An Evaluation of Medication Reconciliation in an Outpatient Nephrology Clinic.

Background: Accreditation Canada recognizes medication reconciliation as a key required organizational practice (ROP) to enhance patient safety. Patients with chronic kidney disease (CKD) carry a high risk for adverse drug events due to multiple co-morbidities, using many medications, and being cared for by many practitioners. Data evaluating the benefits of ambulatory medication reconciliation (AmbMR) in patients with advanced CKD is limited. Methods: We retrospectively evaluated types and rates of medication discrepancies and their potential index for patient harm using the Cornish classification system in a cohort of consecutive non-dialysis-dependent CKD stage 5 patients who received AmbMR. Results: AmbMR was conducted 225 times on 115 patients during the study period. One hundred eighty medication discrepancies were identified. The most common discrepancy identified was incorrect drug followed by discrepant dose, discrepant frequency, and drug omission. Sixty-three percent of discrepancies were classified as unlikely to cause patient discomfort or clinical deterioration, 36% were classified as likely to cause moderate harm, and one percent was classified as potential to cause serious harm. Conclusion: Medication discrepancies are common in patients with advanced CKD. Nearly a quarter of patients may experience moderate discomfort or clinical deterioration from discrepancies. Our study showed that in patients with non-dialysis-dependent CKD stage 5, the risk of patient harm associated with medication discrepancies can be reduced by conducting AmbMR.

Enhanced Ehrlich tumor inhibition using DOX-NP and gold nanoparticles loaded liposomes.

Treatment with doxorubicin (DOX) is a common treatment for different types of cancer. DOX-NP is one of a well established marketed liposomal formulation for DOX. It has advantages over free DOX in reducing the cardiac toxicity and increasing the efficacy. Gold nanoparticles (GNPs), have been widely used in biomedical applications such as medical imaging and biosensors. Mice bearing Ehrlich tumor were injected with saline, free doxorubicin (DOX) in solution, gold nanoparticles loaded liposomes and commercial liposomal encapsulated doxorubicin (DOX-NP). The results showed that GNPs loaded liposomes could enhance the antitumor activity of commercial liposomal formulation (DOX-NP) and displayed significantly decreased systemic toxicity compared with free DOX and commercial liposomal formulation (DOX-NP) at the equivalent dose. So the injection of GNPs and DOX-NP is expected to increase the cell killing and make it a promising approach to cancer treatment.

Gamma irradiation effects on the electrical properties of gold nanoparticles.

Gold nanoparticles (AuNPs) offer a great promising in biomedical applications and their size has been shown to be important parameters that affect the particles uptake and cellular imbibition. The presented dielectric data indicates that AuNPs have well characteristic dispersion in the alpha relaxation region. The presented work aims to characterize and improve the quality control of AuNPs, define the benefit combination effects of size and gamma irradiation on the properties of AuNPs dielectric relaxation spectroscopy.

Effect of incubating egg exposure to magnetic field on the biophysical blood properties of newly-hatched chicks.

Due to widespread of human exposure to electromagnetic fields, there has been increasing public concern about the potential health risks from low-frequency electromagnetic fields; ELF-EMF. The magnetic fields (MFs) affects functions of the living organisms, such as DNA synthesis and ion transportation through the cell membranes. In the present work, the effects of short-term exposure to magnetic fields (MFs) prior to incubation were investigated on the biophysical blood properties of chicks hatched from layer-type breeder eggs. The eggs were exposed to a MF of 0.75 mT at 50 Hz for 20, 40 and 60 min before incubation. This study was performed by measuring the dielectric relaxation of hemoglobin (Hb) molecules and the membrane solubility of red blood cells (RBCs) using the non-ionic detergent octylglucoside. Exposure of the eggs to a MF increased the conductivity of the Hb molecules. The pronounced increase in the conductivity of the exposed eggs might be attributed to an increase in the surface charge of the Hb macromolecules, resulted from the formation of highly active molecular species. This speculation can be supported by the increase in the relaxation time of the exposed groups. The solubilization process of the RBC membrane indicates a loss in the mobility of RBCs in the blood of hatching chicks.

Nanofibers of cellulose acetate containing ZnO nanoparticles/graphene oxide for wound healing applications.

A combination of nanostructured zinc oxide (ZnO) or graphene oxide or both of them with cellulose acetate (CA) enhances a new functionality of nanofibers aiming to improve bio-composite materials for wound healing application. The obtained nanofibers have been investigated using XRD, FTIR, and FESEM. It was observed that the maximum height of the roughness increased from 253 to 651.9 nm for both GO and ZnO/GO in the powdered phase, while it plunged from 613 to 482 nm and developed to 801 nm for ZnO@CA, GO@CA, and ZnO/GO@CA, receptively. Further, the mechanical properties of the obtained scaffolds have been tested and displayed a tremendous variation of tensile strength from 5.44 ± 0.81 to 12.87 ± 0.93 and 8.82 ± 1.2 MPa, while the toughness increased from 23.29 ± 1.4 to 68.95 ± 4.5 and 57.75 ± 3.6 MJ/m3 for ZnO@CA, GO@CA and ZnO/GO@CA, receptively. Moreover, the cell viability was investigated and showed a progression of 97.38 ± 3.9% for ZnO/GO@CA. Furthermore, the adhesion of human fibroblasts cell line towards the obtained nanofibrous scaffolds were examined and displayed that cells were proliferated and spread considerably through the scaffolds, whereas their filopodia have followed the morphology of the fibers.

