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Quality Assurance when Using Therapeutic Drug Monitoring: A Lamotrigine Split Sample Method to Reflect Comparability 使用治疗药物监测时的质量保证:拉莫三嗪分裂样品法以反映可比性
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000149
Roy G Beran
Purpose: Therapeutic drug monitoring can optimise patient outcomes if the Anti-Epileptic Medication (AEM) level is received in a timely fashion. When choosing a laboratory (lab) to measure levels, the treating physician must incorporate quality assurances so as to be confident that the results are reliable and concordant with results accepted from the current lab. The study aims to generate a practical example of how one can improve the use of drug monitoring in patients with epilepsy. Methods: A split-sampling procedure was used to analyse the AEM levels reported by two different labs. The results were categorised in accordance with the physician’s defined therapeutic range: sub-therapeutic: <10mg/L; therapeutic: 10-16mg/L; and supra-therapeutic: >16mg/L, to determine if categorisation varied between the labs. Results were further evaluated to compensate for absolute and/or clinically significant differences. Results: Categories were concordant for 43/50 (86%) of results. Of the 7/50 (14%) category discordant results, five (10% of results) were not clinically significant. In only 4% (2/50) of patients was the discordance sufficient to have possibly generated a treatment modification depending upon the patient’s clinical picture. Overall, the absolute difference in the levels reported by the two labs was neither significant nor statistically different. Conclusion: Split-sampling studies are a practical way of ensuring physician confidence and demonstrating quality assurance when changing labs.
目的:如果及时收到抗癫痫药物(AEM)水平,治疗药物监测可以优化患者的预后。当选择一个实验室(实验室)来测量水平时,治疗医生必须结合质量保证,以确信结果是可靠的,并与当前实验室接受的结果一致。这项研究的目的是产生一个实际的例子,说明如何改善癫痫患者药物监测的使用。方法:采用分选方法对两个不同实验室报告的AEM水平进行分析。根据医生定义的治疗范围对结果进行分类:亚治疗:16mg/L,以确定实验室之间的分类是否不同。进一步评估结果以弥补绝对和/或临床显著差异。结果:分类一致性为43/50(86%)。在7/50(14%)类不一致结果中,5例(10%)无临床意义。只有4%(2/50)的患者的不一致足以根据患者的临床情况可能产生治疗修改。总的来说,两个实验室报告的水平的绝对差异既不显著,也没有统计学差异。结论:分采样研究是一种实用的方法,确保医生的信心,并在更换实验室时展示质量保证。
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引用次数: 0
Hungtington Disease: Biopharmaceutical Methods of Interest in the Quantification of Therapeutic Agents Utilized in the Management of the Disorder 亨廷顿病:用于疾病管理的治疗剂量化的生物制药方法
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000156
Chika J Mbah
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引用次数: 0
Regulation of Energy Homeostasis in Cancer 癌症中能量稳态的调节
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000199
Ş. Tetik
The disease called cancer is actually the abnormal uncontrolled growth and proliferation of cells in our body by mutation. Reprogramming of metabolism in order to carry on the growth and proliferation of cancer cells is one of the most important changes seen in cancer cells. Altered metabolism is among the main causes of cancer. Cancer cells consume a lot of energy therefore it starts seeking for alternative fuels and their metabolisms vary compared to normal cells. The most important of these differences is aerobic glycolysis known as the ‘Warburg effect’. AMP-activated protein kinase (AMPK) is an energy sensor of our body and keeps it in a certain order. AMPK provides the balance between catabolism and anabolism. Another issue that needs to be mentioned in cancer metabolism is the p53 gene. The p53 gene is the most frequently mutated gene in cancer cells and is responsible for cell cycle and death. It is our circadian system that regulates metabolism in a 24-hour rhythm. In daily nutrition, the time of feeding is as important as the amount of energy intake. Our circadian system regulates glucose, lipid and energy metabolism, glucose homeostasis, as well as hunger and satiety cycles. Changes in metabolism occur when the order of the circadian system has been left. This situation causes the metabolic diseases. Circadian disruption has a carcinogenic effect on our body. We should try to protect our health by maintaining our circadian system. In this review we discuss the regulation of energy homeostasis with glucose, alternative ways, and circadian rhythm disruption in cancer cells.
