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Increased Demand for Pharmaceutical Drugs Containing Potassium Iodide In Connection with the Russia-Ukraine Conflict. 与俄乌冲突有关的对含碘化钾药品的需求增加。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2023-04-15 DOI: 10.1691/ph.2023.2541
S Enners, G Gradl, M Kieble, O Iliescu, L Freudewald, A Said, M Schulz

The current conflict between Russia and Ukraine increased concerns in the German population of a release of radioactive substances, e.g.radioactive iodine. A high dose of potassium iodide (PI) may prevent accumulation of radioactive iodine in the thyroid gland. Therefore, the German government keeps a sufficient quantity of PI in stock for public supply in case of an emergency. We investigated ambulatory drug dispensing rates of PI and found that the total dispensing of PI (statutory health insurance (SHI), private health insurance (PHI), and overthe-counter (OTC)) increased by 106% from February to March 2022. Changes in PI dispensing were mainly due to an increase in OTC sales, where PI as an antidote showed a sevenfold increase from around 930 packages (February 2022) to 6,500 packages (March 2022), while SHI and PHI dispensing remained relatively low. Furthermore, we investigated whether these changes in dispensing raised the number of suspected adverse drug reactions (ADR). We found no increase of ADR reports related to the use of PI-containing medicinal products between February and September 2022, neither in our national pharmacovigilance nor in the European EudraVigilance database. The data suggest that the mere possibility of a nuclear disaster in Ukraine raised the demand of PI in Germany. Thus, timely and proactive information and reassurance of the public of supply reliability by the Government in a case of a nuclear emergency could be helpful in preventing potential drug shortages and unfounded concern.

目前俄罗斯和乌克兰之间的冲突增加了德国民众对放射性物质(如放射性碘)泄漏的担忧。高剂量的碘化钾(PI)可以防止放射性碘在甲状腺中的积累。因此,德国政府储备了足够数量的PI以备不时之需。我们调查了个人健康保险(法定健康保险(SHI)、私人健康保险(PHI)和非处方(OTC))的门诊药品调剂率,发现从2022年2月到3月,个人健康保险(SHI)的总调剂率增长了106%。PI分配的变化主要是由于OTC销售的增加,其中PI作为解药从约930包(2022年2月)增加到6500包(2022年3月),增长了7倍,而SHI和PHI分配仍然相对较低。此外,我们还调查了这些调剂的变化是否增加了可疑药物不良反应(ADR)的数量。我们发现,在2022年2月至9月期间,无论是在我们的国家药物警戒中,还是在欧洲药物警戒数据库中,与使用含有pi的药品相关的不良反应报告都没有增加。数据表明,仅仅是乌克兰发生核灾难的可能性就提高了德国对PI的需求。因此,在发生核紧急情况时,政府及时主动地提供信息并向公众保证供应的可靠性,可能有助于防止潜在的药品短缺和毫无根据的担忧。
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引用次数: 0
600 Years of Town Hall Pharmacy (raeapteek) in Tallinn, Estonia. 爱沙尼亚塔林600年的市政厅药房(raeapteek)
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2023-04-15 DOI: 10.1691/ph.2023.2065
A Raal, J Koppel

The Town Hall Pharmacy (Raeapteek) in the Town Hall Square of Tallinn, Estonia (N59°26'16.001'' E24°44'45.412'') was first mentioned in historical records on 8 April 1422. To our best knowledge, the Raeapteek is the oldest community pharmacy in Europe which has operated on the same premises since the beginning. There are several hypotheses about the actual opening time of Raeapteek: it is possible that the pharmacy was operating on the square of the Tallinn Town Hall as early as in 1415, 1420, 1392 or even in 1248. In the territory of present-day Estonia, two pharmacies (in Tartu first mentioned in 1430) were already in business in less than 200 kilometres from each other before community pharmacies were opened in Russia, Sweden, Finland, Norway, Denmark, Lithuania, and other cities. The Raeapteek played an essential role in the establishment of the current Estonian History Museum, the Estonian Pharmaceutical Factory, K. C. Fick's faience manufactory and other dignified institutions had their beginning at the pharmacy. Now, the pharmacy functions hand-in-hand with the museum which is supported by the city of Tallinn.

