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Articles 3631 - 3660 of 9501

Full-Text Articles in Medicine and Health Sciences

Research News, Grants, 2021, Volume 4, Soumyajit Majumdar Jan 2021

Research News, Grants, 2021, Volume 4, Soumyajit Majumdar

Grants (2015-)

Grants and contracts awarded during October - December 2021.


Computational Modeling Of Non-Active Functional States Of The Cannabinoid Receptor 1 And Its Ligands, Ayooluwa Olufunmi Aderibigbe Jan 2021

Computational Modeling Of Non-Active Functional States Of The Cannabinoid Receptor 1 And Its Ligands, Ayooluwa Olufunmi Aderibigbe

Electronic Theses and Dissertations

The cannabinoid receptor 1 (CB1) is a class A G-protein coupled receptor that is implicated in a variety of physiological processes, such as energy homeostasis, appetite regulation, cognition and motor control, and mood regulation. CB1 is widely distributed throughout the body, but is mainly expressed in the brain. Molecules that reduce CB1 signaling exhibit anti-obesity properties due to their effect in reducing appetite and body weight gain. However, the consequence of reducing CB1 signaling in the CNS includes adverse neuropsychiatric effects such as depression and suicidal ideation. Two methods of scientific interest for developing CB1 antagonists as anti-obesity drugs are …


Positive Deviants For Medication Therapy Management: A Mixed-Methods Comparative Case Study Of Community Pharmacy Practices, Omolola A. Adeoye-Olatunde, Leslie M. Lake, Celena Strohmier, Amanda K. Gourley, Ashli R. Ray, Alan J. Zillich, Margie E. Snyder Jan 2021

Positive Deviants For Medication Therapy Management: A Mixed-Methods Comparative Case Study Of Community Pharmacy Practices, Omolola A. Adeoye-Olatunde, Leslie M. Lake, Celena Strohmier, Amanda K. Gourley, Ashli R. Ray, Alan J. Zillich, Margie E. Snyder

Department of Pharmacy Practice Faculty Publications

Background

To optimize medication use in older adults, the Centers for Medicare & Medicaid Services (CMS) launched Medication Therapy Management (MTM) services as part of Medicare Part D policy; however, strategies for achieving high quality MTM outcomes are not well understood.

Objective

The objective of this study was to generate hypotheses for strategies contributing to community pharmacies’ high performance on policy-relevant MTM quality measures.

Methods

This mixed-methods comparative case study was guided by the Positive Deviance approach and Chronic Care Model. The study population consisted of pharmacy staff employed by a Midwestern division of a national supermarket-community pharmacy chain. Data …


A User-Centered Evaluation Of Medication Therapy Management Alerts For Community Pharmacists: Recommendations To Improve Usability And Usefulness, Margie Snyder, Omolola A. Adeoye-Olatunde, Stephanie A. Gernant, Julie Diiulio, Heather A. Jaynes, William R. Doucette, Alissa L. Russ-Jara Jan 2021

A User-Centered Evaluation Of Medication Therapy Management Alerts For Community Pharmacists: Recommendations To Improve Usability And Usefulness, Margie Snyder, Omolola A. Adeoye-Olatunde, Stephanie A. Gernant, Julie Diiulio, Heather A. Jaynes, William R. Doucette, Alissa L. Russ-Jara

Department of Pharmacy Practice Faculty Publications

Background

Community pharmacists provide comprehensive medication reviews (CMRs) through pharmacy contracts with medication therapy management (MTM) vendors. These CMRs are documented in the vendors' web-based MTM software platforms, which often integrate alerts to assist pharmacists in the detection of medication therapy problems. Understanding pharmacists’ experiences with MTM alerts is critical to optimizing alert design for patient care.

Objectives

The objectives of this study were to 1) assess the usability and usefulness of MTM alerts for MTM vendor-contracted community pharmacists and 2) generate recommendations for improving MTM alerts for use by community pharmacists.

