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Immuno-Oncology Overview Immuno-Oncology概述
Pub Date : 2017-08-03 DOI: 10.4172/2376-0419.1000E145
N. Ibrahim
The essential feature of the immune system is the ability to recognize and differentiate any foreign body or abnormal cells such as tumor cells from normal cells. Tumor cells produce tumor antigens which activate the immune system. These antigens attract immune cells to the tumor site where they invade and attack. Accordingly, the immune system recognizes the tumor cells and targets them for elimination.
免疫系统的基本特征是能够识别和区分任何异物或异常细胞,如肿瘤细胞和正常细胞。肿瘤细胞产生激活免疫系统的肿瘤抗原。这些抗原吸引免疫细胞到肿瘤部位,在那里它们入侵和攻击。因此,免疫系统识别肿瘤细胞,并将其作为清除目标。
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引用次数: 1
Does Message-Based Communication Through Mobile Phones for Medication and Treatment Adherence Improve Health Outcomes? A Systematic Review 通过手机进行基于信息的药物和治疗依从性沟通是否能改善健康结果?系统回顾
Pub Date : 2017-07-25 DOI: 10.4172/2376-0419.1000179
C. Mwangi, C. Mukanya
Medical non-adherence has been a pervasive issue in healthcare for far too long and consequences of medical non-adherence are far reaching. With the proliferation of mobile technology globally, there have been concerted efforts to improve adherence using mHealth both in developed and developing countries. The objective of this study was to evaluate through previous studies whether mobile phone innovations improve health outcomes through adherence messages to patients and how many of the studies mention and actually consider the content going out to patients as contributing to positive or negative health outcome. A systematic review was conducted using four search engines: PubMed, Mendley, Advanced Google, and Google Scholar. The publications were randomized clinical trials, cross-sectional studies, and pre and post interventional studies. The publications reviewed were considered to be eligible if they were based on use of mobile technology or smart phone applications in improving health outcomes through sending adherence messages. Forty one potential articles were retrieved based on the first search criteria and review of abstracts. Full text was not obtainable for 11 articles due to fees to access the document and/or a registration requirement for the websites making the full text inaccessible. Nine articles were published before the year 2009, 7 were systematic reviews, 1 was an SMS based study but was used by community health workers and did not necessarily address adherence, 3 were protocols for a study to be done, 10 articles met all the inclusion criteria. Mobile health technology has been proven to contribute towards improving adherence to treatment, medication and appointments. However it is crucial to consider the content and its development processes just as much as the technology in use as this might elevate the health outcomes even higher.
长期以来,医疗不依从一直是医疗保健领域普遍存在的问题,医疗不依从的后果影响深远。随着移动技术在全球范围内的普及,发达国家和发展中国家都在努力提高使用移动医疗的依从性。本研究的目的是通过以往的研究来评估手机创新是否通过向患者传递依从性信息来改善健康结果,以及有多少研究提到并实际考虑到向患者提供的内容对健康结果的积极或消极影响。系统评价使用四个搜索引擎:PubMed、Mendley、Advanced Google和Google Scholar。这些出版物包括随机临床试验、横断面研究和介入前后研究。如果所审查的出版物是基于使用移动技术或智能手机应用程序通过发送依从性信息来改善健康结果,则被认为是合格的。根据第一检索标准和摘要综述检索了41篇潜在文章。11篇文章无法获得全文,原因是获取文件的费用和/或网站的注册要求,无法获得全文。9篇文章在2009年之前发表,7篇是系统评价,1篇是基于SMS的研究,但被社区卫生工作者使用,不一定涉及依从性,3篇是即将进行的研究的方案,10篇文章符合所有纳入标准。事实证明,移动保健技术有助于提高对治疗、药物和预约的依从性。然而,至关重要的是要像考虑所使用的技术一样考虑内容及其开发过程,因为这可能会提高健康结果。
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引用次数: 2
Risk Factors for Bleeding Events with Enoxaparin, Dabigatran and Fondaparinux in Hospitalized Patients with Varying Levels of Renal Impairment 不同程度肾功能损害住院患者应用依诺肝素、达比加群和Fondaparinux出血事件的危险因素
Pub Date : 2017-07-19 DOI: 10.4172/2376-0419.1000178
T. Ahuja, J. Altshuler, J. Papadopoulos
Background: Anticoagulants with renal elimination may accumulate in patients with renal impairment and potentially increase the risk of bleeding. Limited data are available to elucidate the potential bleeding risk present in patients with moderate renal impairment defined as creatinine clearance of 30-50 mL/min. Objective: To evaluate potential risk factors for bleeding over various renal function ranges in patients on enoxaparin, fondaparinux, or dabigatran. Methods: Retrospective chart review from 2010 until 2011 identified patients who incurred a bleeding episode on therapeutic dosed enoxaparin, dabigatran, or fondaparinux stratified according to renal function and presence of pre-defined potential risk factors for bleeding. Bleeding episodes identified using UHC Safety Intelligence, a selfreporting database used to identify safety improvement opportunities. Results: A total of 27 (2.16%) bleeding episodes were identified, 20 occurring during enoxaparin pharmacotherapy and 7 during treatment with dabigatran. There were no fondaparinux bleeds identified. Patients with normal renal function, moderate renal impairment and severe renal impairment incurred 9, 12 and 6 bleeds, respectively. Conclusion: A similar number of patients incurred bleeding episodes on enoxaparin in the normal renal function group and moderate renal impairment group. Patients experiencing bleeding episodes in the enoxaparin group with moderate renal impairment were of advanced age and female. Enoxaparin bleeding episodes were noted in patients with hypertension in all renal function ranges. Patients who bled on dabigatran had some degree of renal impairment and were of advanced age. Concomitant p-glycoprotein inhibitor use was observed in patients with bleeding episodes on dabigatran in patients with renal impairment.
