Effectiveness of countermeasure for polypharmacy by multidisciplinary team review in patients with diabetes mellitus.

AIMS/INTRODUCTION: Polypharmacy in diabetes patients is related to worse clinical outcomes. The aim of this study was to evaluate the usefulness of our countermeasure for polypharmacy, which combines a pharmacist check followed by a multidisciplinary team review in diabetic patients with polypharmacy. METHODS: A single-center, retrospective observational study was conducted at Gifu University Hospital. Study participants included diabetic patients taking six or more drugs on admission to the diabetes ward between July 2021 and June 2022. Drugs which were discontinued by the present countermeasure were examined, and the number of drugs being taken by each patient was compared between admission and discharge. RESULTS: 102 of 308 patients were taking six or more drugs on admission. The drugs being taken by these patients were evaluated by pharmacists using a checklist for polypharmacy. Eighty-four drugs which were evaluated as inappropriate or potentially inappropriate medications by pharmacists were discontinued following the multidisciplinary team review. The median and mean number of drugs taken by the 102 patients significantly decreased from 9.0 (IQR: 8-12) and 9.26 ± 2.64 on admission to 9.0 (IQR: 6-10) and 8.42 ± 2.95 on discharge (P = 0.0002). We followed up with these patients after discontinuation of the drugs and confirmed that their clinical status had not deteriorated. CONCLUSION: The present countermeasure for polypharmacy, which combines a pharmacist check based on a checklist for evaluating polypharmacy followed by a multidisciplinary team review, was useful for reducing the number of inappropriate or potentially inappropriate medications taken by diabetes patients with polypharmacy.

Physicochemical properties of wooden breast-extracted myosin and rheological properties of its heat-induced gel.

BACKGROUND: It is reported that broilers with 'wooden breast' have poor processing properties, such as low binding and water-holding capacities. However, the reason for the poor functional characteristics has not been clarified. In this study, myosin was extracted from a wooden breast. Its physicochemical properties were investigated to clarify the relationship between the structure and physicochemical properties of the heating gel of myosin obtained from the wooden breast. RESULTS: The turbidity of myosin solution extracted from wooden breast increased with increase in the heat treatment to a higher value than that from the normal breast meat myosin. The solubility of myosin collected from a wooden breast after heating decreased like normal breast muscle myosin. The surface hydrophobicity of myosin removed from wooden breast increased continually above 60 °C, unlike the change in surface hydrophobicity of normal breast myosin. The free thiol group of myosin extracted from the wooden breast was higher than normal breast myosin before and after heating. The apparent elasticity of heat-induced gels and chicken meat sausages was significantly lower in sausages and gel with wooden breast than normal ones (P < 0.05). The microstructure of the heated gel of normal myosin showed a fine network structure. In contrast, the heat-induced gel of wooden breast-extracted myosin showed a structure with loosely connected aggregates and many gaps. CONCLUSION: The coarseness of the internal gel structure of myosin extracted from wooden breast was shown to affect the apparent elasticity of the gel and sausages made from the chicken meat. © 2023 Society of Chemical Industry.

Immune Response in Chickens Vaccinated with Freeze-Thawed or Warmed Water-in-Oil Vaccine.

This study investigated whether freezing or warming water-in-oil (W/O) vaccines affected the immune responses of chickens. One of the conditions affecting the efficacy of commercially available animal vaccines is the storage temperature range. Previous studies have shown that the properties of some inactivated vaccines change owing to freezing, leading to reduced immune responsiveness after inoculation. In this study, we first determined the freezing temperatures of a commercial W/O vaccine using freezers maintained at -10, -13, -15, and -20°C. The results showed that the W/O vaccine froze from -10 to -12°C. Next, we evaluated the effect on antibody level transitions (sample-to-positive ratio) in 46-day-old broiler chickens vaccinated with the W/O vaccine that was maintained at -20°C, 5°C, and -10°C, in that order. In addition, the effect on antibody value transitions was evaluated in 45-day-old broiler chickens vaccinated with the W/O vaccines that were frozen and thawed between -20°C and 5°C repeatedly or warmed to 45°C. In these experiments, no remarkable effect of the freeze-thawing or warming treatments on antibody value transitions was observed. These results suggested that the efficacy of the W/O vaccine was not significantly affected when placed in a frozen environment or left in a room temperature environment of 42°C or lower for approximately 5 d. These data indicate the possibility of expanding the temperature range for handling W/O vaccines.