位于爱沙尼亚塔林市政厅广场(N59°26'16.001 " E24°44'45.412 ")的市政厅药房(Raeapteek)于1422年4月8日首次在历史记录中被提及。据我们所知,Raeapteek是欧洲最古老的社区药房,从一开始就在同一场所经营。关于Raeapteek的实际开业时间有几种假设:早在1415年、1420年、1392年甚至1248年,这家药店就可能在塔林市政厅的广场上营业。在今天的爱沙尼亚境内,早在俄罗斯、瑞典、芬兰、挪威、丹麦、立陶宛和其他城市开设社区药店之前,就有两家药店(1430年在塔尔图首次被提及)在相距不到200公里的地方开始营业。Raeapteek在建立目前的爱沙尼亚历史博物馆、爱沙尼亚制药厂、K. C. Fick的瓷器厂和其他有尊严的机构方面发挥了重要作用,它们都是从药房开始的。现在,药房与博物馆携手并进,博物馆由塔林市支持。
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引用次数: 0
Novel Compounds with Promising IDO1 Inhibitory Activity As New Cancer Drug Candidates: Derivatives Of N, N'-diphenylurea Linked With 1,2,3-triazole. 具有IDO1抑制活性的新型抗癌药物:N, N'-二苯脲- 1,2,3-三唑衍生物。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2023-04-15 DOI: 10.1691/2023.2552
Bin Sun, Xiaofei Liu, Xiuwei Sun, Yingjie Zhou, Xiaoqing Gong, Longfei Mao, Weichen Shi, Peng Deng, Lin Shi

To explore potential indoleamine 2,3-dioxygenase 1 (IDO1) inhibitors, we designed a series of compounds incorporating urea and 1,2,3-triazole structures. IDO1 enzymatic activity experiments with the synthesized compounds were used to verify their molecular-level activity; for instance, the half maximal inhibitory concentration value of compound 3c was 0.07 μM. Our research has yielded a series of novel IDO1 inhibitors which may be beneficial in the development of drugs targeting IDO1 for cancer treatment.

为了探索吲哚胺2,3-双加氧酶1 (IDO1)的潜在抑制剂,我们设计了一系列含有尿素和1,2,3-三唑结构的化合物。对合成的化合物进行IDO1酶活性实验,验证其分子水平活性;如化合物3c的半最大抑制浓度值为0.07 μM。我们的研究已经产生了一系列新的IDO1抑制剂,这些抑制剂可能有助于开发针对IDO1的癌症治疗药物。
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引用次数: 0
Clinical Efficacy and Safety of Flumatinib in Newly Diagnosed Chronic Myelogenous Leukemia. 氟马替尼治疗新诊断慢性粒细胞白血病的临床疗效和安全性。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2023-04-15 DOI: 10.1691/ph.2023.2536
Lei Jiang, Mingzhen Yang

The present study aimed to investigate the efficacy and safety of flumatinib in patients newly diagnosed with chronic myeloid leukemia in the chronic phase (CML-CP). A retrospective study was conducted using five patients newly diagnosed with CML-CP who received flumatinib (600 mg/day). Results of the present study demonstrated that all five patients with CML-CP that were treated with flumatinib achieved the optimal molecular response within three months. In addition, two patients experienced major molecular response (MMR), and one patient acquired undetectable molecular residual disease, which was maintained for more than one year. Moreover, one patient exhibited grade 3 hematological toxicity, two patients exhibited transient diarrhea, one patient exhibited vomiting and one patient exhibited a rash with pruritus. No second-generation tyrosine kinase inhibitor-specific adverse cardiovascular events occurred in any patients. In conclusion, flumatinib exhibits high efficacy and high early molecular response rate in patients newly diagnosed with CML-CP. The majority of patients obtained MMR within three months, and the adverse reactions experienced were mild and tolerable.

本研究旨在探讨氟马替尼对新诊断慢性髓系白血病慢性期(CML-CP)患者的疗效和安全性。对5名新诊断为CML-CP的患者进行了回顾性研究,他们接受了氟马替尼(600mg /天)治疗。本研究结果表明,氟马替尼治疗的5例CML-CP患者均在3个月内获得最佳分子反应。此外,2例患者出现了重大分子反应(MMR), 1例患者获得了无法检测到的分子残留疾病,并维持了一年多。此外,1例患者表现为3级血液毒性,2例患者表现为短暂性腹泻,1例患者表现为呕吐,1例患者表现为皮疹伴瘙痒。所有患者均未发生第二代酪氨酸激酶抑制剂特异性不良心血管事件。综上所述,氟马替尼对新诊断的CML-CP患者具有较高的疗效和早期分子缓解率。大多数患者在三个月内获得MMR,所经历的不良反应轻微且可耐受。
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引用次数: 0
Nodakenin Inhibits Melanogenesis Via the ERK/MSK1 Signaling Pathway. Nodakenin通过ERK/MSK1信号通路抑制黑色素生成。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2023-04-15 DOI: 10.1691/ph.2023.2490
Yeahwa Yoon, Seunghee Bae, Tae Jin Kim, Sungkwan An, Jae Ho Lee