背景:肾消除抗凝剂可能在肾损害患者中积累,并可能增加出血的风险。有限的数据可用于阐明肌酸酐清除率为30-50 mL/min的中度肾功能损害患者存在的潜在出血风险。目的:评价依诺肝素、氟达肝素或达比加群治疗患者不同肾功能范围出血的潜在危险因素。方法:回顾性回顾2010年至2011年的图表,确定根据肾功能和预先定义的出血潜在危险因素分层治疗剂量依诺肝素、达比加群或氟达肝素发生出血事件的患者。使用全民健康覆盖安全情报识别出血事件,这是一个用于识别安全改进机会的自我报告数据库。结果:共发现27例(2.16%)出血,其中20例发生在依诺肝素治疗期间,7例发生在达比加群治疗期间。没有发现肝静脉出血。肾功能正常、中度肾功能损害和重度肾功能损害患者出血分别为9例、12例和6例。结论:依诺肝素在肾功能正常组和中度肾功能损害组发生出血事件的患者数量相近。在中度肾功能损害的依诺肝素组中,出现出血发作的患者为高龄和女性。依诺肝素出血发生在所有肾功能范围的高血压患者中。使用达比加群出血的患者有一定程度的肾功能损害,且年龄较大。在肾损害患者服用达比加群后出血发作的患者中观察到p糖蛋白抑制剂的同时使用。
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引用次数: 2
Disease and Prescription Pattern for Outpatients with NeurologicalDisorders in Bangladesh: An Empirical Pilot Study 孟加拉国门诊神经疾病患者的疾病和处方模式:一项实证试点研究
Pub Date : 2017-07-11 DOI: 10.4172/2376-0419.1000177
Fakhrul Hasan, A. A. Noor, Mosiqure Rahman, Kala Chand Debnath, S. Islam
Background: To study the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh. Methods: The study was conducted on 1684 patients in six hospitals of Dhaka city from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about sex, age, marital status, occupation, residential status, affected disease, self-medicated drugs and prescribed drugs. Results: Out of 1684 patients, male 963 (57.19%) predominance. The study revealed that headache and migraine 50 (29.75%), stroke 403 (23.93%) and seizure 119 (7.07%) were more projecting neurological disorders. Genetic reason for the neurological disorders was found among only 208 (12.35%) patients. Among 812 patients follow up was reported for 575 (70.82%) patients in which physician follow up was 441 (54.31%) and non-physician follow up was 134 (16.51%) patients. Maximum self-medication usage was found for the period of 3 to 6 months for 247 (41.79%) patients. Disease recovery was satisfactory with the self-medication for 223 (37.73%) patients and 38 (6.43%) patients reported side effects. Most extensively prescribed medicines were multivitamins and multi-minerals 675 (40.08%), NSAIDs and other analgesic 560 (33.25%), antiulcerant 476 (28.27%), anticoagulants 438 (26%), antihyperlipidemic 387 (22.98%) and antiepileptic 305 (18.11%) drugs respectively. The crucial reasons for the selection of prescribed medicines were the confidence with physician’s prescribed drug 690 (40.97%) and knowledge of the drugs 590 (23.99%). The period of prescribed medicines usage was 1 to 3 months for 669 (39.73%) patients and 3 to 6 months for 491 (29.16%) patients. The patient’s compliance for prescribed medicines was satisfactory for 582 (34.56%) patients, good for 474 (28.15%) patients and side effect was reported for 391 (23.22%) patients. Conclusion: In Bangladesh neurological diseases are not surprising rather than other different diseases prevail in different age and sex. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of healthcare management system. Appropriate management of the healthcare system can overcome the existing inconsistencies as well as increase the knowledge, awareness and perception of the patients about health and disorders.
