RESUMEN
BACKGROUND: Patients with recurrent epistaxis, particularly due to hereditary hemorrhagic telangiectasia (HHT) are recommended to apply topical tranexamic acid (TXA) to reduce bleeding events. Those patients may suffer ciliary dysfunction due to TXA's effects on ciliary beating frequency (CBF) and their consequences. METHODOLOGY/PRINCIPAL: Human nasal epithelial cells were harvested with a nasal brush in 30 healthy subjects. We investigated the CBF in RPMI medium using high-frequency video microscopy. TXA was added to the cells in various concentrations ranging from 2 to 5%, including the therapeutic concentration (2%) and a control (0%). RESULTS: CBF in the control condition was 6.1 ± 1.6 Hz. TXA reduces CBF in a time and concentration dependent manner, to, e.g. 4.3 ± 1.2 Hz with 2% TXA and 3.3 ± 0.9 Hz with 5% TXA after 16-20 min. The differences in CBF were statistically significant for all concentrations of TXA. CONCLUSIONS: TXA has the potential to significantly impair nasal epithelial function. Therefore, frequent or regular topical nasal application of TXA should be done under close monitoring of nasal function, especially in patients with co-morbidities like chronic rhinosinusitis.
Asunto(s)
Ácido Tranexámico , Cilios , Epistaxis , Células Epiteliales , Humanos , Mucosa Nasal , Ácido Tranexámico/farmacologíaRESUMEN
A scale to measure physicians' attitudes toward clinical pharmacy was developed and validated. Based on physician-clinical pharmacist interactions, statements were written and edited into tentative subscales. A preliminary test resulted in a reduction in the number of items and subscales. The final field test, based on responses from 166 physicians, after factor analysis, yielded 23 items in 5 subscales, with a scale reliability of 0.94. As additional measures of validity, physicians' responses showed significant differences in attitudes between subscales and differences by specialty. Differences also were demonstrated by physician status and age. No differences were shown by amount of exposure to clinical pharmacists. Reliability and validity of the scale have been supported and additional research into the concurrent validity of the scale is suggested.
Asunto(s)
Actitud del Personal de Salud , Farmacéuticos , Servicio de Farmacia en Hospital/normas , Rol del Médico , Rol , Factores de Edad , Humanos , Relaciones InterprofesionalesRESUMEN
Ultrasonic diagnosis of ectopic pregnancy has been thought to depend on exclusion of intrauterine pregnancy on the basis of absence of an intrauterine gestational sac. Two cases illustrating intrauterine echoes suggesting a gestational sac associated with ectopic pregnancy and a plausible explanation for this phenomenon are presented. Because of this and the rare possibility of coexisting intrauterine and extrauterine pregnancies, the ultrasonographer must be wary of dismissing the possibility of an ectopic pregnancy because of an intrauterine gestational sac, whether real or apparent.