The aim of the present study was to investigate the potential inhibitory effects of nodakenin, a coumarin glucoside derivative from the root extract of Angelica gigas Nakai (AGN), on melanogenesis and its underlying mechanisms in B16F10 melanoma cells. The inhibitory effects of nodakenin on melanogenesis were evaluated by determining melanin contents and tyrosinase activity in α -melanocyte stimulating hormone (α-MSH)-treated B16F10 melanoma cells. The mechanisms associated with the anti-pigmentation effect of nodakenin were investigated by quantitative real-time PCR and immunoblotting analysis. Using the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT keratinocytes and B16F10 melanoma cells mimicking in vivo melanin biosynthesis, the effect of nodakenin on melanin production was evaluated. Melanin content analysis showed that nodakenin decreased cellular melanin biosynthesis in α-MSH-treated B16F10 cells. Immunoblotting revealed that CREB phosphorylation, MITF, a mastering transcription factor of melanogenesis and its downstream genes tyrosinase, tyrosinase-related protein 1, and tyrosinase-related protein 2 were downregulated by nodakenin in a dose-dependent manner. Interestingly, nodakenin did not affect the phosphorylation of PKA and p38 MAPK but the phosphorylation of ERK1/2 and MSK1. In addition, the inhibition of melanin accumulation by nodakenin in the UVB-irradiated conditioned media culture system and UVB-irradiated co-cultivation system of HaCaT and B16F10 cells suggests that nodakenin has potential as an anti-pigmentation activity. These data suggest that nodakenin inhibits the melanogenesis in B16F10 cells by interfering the ERK/ MSK1/CREB axis and thus preventing MITF expression.

本研究的目的是研究nodakenin(一种从当归根提取物中提取的香豆素糖苷衍生物)对B16F10黑色素瘤细胞黑色素形成的潜在抑制作用及其潜在机制。通过测定α-促黑素细胞激素(α- msh)处理的B16F10黑色素瘤细胞的黑色素含量和酪氨酸酶活性,评价nodakenin对黑色素生成的抑制作用。采用实时荧光定量PCR和免疫印迹法研究nodakenin抗色素沉着作用的相关机制。采用uvb辐照的条件培养基培养体系和uvb辐照的HaCaT角质形成细胞与B16F10黑色素瘤细胞模拟体内黑色素合成的共培养体系,评价nodakenin对黑色素生成的影响。黑色素含量分析显示,nodakenin降低了α- msh处理的B16F10细胞黑色素的生物合成。免疫印迹显示,nodakenin以剂量依赖性的方式下调CREB磷酸化、黑色素形成的主要转录因子MITF及其下游基因酪氨酸酶、酪氨酸酶相关蛋白1和酪氨酸酶相关蛋白2。有趣的是,nodakenin不影响PKA和p38 MAPK的磷酸化,但影响ERK1/2和MSK1的磷酸化。此外,在uvb辐照的条件培养基培养体系和uvb辐照的HaCaT和B16F10细胞共培养体系中,nodakenin对黑色素积累的抑制作用表明nodakenin具有潜在的抗色素沉淀活性。这些数据表明nodakenin通过干扰ERK/ MSK1/CREB轴抑制B16F10细胞的黑色素生成,从而阻止MITF的表达。
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引用次数: 1
Effect of a superdisintegrant on disintegration of orally disintegrating tablets determined by simulated wetting test and in vitrodisintegration test. 用模拟湿法和体外崩解法测定超崩解剂对口腔崩解片崩解的影响。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2022-10-01 DOI: 10.1691/ph.2022.2015
L Sutthapitaksakul, K Thanawuth, K Huanbutta, P Sriamornsak

The disintegration time is critical for characterizing orally disintegrating tablets (ODTs), according to regulatory standards. The current study aimed to assess the effect of superdisintegrants such as sodium starch glycolate, croscarmellose sodium, and crospovidone on the disintegration of ODTs using simulated wetting and in vitro disintegration tests. The results showed that the wetting time of ODTs containing sodium starch glycolate and croscarmellose sodium was 17 - 21 s, but the wetting time of ODTs containing crospovidone was 9 - 12 s. In contrast, there was no significant difference in in vitro disintegration time among ODTs using different disintegrants (ca. 14 to 18 s) The quick wetting time of ODTs with crospovidone may be attributed to strong capillary characteristics of crospovidone. It is suggested that determining the disintegration time of ODTs just through simulated wetting test is insufficient and may lead to biases. As a result of the findings, it is recommended that an additional disintegration test, imitating saliva fluid absorption and tablet breaking, to provide a more precise evaluation of ODTs.