Methods

This was a convergent, parallel mixed-methods evaluation …


A Mixed-Methods Study Of Pharmacy Instructors' Early Experiences With A Teaching Electronic Medical Record, Omolola A. Adeoye-Olatunde, Olga O. Vlashyn, Kimberly Plake, Jamie L. Woodyard, Zachary A. Weber, Debra K. Litzelman, Alissa L. Russ-Jara Jan 2021

A Mixed-Methods Study Of Pharmacy Instructors' Early Experiences With A Teaching Electronic Medical Record, Omolola A. Adeoye-Olatunde, Olga O. Vlashyn, Kimberly Plake, Jamie L. Woodyard, Zachary A. Weber, Debra K. Litzelman, Alissa L. Russ-Jara

Department of Pharmacy Practice Faculty Publications

Introduction

As use of electronic medical records (EMRs) increases in healthcare, multiple accreditation organizations recommend training future clinicians on EMRs as part of the academic curriculum. Therefore, some pharmacy programs now utilize an academic EMR. Our objective was to examine pharmacy instructors' early experiences with a commercially available teaching EMR (tEMR) in order to identify current and future priorities along with benefits and barriers to academic EMR use in pharmacy education.

Methods

We conducted semi-structured interviews and a web-based survey with pharmacy instructors. Interview and survey data analyses consisted of hybrid inductive/deductive approaches to coding data and descriptive statistics, …


Research And Scholarly Methods: Semi-Structured Interviews, Omolola A. Adeoye-Olatunde, Nicole Olenik Jan 2021

Research And Scholarly Methods: Semi-Structured Interviews, Omolola A. Adeoye-Olatunde, Nicole Olenik

Department of Pharmacy Practice Faculty Publications

The popularity and value of qualitative research has increasingly been recognized in health and pharmacy services research. Although there is certainly an appropriate place in qualitative research for other data collection methods, a primary benefit of the semi-structured interview is that it permits interviews to be focused while still giving the investigator the autonomy to explore pertinent ideas that may come up in the course of the interview, which can further enhance understanding of the pharmacy service being assessed. The purpose of this narrative review is to summarize methodological considerations and procedures for conducting semi-structured interviews in pharmacy services research. …


An Evaluation Of The Spread And Scale Of Patienttoc™ From Primary Care To Community Pharmacy Practice For The Collection Of Patient-Reported Outcomes: A Study Protocol, Margie Snyder, Betty Chewning, David Kreling, Susan M. Perkins, Lyndee M. Knox, Omolola A. Adeoye-Olatunde, Heather A. Jaynes, Jon C. Schommer, Matthew M. Murawski, Nisaratana Sangasubana, Lisa A. Hillman, Geoffrey M. Curran Jan 2021

An Evaluation Of The Spread And Scale Of Patienttoc™ From Primary Care To Community Pharmacy Practice For The Collection Of Patient-Reported Outcomes: A Study Protocol, Margie Snyder, Betty Chewning, David Kreling, Susan M. Perkins, Lyndee M. Knox, Omolola A. Adeoye-Olatunde, Heather A. Jaynes, Jon C. Schommer, Matthew M. Murawski, Nisaratana Sangasubana, Lisa A. Hillman, Geoffrey M. Curran

Department of Pharmacy Practice Faculty Publications

Background

Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed …


Development Of Site - Specific Drug Delivery Systems Using Hot Melt Extrusion And Fused Deposition Modeling 3d Printing, Nagireddy Reddy Dumpa Jan 2021

Development Of Site - Specific Drug Delivery Systems Using Hot Melt Extrusion And Fused Deposition Modeling 3d Printing, Nagireddy Reddy Dumpa

Electronic Theses and Dissertations

Due to preferential site of drug absorption and the need for increased concentration of medication at the required tissues, dosage forms should be designed or formulated in such a way that medication is released at a specific site or after a specific time in the gastrointestinal tract (GIT). Knowledge of transit times of dosage forms in each part of GIT, by use of particular polymers or employing specific delivery systems such as floating systems, delivery of medication to specific sites in the GIT can be achieved. HME coupled FDM 3D printing has the capability to create customized dosage forms for …


Nmr-Based Characterization Of A Glucan Isolated From Ganoderma Lucidum, Alysia Gonzales Jan 2021

Nmr-Based Characterization Of A Glucan Isolated From Ganoderma Lucidum, Alysia Gonzales

