Cardiovascular adaptations to particle inhalation exposure: molecular mechanisms of the toxicology.

Ambient air, occupational settings, and the use and distribution of consumer products all serve as conduits for toxicant exposure through inhalation. While the pulmonary system remains a primary target following inhalation exposure, cardiovascular implications are exceptionally culpable for increased morbidity and mortality. The epidemiological evidence for cardiovascular dysfunction resulting from acute or chronic inhalation exposure to particulate matter has been well documented, but the mechanisms driving the resulting disturbances remain elusive.

Patient Satisfaction with Substance Use Disorder Rehabilitation Services: a Qualitative Study.

Despite its recognized value, there is a gap in the assessment of patient satisfaction among patients with substance use disorder (SUD) in rehabilitation. The study objective was to determine patient satisfaction dimensions relevant to individuals receiving residential rehabilitation for SUD. Semi-structured interviews were conducted with the following: (1) adult males enrolled in the program and (2) counseling staff involved in the care of these individuals.

Adolescent Vaccines: Current Recommendations and Techniques to Improve Vaccination Rates.

With multiple vaccines for adolescents recommended, it is imperative providers remain up to date with the current recommendations. With misinformation of vaccine safety and effectiveness in the mainstream media and social media, adolescents are a vulnerable population that needs to be reviewed and educated. Adolescents are typically only just starting to take ownership of their health care.

Prevalence of Multimorbidity among Asian Indian, Chinese, and Non-Hispanic White Adults in the United States.

Asian Americans are the fastest-growing minority group in the United States, yet little is known about their multimorbidity. This study examined the association of Asian Indians, Chinese and non-Hispanic whites (NHWs) to multimorbidity, defined as the concurrent presence of two or more chronic conditions in the same individual. We used a cross-sectional design with data from the National Health Interview Survey (2012-2017) of Asian Indians, Chinese, and NHWs ( = 132,666).

Meta-Analysis Comparing Direct Oral Anticoagulants Versus Warfarin in Morbidly Obese Patients With Atrial Fibrillation.

The International Society of Thrombosis and Haemostasis recommends warfarin therapy over direct oral anticoagulants (DOACs) in patients with a body mass index >40 kg/m or weight > 120 kg due to limited clinical data in morbidly obese patients. The aim of the meta-analysis was to compare DOACs with warfarin in morbidly obese patients with atrial fibrillation (AF) and to optimize an anticoagulation therapy in the population. MEDLINE, Embase, Google Scholar, Web of Science, and Cochrane Library database searches for relevant articles through December 23, 2019 were performed.

The Association of Osteoarthritis and Related Pain Burden to Incident Alzheimer's Disease and Related Dementias: A Retrospective Cohort Study of U.S. Medicare Beneficiaries.

Background: Emerging evidence suggests osteoarthritis (OA) and related symptom burden may increase risk for Alzheimer's disease and related dementias (ADRD). However, longitudinal studies are sparse, and none have examined the potential mediating effects of mood or sleep disorders.

Objective: To determine the association of OA and related pain to incident ADRD in U.

Medroxyprogesterone Acetate Impairs Amyloid Beta Degradation in a Matrix Metalloproteinase-9 Dependent Manner.

Despite the extensive use of hormonal methods as either contraception or menopausal hormone therapy (HT), there is very little known about the potential effects of these compounds on the cellular processes of the brain. Medroxyprogesterone Acetate (MPA) is a progestogen used globally in the hormonal contraceptive, Depo Provera, by women in their reproductive prime and is a major compound found in HT formulations used by menopausal women. MPA promotes changes in the circulating levels of matrix metalloproteinases (MMPs), such as MMP-9, in the endometrium, yet limited literature studying the effects of MPA on neurons and astroglia cells has been conducted.

Antibiotic de-escalation on internal medicine services with rounding pharmacists compared to services without.

Background Antimicrobial stewardship programs ensure antibiotic therapy is used appropriately and includes de-escalation when clinical status or culture data indicates broad-spectrum agents are no longer needed. Although the impact of infectious diseases clinical pharmacists has been well documented, there is limited research evaluating the impact of adult internal medicine clinical pharmacists on broad-spectrum antibiotic de-escalation while rounding on internal medicine teams. Objective To determine if broad-spectrum antibiotics were de-escalated more regularly and more rapidly in patients on internal medicine services with a rounding pharmacist at the bedside compared to internal medicine services without rounding pharmacists.

