Effect of Perioperative Stroke on Survival After Carotid Intervention.

Objectives: Perioperative stroke is the most dreaded complication of carotid artery interventions and can severely affect patients' quality of life. This study evaluated the impact of this event on mortality for patients undergoing interventional treatment of carotid artery stenosis with three different modalities.

Methods: Patients undergoing carotid revascularization at participating Memorial Hermann Health System facilities were captured from 2003-2022.

A new paradigm in adverse drug reaction reporting: consolidating the evidence for an intervention to improve reporting.

Introduction: Adverse drug reaction (ADR) under-reporting is highly prevalent internationally and interventions created to address this problem have only been temporarily successful. This review aims to investigate how to leverage digital applications and automation across the healthcare industry to improve the quantity and quality of ADR reporting.

Areas Covered: This review investigated the significance of ADR under-reporting, the barriers of reporting ADRs, and the magnitude of success of various interventions to improve ADR reporting by searching the EMBASE and MEDLINE databases to include studies published between January 2000 and February 2022.

Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker.

Background: End-stage kidney disease (ESKD) incidence has been increasing over time, contributing significantly to morbidity and mortality. However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker fits within the multidisciplinary CKD care. This integrative systematic review aims to summarise the existing evidence on psychosocial determinants of outcomes in ESKD and the role of the social worker in nephrology care.

Levofloxacin: Insights Into Antibiotic Resistance and Product Quality.

Counterfeit and substandard medicines are recognized as one of serious threats to public health. The product quality of antibacterial medicine will compromise patients' recovery and increase the chance of antibacterial resistance. The review aims to provide a summary of low quality levofloxacin issues and the risk factors as well as suggesting the aspects of product quality that need to be regulated strictly.

Impact of redo sternotomy on proximal aortic repair: Does previous aortic repair affect outcomes?

Purpose: Proximal aortic repair (AoR) in the setting of previous sternotomy may be associated with greater risk than primary repair. Our objective was to determine whether redo sternotomy increases the risk of adverse outcomes following proximal aortic surgery.

Methods: We reviewed all proximal AoRs from 1991 to 2014.

Intercostal artery management in thoracoabdominal aortic surgery: To reattach or not to reattach?

Background: The need for intercostal artery (ICA) reattachment in surgery for descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm (TAAA) remains controversial. We reviewed our experience over a 14-year period to assess the effects of ICA management on neurologic outcome after DTAA/TAAA repair.

Methods: Intraoperative data were reviewed to ascertain the status of T3-12 ICAs and L1-4 ICAs.

Patients' understanding and use of analgesia for postnatal pain following hospital discharge.

Background Postnatal pain is one of the limiting factors in the recovery of women from child birth. Despite the routine prescribing of analgesics for postnatal pain, limited research is available on the use of analgesics by the women in postnatal period. Objective To measure the utilisation and effectiveness of prescribed oral analgesics, the incidence and severity of pain, and factors associated with poor pain control on the fifth-day post-hospital discharge in postnatal women.

Antimicrobial drug use in primary healthcare clinics: a retrospective evaluation.

Objectives: To examine the appropriateness of antibiotics prescribed for acute infection based on the Malaysian national antibiotic guidelines and the defined daily dose (DDD) system of the World Health Organization (WHO). This study also aimed to describe the factors influencing the drug use pattern and to investigate the procurement patterns of antibiotics in the primary healthcare setting.

Methods: A retrospective cohort follow-up study of randomly selected patients from all patients who received any antibiotic between January and December 2013 was conducted at three primary healthcare clinics in Selangor State of Malaysia.

Clinical Pathway and Monthly Feedback Improve Adherence to Antibiotic Guideline Recommendations for Community-Acquired Pneumonia.

Background: Compliance with community-acquired pneumonia (CAP) guidelines remains poor despite a substantial body of evidence indicating that guideline-concordant care improves patient outcomes. The aim of this study was to compare the relative effectiveness of a general educational and a targeted emergency department intervention on improving physicians' concordance with CAP guidelines.

Methods: Two distinct interventions were implemented over specific time periods.

Stability of Cefepime in pH-Neutral Peritoneal Dialysis Solutions Packaged in Dual-Compartment Bags.

Intraperitoneal cefepime is used for the treatment of peritoneal dialysis (PD)-associated peritonitis caused by gram-negative bacteria. The current study investigated the stability of cefepime in a pH-neutral PD solution. A reconstituted solution of cefepime was injected into a total of 9 PD bags and stored at 4°C, 25°C or 37°C for various time points.

A web-based training program to support chronic kidney disease screening by community pharmacists.

Background Community pharmacists' role in screening of several chronic diseases has been widely explored. The global health burden of chronic kidney disease is high; however, the progression and adverse outcomes can be prevented or delayed by detecting and treating the disease in its initial stages 1-3. Therefore, a web-based training program was developed to enhance pharmacists' knowledge and skills required to perform a chronic kidney disease screening service in a community setting.

Medication Regimen Complexity and Adherence in Haemodialysis Patients: An Exploratory Study.

Background: The impact of medication regimen complexity on adherence in hemodialysis patients is unknown. We investigated regimen complexity, perceived burden of medicines (PBM) and health-related quality of life (HR-QoL) as potential predictors of adherence.

Methods: Adult (≥18 years) hemodialysis patients were included.

Perceptions and Practices of Community Pharmacists towards Antimicrobial Stewardship in the State of Selangor, Malaysia.

Background: Increasing antimicrobial resistance is one of the pressing concerns globally. Injudicious use of antibiotics is one of the modifiable factors responsible for antimicrobial resistance. Given the widespread use of antimicrobials in community settings, pharmacists have an important role in ensuring appropriate use of antibiotics.