Electronic Theses and Dissertations

Ganoderma lucidum is a polypore fungus commonly known as Lingzhi, Youngji or Reishi mushroom in East Asia. It is frequently marketed as an herbal supplement and often utilized as traditional Chinese medicine. Our research comprises the structural investigation of the principal polysaccharide from this fungus. After proper purification, the fungal glucan was subjected to multiple experiments of NMR spectroscopy, including 1D 1H and 13C, 2D; 1H-1H COSY, 1H-1H TOCSY, 1H-1H NOESY, 1H-13C HSQC, 1H-1H Phase Sensitive-TOCSY, and 1H-13C TOCSY-HSQC NMR spectra. Data has confirmed that this fungal polysaccharide contains residues of glucose (91.31%) as major, galactose (4.99%), and mannose (3.69%) …


Towards A New Method Of Determining Protein Structure, Niloofar Abolhasani Khaje Jan 2021

Towards A New Method Of Determining Protein Structure, Niloofar Abolhasani Khaje

Electronic Theses and Dissertations

Hydroxyl radical protein footprinting (HRPF) by fast photochemical oxidation of proteins (FPOP) is a mass spectrometry-based technique that measures the apparent protein oxidation rate by freely diffusing hydroxyl radicals at different regions in a protein, and correlates changes in this apparent rate with changes in the solvent accessibility of the protein target based on quantifying the amount of oxidation of different regions of a protein. While there have been many advancements in HRPF-FPOP, oxidation measurement still suffers from high variability between measurements. High variability reduces the power statistical power this technique even in the presence of radical dosimetry measurements and …


Design And Synthesis Of Salvinorin-Based Compounds For The Opioid Receptors., Nicholas S. Akins Jan 2021

Design And Synthesis Of Salvinorin-Based Compounds For The Opioid Receptors., Nicholas S. Akins

Electronic Theses and Dissertations

Opioid receptors (OR) are expressed throughout both the peripheral and central nervous system and play crucial roles in the modulation of antinociception, addiction, anxiety, and depression. Salvinorin A, the main isolate of the hallucinogenic plant Salvia divinorum, is one of the most potent naturally occurring kappa opioid receptor agonists. Salvinorin A possesses beneficial effects as a therapeutic in a variety of CNS disorders, but due to its strong hallucinating, anxiogenic effects, and short half-life(t1/2), it has never advanced to clinical trials. Instead, salvinorin A has been used as an important prototype for the development of related drug candidates. Our initial …


Abuse Deterrent Formulation Using Hot Melt Extrusion Technology, Vishvesh Raje Jan 2021

Abuse Deterrent Formulation Using Hot Melt Extrusion Technology, Vishvesh Raje

Electronic Theses and Dissertations

The purpose of the current study was to formulate hot melt extruded (HME) abuse deterrent pellets of acetaminophen(APAP), a model drug with the aid of high molecular weight hydroxypropyl methylcellulose (HPMC 4M ) and gelling agents (starch, pectin and carbopol). The formulated HME pellets were assessed for their abuse-deterrence (AD) potential using Category- 1 laboratory in-vitro evaluation standards. The pellets were examined for the particle size reduction (PSR), extraction in small volume, syringeability, thermal manipulation and dissolution for evaluating the resilience of the AD properties. Though, most of the formulation showed complete particle size reduction after grinding, grounded pellets were …


Applications Of Hot-Melt Extrusion (Hme) Technology And Investigation Of A Screening Tool For Hme, Gauri Deepak Shadambikar Jan 2021

Applications Of Hot-Melt Extrusion (Hme) Technology And Investigation Of A Screening Tool For Hme, Gauri Deepak Shadambikar

Electronic Theses and Dissertations

Hot-melt extrusion (HME), an adaptable technology, has established its position in manufacturing operations like amorphous solid dispersions, immediate and controlled oral formulations, implants and taste masked products. In recent years the industrial focus has shifted towards continuous manufacturing, thus HME is being explored for new applications. The aim of this research was to investigate the novel applications of HME by carrying out an in-depth study to understand the interaction between the process and product and to investigate a screening tool for its small-scale formulation and development.As HME consumes large amount of samples during the developmental phase, we investigated a screening …


