196,416 research outputs found
Investigation of drug-related problems in patients hospitalized in chest disease wards: A randomized controlled trial
No full textCopyright © 2023 Bektay, Sancar, Okyaltirik, Durdu and Izzettin.Objective: According to the World Health Organization (WHO), chest diseases are among the 10 diseases that cause the highest mortality worldwide. Drug-related problems (DRPs), readmission, and antimicrobial resistance are critical problems in chest disease wards. Active involvement of clinical pharmacists (CPs) who are focused on reducing the risks of potential problems is needed. The aim of this study is to investigate the effects of pharmaceutical care (PC) services on the pulmonology service. Method: A randomized controlled trial at a university hospital in Istanbul was conducted between June 2020 and December 2021. The participants were randomized into the control group (CG) and intervention group (IG). In the CG, CPs identified and classified the DRPs according to Pharmaceutical Care Network Europe v9.0 (PCNE) and provided solutions to DRPs for the IG. The effect of PC services was evaluated by the number and classification of DRPs, and readmissions within 30 days were compared between the two groups. Results: Out of 168 patients, 82 were assigned to the IG. The average number of medicines administered per patient in the CG and IG was 14.45 ± 7.59 and 15.5 ± 6.18, respectively. In the CG and IG, the numbers of patients with DRPs were 62 and 46, respectively. The total number of DRPs was 160 for CG and 76 for IG. A statistically significant difference was found in favor of the IG, in terms of the number of patients with DRPs, the total number of DRPs, and readmission within 30 days (p < 0.05). Conclusion: In this study, CP recommendations were highly accepted by the healthcare team. Pharmaceutical care services provided by CPs would decrease possible DRPs and led to positive therapeutic outcomes. Cognitive clinical pharmacy services have beneficial effects on health care, and these services should be expanded in all settings where patients and pharmacists are present
Spinocerebellar ataxia with axonal neuropathy:consequence of a Tdp1 recessive neomorphic mutation?
No full textTyrosyl-DNA phosphodiesterase 1 (Tdp1) cleaves the phosphodiester bond between a covalently stalled topoisomerase I (Topo I) and the 3' end of DNA. Stalling of Topo I at DNA strand breaks is induced by endogenous DNA damage and the Topo I-specific anticancer drug camptothecin (CPT). The H493R mutation of Tdp1 causes the neurodegenerative disorder spinocerebellar ataxia with axonal neuropathy (SCAN1). Contrary to the hypothesis that SCAN1 arises from catalytically inactive Tdp1, Tdp1-/- mice are indistinguishable from wild-type mice, physically, histologically, behaviorally, and electrophysiologically. However, compared to wild-type mice, Tdp1-/- mice are hypersensitive to CPT and bleomycin but not to etoposide. Consistent with earlier in vitro studies, we show that the H493R Tdp1 mutant protein retains residual activity and becomes covalently trapped on the DNA after CPT treatment of SCAN1 cells. This result provides a direct demonstration that Tdp1 repairs Topo I covalent lesions in vivo and suggests that SCAN1 arises from the recessive neomorphic mutation H493R. This is a novel mechanism for disease since neomorphic mutations are generally dominant
Klinik eczacılık uzmanlık programı kapsamında iç hastalıkları servislerindeki müdahaleler: Retrospektif bir çalışma
No full textObjective: Drug-related problems are a common health problem in hospitalized patients, affecting optimal patient outcomes. The aim of the study is to classify the drug-related problems detected by clinical pharmacy resident in hospitalized patients during their rotations and evaluate their interventions to the healthcare team. Material and Method: This is a retrospective study in which the drug-related problems of the patients hospitalized in the internal medicine wards between April and November 2018 were examined during the rotations of the clinical pharmacy resident. Patients’ demographics, prescribed medicine, laboratory findings were recorded. Drug-related problems are classified with the Pharmaceutical Care Network Europe Version 9.1 system. Result and Discussion: Ninety-two patients were included in the study. The median age of patients was 60.5 years and 59.8% of them were female. Most of the patients (63%) had three or more comorbidities. The most frequent comorbidities were hypertension (21.70%) and diabetes mellitus (10.64%). One hundred forty-seven drug-related problems were detected in 57 patients (62%). Potential drug-drug interactions (55.78%), errors in dosing timing instructions (9.52%), and inappropriate drug use according to guidelines (8.16%) were the most common causes of drug-related problems. The acceptance rate of interventions for resolving drug-related problems was 65%. The most common drug-related problems in this study were due to drug selection. The acceptance rate of recommendations for drug-related problems was lower than in the literature. However, this initial acceptance rate can be considered successful in a center where clinical pharmacy services have not been established.Amaç: İlaçla ilgili sorunlar, hastanede yatan hastalarda optimal hasta sonuçlarını etkileyen yaygın
bir sağlık sorunudur. Çalışmanın amacı, klinik eczacılık asistanının rotasyonları sırasında
hastanede yatan hastalarda tespit ettiği ilaçla ilgili sorunları sınıflandırmak ve sağlık ekibine
yapılan girişimleri değerlendirmektir.