崩解时间是表征口腔崩解片(ODTs)的关键,根据监管标准。本研究旨在通过模拟润湿试验和体外崩解试验,评估超崩解剂如淀粉乙醇酸钠、交联棉糖钠和交联维酮对odt崩解的影响。结果表明,含淀粉乙醇酸钠和交联棉糖钠的odt润湿时间为17 ~ 21 s,而含交联维酮的odt润湿时间为9 ~ 12 s。而使用不同崩解剂的odt体外崩解时间差异不显著(约为14 ~ 18 s),其快速湿润时间可能与强毛细管特性有关。结果表明,仅通过模拟润湿试验来确定odt的崩解时间是不够的,可能会导致偏差。根据研究结果,建议进行额外的崩解试验,模拟唾液液吸收和药片破碎,以提供更准确的odt评估。
{"title":"Effect of a superdisintegrant on disintegration of orally disintegrating tablets determined by simulated wetting test and <i>in vitro</i>disintegration test.","authors":"L Sutthapitaksakul,&nbsp;K Thanawuth,&nbsp;K Huanbutta,&nbsp;P Sriamornsak","doi":"10.1691/ph.2022.2015","DOIUrl":"https://doi.org/10.1691/ph.2022.2015","url":null,"abstract":"<p><p>The disintegration time is critical for characterizing orally disintegrating tablets (ODTs), according to regulatory standards. The current study aimed to assess the effect of superdisintegrants such as sodium starch glycolate, croscarmellose sodium, and crospovidone on the disintegration of ODTs using simulated wetting and <i>in vitro</i> disintegration tests. The results showed that the wetting time of ODTs containing sodium starch glycolate and croscarmellose sodium was 17 - 21 s, but the wetting time of ODTs containing crospovidone was 9 - 12 s. In contrast, there was no significant difference in <i>in vitro</i> disintegration time among ODTs using different disintegrants (ca. 14 to 18 s) The quick wetting time of ODTs with crospovidone may be attributed to strong capillary characteristics of crospovidone. It is suggested that determining the disintegration time of ODTs just through simulated wetting test is insufficient and may lead to biases. As a result of the findings, it is recommended that an additional disintegration test, imitating saliva fluid absorption and tablet breaking, to provide a more precise evaluation of ODTs.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"287-290"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Effect of cyasterone on intestinal flora in a BRAFV600E-mutant mouse model of colorectal cancer. 半雄酮对结肠癌brafv600e突变小鼠肠道菌群的影响
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2022-10-01 DOI: 10.1691/ph.2022.2422
Ying Xiong, Xinyue Zheng, Yongmei Xie, Youling Gong, Y I Luo

BRAF V600E-mutated colorectal cancer (CRC) is very aggressive and responds poorly to standard treatment. In this study, BRAFV600E-mutant mice with CRC were treated with intragastric cyasterone, a compound commonly used in traditional Chinese herbal medicine, for 21 days. Microbial DNA was extracted from mouse intestinal contents for 16S ribosomal RNA gene amplicon sequencing and analyzed. Our results indicated that cyasterone enhanced the diversity of the gut microbiota. The abundance of beneficial bacteria, such as Prevotellaceae, Muribaculaceae, and Ruminococcaceae was significantly higher in cyasterone-treated mice than controls. The abundance of Erysipelotrichaceae, a family of bacteria that promotes inflammation in the gut, was significantly positively correlated with tumor weight. Cyasterone is a potential inhibitor of BRAFV600E-mutant CRC via its effects on intestinal flora.