Association of sleep quality with telomere length, a marker of cellular aging: A retrospective cohort study of older adults in the United States.

Background: Sleep quality is a risk factor for age-related diseases, and although the underlying mechanisms remain unclear, the effects of poor sleep quality on telomere length (TL) may play a role.

Objective: The objective of the study was to evaluate the independent association between sleep quality and salivary TL in a large sample of older adults.

Design: We adopted a retrospective cohort design, and participants comprised 5,268 adults drawn from the Health and Retirement Study.

Competency-based education in pharmacy: A review of its development, applications, and challenges.

Rationale, Aims, And Objectives: There has been a resurgence of interest in the application of competency-based education (CBE) in health care professionals' education in recent years, including the pharmacy profession. This model strives to prepare a competent pharmacy workforce to help meet societal needs for effective, safe, and economical health care services. The aim of this narrative review is to provide an overview of the applications of CBE in the education and training of pharmacists, the process for constructing a competency-based pharmacy curriculum, and the potential advantages and challenges associated with its implementation.

Interprofessional education and collaborative practice in Kuwait: attitudes and barriers from faculty.

Interprofessional education (IPE) has been adopted in many educational systems to prepare students in the health professions for team-based practice, but its implementation is still limited in many countries. In preparation for the introduction of IPE within Kuwait University Health Sciences Center, a cross-sectional survey was conducted to explore the attitudes of faculty members (academic staff/academic support staff) toward collaborative practice and IPE, their training needs, and perceived barriers to implementing IPE. Two hundred and ten individuals completed the survey (60% response rate).

Dipeptidyl Peptidase-4 Inhibitors and Joint Pain: A Retrospective Cohort Study of Older Veterans with Type 2 Diabetes Mellitus.

Background: In recent years, dipeptidyl peptidase (DPP)-4 inhibitors have been added to the diabetes treatment algorithm. Few published studies have shown that the use of DPP-4 inhibitors is associated with joint pain. To our knowledge, no population-based studies in the United States have studied this association.

Nanoparticle formulation and in vitro efficacy testing of the mitoNEET ligand NL-1 for drug delivery in a brain endothelial model of ischemic reperfusion-injury.

Ischemic reperfusion injury after a stroke is a leading cause of mortality and disability due to neuronal loss and tissue damage. Mitochondrial dysfunction plays a major role in the reperfusion-injury sequelae, and offers an attractive drug target. Mitochondrial derived reactive oxygen species (ROS) and resultant apoptotic cascade are among the primary mechanisms of neuronal death following ischemia and reperfusion injury.

Pyrvinium Pamoate Use in a B cell Acute Lymphoblastic Leukemia Model of the Bone Tumor Microenvironment.

Purpose: Pyrvinium pamoate (PP) is an anthelmintic drug that has been found to have anti-cancer activity in several cancer types. In the present study, we evaluated PP for potential anti-leukemic activity in B cell acute lymphoblastic leukemia (ALL) cell lines, in an effort to evaluate the repurposing potential of this drug in leukemia.

Methods: ALL cells were treated with PP at various concentrations to determine its effect on cell proliferation.

A Longitudinal Study of the Association of Opioid Use with Change in Pain Interference and Functional Limitations in a Nationally Representative Cohort of Adults with Osteoarthritis in the United States.

Introduction: Real-world data are sparse on longitudinal associations of opioid use with pain interference with activities (PIA) and daily function with osteoarthritis (OA) in the USA.

Methods: Data from the 2010-2015 Medical Expenditure Panel Surveys were analyzed for community-dwelling adults with OA. Opioid use patterns were defined as persistent, intermittent, and no use.

Use of Direct Oral Anticoagulants in Morbidly Obese Patients.