Gereç ve Yöntem: Bu çalışma, Nisan-Kasım 2018 tarihleri arasında iç hastalıkları servislerinde
yatan hastaların klinik eczacılık asistanının rotasyonları sürecinde ilaçla ilgili sorunlarının
incelendiği retrospektif bir çalışmadır. Hastaların demografik bilgileri, reçete edilen ilaçlar,
laboratuvar bulguları kaydedildi. İlaçla ilgili sorunlar, Avrupa Farmasötik Bakım Ağı Versiyon 9.1
sistemi ile sınıflandırıldı.
Sonuç ve Tartışma: Çalışmaya 92 hasta dahil edilmiştir. Hastaların ortanca yaşı 60.5’tir ve
%59.8'i kadındı. Hastaların çoğunda (%63) üç veya daha fazla ek eşlik eden hastalık vardır. En sık
eşlik eden hastalıklar hipertansiyon (%21.70) ve diabetes mellitus'tur (%10.64). Hastaların
57’sinde (%62) 147 adet ilaçla ilgili sorun saptandı. Potansiyel ilaç-ilaç etkileşimleri (%55.78), doz
zamanlama talimatlarındaki hatalar (%9.52) ve kılavuzlara göre uygunsuz ilaç kullanımı (%8.16)
ilaçla ilgili sorunların en yaygın nedenleri olarak belirlenmiştir. İlaçla ilgili sorunların çözümüne
yönelik önerilerin kabul oranı %65'tir. Bu çalışmada en yaygın karşılaşılan ilaçla ilgili sorunlar
ilaç seçiminden kaynaklanmaktadır. İlaçla ilgili sorunlar için önerilerin kabul oranı literatüre
kıyasla daha düşüktür. Ancak klinik eczacılık hizmetinin henüz kurulmadığı bir merkezde bu ilk
kabul oranları başarılı olarak kabul edilebili
The impact of clinical pharmacist-led hypertension screening at the community pharmacy in Türkiye
No full text© 2022 Marmara University Press.The aim of this study was to evaluate the impact of clinical pharmacist-led hypertension screening program (including referring high-risk individuals who are not aware of being hypertensive or prehypertensive to the physician) at a community pharmacy in Türkiye. This prospective observational pilot study was conducted in a community pharmacy located in Mersin-Türkiye between October 2017 and April 2018. Blood pressure measurements were performed by the clinical pharmacist at baseline and follow-up. The rate of participants who had high blood pressure measurements (≥140 mmHg for systolic and/or ≥90 mmHg for diastolic) was determined at the baseline by clinical pharmacist. According to the guidelines, participants with high blood pressure were referred directly to the physician by the clinical pharmacist. In the follow-up, the number of patients diagnosed with prehypertension or hypertension and the changes in their measurement of blood pressure were identified between baseline and follow-up. According to findings of clinical pharmacist-led blood pressure measurement, 23 (37.1%) out of 62 participants with high blood pressure were referred to the physician by the clinical pharmacist. In the follow-up, it was determined that 12 patients (52.2%) out of 23 participants were diagnosed with hypertension by a physician and eight patients (34.8%) out of 23 participants had prehypertensive. According to the findings of this pilot study, it was determined a positive impact of the clinical pharmacist-led hypertension screening program for high-risk individuals for hypertension
Assesment of the effect of alendronate therapy on urine calcium/creatinine ratio in patients with senil osteoporosis
No full textAmaç: Bu çalışmada, alendronat kullanan senil osteoporozlu kadınlarda alendronat tedavisinin idrar kalsiyum/kreatinin oranları üzerine etkisinin değerlendirilmesi amaçlanmıştır.
Yöntem: Bu amaçla, tedavi öncesi ve 3 aylık tedavi sonrasında hastaların idrar kalsiyum/kreatinin oranları ölçülmüş ve ayrıca serum
kalsiyum, fosfor, alkalen fosfataz (ALP), paratiroid hormon (PTH)
değerlerinin sonuçları değerlendirilmiştir.