BRAF v600e突变的结直肠癌(CRC)具有很强的侵袭性,对标准治疗的反应很差。在本研究中,brafv600e突变的结直肠癌小鼠灌胃cyasterone治疗21天,cyasterone是一种常用的中草药化合物。从小鼠肠道内容物中提取微生物DNA,进行16S核糖体RNA基因扩增子测序分析。我们的研究结果表明,半雄酮增强了肠道微生物群的多样性。有益菌如普氏菌科、Muribaculaceae和Ruminococcaceae的丰度在cyasterone处理的小鼠中显著高于对照组。丹毒科(一种促进肠道炎症的细菌家族)的丰度与肿瘤重量显著正相关。通过对肠道菌群的影响,半雄酮是brafv600e突变型结直肠癌的潜在抑制剂。
{"title":"Effect of cyasterone on intestinal flora in a <i><sup>BRAF</sup></i>V600E-mutant mouse model of colorectal cancer.","authors":"Ying Xiong,&nbsp;Xinyue Zheng,&nbsp;Yongmei Xie,&nbsp;Youling Gong,&nbsp;Y I Luo","doi":"10.1691/ph.2022.2422","DOIUrl":"https://doi.org/10.1691/ph.2022.2422","url":null,"abstract":"<p><p><i>BRAF <sup>V600E</sup></i>-mutated colorectal cancer (CRC) is very aggressive and responds poorly to standard treatment. In this study, <i>BRAF<sup>V600E</sup></i>-mutant mice with CRC were treated with intragastric cyasterone, a compound commonly used in traditional Chinese herbal medicine, for 21 days. Microbial DNA was extracted from mouse intestinal contents for 16S ribosomal RNA gene amplicon sequencing and analyzed. Our results indicated that cyasterone enhanced the diversity of the gut microbiota. The abundance of beneficial bacteria, such as Prevotellaceae, Muribaculaceae, and Ruminococcaceae was significantly higher in cyasterone-treated mice than controls. The abundance of Erysipelotrichaceae, a family of bacteria that promotes inflammation in the gut, was significantly positively correlated with tumor weight. Cyasterone is a potential inhibitor of <i>BRAF<sup>V600E</sup></i>-mutant CRC <i>via</i> its effects on intestinal flora.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"291-294"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the impact of de-escalating antimicrobial therapy in burn patients: a retrospective cohort study. 评估烧伤患者降压抗菌药物治疗的影响:一项回顾性队列研究。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2022-10-01 DOI: 10.1691/ph.2022.2455
Y Kohama, M Kosugi, M Arakawa, S Hidaka

Antimicrobials should be used appropriately to minimise the risk of resistant strains arising in association with overuse. De-escalation of antimicrobial therapy is one strategy used to ensure appropriate use, but its safety and efficacy in burn patients are unclear. The aim of this study was to evaluate the safety and efficacy of de-escalation therapy for treating infections in burn patients. This retrospective cohort study investigated patients admitted to our intensive care unit with burns and treated for infection between October 1, 2013, and September 30, 2020. Patients were classified into a de-escalation group (Group D) comprising patients treated with empiric antimicrobial therapy followed by de-escalation and a non-de-escalation group (Group ND) comprising patients who did not undergo de-escalation. Characteristics and outcomes were compared between groups. Forty-three patients met the inclusion criteria, including 15 patients in Group D and 28 patients in Group ND. Bacterial species commonly detected in these patients were Corynebacterium spp. (17.3%), Pseudomonas aeruginosa (16.1%), and Staphylococcus aureus (9.6%) . No inter-group difference was seen in 28-day mortality (6.7% vs 21.4%, p =0.391). Multidrug-resistant strains were detected significantly less frequently in Group D (13.0%) than in Group ND (26.1%, p =0.003). De-escalation was associated with use of two or more antimicrobials as empiric antimicrobial therapy. As the use of de-escalation in infection treatment did not impact 28-day mortality, de-escalation might be safe for treating infections in burn patients.