An In-Depth Approach For Functional Oligosaccharide Analysis, Hao Liu Jan 2021

An In-Depth Approach For Functional Oligosaccharide Analysis, Hao Liu

Electronic Theses and Dissertations

Heparin and heparan sulfate (Hp/HS) are linear complex glycosaminoglycans (GAGs), which are involved in diverse biological processes. Although Hp/HS GAGs influence numerous physiological and pathophysiological processes, their high degree of size polydispersity and sequence microheterogeneity make structure-function characterization challenging. In addition, it is hard to understand the structures that underlie any of the various functions with MS, because of the lability of the sulfate group during tandem mass spectrometry (MS/MS) analysis. The work presented here describes an in-depth approach for functional oligosaccharide characterization including chemical derivatization of Hp to inhibit COVID-19 infection, multi-dimensional liquid chromatography (LC) fractionation method, chemical derivatization …


Consequences To Patients, Clinicians, And Manufacturers When Very Serious Adverse Drug Reactions Are Identified (1997-2019): A Qualitative Analysis From The Southern Network On Adverse Reactions (Sonar), Charles L. Bennett M.D., Ph.D., Shamia Hoque, Nancy Olivieri, Matthew A. Taylor, David Aboulafia, Courtney Lubaczewski, Andrew C. Bennett, Jay Vemula, Benjamin Schooley, Bartlett J. Witherspoon, Ashley C. Godwin, Paul S. Ray, Marc Fishman, Georgne Herring, Anne Ventrone, Juan Aldaco, William J. Hrushesky, John Restaino, Henrik S. Thomsen, Robert Marx, Et. Al. Jan 2021

Consequences To Patients, Clinicians, And Manufacturers When Very Serious Adverse Drug Reactions Are Identified (1997-2019): A Qualitative Analysis From The Southern Network On Adverse Reactions (Sonar), Charles L. Bennett M.D., Ph.D., Shamia Hoque, Nancy Olivieri, Matthew A. Taylor, David Aboulafia, Courtney Lubaczewski, Andrew C. Bennett, Jay Vemula, Benjamin Schooley, Bartlett J. Witherspoon, Ashley C. Godwin, Paul S. Ray, Marc Fishman, Georgne Herring, Anne Ventrone, Juan Aldaco, William J. Hrushesky, John Restaino, Henrik S. Thomsen, Robert Marx, Et. Al.

Faculty Publications

Background

Adverse drug/device reactions (ADRs) can result in severe patient harm. We define very serious ADRs as being associated with severe toxicity, as measured on the Common Toxicity Criteria Adverse Events (CTCAE)) scale, following use of drugs or devices with large sales, large financial settlements, and large numbers of injured persons. We report on impacts on patients, clinicians, and manufacturers following very serious ADR reporting.

Methods

We reviewed clinician identified very serious ADRs published between 1997 and 2019. Drugs and devices associated with reports of very serious ADRs were identified. Included drugs or devices had market removal discussed at Food …


Bisphosohoglycertae Mutase: A Potential Target For Sickle Cell Disease, Anfal S. Aljahdali Jan 2021

Bisphosohoglycertae Mutase: A Potential Target For Sickle Cell Disease, Anfal S. Aljahdali

Theses and Dissertations

Bisphosphoglycerate mutase (BPGM) is a part of the erythrocyte glycolysis system. Specifically, it is a central enzyme in the Rapoport-Leubering pathway, a side glycolytic pathway involved in the regulation of the concentration of the natural allosteric effector of hemoglobin (Hb), 2,3-bisphosphoglycerate (2,3-BPG). BPGM catalyses the synthesis and hydrolysis of 2,3-BPG through its synthase and phosphatase activities. The synthase activity is the main role of BPGM, while the phosphatase activity is low and is activated by the physiological effector, 2-phosphoglycolate (2-PG) with the latter mechanism poorly understood.

