ABSTRACT
OBJECTIVE: The evaluation of the prevalence of potential drug-drug interactions and assessment of their clinical relevance in patients' discharge medication in the medical ward of a community teaching hospital. The relevant clinical information was reported to the treating physicians. METHODS: 200 patients at discharge from a medical ward were included. Prescribed drugs were analysed for interactions using commercially available software (Pharmavista). Clinical pharmacists and a physician assessed the clinical relevance of detected interactions, eliminated those which were not considered clinically relevant and formulated recommendations for those considered clinically relevant. A written recommendation was given to the physician to provide rapid feedback before discharge. RESULTS: The median age of the 200 patients studied was 69 years. At discharge, patients took an average of 7 different drugs. 62.5% of patients had at least one potential drug-drug interaction. In total, 373 potential drug-drug interactions were identified: 223 (60%) of minor severity, 143 (38%) of moderate severity and 7 (2%) of major severity. CONCLUSIONS: A computerised drug-drug interaction program (detection) together with clinical pharmacological experience (interpretation/evaluation) can be useful for decreasing the number of potentially harmful drug combinations. This approach may lead to an improvement in the quality of prescription, reducing possible risks and thus contributing to patient safety.
Subject(s)
Drug Interactions , Drug Therapy, Combination/adverse effects , Patient Discharge , Aged , Aged, 80 and over , Community Pharmacy Services , Cross-Sectional Studies , Female , Hospital Records , Hospitals, Teaching , Humans , Male , Medication Errors/prevention & control , Medication Errors/statistics & numerical data , Middle Aged , Prospective Studies , Software , SwitzerlandABSTRACT
AIM: The growth of gliomas depends on the balance of factors stimulating or inhibiting angiogenesis, tumor cell invasion and proliferation. The administration of endogenous inhibitors to experimental human gliomas in animal models resulted in a significant inhibition of tumor growth. It is becoming apparent that resistance can develop over time to many types of endogenous inhibitors and seems to be influenced by the tumor type and system of delivery. METHODS: We recently isolated a potent endogenous inhibitor, called human PEX, from human glioma cells in culture. Human PEX is a potent inhibitor of angiogenesis, tumor and endothelial cell proliferation and migration. In this paper, we investigated the ability of human PEX to sustain inhibition of glioma growth for a prolonged period of time. We initially developed a recombinant form of the inhibitor and showed that this form had similar in vitro and in vivo activities to the natural one. Human PEX was then administered to nude mice intracranial human glioma model, in combination with metronomic chemotherapy, for a period of 185 days, starting 15 days after tumor cells implantation. RESULTS: Our data showed that the systemic administration of human PEX mantained a very prolonged inhibition of glioma growth (50% survival of animals treated with 2 mg/kg/days was 160 days vs 24 days of the control) and had a synergistic effect with low dose chemotherapy. Histological analysis of tumors, showed that treatment with PEX was associated with a decrease of vascularity, cell proliferation, and increase in apoptosis. CONCLUSION: These data indicate that human PEX controls tumor growth by separate mechanisms. In addition, treatment with PEX produced well delineated tumors, indicating the persistence of a direct anti-invasive effect of the molecule even after a prolonged period of treatment.
Subject(s)
Angiogenesis Inhibitors/pharmacology , Endothelial Cells/drug effects , Glioma/drug therapy , Matrix Metalloproteinase 2/pharmacology , Peptide Fragments/pharmacology , Animals , Apoptosis/drug effects , Blotting, Western , Cell Division/drug effects , Disease Models, Animal , Glioma/pathology , Humans , Male , Mice , Mice, Nude , Neoplasm Transplantation , Polymerase Chain Reaction , Recombinant Proteins/pharmacology , Time Factors , Tumor Cells, CulturedABSTRACT
Concentrations of cefaclor (CFC) or amoxicillin-clavulanic acid (AMX/CA) in middle-ear fluid collected preserving the stability and clearing the cell contents has been compared to those obtained using the traditional method. Sixty-seven children with effusive otitis media were treated orally with CFC (20 mg/kg of body weight) or AMX/CA (20 mg/kg) (4:1 ratio). The concentrations in cell-free fluid (C-) appear higher than those in the total fluid (C+) (as assayed traditionally).
