Integrative Medicine Elective for the Well-being of Pharmacy Students.

Objective: To describe the impact of an integrative medicine elective on the well-being of pharmacy students at the University of Maryland School of Pharmacy and examine the relationship between perceived stress and happiness.

Methods: Students completed the Perceived Stress Scale (PSS) and Subjective Happiness Scale (SHS) before and 3 months after taking the course. Our study compared the outcomes of each composite score from the PSS and SHS before and after course participation to detect any difference.

CD4+ T-cell recovery in HIV/hepatitis C co-infected patients following successful hepatitis C treatment.

Introduction: Hepatitis C virus (HCV)/HIV co-infection has been identified as a risk for impaired CD4+ T-cell recovery, possibly mediated by HCV-induced liver fibrosis and/or immune activation. As HCV direct-acting antivirals (DAAs) may partially reverse liver fibrosis and immune activation, sustained HCV virological response (SVR) may lead to improved CD4 recovery. We explored the effect of HCV DAA-induced SVR on CD4 recovery among patients living with both HCV and HIV, including those with poor CD4 recovery on antiretroviral therapy (immunological non-responders [INRs]).

A Comprehensive Review of Herbal Supplements Used for Persistent Symptoms Attributed to Lyme Disease.

Context: Lyme disease is the most common, tick-borne disease in the USA. While most patients successfully recover with antibiotics, some patients experience persistent symptoms for months to years. Patients who attribute chronic symptoms to Lyme disease commonly use herbal supplements.

Interprofessional Culinary Medicine Training Enhanced Nutrition Knowledge, Nutrition Counseling Confidence, and Interprofessional Experience.

Culinary medicine training combining evidence-based nutrition instruction with experiential cooking application has improved nutrition knowledge, skills, and attitudes in the professional and personal lives of medical students. However, interprofessional culinary training remains largely unstudied among professional students who will be involved in collaborative patient care. The goal of this study was to evaluate the feasibility and effectiveness of an elective interprofessional culinary medicine course for students in the medical, pharmacy, social work, nursing, law, and dentistry schools at the University of Maryland, Baltimore.

Utility of On-Treatment Viral Loads During Treatment With Direct-Acting Antivirals in Patients Infected With Chronic Viral Hepatitis C.

Direct-acting antiviral (DAA) agents have revolutionized the treatment of chronic hepatitis C virus (HCV) infection. Current data regarding the utility of on-treatment HCV viral load (VL) monitoring are conflicting and limited data are available in HIV-coinfected patients. The objective of the study was to determine whether on-treatment VLs are predictive of HCV cure in a real-world population.

Health Care Resource Utilization Associated With Parkinson Disease Among Medicare Beneficiaries.

Objective: To compare differences in health care resource utilization (HcRU) over time between Medicare beneficiaries with and without Parkinson disease (PD).

Methods: This retrospective observational study used the Chronic Conditions Data Warehouse (5% Medicare sample) between 2005 and 2015. In a propensity score-matched (age, sex, race, and comorbidity adjusted) sample of beneficiaries with and without PD, we examined all-cause HcRU due to inpatient admissions, emergency department (ED) admissions, skilled nursing facility (SNF) admissions, health care provider encounters, neurologist visits, rehabilitation service visits, and non-PD medication fills.

Effectiveness of 8 weeks of ledipasvir/sofosbuvir for hepatitis C in HCV-HIV-coinfected patients.

Background: Data is limited on the use of 8 weeks of therapy with ledipasvir/sofosbuvir (LDV/SOF) for special populations such as HCV-HIV-coinfected patients. The primary objective of this analysis was to compare sustained virological response at 12 weeks after end of therapy (SVR12) rates among HCV-monoinfected and HCV-HIV-coinfected patients in a real-world clinical setting. Additionally, we compared SVR12 rates among patients receiving 8 versus 12 weeks of therapy.

Direct-Acting Antivirals to Prevent Vertical Transmission of Viral Hepatitis C: When Is the Optimal Time to Treat?

