151 research outputs found
Multivariate Analysis of Single-Sweep Evoked Brain Potentials for Pharmaco-Electroencephalography
No full textBACKGROUND AND AIMS: Current findings on altered evoked potentials (EPs) caused by morphine are based on common alterations for a group of subjects after drug administration. However, this ignores the analysis of individual responses, which may explain the clinical differences in efficacy. Therefore, we explored the individual responses to morphine in terms of the altered single-sweep characteristics in a placebo-controlled crossover study. To account for multifactorial mechanisms, several characteristics were assessed simultaneously by multivariate pattern analysis (MVPA).METHODS: EPs were recorded from 62 channels and obtained before and after morphine and placebo administration during repeated electrical stimulations of the oesophagus in 12 healthy males. Additionally, the pain detection threshold was recorded to reflect the subjective analgesic effect in each subject. The characteristics of the sweeps were extracted by a multivariate matching pursuit algorithm with Gabor atoms implemented with a variable amplitude and constant phase across the sweeps. The single-sweep amplitudes were used as input to an MVPA algorithm to discriminate individual responses. The accuracy of the MVPA for each individual subject was used for correlation analysis of the analgesic effect.RESULTS: The mean classification accuracy when discriminating pre- and posttreatment morphine responses was 72% (p = 0.01). The individual classification accuracy was positively correlated to the analgesic effect of morphine (p = 0.03). Furthermore, the 2 posttreatment responses were classified and validated by the classification of the 2 pretreatment responses (p = 0.001).CONCLUSIONS: The alterations in the single-sweep EPs after morphine reflect the analgesic effect. The MVPA approach is a novel methodology for monitoring the individual efficacy of analgesics. © 2015 S. Karger AG, Basel.</p
Emergency Drug Kits at the Danish Hospital Pharmacies: A Study of the Management and Challenges
No full textTranslational pain research: Evaluating analgesic effect in experimental visceral pain models
No full text© 2009 The WJG Press and Baishideng. All rights reserved.Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can be achieved through standardized experimental human pain models. Experimental pain models in healthy volunteers are advantageous for evaluation of analgesic action, as this is often difficult to assess in the clinic because of confounding factors such as sedation, nausea and general malaise. These pain models facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic studies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical treatment of visceral pain. To improve treatment of visceral pain, it is important to study the underlying mechanisms of pain and the action of analgesics used for its treatment. An experimental pain model activates different modalities and can be used to investigate the mechanism of action of different analgesics in detail. In combination with pharmacokinetic studies and objective assessment such as electroencephalography, new information regarding a given drug substance and its effects can be obtained. Results from experimental human visceral pain research can bridge the gap in knowledge between animal studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.Anne Estrup Olesen, Trine Andresen, Lona Louring Christrup and Richard N Upto
The analgesic effect of pregabalin in patients with chronic pain is reflected by changes in pharmaco-EEG spectral indices.
No full textItem does not contain fulltextAIM: To identify electroencephalographic (EEG) biomarkers for the analgesic effect of pregabalin in patients with chronic visceral pain. METHODS: This was a double-blind, placebo-controlled study in 31 patients suffering from visceral pain due to chronic pancreatitis. Patients received increasing doses of pregabalin (75mg-300mg twice a day) or matching placebo during 3 weeks of treatment. Pain scores were documented in a diary based on a visual analogue scale. In addition, brief pain inventory-short form (BPI) and quality of life questionnaires were collected prior to and after the study period. Multi-channel resting EEG was recorded before treatment onset and at the end of the study. Changes in EEG spectral indices were extracted, and individual changes were classified by a support vector machine (SVM) to discriminate the pregabalin and placebo responses. Changes in individual spectral indices and pain scores were correlated. RESULTS: Pregabalin increased normalized intensity in low spectral indices, most prominent in the theta band (3.5-7.5Hz), difference of -3.18, 95% CI -3.57, -2.80; P= 0.03. No changes in spectral indices were seen for placebo. The maximum difference between pregabalin and placebo treated patients was seen in the parietal region, with a classification accuracy of 85.7% (P= 0.009). Individual changes in EEG indices were correlated with changes in pain diary (P= 0.04) and BPI pain composite scores (P= 0.02). CONCLUSIONS: Changes in spectral indices caused by slowing of brain oscillations were identified as a biomarker for the central analgesic effect of pregabalin. The developed methodology may provide perspectives to assess individual responses to treatment in personalized medicine.01 maart 201