背景:研究孟加拉国神经系统疾病门诊患者的患病率和处方模式。方法:对2014年3月至2015年6月在达卡市6家医院就诊的1684例患者进行研究。数据通过预先设计的问卷从患者中收集,包括性别、年龄、婚姻状况、职业、居住状况、受影响疾病、自用药物和处方药物等信息。结果:1684例患者中,男性963例,占57.19%。研究发现,头痛和偏头痛50例(29.75%)、中风403例(23.93%)和癫痫119例(7.07%)更倾向于神经系统疾病。在208例(12.35%)患者中发现神经系统疾病的遗传原因。812例患者中随访575例(70.82%),其中医师随访441例(54.31%),非医师随访134例(16.51%)。247例(41.79%)患者自我用药最多的时间为3 ~ 6个月。223例(37.73%)患者自我服药后病情恢复满意,38例(6.43%)出现不良反应。处方最多的药物分别是多种维生素及多种矿物质675种(40.08%)、非甾体抗炎药及其他镇痛药560种(33.25%)、抗溃疡药476种(28.27%)、抗凝血药438种(26%)、降血脂药387种(22.98%)和抗癫痫药305种(18.11%)。选择处方药物的关键原因是对医师处方药物的信心(690)(40.97%)和对药物的了解(590)(23.99%)。处方用药时间为1 ~ 3个月的669例(39.73%),3 ~ 6个月的491例(29.16%)。患者服药依从性满意582例(34.56%),良好474例(28.15%),不良反应391例(23.22%)。结论:在孟加拉国,神经系统疾病并不奇怪,而不同的疾病在不同的年龄和性别中流行。头痛、偏头痛、中风和癫痫是这里最常见的神经系统疾病。由于医疗管理系统的异常,这些疾病的治疗程序不太合适。对卫生保健系统的适当管理可以克服现有的不一致,并增加患者对健康和疾病的认识、意识和感知。
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引用次数: 0
Role of Vitamin D in Various Illnesses: A Review 维生素D在多种疾病中的作用综述
Pub Date : 2017-06-22 DOI: 10.4172/2376-0419.1000176
P. Tiwari, N. Sharma
Vitamin D, a fat-soluble vitamin, concentrations need to be maintained for functioning of the metabolic, immune, reproductive, muscular, skeletal, respiratory and cutaneous systems of men and women of all ages. A rough estimate indicates that about 1 billion people globally are vitamin D deficient. The physiological functions of active vitamin D (calcitriol) are related to calcium homeostasis and osteoporosis, with possible roles in diabetes, cancer, ischemic heart disease, and autoimmune and infectious diseases. Vitamin D deficit increases the risk of malignancies, particularly of colon, breast and prostate gland, of chronic inflammatory and autoimmune diseases (e.g. insulin-dependent diabetes mellitus, inflammatory bowel disease, multiple sclerosis), as well as of metabolic disorders (metabolic syndrome, hypertension). The eight disorders discussed in this review are heart disease, bone disorder, colorectal cancer and other malignancies, infectious, inflammatory and autoimmune diseases, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis and type-I diabetes mellitus. There is a strong evidence for association between heart diseases, bone disorders, colorectal cancers, infectious, inflammatory and autoimmune diseases, inflammatory bowel diseases, multiple sclerosis, diabetes mellitus type-I and vitamin D. the extent of vitamin D deficiency’s contribution in the development of osteoporosis, breast cancer, rheumatoid arthritis is unclear.