Objective: To describe the most current evidence for the use of direct-acting antivirals (DAAs) to treat hepatitis C along the pregnancy-pediatric continuum in the United States.

Data Sources: The MEDLINE/PubMed databases were searched (January 1995 to February 2018) for articles in English using the terms: hepatitis C, vertical transmission, pregnancy, pediatrics, ribavirin, interferon, direct acting antivirals, daclatasvir, dasabuvir, elbasvir, glecaprevir, grazoprevir, ledipasvir, ombitasvir, paritaprevir, pibrentasvir, simeprevir, sofosbuvir, and velpatasvir.

Study Selection And Data Extraction: All relevant studies, meta-analyses, systematic reviews, guidelines, and review articles were evaluated for inclusion.

Future Considerations for the Evaluation of Hepatitis C Virus Treatments in Pan-Genotypic Therapy for Noncirrhotic Treatment-Naive Patients.

Unlabelled: Given the recent approval of the first pan-genotypic chronic hepatitis C virus (HCV) therapy, managed care, health systems, and clinicians will need to evaluate current practices related to essential laboratory assessments used to select therapy. Historically, clinicians and payers required a battery of tests to determine HCV genotype, viral load, degree of fibrosis, and organ function. In light of current and forthcoming approvals of pan-genotypic therapy, clinicians and payers can expect a more competitive marketplace and a downward curve in the price of therapy.

Evaluating a Collaborative Approach to Improve Prior Authorization Efficiency in the Treatment of Hepatitis C Virus.

Objective: A team-based approach to obtaining prior authorization approval was implemented utilizing a specialty pharmacy, a clinic-based pharmacy technician specialist, and a registered nurse to work with providers to obtain approval for medications for hepatitis C virus (HCV) infection. The objective of this study was to evaluate the time to approval for prescribed treatment of HCV infection.

Methods: A retrospective observational study was conducted including patients treated for HCV infection by clinic providers who received at least 1 oral direct-acting antiviral HCV medication.

Structure-based design of N-substituted 1-hydroxy-4-sulfamoyl-2-naphthoates as selective inhibitors of the Mcl-1 oncoprotein.

Structure-based drug design was utilized to develop novel, 1-hydroxy-2-naphthoate-based small-molecule inhibitors of Mcl-1. Ligand design was driven by exploiting a salt bridge with R263 and interactions with the p2 pocket of the protein. Significantly, target molecules were accessed in just two synthetic steps, suggesting further optimization will require minimal synthetic effort.

Are Fluoroquinolones Appropriate for the Treatment of Extended-Spectrum β-Lactamase-Producing Gram-Negative Bacilli?

To review the data analyzing the role of fluoroquinolones in the treatment of extended-spectrum β-lactamase (ESBL)-producing infections and rates and methods of co-transmission of resistance. A MEDLINE literature search was performed using the search terms , and from 1996 to June 2015. Additional references were identified from a review of literature citations.

What does the pharmacological future of treating chronic hepatitis C look like?

Development of direct acting antivirals has revolutionized the standard of care for the treatment of hepatitis C virus. New interferon-free regimens provide sustained virologic response rates of >90% in many genotype 1 patients with only 12 weeks of oral therapy. This review will provide a brief overview of current standards of care with a summary of the evidence supporting the recommended combinations of direct acting antivirals.

Vancomycin-associated nephrotoxicity in adult medicine patients: incidence, outcomes, and risk factors.

Objective: The prevalence of vancomycin-associated nephrotoxicity (VAN) is reported to vary from 1.0-42.6%, with most data from critically ill patients.

Treatment strategy for a multidrug-resistant Klebsiella UTI.

Objective: To describe the management strategy for a multidrug-resistant (MDR) Klebsiella urinary tract infection (UTI).