Bulgular: 3 aylık tedaviden sonra idrar kalsiyum/kreatinin oranında
ve serum ALP, kalsiyum ve fosfor düzeylerinde istatistiksel olarak
anlamlı bir düşüş ve serum PTH düzeyinde de bu değişikliklere
cevap olarak anlamlı yükselme görülmüştür (p<0.05).
Sonuç: Tedavi başlangıcında osteoporoz hastalarının tedavi etkinliğinin ve uyuncunun değerlendirilmesi için idrar kalsiyum/kreatinin
oranının izlem parametresi olarak kullanılabileceği sonucuna varılmıştır.Objective: In this study, it is aimed to assess the effects of
alendronate treatment on urinary calcium/creatinine ratio in
female patients newly diagnosed as senile osteoporosis and
prescribed alendronate treatment.
Method: According to this aim, urinary calcium/creatinine ratio
were measured at baseline and after 3 months alendronate
therapy and also the levels of serum calcium , phosphorus, alkaline
phosphatase (ALP), parathyroid hormone (PTH) were evaluated.
Results: Statistically significant decreases in serum ALP, calcium
and phosphorus levels and urinary calcium/creatinine ratio were
observed and as a response to these alterations, serum PTH levels
were increased significantly after three months therapy (p<0.05).
Conclusion: It was found that urinary calcium/creatinine ratio
can be used in evaluation of treatment efficacy and adherence of
patients with osteoporosis at the beginning of the therap
Bir Serbest Eczanede Eczacı Danışmanlığında Yürütülen Sigara Bırakma Programının Sonuçlarının Değerlendirilmesi
No full textAmaç: Çalışmada, bir serbest eczanede klinik eczacı tarafından yürütülen ‘nikotin replasman tedavisiyle (nikotin sakızı ve nikotin tabletini
içeren) sigara bırakma programının bir yıllık sonuçlarının değerlendirilmesi amaçlanmıştır.
Yöntem: Çalışma Haziran 2009 - Haziran 2010 tarihleri arasında
gerçekleştirilmiştir. İlk görüşmede katılımcıların demografik ve klinik
verileri toplanmış ve her bir katılımcıya ‘Fagerstrom Nikotin Bağımlılık
Testi’ uygulanmıştır. Daha sonra klinik eczacı tarafından katılımcılar
sigaranın zararları hakkında bilgilendirilmiş ve her bir katılımcının
bağımlılık derecesine göre uygun OTC (tezgah üstü ilaç- reçetesiz
ilaç) nikotin replasman ürünü tavsiye edilmiştir. Katılımcılar klinik
eczacı tarafından on iki ay boyunca yüz yüze veya telefonla yapılan
düzenli görüşmelerle takip edilmiştir.
Bulgular: Çalışmaya katılan 33 katılımcının yaş ortalaması
41.57±11.90 (aralık: 24-66 yıl) olarak hesaplanmıştır. Fagerstrom
Nikotin Bağımlılık Testi sonuçlarına göre katılımcıların onbeşinde
düşük nikotin bağımlılığı, dokuzunda orta bağımlılık ve kalan dokuz
katılımcıda ise yüksek nikotin bağımlılığı saptanmıştır. Hastaların ikisi
bir yıllık takipte kaybedilmiş, çalışma 31 hasta ile tamamlanmıştır.
Çalışma sonunda, klinik eczacı danışmanlığında serbest eczanede
yürütülen sigara bırakma programıyla bir yıl boyunca takip edilen
otuz bir katılımcının yirmisinin (%64.5) sigara kullanmayı bıraktığı
görülmüştür.
Sonuç: Bu bilgiler ışığında, eğitimli ve kolay ulaşılabilir sağlık mensupları olan eczacıların sigara bırakma programlarında aktif rol almaları gerekmekte olduğu sonucuna ulaşılmıştır.
Anahtar sözcükler: Sigara bırakma, klinik eczacılık, nikotin replasman tedavisiObjective: It was aimed to retrospectively evaluate the effects of
clinical pharmacist-led smoking cessation program directed with
nicotine replacement therapy including nicotine gum and nicotine
tablet by determining the quitting rate of participants.