维生素D是一种脂溶性维生素,需要维持其浓度,以维持所有年龄男女的代谢、免疫、生殖、肌肉、骨骼、呼吸和皮肤系统的功能。粗略估计,全球约有10亿人缺乏维生素D。活性维生素D(骨化三醇)的生理功能与钙稳态和骨质疏松有关,可能在糖尿病、癌症、缺血性心脏病、自身免疫性疾病和传染病中起作用。缺乏维生素D会增加患恶性肿瘤,特别是结肠癌、乳腺癌和前列腺癌的风险,也会增加患慢性炎症和自身免疫性疾病(如胰岛素依赖型糖尿病、炎症性肠病、多发性硬化症)以及患代谢紊乱(代谢综合征、高血压)的风险。这八种疾病是心脏病、骨骼疾病、结直肠癌和其他恶性肿瘤、感染性、炎症性和自身免疫性疾病、炎症性肠病、多发性硬化症、类风湿性关节炎和i型糖尿病。有强有力的证据表明,心脏病、骨骼疾病、结直肠癌、传染病、炎症性和自身免疫性疾病、炎症性肠病、多发性硬化症、i型糖尿病和维生素D之间存在关联。但维生素D缺乏在骨质疏松症、乳腺癌、类风湿性关节炎中的作用程度尚不清楚。
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引用次数: 7
Heat Shock Proteins (Hsp): Classifications and Its Involvement in Health and Disease 热休克蛋白(Hsp):分类及其在健康和疾病中的作用
Pub Date : 2017-04-29 DOI: 10.4172/2376-0419.1000175
K. Datta, K. Rahalkar, Dinesh Dk
For the reason that no model will ever totally replicate clinical human wound healing, it is necessary that the model operated be selected with care. Heat Shock Proteins (Hsp) is articulated in response to numerous biological stresses, comprising heat, high pressures, and toxic composites. It is also one of the mainly bountiful cellular proteins found under non-stress situation. Hsp70 and Hsp90 refer to families of heat shock proteins on the order of 70, 90 kilo Daltons in size, respectively. The small 8 kD protein ubiquitin, which marks proteins for degradation, also has features of a heat shock protein. Cells are attentive about getting these folds right for the reason that mis-folded proteins can change the normal life of the cell. In some cases change is good, in others deadly. When Heat Shock Proteins 90 is conceded the number of morphological alterations upsurges, which lead to creation of inactive or abnormally active polypeptides.
由于任何模型都不可能完全复制临床人体伤口愈合,因此必须谨慎选择手术模型。热休克蛋白(Hsp)是对多种生物应激的反应,包括热、高压和有毒复合物质。它也是在非应激情况下发现的主要丰富的细胞蛋白之一。Hsp70和Hsp90是指大小分别为70、90千克道尔顿量级的热休克蛋白家族。小的8 kD蛋白泛素,标志着蛋白质的降解,也具有热休克蛋白的特征。细胞对正确折叠非常关注,因为错误折叠的蛋白质会改变细胞的正常生命。在某些情况下,变化是好的,在另一些情况下,变化是致命的。当热休克蛋白90被承认时,形态学改变的数量激增,这导致产生不活跃或异常活跃的多肽。
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引用次数: 8
Poly Pharmacy-Induced Long-QT Syndrome and Torsades de Pointes: A Case Report 多药致长qt综合征和足扭转1例报告
Pub Date : 2017-04-28 DOI: 10.4172/2376-0419.1000174
M. Hajiesmaeili, G. Afzal, Z. Sahraei
Polypharmacy-induced QT prolongation is a possible hazardous adverse effect of several medication combinations. When QT prolongation leads to torsade de pointes, life-threatening or mortal outcomes can result. A 45-year-old man presented to the emergency department due to the use of methadone in the field with ventricular tachycardia and after successful resuscitation after cardiac arrest, under ICU care, has been exacerbated torsade de point due to polypharmacy with high-dose methadone, the patient had multiple risk factors for prolonged QT syndrome including methadone therapy, multiple drug therapy leading to potential drug interactions, electrolyte disturbances such as hypomagnesaemia. Clinical pharmacy must be aware of multidrug interactions potentiating QT prolongation and leading to torsade de pointes. In this article has emphasized the importance of considering the cumulative effects of several drugs used in the ICU and their timely treatment and possible avoidance of poly pharmacy.
多药性QT间期延长是多种药物联合使用可能产生的危险副作用。当QT延长导致心尖扭转时,可能导致危及生命或致命的后果。1例45岁男性患者因室性心动过速现场使用美沙酮,在心脏骤停后成功复苏后,在ICU监护下,因多剂量美沙酮加重了扭转角,患者存在延长QT综合征的多重危险因素,包括美沙酮治疗、多药物治疗导致潜在药物相互作用、电解质紊乱如低镁血症。临床药学必须意识到多药相互作用可延长QT间期并导致椎体扭转。本文强调了考虑重症监护病房使用的几种药物的累积效应及其及时治疗和可能避免多重用药的重要性。
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引用次数: 2
Gut Microbiota: What We Could Do, Not Just Use âÂÂYoung Healthy PooâÂÂfor Drugs? 肠道微生物群:除了使用âÂÂYoung健康PooâÂÂfor药物,我们还能做些什么?