In 2016, the International Society on Thrombosis and Haemostasis (ISTH) published guidelines advising caution when using direct oral anticoagulants (DOACs) in patients with morbid obesity due to limited clinical efficacy and safety data supporting their use in this patient population. In this review, we analyzed published articles in the MEDLINE database (from inception through May 29, 2019), and the Cochrane Library, Google Scholar, and EMBASE databases (from inception through April 26, 2019) that evaluated morbidly obese patients with atrial fibrillation (AF) or venous thromboembolism (VTE) who received DOACs. A total of 19 studies, which included pharmacokinetic studies, original phase III trials for the DOACs, post hoc analyses of phase III trials, and retrospective cohort studies, were evaluated.

Prescription Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Depression among Adults with Inflammatory Chronic Conditions in the United States.

The association of prescription NSAIDs to presence of depression among adults with inflammatory chronic conditions in adults with and without depression and seeking care in routine clinical practice remains unknown. We examined the association of prescription NSAIDs to depression among adults with inflammatory chronic conditions in a nationally representative sample of the US non-institutionalized civilian population. We used a retrospective cross-sectional design.

Use of a Modified Delphi Process to Define the Leadership Characteristics Expected of Pharmacy Faculty Members.

To reach a consensus on a working definition for leadership and identify expectations for leadership among all pharmacy faculty members. A modified Delphi process was employed to establish consensus among experienced department and division chairs regarding the definition and expectations of faculty leadership to guide faculty evaluation and development. From the AACP faculty roster, 280 department and division chairs were surveyed to identify participants with at least five years of experience in their roles and willingness to participate.

Assessment of Patient Education about Statin Therapy on Quality Measures and Knowledge in an Independent Community Pharmacy.

Objectives: The objectives were to 1) assess the possible impact of face-to-face patient education on Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) performance scores, 2) determine if face-to-face patient education increased overall knowledge and number of identified patients on statin therapy, and 3) identify barriers to statin therapy in targeted patients with diabetes.

Design: Participants received an anonymous survey tool collecting demographic data and assessing barriers, baseline knowledge, and perceptions about statin therapy. Following the initial survey, participants received education from the pharmacist describing the risks and benefits of statin therapy and were given a supplemental pamphlet.

The association of pain interference and opioid use with healthcare utilization and costs, and wage loss among adults with osteoarthritis in the United States.

To examine associations of opioid use and pain interference with activities (PIA), healthcare resource utilization (HRU) and costs, and wage loss in noninstitutionalized adults with osteoarthritis in the United States (US). Adults with osteoarthritis identified from the Medical Expenditure Panel Survey for 2011/2013/2015 were stratified by no-opioid use with no/mild PIA, no-opioid use with moderate/severe PIA, opioid use with no/mild PIA, and opioid use with moderate/severe PIA. Outcomes included annualized total HRU, direct healthcare costs, and wage loss.

Efficacy and Safety of the Use of Pulmonary Arterial Hypertension Pharmacotherapy in Patients with Pulmonary Hypertension Secondary to Left Heart Disease: A Systematic Review.

Pulmonary hypertension (PH) is often caused by left heart disease (LHD) such as heart failure (HF) or valvular heart disease. Historically, few randomized controlled trials have evaluated the off-label use of medications for treating pulmonary arterial hypertension (PAH) in patients with PH-LHD. However, multiple randomized controlled trials have been published over the last decade that investigated their use in patients with PH-LHD.

Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States.

Objective: To estimate the burden of osteoarthritis (OA) among noninstitutionalized adults (≥18 years of age) in the US.

Design: Weighted nationally representative data from the 2015 Medical Expenditure Panel Survey were used to estimate OA prevalence in noninstitutionalized adults and compare adults with OA to those without OA for clinical (pain interference with activities [PIA], functional limitations), humanistic (health-related quality-of-life [HRQoL]) and economic outcomes (healthcare costs, wage loss). Productivity/wage loss was estimated among employed working-age adults (18-64 years).

Essential Elements for Core Required Advanced Pharmacy Practice Experiences.

ince 2004, concerns and calls for greater quality assurance in experiential education have been published. The Accreditation Council for Pharmacy Education (ACPE) "Standards 2016" provide limited differentiation across the four required practice experiences, and, as such, schools interpret them differently. Both schools and accreditation site visit teams would benefit from a common set of guidance for the required Advanced Pharmacy Practice Experiences (APPEs), so that they can ensure consistency and quality in student experiences across practice sites.