应适当使用抗菌素,以尽量减少因过度使用而产生耐药菌株的风险。抗菌药物治疗的降级是一种确保适当使用的策略,但其在烧伤患者中的安全性和有效性尚不清楚。本研究的目的是评估降级疗法治疗烧伤患者感染的安全性和有效性。这项回顾性队列研究调查了2013年10月1日至2020年9月30日期间因烧伤和感染接受治疗的重症监护病房患者。患者被分为降级组(D组),包括接受经验性抗菌药物治疗的患者,随后降级;非降级组(ND组),包括未接受降级治疗的患者。比较两组间的特征和结果。43例患者符合纳入标准,其中D组15例,ND组28例。检出的细菌种类主要为棒状杆菌(17.3%)、铜绿假单胞菌(16.1%)和金黄色葡萄球菌(9.6%)。28天死亡率组间无差异(6.7% vs 21.4%, p =0.391)。D组多药耐药菌株检出率(13.0%)显著低于ND组(26.1%,p =0.003)。降级与使用两种或两种以上抗菌素作为经验性抗菌素治疗有关。由于在感染治疗中使用降级治疗不会影响28天死亡率,因此降级治疗烧伤患者感染可能是安全的。
{"title":"Evaluating the impact of de-escalating antimicrobial therapy in burn patients: a retrospective cohort study.","authors":"Y Kohama,&nbsp;M Kosugi,&nbsp;M Arakawa,&nbsp;S Hidaka","doi":"10.1691/ph.2022.2455","DOIUrl":"https://doi.org/10.1691/ph.2022.2455","url":null,"abstract":"<p><p>Antimicrobials should be used appropriately to minimise the risk of resistant strains arising in association with overuse. De-escalation of antimicrobial therapy is one strategy used to ensure appropriate use, but its safety and efficacy in burn patients are unclear. The aim of this study was to evaluate the safety and efficacy of de-escalation therapy for treating infections in burn patients. This retrospective cohort study investigated patients admitted to our intensive care unit with burns and treated for infection between October 1, 2013, and September 30, 2020. Patients were classified into a de-escalation group (Group D) comprising patients treated with empiric antimicrobial therapy followed by de-escalation and a non-de-escalation group (Group ND) comprising patients who did not undergo de-escalation. Characteristics and outcomes were compared between groups. Forty-three patients met the inclusion criteria, including 15 patients in Group D and 28 patients in Group ND. Bacterial species commonly detected in these patients were <i>Corynebacterium</i> spp. (17.3%), <i>Pseudomonas aeruginosa</i> (16.1%), and <i>Staphylococcus aureus</i> (9.6%) <i>.</i> No inter-group difference was seen in 28-day mortality (6.7% vs 21.4%, <i>p</i> =0.391). Multidrug-resistant strains were detected significantly less frequently in Group D (13.0%) than in Group ND (26.1%, <i>p</i> =0.003). De-escalation was associated with use of two or more antimicrobials as empiric antimicrobial therapy. As the use of de-escalation in infection treatment did not impact 28-day mortality, de-escalation might be safe for treating infections in burn patients.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"311-315"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A new medication-based prediction score for postoperative delirium in surgical patients: Development and proof of feasibility in a retrospective patient cohort. 一种新的基于药物的手术患者术后谵妄预测评分:在回顾性患者队列中的发展和可行性证明。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2022-10-01 DOI: 10.1691/ph.2022.2438
V Hindelang, K Dimitriadis, T Saller, K Golla, H Mannell, M J Hug, D Strobach

Structured risk screening for postoperative delirium (POD) considering prehospital medication is not established. We aimed to develop a POD-risk prediction score based on known risk factors and delirium-risk increasing drugs to be used by pharmacists during medication reconciliation at hospital admission, and to test for feasibility in a retrospective cohort of surgical patients. Therefore, established POD-risk factors and drugs were extracted from the literature and a score was generated. Following this, the score was tested for feasibility in a retrospective 3-month-cohort of surgical patients. For patients with higher scores suggesting higher probability of POD, patient charts were screened for documentation of POD. For development of the score, the following POD-risk factors were defined and points assigned for score calculation: age (≥65 years=1 point/≥75 years=2), male sex (1), renal insufficiency (RI; 1), hepatic impairment (HI; Model-of-endstage-liver-disease (MELD) 10-14=1/≥15=2), delirium-risk increasing drugs (1 point per drug class), anticholinergic drug burden (ACB; ≥3=1). In the retrospective test cohort of 1174 surgical patients these factors concerned: age ≥65 years 567 patients (48%)/≥75 years 303 (26%), male 652 (55%), RI 238 (20%), MELD 10-14 106 (9%)/≥15 65 (5%), ≥ 1 delirium-risk increasing drug 418 (36%), ACB ≥3 106 (9%). The median POD-risk prediction score was 2 (range 0-9). Of 146 patients (12%) with a score ≥ 5, POD was documented for 43 (30%), no evidence for POD for 91 (62%) and data inconclusive for 12 (8%). For scores of ≥ 7, POD was documented for 50% of the patients with sufficient POD documentation. Overall, POD documentation was poor. To summarize, we developed and successfully tested the feasibility of a POD-prediction-score assessable by pharmacists at medication reconciliation at hospital admission.