这种叫做癌症的疾病实际上是我们体内细胞通过突变而不受控制地生长和增殖。为了癌细胞的生长和增殖而进行的代谢重编程是癌细胞中最重要的变化之一。新陈代谢的改变是癌症的主要原因之一。癌细胞消耗大量的能量,因此它开始寻找替代燃料,它们的代谢与正常细胞相比有所不同。这些差异中最重要的是有氧糖酵解,被称为“Warburg效应”。amp活化蛋白激酶(AMPK)是我们身体的能量传感器,并使其保持一定的秩序。AMPK提供分解代谢和合成代谢之间的平衡。在癌症代谢中需要提到的另一个问题是p53基因。p53基因是癌细胞中最常发生突变的基因,与细胞周期和死亡有关。我们的昼夜节律系统以24小时为周期调节新陈代谢。在日常营养中,饲喂的时间与摄入能量的多少同样重要。我们的昼夜节律系统调节葡萄糖、脂质和能量代谢、葡萄糖稳态以及饥饿和饱腹循环。当昼夜节律系统的秩序被打破时,新陈代谢就会发生变化。这种情况导致代谢性疾病。昼夜节律紊乱对我们的身体有致癌作用。我们应该通过维持我们的昼夜节律系统来保护我们的健康。在这篇综述中,我们讨论了肿瘤细胞中葡萄糖对能量稳态的调节,替代方法和昼夜节律中断。
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引用次数: 0
Evaluation of the Use of SGLT2 Inhibitor in the Symptomatic Improvement of Patients with Chagas Cardiomyopathy 评价SGLT2抑制剂在Chagas心肌病患者症状改善中的应用
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000197
Clara Salles Figueiredo
Chagas cardiomyopathy (CC) remains a serious disease with a poor prognosis in Latin America, and its treatment is based on the use of drugs commonly prescribed for heart failure (HF). Sodium glucose cotransporter-2 inhibitors (SGTL2i) improved cardiovascular mortality and HF hospitalization in several trials. As a result of growing body evidence in HF from different etiologies, it is reasonable to consider its potential benefits in CC. This study describes the impact on quality of life (QoL), using the New York Heart Association (NYHA) classification, the KCCQ and the 6MWT, in symptomatic patients with CC after the use of Dapagliflozin, an SGTL2i inhibitor, for a 12-week period. In this case of series of patients with Chagas Heart Disease, the use of dapagliflozin was associated with significant improvement in symptoms assessed by the NYHA classification and KCCQ scores, however there was not an improvement in performance on the 6MWT.
恰加斯心肌病(CC)在拉丁美洲仍然是一种预后不良的严重疾病,其治疗基于使用通常用于心力衰竭(HF)的药物。在一些试验中,葡萄糖共转运蛋白-2抑制剂钠(SGTL2i)可改善心血管死亡率和心衰住院率。由于来自不同病因的HF的身体证据越来越多,考虑其对CC的潜在益处是合理的。本研究描述了使用达格列净(一种SGTL2i抑制剂)12周后,对有症状的CC患者生活质量(QoL)的影响,采用纽约心脏协会(NYHA)分类,KCCQ和6MWT。在这组恰加斯心脏病患者中,使用达格列净与NYHA分类和KCCQ评分评估的症状显著改善相关,但在6MWT上的表现没有改善。
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引用次数: 0
Use of Drug Eluting Stent (DES) Therapy in Coronary Artery Disease: A Better Safety 药物洗脱支架(DES)治疗冠状动脉疾病:安全性更高
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000211
Nikunja Kishor Mishra
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引用次数: 0
Review Report on Natural Products as Anti-Fungal Agents 天然产物作为抗真菌剂的研究综述
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000191
Somia Gul
Human fungal infections have been greatly increasing nowadays mainly, in patients of cancer, AIDS and those that are immunecompromised. Therefore, the usage of anti-fungal drugs has also been increased, resulting in resistance to the currently available drugs. The resistance to anti-fungal drugs has an inference to the health of the community. As the currently used anti-fungal drugs have limited effective activity, more drug-drug interactions, and toxicity issues, it seems essential to identify therapeutic options for fungal infections. Discovering new anti-fungal compounds from the natural products like plants could provide a significant source for new medicinal products. This review discusses the currently available natural products reported as antifungal agents, current status of those products, as well as, advancement and future perspective of natural products as anti-fungal agents.