Method: This study was conducted between June 2009- June
2010. At the first meeting, the demographic and clinical data were
collected and ‘the Fagerstrom Nicotine Addiction Test’ was applied to
each participants. The clinical pharmacist informed the participants
about the harms of smoking and also advised the appropriate
over the counter nicotine replacement products according to each
participant’s degree of dependence. Participants were monitored
by the pharmacist at regular intervals, either face-to-face or by
telephone throughout the 12-month study period.
Results: The study was conducted on 33 subjects. The mean age of
the participants were 41.57±11.90 (range: 24-66). According to the
results of the Fagerstrom Nicotine Addiction Test, 15 of them were
determined as low nicotine dependent, 9 of them were determined
as medium dependent and 9 participants were determined as
high dependent. Two patients were lost to follow-up and the study
was completed with 31 patients. At the end of the study, it was
determined that 64.5% of the 31 participants successfully quitted
smoking by the pharmacist-led smoking cessation program at the
community pharmacy.
Conclusion: According to these data, it was seen that pharmacists
who are the competent and easy to access health care provider
should involve in smoking cessation programs.
Key words: Smoking cessation, clinical Pharmacist, nicotine
replacement therap
Pediatric patients with COVID-19: A retrospective single-center experience
No full textObjectives: The pandemic of coronavirus disease 2019 (COVID-19) is still effective all over the world. Compared to adults, data on
pediatric patients are limited. In this study, we aimed to retrospectively examine the demographic, clinical, and laboratory characteristics of pediatric patients who were followed up with the diagnosis of COVID-19 in the first 3 months of the pandemic in our hospital.
Methods: A total of 190 patients, aged 1 month–18 years, who were followed up with a definite/probable diagnosis of COVID-19,
who were treated in the Pediatric Infection Clinic, were included in the study. The demographic features, clinical characteristics,
and laboratory findings of the patients were retrospectively analyzed from their electronic medical records.
Results: Eighty (42.1%) of the patients were laboratory confirmed (Polymerase chain reaction positive in nasopharyngeal swab).
Mean age was 72 (2–216 months) and 102 (53.7%) patients were female. Family contact history was present in 115 (60.5%) patients.
The patients were classified as asymptomatic (5.8%), mild (73.2%), moderate (18.4%), and severe/critical (2.6%) according to the
severity of the disease. The most common symptoms were cough (71.1%) and fever (51.1%). Hydroxychloroquine alone or in combination was the most commonly used agent.
Conclusion: In our study, in which we examined the pediatric COVID-19 patients, most of the patients had a mild clinical course,
but there were applications with different clinical pictures such as acute appendicitis. Therefore, COVID-19 infection, which is still
very unknown, will continue to surprise us with both changing treatment protocols and clinical presentations such as multisystem
inflammatory syndrome in children
The effect of the clinical pharmacist in minimizing drug-related problems and related costs in the intensive care unit in Turkey: A non-randomized controlled study
No full textWhat is known and objective:Drug-related problems (DRPs) are common inhospitalized patients in intensive care unit (ICU). The aim of the study is to reduceDRPs and associated costs with clinical pharmacist's (CP) recommendations.Methods:The study is a prospective, non-randomized controlled study conducted inthe ICU for a total of 6 months (1 January 2021–30 June 2021) in 2-month con-trol, 2-month study, and 2-month control periods. Patients who were hospitalizedfor more than 24 h and used more than one medication were included in thestudy. The PCNE V9.1 Classification system was used in the classification ofDRPs. During the intervention period, CP recommendations for DRPs wereproposed to the healthcare team.Results and discussion:A total of 146 patients were included in the study. A total of1061 DRPs from all periods were detected. The most common causes of DRPs werepotential drug–drug interactions (31.76%), high dose (12.44%), and dose timinginstruction errors (9.24%). For 347 DRPs identified during the study period, 259 inter-ventions (74.63%) were recommended, and 238 (91.89%) were accepted by physi-cians. Interventions were mostly made as interrupting/discontinuing the drug(28.02%), changing the dose (25.27%), changing the instructions for use (20.32%),and starting a new drug (15.93%). Cost savings were achieved with CP recommenda-tions applied.What is new and conclusion:The CP's recommendations were highly accepted bythe healthcare team. With the CP's participation in routine patient rounds in thehealthcare team of the ICU, drug-related costs would also decrease
Dr. Duane M. Jackson, Morehouse College, July 2011
No full textThis video is a conversation with Dr. Duane M. Jackson. Dr. Jackson talks about his paper, "Recall and the Serial Position Effect: The Role of Primacy and Recency on Accounting Students' Performance." Jackie Daniel, AUC Woodruff Library, is the interviewer
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