Attitude, barriers and facilitators to practice-based research: cross-sectional survey of hospital pharmacists in Saudi Arabia.

Background: Little is known about the perceived attitude, barriers and facilitators of Saudi Pharmacists about practice based research. We aimed to measure the attitude, barriers, and facilitators of Saudi hospital pharmacists towards pharmacy practice research.

Method: A cross-sectional survey of hospital pharmacists (n = 216) working in King Abdulaziz Medical Cities in Central, Eastern and Western region hospitals was conducted during first week of September, 2013.

Nonadherence to Medication Therapy in Haemodialysis Patients: A Systematic Review.

Background: End-stage kidney disease (ESKD) patients are often prescribed multiple medications. Together with a demanding weekly schedule of dialysis sessions, increased number of medicines and associated regimen complexity pre-dispose them at high risk of medication nonadherence. This review summarizes existing literature on nonadherence and identifies factors associated with nonadherence to medication therapy in patients undergoing haemodialysis.

Stability of Tigecycline in Different Types of Peritoneal Dialysis Solutions.

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Introduction: Intraperitoneal tigecycline is a potential option for the treatment of peritoneal dialysis (PD)-associated peritonitis caused by microorganisms resistant to commonly used antibiotics. However, the stability of tigecycline must be assessed in the PD solution before evaluating its safety and therapeutic efficacy in PD-associated peritonitis. The objective of this study was to investigate the stability of tigecycline in 3 types of PD solutions at different temperatures for various time points.

Non-Anticoagulant Fractions of Enoxaparin Suppress Inflammatory Cytokine Release from Peripheral Blood Mononuclear Cells of Allergic Asthmatic Individuals.

Background: Enoxaparin, a low-molecular-weight heparin, is known to possess anti-inflammatory properties. However, its clinical exploitation as an anti-inflammatory agent is hampered by its anticoagulant effect and the associated risk of bleeding.

Objective: The aim of the current study was to examine the ability of non-anticoagulant fractions of enoxaparin to inhibit the release of key inflammatory cytokines in primed peripheral blood mononuclear cells derived from allergic mild asthmatics.

Metformin utilisation in Australian community and aged care settings.

Objective: The objective of this study was to: (i) evaluate the potentially inappropriate prescribing (PIP; defined as the use of metformin in the presence of contraindications and/or use in excessive dosage based on the renal function) of metformin in people receiving medication reviews in Australia and (ii) identify the predictors for PIP of metformin.

Method: Retrospective study of patients taking metformin through a large medication review database, containing records between January 2010 and June 2012. Data, including demographics, medical conditions, medications and relevant pathology results, were extracted for analysis.

Opposing effects of low molecular weight heparins on the release of inflammatory cytokines from peripheral blood mononuclear cells of asthmatics.

Background: T-cell-mediated inflammatory cytokines, such as interleukin (IL)-4, IL-5, IL-13 and tumor necrosis factor-alpha (TNF-α), play an important role in the initiation and progression of inflammatory airways diseases. Low-molecular-weight heparins (LMWHs), widely used anticoagulants, possess anti-inflammatory properties making them potential treatment options for inflammatory diseases, including asthma. In the current study, we investigated the modulating effects of two LMWHs (enoxaparin and dalteparin) on the release of cytokines from stimulated peripheral blood mononuclear cells (PBMCs) of asthmatic subjects to identify the specific components responsible for the effects.

Factors influencing ceftriaxone use in community-acquired pneumonia: Emergency doctors' perspectives.

Objective: To explore the perceptions of ED doctors regarding the use of ceftriaxone in patients with community-acquired pneumonia (CAP).

Methods: Face-to-face interviews were conducted with ED doctors in an Australian tertiary public hospital. A semi-structured interview method was used for collecting data and a framework analysis approach utilised to identify emerging themes regarding the influences on ED prescribers when using ceftriaxone for CAP.

Barriers and Facilitators to Adoption of a Web-based Antibiotic Decision Support System.

Objective: To measure clinicians' perceptions of barriers and facilitators to the adoption of a Computerised Decision Support System (CDSS) for antibiotic approval, and to examine the correlation between these perceptions and actual usage of the system by clinicians.

Methods: This study was conducted in a tertiary care university hospital of Melbourne, Australia. A survey tool comprising of demographic items and newly developed scales to measure clinicians' perceptions of barriers and facilitators to use of an CDSS was developed.

The role of perceptions of clinicians in their adoption of a web-based antibiotic approval system: do perceptions translate into actions?

Purpose: Computerized Decision Support Systems have been shown to improve clinicians' performance. Clinicians' adoption of these systems is crucial for their success. Studying clinicians' perceptions can provide an insight into the determinants of clinicians' adoption of such systems.

Delineation of the minimal commonly deleted segment and identification of candidate tumor-suppressor genes in del(9q) acute myeloid leukemia.

Deletion of the long arm of chromosome 9, del(9q), is a recurring chromosomal aberration in acute myeloid leukemia (AML) that is frequently associated with t(8;21). The critical gene products affected by del(9q) are unknown but likely cooperate with the AML1/ETO fusion gene created by t(8;21) in leukemogenesis. In 43 AML samples with del(9q), we used high-density microsatellite markers to define the commonly deleted region (CDR) to less than 2.

Impact of pharmacist recommendations on the cost of drug therapy in ICU patients at a Malaysian hospital.

Objectives: To analyse clinical pharmacists interventions in the ICU of the Penang General Hospital (Penang, Malaysia) and to assess the pharmaco-economic impact of these interventions.

Methods: A clinical pharmacist reviewed drug prescriptions during one month. Drug-related problems were documented on a prepared from including a suggestion for a change in prescribing.