Pub Date : 2017-04-28 DOI: 10.4172/2376-0419.1000173
Y. Yiqing
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引用次数: 0
Utilization of Polymeric Nanoparticle in Cancer Treatment: A Review 高分子纳米颗粒在肿瘤治疗中的应用综述
Pub Date : 2017-04-21 DOI: 10.4172/2376-0419.1000172
S. Thakur, Pramod Ks, R. Malviya
Rapid advancement in medicine and biotechnology has driven the field of drug discovery. Novel approaches of drug delivery such as formulating the polymeric nanoparticles is revolutionizing the future of medicines. Newly potent and target specific drugs led to enhance therapeutic utility. These challenges, coupled with the complexity and variety, are fueling the advancement of novel drug delivery systems that overcome bioavailability and delivery obstacles. In present scenario, nanoparticles have been acting as carriers for delivering a wide range of potential drugs. Due to their versatility and wide range of properties and they represent a promising drug delivery system of controlled and targeted release. The utilization of polymeric nanoparticles is a plan that aims to minimize adverse effect and will optimize therapeutic effects. Nanoparticle-based therapy facilitates safe and efficacious therapy for cancer patients. Advancement in Nanomedicine technologies provides clear evidence that polymeric nanotherapies have a significant impact in oncology. Improvement in therapeutic utility of polymeric nano-particulate system is highlighted in this paper. This review deals with the polymeric nanoparticulate systems, fate of nanoparticles, its types, targetting mechanism, application and recent patents.
医学和生物技术的快速发展推动了药物发现领域的发展。新方法的药物输送,如配制聚合物纳米粒子是革命性的药物的未来。新的强效和靶向性药物提高了治疗效果。这些挑战,加上复杂性和多样性,正在推动克服生物利用度和递送障碍的新型药物递送系统的进步。在目前的情况下,纳米颗粒已经作为载体,以提供广泛的潜在药物。由于它们的多功能性和广泛的性质,它们代表了一种有前途的控制和靶向释放的药物传递系统。利用聚合纳米颗粒是一种旨在减少不良反应和优化治疗效果的计划。纳米粒子为癌症患者提供安全有效的治疗。纳米医学技术的进步提供了明确的证据,聚合物纳米治疗在肿瘤学中具有重要的影响。本文重点介绍了高分子纳米颗粒系统在治疗方面的应用。本文综述了高分子纳米粒子体系、纳米粒子的命运、类型、靶向机制、应用和最新专利。
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引用次数: 14
Advocating for Pharmacy: What Can You Do? 倡导药房:你能做些什么?
Pub Date : 2017-04-14 DOI: 10.4172/2376-0419.1000E144
Aisha Morris Moultry
In this political climate and era of highly debated healthcare, it is more important than ever to be involved in advocacy for the profession. When the Medicare Modernization Act (MMA) passed in 2003 and subsequently the Patient Protection and Affordable Care Act (PPACA) in 2010, pharmacists saw an opportunity to gain provider status. However, the profession encountered barriers in the area of reimbursement. Thus, it is important that pharmacists have a presence when decisions are being made about the profession. A proven and successful avenue to pursue this is advocacy. Advocacy is defined as the act or process of supporting a cause or proposal [1]. Although political advocacy through a presence at the local state capitol or Washington, D.C. tends to be the type of advocacy that immediately comes to mind, other methods for promoting the profession can occur in the form of promotion in the community with patients and other practitioners or in an academic setting to future professionals.
在这个政治气候和医疗保健高度争论的时代,参与倡导这个职业比以往任何时候都更重要。2003年《医疗保险现代化法案》(MMA)通过,随后2010年《患者保护和平价医疗法案》(PPACA)通过,药剂师看到了获得提供者地位的机会。但是,该专业人员在偿还费用方面遇到了障碍。因此,重要的是,药剂师有一个存在,当决定有关的职业。实现这一目标的一个行之有效的途径是倡导。倡导被定义为支持某项事业或提案的行为或过程[1]。虽然通过在当地州议会大厦或华盛顿特区的出现进行政治宣传往往是立即想到的宣传类型,但其他促进职业发展的方法可以在社区中与患者和其他从业者或在学术环境中对未来的专业人员进行宣传。
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引用次数: 1
期刊
Journal of Pharmaceutical Care & Health Systems
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