考虑院前用药的术后谵妄(POD)的结构化风险筛查尚未建立。我们的目的是建立一个基于已知危险因素和谵妄风险增加药物的pod风险预测评分,供药剂师在住院时进行药物调节时使用,并在手术患者的回顾性队列中测试其可行性。因此,从文献中提取已确定的pod危险因素和药物,并进行评分。随后,在3个月的外科患者回顾性队列中测试评分的可行性。对于得分越高的患者,POD的可能性越高,筛选患者病历以记录POD。在制定评分时,定义了以下pod危险因素并分配了积分用于评分计算:年龄(≥65岁=1分/≥75岁=2分)、男性(1分)、肾功能不全(RI;1)肝损害(HI);终末期肝病模型(MELD) 10-14=1/≥15=2),谵妄风险增加药物(每类药物1分),抗胆碱能药物负担(ACB;≥3 = 1)。在1174例外科患者的回顾性试验队列中,这些因素涉及:年龄≥65岁567例(48%)/≥75岁303例(26%),男性652例(55%),RI 238例(20%),MELD 10-14 106例(9%)/≥15 65例(5%),≥1种增加精神错乱风险的药物418例(36%),ACB≥3 106例(9%)。pod风险预测评分中位数为2分(范围0-9)。在评分≥5的146例患者(12%)中,43例(30%)被记录为POD, 91例(62%)无证据证明POD, 12例(8%)数据不确定。对于评分≥7分的患者,50%的患者有足够的POD记录。总的来说,POD文档很差。总之,我们开发并成功测试了pod预测评分的可行性,该评分可由药剂师在住院时进行药物和解评估。
{"title":"A new medication-based prediction score for postoperative delirium in surgical patients: Development and proof of feasibility in a retrospective patient cohort.","authors":"V Hindelang,&nbsp;K Dimitriadis,&nbsp;T Saller,&nbsp;K Golla,&nbsp;H Mannell,&nbsp;M J Hug,&nbsp;D Strobach","doi":"10.1691/ph.2022.2438","DOIUrl":"https://doi.org/10.1691/ph.2022.2438","url":null,"abstract":"<p><p>Structured risk screening for postoperative delirium (POD) considering prehospital medication is not established. We aimed to develop a POD-risk prediction score based on known risk factors and delirium-risk increasing drugs to be used by pharmacists during medication reconciliation at hospital admission, and to test for feasibility in a retrospective cohort of surgical patients. Therefore, established POD-risk factors and drugs were extracted from the literature and a score was generated. Following this, the score was tested for feasibility in a retrospective 3-month-cohort of surgical patients. For patients with higher scores suggesting higher probability of POD, patient charts were screened for documentation of POD. For development of the score, the following POD-risk factors were defined and points assigned for score calculation: age (≥65 years=1 point/≥75 years=2), male sex (1), renal insufficiency (RI; 1), hepatic impairment (HI; Model-of-endstage-liver-disease (MELD) 10-14=1/≥15=2), delirium-risk increasing drugs (1 point per drug class), anticholinergic drug burden (ACB; ≥3=1). In the retrospective test cohort of 1174 surgical patients these factors concerned: age ≥65 years 567 patients (48%)/≥75 years 303 (26%), male 652 (55%), RI 238 (20%), MELD 10-14 106 (9%)/≥15 65 (5%), ≥ 1 delirium-risk increasing drug 418 (36%), ACB ≥3 106 (9%). The median POD-risk prediction score was 2 (range 0-9). Of 146 patients (12%) with a score ≥ 5, POD was documented for 43 (30%), no evidence for POD for 91 (62%) and data inconclusive for 12 (8%). For scores of ≥ 7, POD was documented for 50% of the patients with sufficient POD documentation. Overall, POD documentation was poor. To summarize, we developed and successfully tested the feasibility of a POD-prediction-score assessable by pharmacists at medication reconciliation at hospital admission.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"302-306"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Occurrence of voriconazole-induced cutaneous squamous cell carcinoma in Japan: data mining from different national pharmacovigilance databases. 伏立康唑诱发的皮肤鳞状细胞癌在日本的发生:来自不同国家药物警戒数据库的数据挖掘。
IF 1.6 4区 医学 Q4 CHEMISTRY, MEDICINAL Pub Date : 2022-10-01 DOI: 10.1691/ph.2022.2453
H Tanaka, M Okuma, T Ishii

