Single pharmacy governed denosumab home administration: optimal adherence by means of a fracture liaison service (FLS) and home care collaboration.

Low adherence for denosumab (Dmab, Prolia®) is of major concern. Dutch pharmacies deliveries were calculated recently being 76.5% for a total of 3 injections. INTRODUCTION: Comparing a model where the prescriber maintains responsibility for adherence (model HC1) (Dmab is purchased and dispensed by patient's own community pharmacy and administered through a home care service (HC)) or an all-in-one model where the pharmacist maintains responsibility for the adherence (Dmab is purchased, dispensed, and administered by a pharmacist's HC) (HC2). METHODS: We counted the number of Dmab injections, follow-up appointments on time, Dmab administrations delayed to a maximum of 60 days, the number of Dmab discontinuations, and all causes legally traceable under EU privacy act (EDPR). RESULTS: Home care started by 2014 (study closure in 2021) and included 711 Dmab injections to 256 unique patients: HC1: 536 and HC2: 175 orders. The whole group received on average 2.8 Dmab injections by consistent intervals of about 182 days. Average administration after the latest Dmab injection: 272.8 days (HC1: 362.0 and HC2: 124.0 days). Administration of a subsequent injection > 60 days occurred in 26.6% (HC1: 38.8% and HC2: 6.2%; OR = 9.49). After adjustment for no more than three Dmab injections administered per patient, it occurred in 27.3% (HC1: 51.8% and HC2 4.4%; OR = 23.34). CONCLUSION: It was possible to achieve 94% adherence for Dmab injections treatment just by transferring the complete supply chain to one pharmacy-initiated home care provider after treatment initiation by either a physician or FLS health care professional.

Listeria meningitis during treatment of a meningococcal meningitis in an immunocompetent infant.

A case report of a listeria meningitis 5 days after diagnosis of meningococcal meningitis in a immunocompetent child of 2 years is presented. The infection occurred during hospital admission. Culture results of cerebrospinal fluid (CSF) were confirmed by a listeria-specific polymerase chain reaction in 2 CSF specimens. The listeria meningitis quickly responded to antimicrobial treatment with intravenous amoxicillin combined with tobramycin.

Cytochemical Localization of K-stimulated Adenosine Triphosphatase Activity in Xylem Parenchyma Cells of Barley Roots.

ATPase activity in xylem parenchyma cells of barley (Hordeum vulgare L.) roots was demonstrated cytochemically with a lead precipitation reaction. The methodical parameters of this cytochemical test were optimized for distinction between ATPase-specific and nonspecific precipitates. Optimum conditions were prefixation in 1% glutaraldehyde for 1 hour and incubation for 2 hours in a medium containing 2 mm each of ATP, Ca(2+), and Pb(2+) at pH 7 and 25 C. Problems of cytochemical localizations are discussed.ATPase activity occurred mainly at the plasmalemma, the endoplasmic reticulum nuclear envelope, and outer mitochondrial membranes of xylem parenchyma cells. The tonoplast of these cells showed only little ATPase activity. High K(+) concentrations stimulated ATPase activity, particularly at the plasmalemma. Diethylstilbestrol prevented the formation of ATPase-specific precipitates. The cytochemical demonstration of a K(+)-stimulated ATPase at the plasmalemma of xylem parenchyma cells is discussed in relation to the possible role of this membrane in ion transport to the vessels.