Case Summary: A 69-year-old Caucasian woman with a past medical history of recurrent UTIs and a right-lung transplant presented with fever to 101.4°F, chills, malaise, and cloudy, foul-smelling urine for approximately 1 week.

Prophylaxis of thromboembolic events in patients with nephrotic syndrome.

Objective: To review published literature regarding use of strategies to prevent thrombotic events in patients with nephrotic syndrome (NS).

Data Sources: The MEDLINE/PubMed, EMBASE, and Cochrane databases were queried from 1980 to December 2012 for articles in English using the search terms nephrotic syndrome, thrombosis, thromboembolism, anticoagulation, warfarin, heparin, low-molecular-weight heparin, enoxaparin, dalteparin, tinzaparin, statin, atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin, aspirin, direct thrombin inhibitor, rivaroxaban, argatroban, lepirudin, bivalirudin, dabigatran, factor Xa inhibitor, fondaparinux, rivaroxaban, clopidogrel, ticlopidine, and prasugrel.

Study Selection And Data Extraction: All relevant original studies, meta-analyses, systematic reviews, guidelines, and review articles were assessed for inclusion.

Anemia management in patients with chronic viral hepatitis C.

Objective: To review the literature regarding current strategies for the management of anemia associated with treatment for chronic viral hepatitis C (HCV) in adults.

Data Sources: The MEDLINE/PubMed, EMBASE, and Cochrane databases were searched (January 1980-October 2012) for articles in English using the search terms anemia, ribavirin, dose reduction, erythropoietin stimulating agents, hepatitis C, HIV, liver transplant, telaprevir, and boceprevir.

Study Selection And Data Extraction: All relevant original studies, meta-analyses, systematic reviews, guidelines, and review articles were assessed for inclusion.

Probable rifaximin-induced neutropenia.

Purpose: The development of neutropenia in a patient treated with rifaximin is reported.

Summary: A 45-year-old Caucasian woman with severe ulcerative colitis arrived at the emergency department with complaints of worsening abdominal pain, nausea, and vomiting and was found to have extensive portal vein and superior mesenteric vein thrombosis with additional thrombi in the distal aortic and left common iliac arteries on an abdominal computed tomography angiography scan. A heparin i.

Prophylaxis and treatment of respiratory syncytial virus in adult immunocompromised patients.

Objective: To review the literature regarding current strategies and strategies under active development for the prevention and treatment of respiratory syncytial virus (RSV) infections in immunocompromised adults.

Data Sources: The MEDLINE/PubMed, EMBASE, and Cochrane databases were queried from January 1980 to December 2011 for articles in English using these associated search terms: respiratory syncytial virus, ribavirin, intravenous immunoglobulin, IVIG, palivizumab, motavizumab, lung, pneumonia, transplantation, bone marrow, cancer, malignancy, and vaccine.

Study Selection And Data Extraction: All relevant original studies, meta-analyses, systematic reviews, and review articles were assessed for inclusion.

A review of oral antiretroviral therapy for the treatment of chronic hepatitis B.

Objective: To describe the current evidence for the use of oral antiretroviral (ARV) agents in the treatment of chronic hepatitis B (CHB).

Data Sources: A search from 1950 to April 2010 was conducted using the databases PubMed and MEDLINE with the search terms chronic hepatitis B, lamivudine, entecavir, adefovir, telbivudine, tenofovir, emtricitabine, clevudine, and pradefovir. The search was limited to trials conducted in humans that were published in the English language.

Raltegravir-based HAART regimen in a patient with large B-cell lymphoma.

Objective: To describe the antiretroviral management of a patient diagnosed simultaneously with HIV/AIDS and diffuse large B-cell lymphoma, focusing on the drug-drug interactions between highly active antiretroviral therapy (HAART) and concomitant cancer chemotherapy.

Case Summary: A 55-year-old white man was recently diagnosed with HIV/AIDS and presented 1 month later with complaints of nausea, vomiting, abdominal pain, double vision, right eye discomfort/swelling, and a 3.6-kg weight loss.