Patient Safety Climate in Danish Primary Care: Adaption and Validation of the Danish Safety Attitudes Questionnaire (SAQ-DK-PRIM) [Response to Letter]
Get PDFMarie Haase Juhl,1,2 Anne Estrup Olesen,1,2 Ellen Tveter Deilkås,3 Niels Henrik Bruun,4 Kirsten Høgh Obling,5 Nikoline Rytter,6 Maya Damgaard Larsen,6 Solvejg Kristensen7 1Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark; 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 3Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; 4Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; 5Care and Rehabilitation, Department of Health and Care Services (Danish: “Pleje og Rehabilitering, Staben Sundhed og Omsorg”), the Municipality of Aarhus, Aarhus, Denmark; 6Digitalization and Quality, Department of Health and Care Services (Danish: ‘Digitalisering og Kvalitet, Sundhed og Omsorg’), the Municipality of Aarhus, Aarhus, Denmark; 7Aalborg University Hospital, Psychiatry, Aalborg, Denmar
Patient Safety Climate in Danish Primary Care: Adaption and Validation of the Danish Safety Attitudes Questionnaire (SAQ-DK-PRIM)
Get PDFMarie Haase Juhl,1,2 Anne Estrup Olesen,1,2 Ellen Tveter Deilkås,3 Niels Henrik Bruun,4 Kirsten Høgh Obling,5 Nikoline Rytter,6 Maya Damgaard Larsen,6 Solvejg Kristensen7 1Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark; 2Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 3Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; 4Research Data and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; 5Care and Rehabilitation, Department of Health and Care Services (Danish: “pleje Og Rehabilitering, Staben Sundhed Og Omsorg”), the Municipality of Aarhus, Aarhus, Denmark; 6Digitalization and Quality, Department of Health and Care Services (Danish: “digitalisering og Kvalitet, Sundhed og Omsorg”), The Municipality of Aarhus, Aarhus, Denmark; 7Aalborg University Hospital, Psychiatry, Aalborg, DenmarkCorrespondence: Anne Estrup Olesen, Department of Clinical Pharmacology, Aalborg University Hospital, Gartnerboligen, Ground Floor, Mølleparkvej 8a, Aalborg, 9000, Denmark, Tel +45 97664376, Email [email protected]: A lack of instruments to assess patient safety climate within primary care exists. The objectives of this study were as follows: 1) To adapt the Danish hospital version of the Safety Attitudes Questionnaire (SAQ-DK) for use in primary care; 2) Test the internal consistency and the construct validity of this version; 3) Present benchmark data; and 4) Analyze variance.Methods: The SAQ-DK was adapted for use in Danish primary care settings (SAQ-DK-PRIM) and distributed to healthcare staff members from nursing homes (N = 11), homecare units (N = 4) and healthcare units (N = 2), within the municipality of Aarhus, Central Denmark Region, Denmark. Face- and content validity were assessed. The construct validity was evaluated by a set of goodness-of-fit indices. The internal reliability was evaluated using the item-rest correlations, the inter-item correlations, and Cronbach’s alpha (α).Results: The adaptation process resulted in a questionnaire of 10 items. Eight hundred and thirty healthcare staffs participated (78% of the eligible respondents). In total 586 (70.6%) responses were complete and were included in the analysis. Goodness-of-fit indices from the confirmatory factor analysis showed: Chi2=46.90CFI=0.97, RMSEA = 0.063 (90% CI: 0.044– 0.084), Probability RMSEA (p close)=0.12. Internal reliability was high (Cronbach’s α=0.76). Proportions of participants with a positive attitude was 41.1% and did not differ between the healthcare services. Scale mean score was 70.19 (SD: 18.05) and differed between healthcare services. The safety climate scale scores did not vary according to healthcare service type. ICC was 0.68% indicating no clustering of scores by healthcare service type.Conclusion: Considering the questionnaire’s applicability, short length, strengthened focus on one area of interest and validity, the SAQ-DK-PRIM can serve as a valuable tool for measuring patient safety climate within primary care settings in Denmark.Keywords: primary care, patient safety culture, patient safety climate, questionnaire, validity, reliability, Denmar
Reflection on Pharmacokinetic tutorials – a qualitative analysis of students’ expectations and evaluations
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