BPGM activity and 2,3-BPG levels in red blood cells (RBCs) have a significant role …


Glycosaminoglycan Modulation Of Key Proteins In Alzheimer's Disease, Tamim Chiba Jan 2021

Glycosaminoglycan Modulation Of Key Proteins In Alzheimer's Disease, Tamim Chiba

Theses and Dissertations

Glycosaminoglycans (GAGs) are linear polysaccharides whose disaccharide building blocks consist of an amino sugar (D-glucosamine) and either uronic acid (D-glucuronic acid or L-iduronic acid) or galactose. Nearly all GAGs (with the exception of hyaluronic acid) are covalently attached to proteins, forming proteoglycans, and are ubiquitous in nature. The monomeric units, chain length, degree and pattern of sulfation, and epimerization are important properties that determine the influence of these molecules. Through Coulombic forces, hydrogen bonds and hydrophobic interactions, they regulate many physiological and pathophysiological processes such as blood coagulation, cell growth and differentiation, inflammatory processes, host defense and viral infection mechanisms. …


A Data Driven Approach To Profile Potential Sars-Cov-2 Drug Interactions Using Tylerade, Robert P. Schumaker, Michael A. Veronin, Trevor Rohm, Matthew Boyett, Rohit R. Dixit Jan 2021

A Data Driven Approach To Profile Potential Sars-Cov-2 Drug Interactions Using Tylerade, Robert P. Schumaker, Michael A. Veronin, Trevor Rohm, Matthew Boyett, Rohit R. Dixit

Journal of International Technology and Information Management

We use a data driven approach on a cleaned adverse drug reaction database to determine the reaction severity of several covid-19 drug combinations currently under investigation. We further examine their safety for vulnerable populations such as individuals 65 years and older. Our key findings include 1. hydroxychloroquine/chloroquine are associated with increased adverse drug event severity versus other drug combinations already not recommended by NIH treatment guidelines, 2. hydroxychloroquine/azithromycin are associated with lower adverse drug event severity among older populations, 3. lopinavir/ritonavir had lower adverse reaction severity among toddlers and 4. the combination of azithromycin, hydroxychloroquine and tocilizumab is safer than …


Interesting Case Of Headache With “Can’T Mix Food & Can’T Swallow”, Dr. Shreeraksha K.S, Dr. Shasthara P Jan 2021

Interesting Case Of Headache With “Can’T Mix Food & Can’T Swallow”, Dr. Shreeraksha K.S, Dr. Shasthara P

Digital Journal of Clinical Medicine

No abstract provided.


Attention Deficit Hyperactivity Disorder, Dr. Anu Janardhan, Dr. Kishor M Jan 2021

Attention Deficit Hyperactivity Disorder, Dr. Anu Janardhan, Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.


Case Of Severe Depression With Psychotic Symptoms In Childhood, Vijaykumar Hiremath, Dr. Anusha Pogula, Dr. Kishor M Jan 2021

Case Of Severe Depression With Psychotic Symptoms In Childhood, Vijaykumar Hiremath, Dr. Anusha Pogula, Dr. Kishor M

Digital Journal of Clinical Medicine

No abstract provided.


Development Of Turmeric Oil-Loaded Folic Acid-Grafted Chitosan/Alginate Nanocapsules For Targeted Delivery To Breast Cancer, Htet Htet Moe San Jan 2021

Development Of Turmeric Oil-Loaded Folic Acid-Grafted Chitosan/Alginate Nanocapsules For Targeted Delivery To Breast Cancer, Htet Htet Moe San

Chulalongkorn University Theses and Dissertations (Chula ETD)

Folate receptors that are overexpressed in various cancer cells including breast cancers have become a promising strategy in targeted delivery of chemotherapeutics. In this study, the folic acid (FA)-conjugated chitosan/alginate nanocapsules loaded with turmeric oil (TO-FA-CS/Alg NC) were developed by ionotropic gelation technique to target folate receptors in MBA-MB-231 and MCF-7 breast cancer cell lines. The successful conjugation of FA with CS was confirmed with 1H-NMR and FT-IR, and Box-Behnken design was utilized in optimizing the formulation. The optimized TO-FA-CS/Alg NC rendered suitable particle size (189 nm) with homogenous distribution and high encapsulation efficiency (35.9%) and loading capacity (1.82%). The …


การนำระบบดูแลผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อของโรงพยาบาลรามาธิบดีมาใช้เพื่อพัฒนา ผลลัพธ์ในผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อ, ปวัสดา ท่ามตระกูล Jan 2021

การนำระบบดูแลผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อของโรงพยาบาลรามาธิบดีมาใช้เพื่อพัฒนา ผลลัพธ์ในผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อ, ปวัสดา ท่ามตระกูล

Chulalongkorn University Theses and Dissertations (Chula ETD)

การศึกษานี้มีวัตถุประสงค์เพื่อเปรียบเทียบระยะเวลาที่ผู้ป่วยได้รับยาต้านจุลชีพแบบคาดการณ์ครั้งแรกก่อนและหลังการเริ่มใช้ระบบดูแลผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อของโรงพยาบาลรามาธิบดี (Ramathibodi Sepsis System : RSS) รวมไปถึงเพื่อศึกษาระยะเวลาในการได้รับยาต้านจุลชีพที่เหมาะสมกับผลเพาะเชื้ออัตราการเสียชีวิตในโรงพยาบาล อัตราการเสียชีวิตใน 28 วัน และระยะเวลาในการนอนโรงพยาบาล วิธีวิจัย : เป็นการวิจัยกึ่งทดลอง (Quasi-Experimental study) เปรียบเทียบช่วงก่อนและหลังการใช้ระบบ RSS ศึกษาในผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อที่อายุมากกว่า 18 ปีและเข้ารับการรักษาในโรงพยาบาลรามาธิบดี ระหว่างวันที่ 29 มกราคม พ.ศ. 2564 – 30 เมษายน พ.ศ. 2565 ระบบ RSS เป็นการพัฒนาระบบที่จัดให้มีการทำงานร่วมกันของสหสาขาวิชาชีพประกอบด้วย แพทย์ เภสัชกร และพยาบาล พัฒนาการให้บริการแบบองค์รวมเพื่อการดูแลผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อ โดยประกอบด้วย (1) การกำหนดแนวทางการวินิจฉัยผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อที่เป็นรูปแบบมาตรฐาน เป็นระบบ รวดเร็ว และมีการระบุเวลาวินิจฉัยที่ชัดเจน (2) มีการกำหนดรายการยาต้านจุลชีพเพื่อบรรจุในเครื่องจ่ายยาอัตโนมัติซึ่งจัดตั้งอยู่ ณ บริเวณหอผู้ป่วย เพื่อให้ขั้นตอนการตรวจสอบคำสั่งใช้ยา การจ่ายยา รวดเร็ว (3) การติดตามตรวจสอบผลความไวของเชื้อต่อยาต้านจุลชีพที่ผู้ป่วยได้รับเพื่อให้ผู้ป่วยได้รับยาต้านจุลชีพที่เหมาะสมกับเชื้อก่อโรค ผลการวิจัย : ผู้ป่วยที่ผ่านเกณฑ์คัดเลือกเข้าร่วมการศึกษาจำนวน 137 คนแบ่งผู้ป่วยออกเป็น 2 กลุ่ม คือ กลุ่มก่อนใช้ระบบ RSS 50 คน (กลุ่มควบคุม) และกลุ่มหลังใช้ระบบ RSS 87 คน (กลุ่มศึกษา) พบว่ากลุ่มศึกษามีระยะเวลาในการบริหารยาต้านจุลชีพแบบคาดการณ์ครั้งแรกของผู้ป่วยเร็วกว่ากลุ่มควบคุมอย่างมีนัยสำคัญทางสถิติ: 42 นาที (ค่าพิสัยระหว่างควอไทล์ 21.5, 57.5) เทียบกับ 76 นาที (ค่าพิสัยระหว่างควอไทล์ 35.0, 319.8; p < 0.001) และมีระยะเวลาในการบริหารยาต้านจุลชีพที่เหมาะสมตามผลเพาะเชื้อที่เร็วกว่ากลุ่มควบคุมอย่างมีนัยสำคัญทางสถิติ: 48 ชั่วโมง (ค่าพิสัยระหว่างควอไทล์ 0.9, 84.0) เทียบกับ 96 ชั่วโมง (ค่าพิสัยระหว่างควอไทล์ 54.0,312.0 p = 0.009) นอกจากนั้นยังพบอัตราการเสียชีวิตในโรงพยาบาล เสียชีวิตใน 28 วัน และระยะเวลาในการนอนรักษาตัวในโรงพยาบาลลดลง ในกลุ่มศึกษาเมื่อเทียบกับกลุ่มควบคุมแต่ไม่มีนัยสำคัญทางสถิติที่ระดับ .05 สรุป : การใช้ระบบ RSS มาใช้ในการดูแลผู้ป่วยที่มีภาวะพิษเหตุติดเชื้อ ช่วยลดระยะเวลาในการบริหารยาต้านจุลชีพแบบคาดการณ์ครั้งแรก ลดระยะเวลาในการบริหารยาต้านจุลชีพที่เหมาะสมตามผลเพาะเชื้อ และ มีแนวโน้มส่งผลลดอัตราการเสียชีวิต


ปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกในผู้ป่วยภาวะหัวใจเต้นผิดจังหวะที่ได้รับยาไรวาร็อกซาแบน, ภัทรพร สิริภัทรชัย Jan 2021

ปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกในผู้ป่วยภาวะหัวใจเต้นผิดจังหวะที่ได้รับยาไรวาร็อกซาแบน, ภัทรพร สิริภัทรชัย

Chulalongkorn University Theses and Dissertations (Chula ETD)

วัตถุประสงค์: เพื่อหาปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกในผู้ป่วยภาวะหัวใจเต้นผิด จังหวะที่ได้รับยาไรวาร็อกซาแบน วิธีการ: งานวิจัยนี้เป็นการศึกษาเชิงวิเคราะห์ชนิดย้อนหลังจาก ผลไปหาเหตุแบบหลายศูนย์ รวบรวมข้อมูลผู้ป่วยที่มีภาวะหัวใจเต้นผิดจังหวะที่ได้รับยาไรวาร็อกซาแบน ณ โรงพยาบาลจุฬาลงกรณ์ และโรงพยาบาลรามาธิบดี ระหว่าง 1 ตุลาคม 2556 ถึง 30 กันยายน 2564 วิเคราะห์ปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกด้วยสถิติการถดถอยโลจิสติค พหุคูณ ผลการวิจัย : กลุ่มตัวอย่าง 455 คน แบ่งเป็นกลุ่มศึกษาคือผู้ที่เกิดภาวะเลือดออก 91 คน ประกอบด้วยภาวะเลือดออกรุนแรง 20 คน ภาวะเลือดออกไม่รุนแรงที่มีความสำคัญทางคลินิก 45 คน และภาวะเลือดออกไม่รุนแรง 26 คน กลุ่มควบคุมคือผู้ที่ไม่เกิดภาวะเลือดออก 364 คน ผลการ วิเคราะห์พบปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกอย่างมีนัยสำคัญทางสถิติ ได้แก่ ประวัติการเกิด ภาวะเลือดออก (adjusted OR: 20.29, p<0.001) ระดับอัลบูมินในเลือดต่ำ (adjusted OR: 2.19, p=0.020) ภาวะโลหิตจาง (adjusted OR: 2.03, p=0.026) และอันตรกิริยาระหว่างยา (adjusted OR: 2.40, p=0.007) เมื่อพิจารณาปัจจัยด้านอายุ น้ำหนัก ขนาดยาไรวาร็อกซาแบนต่อวัน การทำงานของไต ภาวะหัวใจล้มเหลว โรคหลอดเลือด และประวัติโรคหลอดเลือดสมองร่วมด้วย สรุป : ปัจจัยที่มีผลต่อการเกิดภาวะเลือดออกในผู้ป่วยภาวะหัวใจเต้นผิดจังหวะที่ได้รับยาไรวาร็อกซาแบน ได้แก่ ประวัติการเกิดภาวะเลือดออก ระดับอัลบูมินในเลือดต่ำ ภาวะโลหิตจาง อันตรกิริยาระหว่าง ยา ผู้ป่วยที่มีปัจจัยดังกล่าวจึงควรได้รับการดูแลติดตามอย่างใกล้ชิด เพื่อช่วยลดความเสี่ยงในการเกิดภาวะเลือดออกและเพิ่มความปลอดภัยจากการใช้ยาไรวาร็อกซาแบน


