Development of a Digital Platform: A Perspective to Advance Space Telepharmacy.

Goal: Lessons learned from decades of human spaceflight have helped advance the delivery of healthcare in rural and remote areas of the globe. Inclusion of the public in spaceflights is not yet accompanied by technology capable of monitoring their physical and mental health, managing clinical conditions, and rapidly identifying medical emergencies. Telepharmacy is a practice prioritizing pharmacotherapeutic guidance and monitoring to help improve patient quality of life, and can potentially expand the field of space medicine. We seek to advance pharmaceutical care through telepharmacy by developing a digital platform. Objective: This study focuses on the development of a digital platform for teleassistance and pharmaceutical teleconsulting services that builds on lessons learned in delivering space medicine. Methods: The platform contains evidence-based information on various drugs grouped by medical specialty, and also records and saves patient appointments. It has specific service protocols for service standardization, including artificial intelligence, to allow agility in services and escalation. All data is protected by privacy and professional ethics guidelines. Results: The telepharmacy platform is ready and currently undergoing testing for ground applications through validation studies in hospitals or medical clinics. Conclusions: Although developed for use on Earth, this telepharmacy platform provides a good example of how terrestrial healthcare knowledge and technology can be transferred to space missions.

Space motion sickness: A common neurovestibular dysfunction in microgravity.

This article presents a review of the current findings related to neurovestibular physiology, aetiology, and proposed theories on space motion sickness (SMS) during acute and sustained exposure to microgravity. The review discusses the available treatment options including medication and nonpharmacological countermeasure methods that help to prevent the development of SMS in weightlessness. Ground-based simulations using virtual reality, flight simulations, and Barany's chairs can be applied to study SMS and demonstrate its signs and symptoms to space crew members. Space motion sickness has been observed in approximately 70% of astronauts within the first 72 h in microgravity, having in general an instantaneous onset of signs and symptoms. Stomach discomfort, nausea, vomiting, pallor, cold sweating, salivation, tachypnoea, belching, fatigue, drowsiness, and stress hormone release have been documented. This can have detrimental effects on the well-being of astronauts in the initial phase of a space mission. Mental and physical performance may be affected, jeopardizing operational procedures and mission safety.

Description of medication errors detected at a drug information centre in Southern Brazil.

OBJECTIVE: To identify and describe actual or potential medication errors related to drug information inquiries made by staff members of a teaching hospital to a Drug Information Centre from January 2012 to December 2013. METHODS: Data were collected from the records of inquiries made by health care professionals to the Drug Information Centre throughout this period. RESULTS: During the study period, the Drug Information Centre received 3,500 inquiries. Of these, 114 inquiries had medication errors. Most errors were related to prescribing, preparation, and administration and were classified according to severity as category B (57%) (potential errors) and categories C (26.3%) and D (15.8%) (actual errors that did not result in harm to the patient). Error causes included overdose (13.2%), wrong route of administration (11.4%), inadequate drug storage (11.4%), and wrong dosage form (8.8%). The drugs most frequently involved in errors were vitamin K (4.4%), vancomycin (3.5%), and meropenem (3.5%). CONCLUSION: In this study, it was not possible to measure the reduction in error rate involving medication use because of the lack of previous data on this process in the institution. However, our findings indicate that the Drug Information Centre may be used as a strategy to seek improvements in processes involving medication use.

Polysaccharide nanoparticles for protein and Peptide delivery: exploring less-known materials.

Finding adequate carriers for protein and peptide delivery has become an urgent need, owing to the growing number of macromolecules identified as having therapeutic potential. Nanoparticles have emerged in the field as very promising vehicles and much work has been directed to testing the capacity of different materials to compose the matrix of these carriers. Natural materials and, specifically, polysaccharides have been taking the forefront of the challenge, because of several favoring properties that include the higher propensity to exhibit biodegradability and biocompatibility, and also the high structural flexibility. The majority of works found in the literature regarding polysaccharide nanoparticles uses very popular materials like chitosan or hyaluronic acid. This review is aimed at describing and exploring the potential of polysaccharides that are not so well known or that are less explored. For those, the main properties will be described, together with an overview of the reported applications as nanoparticle matrix materials.

A device for sampling arterialized earlobe blood in austere environments.

INTRODUCTION: There is currently no effective method of measuring arterial blood gas tensions in austere environments such as in space or at high altitude. An alternative to direct arterial measurement is the sampling of arterialized earlobe blood, an accurate technique that has been in use in clinical medicine and physiology for more than 50 yr. We, therefore, developed an earlobe arterialized blood (EAB) collector for practical use in extreme environments. METHODS: The results from the EAB collector were compared with simultaneous samples of blood drawn from the radial artery. Six healthy subjects breathed a gas mixture of 12.8% O2 in N2 during 15 min of 8 degree head-down tilt. The blood samples were analyzed immediately. RESULTS: The mean differences in Po2 between arterialized earlobe and radial artery samples were 0.25 +/- 1.25 mmHg for Po2 and 1.0 +/- 0.75 mmHg for Pco2; neither difference was significant. There was no difference between the pH values obtained by the two techniques. CONCLUSION: This study suggests that arterialized blood sampled from the earlobe using the EAB collector may provide sufficiently accurate measurements of the Po2, Pco2 and pH of arterial blood for clinical or research use in extreme environments.