目前,人类真菌感染已大大增加,主要发生在癌症、艾滋病和免疫功能低下的患者中。因此,抗真菌药物的使用也增加了,导致对现有药物的耐药性。抗真菌药物的耐药性影响到社会的健康。由于目前使用的抗真菌药物具有有限的有效活性,更多的药物-药物相互作用和毒性问题,因此确定真菌感染的治疗方案似乎至关重要。从植物等天然产物中发现新的抗真菌化合物可以为新药物提供重要来源。本文综述了目前报道的天然抗真菌药物,天然抗真菌药物的研究现状,以及天然抗真菌药物的研究进展和未来展望。
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引用次数: 0
Electromechanical Properties of Lipid Bilayers in Peptide-Lipid Interactions: Clinical Applications 肽-脂质相互作用中脂质双分子层的机电特性:临床应用
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000204
Daniel Balleza
Despite the amazing diversity and complexity of living systems, all life shares the presence of a semi-permeable lipid membrane. Throughout evolution, this permeability has been finely regulated by the function of proteins that form ion channels. Similarly, some peptides can stabilize by forming aqueous pores in a dose-dependent manner. At high concentrations, however, these peptides can compromise the integrity of the membrane, destroying it. Given this behavior, a huge diversity of antimicrobial peptides and lipo-peptides has been identified. Understanding the physical-chemical principles of their interactions with lipids can contribute to the design of synthetic peptides with antimicrobial activity as an alternative to the use of conventional antibiotics.
尽管生命系统有着惊人的多样性和复杂性,但所有生命都有一个半透性的脂质膜。在整个进化过程中,这种渗透性受到形成离子通道的蛋白质功能的精细调节。类似地,一些肽可以通过以剂量依赖的方式形成水孔来稳定。然而,在高浓度下,这些肽会破坏膜的完整性,破坏它。鉴于这种行为,已经确定了多种多样的抗菌肽和脂质肽。了解它们与脂质相互作用的物理化学原理有助于设计具有抗菌活性的合成肽,以替代传统抗生素的使用。
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引用次数: 0
Opinion of Doing PhD in India 对在印度读博士的看法
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000157
Chandrashekar R
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引用次数: 0
Assessment of Quality of Life in Cancer Patients Supplemented with Ayurvedic Medicine (Body Revival): Case Reports 阿育吠陀药物对癌症患者生活质量的评估(身体恢复):病例报告
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000215
Tapas Kumar Sur
Background: Cancer patients experience a wide range of symptoms, which can affect their daily performance and quality of life (QoL). Objectives: The study’s goal was to evaluate the QoL of cancer patients who were taking natural polyherbal supplement (Body Revival). Methods: A small survey was conducted among 38 cancer patients, who were supplemented with Body Revival for ≥3 months. A structured and validated interview schedule was used to gather data from cancer patients. Results: Out of 38 cancer patients, 58.8% were male and 55% were in the age group of above 60, the majority with cancers in the breast (35%) and the reproductive system (male 27.8% and female 30%), and 44.4% male and 40% female had stage II disease. The QOL of the majority of patient symptoms was significantly improved (p<0.001) with Body Revival supplementation. It improved both the psychological and physical domains of day-to-day life, either by attenuating the adverse events of regular treatments for cancer or by enhancing vital energy in the body. Conclusions: Combining Body Revival supplements with routine medical care may help patients better control their negative symptoms, take initiative with their disease and treatment, and lead healthier lives. To strengthen the present findings, more research is required.
背景:癌症患者经历各种各样的症状,这些症状会影响他们的日常表现和生活质量(QoL)。目的:本研究的目的是评估服用天然多草药补品(Body Revival)的癌症患者的生活质量。方法:对38例肿瘤患者进行小范围调查,并辅以Body Revival治疗≥3个月。一个结构化和有效的访谈计划被用来收集癌症患者的数据。结果:38例肿瘤患者中,男性占58.8%,年龄在60岁以上的占55%,以乳腺癌(35%)和生殖系统癌(男性27.8%,女性30%)居多,男性44.4%,女性40%为II期。大多数患者症状的生活质量显著改善(p<0.001)。它改善了日常生活的心理和生理方面,要么是通过减轻癌症常规治疗的不良事件,要么是通过增强体内的重要能量。结论:将健体补品与常规医疗护理相结合,可帮助患者更好地控制阴性症状,积极主动地对待疾病和治疗,提高生活质量。为了加强目前的发现,需要进行更多的研究。
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引用次数: 0
Complimentary Treatments for Minor GI Disorders 对轻微胃肠道疾病的免费治疗
Pub Date : 1900-01-01 DOI: 10.23880/apct-16000153