Incidence And Severity Of Drug Interactions Before And After Switching Antiretroviral Therapy To Bictegravir/Emtricitabine/Tenofovir Alafenamide In Treatment-Experienced Patients., Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp, Neha S Pandit, Agnes Cha, Emily Huesgen, Melissa Badowski, Elizabeth M Sherman, Jennifer Cocohoba, Ayako Shimada, Scott W Keith Jan 2021

Incidence And Severity Of Drug Interactions Before And After Switching Antiretroviral Therapy To Bictegravir/Emtricitabine/Tenofovir Alafenamide In Treatment-Experienced Patients., Jason J. Schafer, Pharmd, Mph, Bcps, Aahivp, Neha S Pandit, Agnes Cha, Emily Huesgen, Melissa Badowski, Elizabeth M Sherman, Jennifer Cocohoba, Ayako Shimada, Scott W Keith

College of Pharmacy Faculty Papers

Background: Switching antiretroviral therapy (ART) in people with HIV (PWH) can influence their risk for drug-drug interactions (DDIs). The purpose of this study was to assess changes in the incidence and severity of DDIs among PWH who switched their ART to bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF).

Methods: This was a multicenter retrospective cohort study of PWH on ART and at least 1 concomitant medication (CM) who switched to BIC/FTC/TAF between 3/2018 and 6/2019. Using the University of Liverpool's HIV Drug Interaction Database, 2 DDI analyses were performed for each patient. The first assessed patients' preswitch ART regimens with their CM list. The …


Investigations On Novel Cyp26a1/B1 Inhibitor, Dx308: Using Atra Response As A Theraputic Target For Traumatic Brain Injury And Parkinson’S Disease, Jacob Morgan Leatherwood Jan 2021

Investigations On Novel Cyp26a1/B1 Inhibitor, Dx308: Using Atra Response As A Theraputic Target For Traumatic Brain Injury And Parkinson’S Disease, Jacob Morgan Leatherwood

Graduate Student Theses, Dissertations, & Professional Papers

Neurodegenerative diseases (NDs) take a wide spectrum of pathologies and have a tendency to present themselves later in life. Neurodegenerative diseases affect 6 million Americans annually with ~1 million currently living with Parkinson’s disease (PD). One of the greatest contributors to the pathogenesis of neurodegenerative diseases is the occurrence of a traumatic brain injury (TBI) during life.

All-trans-retinoic acid (atRA) is the active metabolite of Vitamin A. The retinoic acid pathway is known to be activated following TBI and is reduced in PD patients. Previous studies found a decrease in inflammation and behavioral deficits following administration of Vitamin …


Acute Monoplegia With Incontinence, Dr. Ruthvik S, Dr. Shastara P Jan 2021

Acute Monoplegia With Incontinence, Dr. Ruthvik S, Dr. Shastara P

Digital Journal of Clinical Medicine

No abstract provided.


A Case Of Superior Venacaval (Svc) Syndrome, Dr. Gayathri K.N, Dr. Rajendra Prasad S, Dr. Ravikumar Y.S, Dr.Varsha T Jan 2021

A Case Of Superior Venacaval (Svc) Syndrome, Dr. Gayathri K.N, Dr. Rajendra Prasad S, Dr. Ravikumar Y.S, Dr.Varsha T

Digital Journal of Clinical Medicine

No abstract provided.


A Case Of Cervical Carcinoma With Bilateral Perinephric Hematoma: A Diagnostic Dilemma, Dr.Shivani R. Kundur, Dr.Manjunath V, Dr.Abhilash Gautham Jan 2021

A Case Of Cervical Carcinoma With Bilateral Perinephric Hematoma: A Diagnostic Dilemma, Dr.Shivani R. Kundur, Dr.Manjunath V, Dr.Abhilash Gautham

Digital Journal of Clinical Medicine

No abstract provided.


A Case Of Mucinous Cystadenocarcinoma Of Ovary In A 13 Year Old Female, Sourav Tapadar, Dr. Sharmila Tapadar Jan 2021

A Case Of Mucinous Cystadenocarcinoma Of Ovary In A 13 Year Old Female, Sourav Tapadar, Dr. Sharmila Tapadar

Digital Journal of Clinical Medicine

No abstract provided.