with exercise in both groups (P \u3c 0.050), pro-inflammatory IL-1β concentration increased only in OA (P \u3c 0.050) and anti-inflammatory IL-10 was greater in CA (P \u3c 0.001). In OA, exercise-related IL-6 and TNF-α induction was enhanced during the follow-up (P \u3c 0.050). IGF-1 decreased with exercise in OA (P \u3c 0.050); however, no differences in resting IGF-1 were observed. In conclusion, low leptin level at rest and a pro-inflammatory cytokine response to acute exercise may reflect a chronic maladaptation state in overtrained athletes. In contrast, the accentuation of IL-6 and TNF-α responses to acute exercise seemed to associate with the progression of recovery from overtraining
The role of Leptin in the development of the corpus luteum
No full textThe mechanistic events leading to infertility issues in women have been investigated for over 50 years and although progress has been made in identifying the potential causes, many cases of infertility remain idiopathic. This becomes problematic when attempting to provide treatments for women striving to conceive a child. One cause of infertility is attributed to a unique component of ovarian tissue that develops following the ovulation of an ovum, the corpus luteum (CL). The CL is a highly vascular tissue that develops at a rate similar to an aggressive tumor and is essential for the maintenance of pregnancy through the synthesis and secretion of the steroid hormone, progesterone. Defects or abnormalities in a CL are believed to account for approximately 65% of recurrent miscarriages. Many of the defects are attributed, in part, to abnormal vascularization (angiogenesis) of the CL, which occurs primarily during the development stage of the luteal lifespan. Leptin is an adipokine hormone that is synthesized and secreted by the CL and exhibits angiogenic promoting properties. Induced luteal leptin deficiency throughout development and maturation of a CL altered the vascular landscape by increasing (P\u3c0.05) the number of large diameter vessels. Furthermore, the leptin deficient CL had a higher occurrence of abnormal, underdeveloped morphology (P\u3c0.05) and a higher (P\u3c0.05) ratio of large luteal cells to small luteal cells. Leptin replacement therapy following an induced leptin deficiency during the development stage of the CL appeared to have accelerated tissue development, increasing overall tissue mass (P\u3c0.05) and forming a structure that resembled a mature CL. This suggests that luteal leptin deficiency increased tissue sensitivity promoting compensatory development with hormone replacement. Collectively, the evidence supports the supposition that leptin is involved in the normal architecture of a developing CL including the vascular and cellular landscape of the tissue