Abdul Kader Mohiuddin
About 80% of the population worldwide use a variety of traditional medicine, including herbal medicines, for the diagnosis, prevention and treatment of illnesses, and for the improvement of general well-being. Total consumer spending on herbal dietary supplements in the United States reached an estimated $8.085 billion in 2017. In addition, the 8.5% increase in total sales from 2016 is the strongest growth for these products in more than 15 years. The main reason to use herbal products in these countries is the assumption of a better tolerability compared to synthetic drugs. Whereas in developing countries herbal medicines are mostly the only available and affordable treatment option. Surveys from industrialized countries reveal as main health areas in which herbal products are used upper airway diseases including cough and common cold; other leading causes are gastrointestinal, nervous and urinary complaints up to painful conditions such as rheumatic diseases, joint pain and stiffness. Gastrointestinal disorders are the most widespread problems in health care. Many factors may upset the GI tract and its motility (or ability to keep moving), including: eating a diet low in fiber; lack of motion or sedentary lifestyle; frequent traveling or changes in daily routine; having excessive dairy products; anxiety and depression; resisting the urge to have a bowel movement habitually or due to pain of hemorrhoids; misuse of laxatives (stool softeners) that, over time, weaken the bowel muscles; calcium or aluminum antacids, antidepressants, iron pills, narcotics; pregnancy. About 30% to 40% of adults claim to have frequent indigestion, and over 50 million visits are made annually to ambulatory care facilities for symptoms related to the digestive system. Over l0 million endoscopies and surgical procedures involving the GI tract are performed each year. Community-based studies from around the world demonstrate that 10% to 46% of all children meet the criteria for RAP. Gastrointestinal disorders such as chronic or acute diarrhea, malabsorption, abdominal pain, and inflammatory bowel diseases can indicate immune deficiency, present in 5% to 50% of patients with primary immunodeficiencies. The gastrointestinal tract is the largest lymphoid organ in the body, so it is not surprising that intestinal diseases are common among immunodeficient patients. Gastroenterologists therefore must be able to diagnose and treat patients with primary immunodeficiency. Further, pathogens do influence the gut function. On the other hand, dietary habits and specific food types can play a significant role in the onset, treatment, and prevention of many GI disorders. Many of these can be prevented or minimized by maintaining a healthy lifestyle, and practicing good bowel habits.
全世界约80%的人口使用各种传统医学,包括草药,来诊断、预防和治疗疾病,并改善总体福祉。2017年,美国消费者在草药膳食补充剂上的总支出估计达到80.85亿美元。此外,与2016年相比,总销售额增长8.5%,是这些产品15年来最强劲的增长。在这些国家使用草药产品的主要原因是假定与合成药物相比耐受性更好。而在发展中国家,草药大多是唯一可用和负担得起的治疗选择。来自工业化国家的调查显示,使用草药产品的主要卫生领域是上呼吸道疾病,包括咳嗽和普通感冒;其他主要原因包括胃肠道、神经系统和泌尿系统疾病,以及风湿性疾病、关节疼痛和僵硬等疼痛状况。胃肠道疾病是医疗保健中最普遍的问题。许多因素可能会扰乱胃肠道及其运动性(或保持运动的能力),包括:低纤维饮食;缺乏运动或久坐的生活方式;经常出差或日常生活有变化;奶制品过多的;焦虑和抑郁;排便的:习惯性地或由于痔疮疼痛而抗拒排便的冲动;滥用泻药(大便软化剂),随着时间的推移,削弱肠道肌肉;钙或铝抗酸剂、抗抑郁药、铁丸、麻醉剂;怀孕。大约30%到40%的成年人声称经常消化不良,每年有超过5000万人次因消化系统相关症状到门诊护理机构就诊。每年有超过1000万例涉及胃肠道的内窥镜检查和外科手术。世界各地以社区为基础的研究表明,10%至46%的儿童符合RAP的标准。慢性或急性腹泻、吸收不良、腹痛和炎症性肠病等胃肠道疾病可表明免疫缺陷,5%至50%的原发性免疫缺陷患者存在免疫缺陷。胃肠道是人体最大的淋巴器官,所以肠道疾病在免疫缺陷患者中很常见也就不足为奇了。因此,胃肠病学家必须能够诊断和治疗原发性免疫缺陷患者。此外,病原体确实会影响肠道功能。另一方面,饮食习惯和特定的食物类型可以在许多胃肠道疾病的发病、治疗和预防中发挥重要作用。其中许多都可以通过保持健康的生活方式和养成良好的排便习惯来预防或减少。
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引用次数: 5
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Advances in Pharmacology &amp; Clinical Trials
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