Fibrous scaffolds of Ag/Fe co-doped hydroxyapatite encapsulated into polycaprolactone: Morphology, mechanical and in vitro cell adhesion.

The development of a scaffold matrix to promote wound healing is a critical requirement to improve the health care system. For this purpose, electrospun scaffolds of polycaprolactone (PCL) have been encapsulated with hydroxyapatite (HAP) doped with different contributions Ag ions. The obtained scaffolds have been investigated by XRD, FTIR and FESEM. It was shown that scaffolds were configured as cross-linked network with diameters around 0.6, 0.9, 2.1, and 2.5 µm for 0.0Ag/Fe-HAP@PCL, 0.4Ag/Fe-HAP@PCL, 0.6Ag/Fe-HAP@PCL, and 0.8Ag/Fe-HAP@PCL, respectively. Additionally, the composition of 0.8Ag/Fe-HAP@PCL exhibited the highest roughness average of 34 nm, while the inorganic root of co-dopant HAP recorded 44.8 nm. The mechanical properties have been investigated and showed that the maximum strain at break was about 129.31 ± 5.4% at no additional Ag ions, and reached its lowest value of 103.02 ± 3.5% at 0.2Ag/Fe-HAP@PCL. On the other hand, cell viability increased from 94.74 ± 4 to 98.9 ± 4% for 0.0Ag/Fe-HAP@PCL and 0.6Ag/Fe-HAP@PCL, respectively. Further, the antibacterial activity was investigated and exhibited that the inhibition zones of E. coli increased from 0.0 at 0.0Ag/Fe-HAP@PCL to 7.5 ± 1.3 mm for 0.8Ag/Fe-HAP@PCL. Moreover, the in vitro cell attachment showed that fibroblast cells proliferated and spread on the fibers' surface and through scaffolds' porosity.

Magnetic field potential effects on the doxorubicin therapeutic activity in Ehrlich tumor growth.

AIM: Therapeutic choices for cancer patients include many combinations of therapeutic protocols. The present study aimed to investigate and discuss the combined effects of magnetic field and chemotherapy treatment on Ehrlich tumor-induced growth in Swiss albino mice. The benefits of both treatments are discussed and interpreted. METHODS: Fifty adult male mice were randomly divided into two groups; ten mice in the first group served as control group and forty in the second group which received a single dose IP injection of tumor fluid (0.02 Ml) to induce tumor. Ten days post injection to allow the tumor to growth, the 40 mice were sub- divided in to 4 sub-groups 10 mice pre each to introduce the treatment. RESULTS: The results indicated tumor growth inhibition regarding mean tumor volume variation (ml) presented. All treatments display tumor growth prevention effect compared to control untreated mice. Treatment with Dox + 7G (MF) exposure exhibited a significant inhibition of tumor growth than that treated alone with DOX or magnetic field; 82% inhibition for DOX + MF 7 G against 60% for 7 G , and 31% for DOX only. Optical density data show a higher values of the molar absorption coefficient ε for all treated groups than untreated one. The fluorescence emission spectra of Hb show an emission peaks λem at 465, 515, and 639 nm. Hematological examination might indicate to discriminative effects to RBCs, WBCs or/and Hb for all treated groups. Moreover, treatment with Dox + 7G MF shows a proper discriminative effects than that treatment with DOX or magnetic field only. Osmotic fragility (OF) test indicates that the combination between drug and magnetic field have nontoxic effect against RBCs membrane. CONCLUSION: Our findings support further exploration of the potential of magnetic fields in cancer therapeutics, either as adjunct or primary therapy. It may be due to enhancing the drug interaction with tumor cells which increase the therapeutic index of DOX and resulted in increased anti-tumor activity against Ehrlich tumor models. These benefits promote the use of the magnetic field in cancer with chemotherapy over the other traditional treatment agents this highly adapted manner can be used in improving the clinical treatment protocol and fights against cancer.

Natural radionuclides in clay deposits: concentration and dose assessment.

Clays are among the most important industrially used minerals. Three potential clay mineral mining sites in Saudi Arabia were chosen, and 21 clay deposit samples were collected. The activity concentrations (average±standard deviation) of the naturally occurring radioactive materials (NORMs), (238)U, (226)Ra, (232)Th, (228)Ra and (40)K, were 49±20, 47±23, 34±11, 40±20 and 751 Bq kg(-1), respectively. The radiation dose assessments (e.g., absorbed dose rate, nGy h(-1); effective dose equivalent, µSv y(-1); and effective dose rate due to dust inhalation, µSv y(-1)) and hazardous indices (e.g., radium equivalent [Ra-eq] value, external hazardous index [Hex], internal hazardous index [Hin] and representative gamma level [Iγ]) were calculated. The wide variations in the activity concentrations of the NORMs according to sampling region could be due to the origin of the geological formation and the geochemical behaviour of the NORMs. Based on calculated hazardous (external and internal) indices, there were no expected radiological hazardous impacts of using clay deposits as building materials.