Long-term voriconazole use may increase the risk of cutaneous squamous cell carcinoma (cSCC), especially in immunocompromised patients. However, relatively little is known regarding voriconazole-induced cSCC in Japan. Thus, the purpose of this study was to evaluate the association between voriconazole use and cSCC in Japan using different national pharmacovigilance databases. First, using the Japanese Adverse Drug Event Report (JADER) database, we evaluated the association between voriconazole use and cSCC in Japan. Second, using the U. S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, we examined regional differences in the occurrence of voriconazole-induced cSCC between Japan and other countries. We calculated reporting odds ratios (RORs) as disproportionality analysis to evaluate voriconazole-induced cSCC. In this study, cases in which one or more of "Bowen's disease", "Carcinoma in situ of skin", "Keratoacanthoma", "Squamous cell carcinoma in skin", or "Squamous cell carcinoma" were reported as adverse events were considered to be cSCC cases. The analysis based on the JADER database showed an association between voriconazole use and cSCC in Japan, with a ROR (95% confidence interval) of 35.37 (25.60-48.87). Further, the analysis based on the FAERS database revealed that signals were detected in Japan as well as in Western countries and Australia. This study is the first in which the association between voriconazole use and cSCC in Japan is assessed using national pharmacovigilance databases. Healthcare providers need to be fully aware of the potential for cSCC development owing to voriconazole use and in all countries, including Japan, ensure careful follow-up of patients' skin.

长期使用伏立康唑可能增加皮肤鳞状细胞癌(cSCC)的风险,特别是免疫功能低下的患者。然而,在日本,对伏立康唑诱导的cSCC的了解相对较少。因此,本研究的目的是通过使用不同的国家药物警戒数据库来评估伏立康唑使用与日本cSCC之间的关系。首先,利用日本不良药物事件报告(JADER)数据库,我们评估了伏立康唑使用与日本cSCC之间的关系。其次,使用美国食品和药物管理局不良事件报告系统(FAERS)数据库,我们检查了伏立康唑诱发的cSCC在日本和其他国家之间发生的地区差异。我们计算报告优势比(RORs)作为歧化分析来评估伏立康唑诱导的cSCC。在本研究中,有一种或多种“Bowen病”、“皮肤原位癌”、“角棘瘤”、“皮肤鳞状细胞癌”或“鳞状细胞癌”不良事件报告的病例被认为是cSCC病例。基于JADER数据库的分析显示,伏立康唑的使用与日本cSCC之间存在关联,ROR(95%可信区间)为35.37(25.60-48.87)。此外,基于FAERS数据库的分析显示,在日本以及西方国家和澳大利亚都检测到了信号。本研究首次利用日本国家药物警戒数据库评估伏立康唑使用与cSCC之间的关系。医疗保健提供者需要充分意识到由于使用伏立康唑而导致cSCC发展的潜力,并在包括日本在内的所有国家确保对患者皮肤进行仔细的随访。
{"title":"Occurrence of voriconazole-induced cutaneous squamous cell carcinoma in Japan: data mining from different national pharmacovigilance databases.","authors":"H Tanaka,&nbsp;M Okuma,&nbsp;T Ishii","doi":"10.1691/ph.2022.2453","DOIUrl":"https://doi.org/10.1691/ph.2022.2453","url":null,"abstract":"<p><p>Long-term voriconazole use may increase the risk of cutaneous squamous cell carcinoma (cSCC), especially in immunocompromised patients. However, relatively little is known regarding voriconazole-induced cSCC in Japan. Thus, the purpose of this study was to evaluate the association between voriconazole use and cSCC in Japan using different national pharmacovigilance databases. First, using the Japanese Adverse Drug Event Report (JADER) database, we evaluated the association between voriconazole use and cSCC in Japan. Second, using the U. S. Food and Drug Administration Adverse Event Reporting System (FAERS) database, we examined regional differences in the occurrence of voriconazole-induced cSCC between Japan and other countries. We calculated reporting odds ratios (RORs) as disproportionality analysis to evaluate voriconazole-induced cSCC. In this study, cases in which one or more of \"Bowen's disease\", \"Carcinoma in situ of skin\", \"Keratoacanthoma\", \"Squamous cell carcinoma in skin\", or \"Squamous cell carcinoma\" were reported as adverse events were considered to be cSCC cases. The analysis based on the JADER database showed an association between voriconazole use and cSCC in Japan, with a ROR (95% confidence interval) of 35.37 (25.60-48.87). Further, the analysis based on the FAERS database revealed that signals were detected in Japan as well as in Western countries and Australia. This study is the first in which the association between voriconazole use and cSCC in Japan is assessed using national pharmacovigilance databases. Healthcare providers need to be fully aware of the potential for cSCC development owing to voriconazole use and in all countries, including Japan, ensure careful follow-up of patients' skin.</p>","PeriodicalId":20145,"journal":{"name":"Pharmazie","volume":"77 10","pages":"307-310"},"PeriodicalIF":1.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10666028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Pharmazie
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