The development of early warning scores or alerting systems for the prediction of adverse events in psychiatric patients: a scoping review.

Background: Adverse events in psychiatric settings present ongoing challenges for both patients and staff. Despite advances in psychiatric interventions and treatments, research on early warning scores and tools to predict patient deterioration is limited. This review provides a summary of the few tools that have been developed in a psychiatric setting, comparing machine learning (ML) and nonmachine learning/traditional methodologies.

Pharmacotherapeutic candidates for myopia: A review.

This review provides insights into the mechanism underlying the pathogenesis of myopia and potential targets for clinical intervention. Although the etiology of myopia involves both environmental and genetic factors, recent evidence has suggested that the prevalence and severity of myopia appears to be affected more by environmental factors. Current pharmacotherapeutics are aimed at inhibiting environmentally induced changes in visual input and subsequent changes in signaling pathways during myopia pathogenesis and progression.

Impact of Pregnancy History and 17-Hydroxyprogesterone Caproate on Cervical Cytokines and Matrix Metalloproteinases.

Objective:  The objective of this study was to evaluate the impact of pregnancy history and 17-hydroxyprogesterone caproate (17-OHPC) treatment on cervical fluid cytokines and matrix metalloproteinases (MMPs).

Study Design:  Cervical fluid was obtained between 16 and 24 weeks from women with only prior term births (controls,  = 26), women with one or more prior spontaneous preterm births (SPTBs) choosing to receive 17-OHPC (17-OHPC,  = 24), or to not receive 17-OHPC (refusers,  = 12). Cervical fluid collections were repeated 2, 4, and 8 weeks after the first sample and concentrations of MMPs and cytokines were measured by multiplex immune assay.

In vitro to in vivo extrapolation of the complex drug-drug interaction of bupropion and its metabolites with CYP2D6; simultaneous reversible inhibition and CYP2D6 downregulation.

Bupropion is a widely used antidepressant and smoking cessation aid and a strong inhibitor of CYP2D6 in vivo. Bupropion is administered as a racemic mixture of R- and S-bupropion and has stereoselective pharmacokinetics. Four primary metabolites of bupropion, threo- and erythro-hydrobupropion and R,R- and S,S-OH-bupropion, circulate at higher concentrations than the parent drug and are believed to contribute to the efficacy and side effects of bupropion as well as to the CYP2D6 inhibition.

Identification and Structural Characterization of Three New Metabolites of Bupropion in Humans.

Bupropion is a widely used antidepressant and the recommended CYP2B6 probe drug. However, current understanding of bupropion elimination pathways is limited. Bupropion has three active circulating metabolites, OH-bupropion, threohydrobupropion, and erythrohydrobupropion, but together with bupropion these metabolites and their conjugates in urine represent only 23% of the dose, and the majority of the elimination pathways of bupropion result in uncharacterized metabolites.

Quality assessment of compounded 17-hydroxyprogesterone caproate.

Objective: The purpose of this study was to evaluate the quality of compounded 17-hydroxyprogesterone caproate (17-OHPC).

Study Design: Compounded 17-OHPC that was obtained from 15 compounding pharmacies throughout the United States was analyzed for potency, impurities, sterility, and pyrogen status.

Results: Eighteen samples were supplied by 15 compounding pharmacies.

Physiologic adaptations to pregnancy.

Pregnancy leads to diverse physiologic changes to accommodate the demands of the developing fetoplacental unit, which affect many major organ systems. Understanding these physiologic adaptations to pregnancy is important for all clinicians because they have important implications for the diagnosis and management of various disorders. This article provides a brief overview of the most notable of these adaptations, including cardiovascular, hematologic, respiratory, renal, immunologic, and gastrointestinal.

Port insertion and removal techniques to minimize premature rupture of the membranes in endoscopic fetal surgery.

Background: Premature rupture of membranes (PROM) remains a significant complication of fetal surgery. Rates of 40% to 100% have been reported after both open and endoscopic fetal surgery. We describe a technique of endoscopic port insertion and removal that minimizes trauma to the membranes.