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1.
Drug Saf ; 47(1): 59-70, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37995048

RESUMEN

BACKGROUND AND OBJECTIVE: Prior molecular modelling analysis identified several medicines as potential inhibitors of glutathione peroxidase 1 (GPx1) which may contribute to development or progression of chronic obstructive pulmonary disease (COPD). This study investigates 40 medicines (index medicines) for signals of COPD development or progression in a real-world dataset. METHODS: Sequence symmetry analysis (SSA) was conducted using a 10% extract of Australian Pharmaceutical Benefits Scheme (PBS) claims data between January 2013 and September 2019. Patients must have been initiated on an index medicine and a medicine for COPD development or progression within 12 months of each other. Sequence ratios were calculated as the number of patients who initiated an index medicine followed by a medicine for COPD development or progression divided by the number who initiated the index medicine second. An adjusted sequence ratio (aSR) was calculated which accounted for changes in prescribing trends. Adverse drug event signals (ADEs) were identified where the aSR lower 95% confidence interval (CI) was greater than 1. RESULTS: Twenty-one of 40 (53%) index medicines had at least one ADE signal of COPD development or progression. Signals of COPD development, as identified using initiation of tiotropium, were observed for atenolol (aSR 1.32, 95% CI 1.23-1.42) and naproxen (aSR 1.14, 95% CI 1.06-1.23). Several signals of COPD progression were observed, including initiation of fluticasone propionate/salmeterol following initiation of atenolol (aSR 1.44, 95% CI 1.30-1.60) and initiation of aclidinium/formoterol following initiation of naproxen (aSR 2.21, 95% CI 1.34-3.65). CONCLUSION: ADE signals were generated for several potential GPx1 inhibitors; however, further validation of signals is required in large well-controlled observational studies.


Asunto(s)
Prescripciones de Medicamentos , Inhibidores Enzimáticos , Glutatión Peroxidasa GPX1 , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Glutatión Peroxidasa GPX1/antagonistas & inhibidores , Revisión de Utilización de Seguros/estadística & datos numéricos , Australia , Inhibidores Enzimáticos/efectos adversos , Inhibidores Enzimáticos/uso terapéutico , Prescripciones de Medicamentos/estadística & datos numéricos , Progresión de la Enfermedad
2.
Pharm Res ; 40(6): 1553-1568, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37173537

RESUMEN

BACKGROUND: Chronic Obstructive Pulmonary Disease is characterised by declining lung function and a greater oxidative stress burden due to reduced activity of antioxidant enzymes such as Glutathione Peroxidase 1. OBJECTIVES: The extent to which drugs may contribute to this compromised activity is largely unknown. An integrative drug safety model explores inhibition of Glutathione Peroxidase 1 by drugs and their association with chronic obstructive pulmonary disease adverse drug events. METHODS: In silico molecular modelling approaches were utilised to predict the interactions that drugs have within the active site of Glutathione Peroxidase 1 in both human and bovine models. Similarities of chemical features between approved drugs and the known inhibitor tiopronin were also investigated. Subsequently the Food and Drug Administration Adverse Event System was searched to uncover adverse drug event signals associated with chronic obstructive pulmonary disease. RESULTS: Statistical and molecular modelling analyses confirmed that the use of several registered drugs, including acetylsalicylic acid and atenolol may be associated with inhibition of Glutathione Peroxidase 1 and chronic obstructive pulmonary disease. CONCLUSION: The integration of molecular modelling and pharmacoepidemological data has the potential to advance drug safety science. Ongoing review of medication use and further pharmacoepidemiological and biological analyses are warranted to ensure appropriate use is recommended.


Asunto(s)
Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Enfermedad Pulmonar Obstructiva Crónica , Animales , Bovinos , Humanos , Glutatión Peroxidasa GPX1 , Glutatión , Glutatión Peroxidasa/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico
3.
Ther Drug Monit ; 45(3): 368-375, 2023 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-36194490

RESUMEN

BACKGROUND: Different software applications have been developed to support health care professionals in individualized drug dosing. However, their translation into clinical practice is limited, partly because of poor usability and integration into workflow, which can be attributed to the limited involvement of health care professionals in the development and implementation of drug dosing software. This study applied codesign principles to inform the design of a drug dosing software to address barriers in therapeutic drug monitoring using vancomycin as an example. METHODS: Three workshops (face-to-face and online) were conducted by design researchers with pharmacists and prescribers. User journey storyboards, user personas, and prototyping tools were used to explore existing barriers to practice and opportunities for innovation through drug dosing software design. A prototype of the software interface was developed for further evaluation. RESULTS: Health care professionals (11 hospital pharmacists and 6 prescribers) with ≥2 years of clinical experience were recruited. Confidence and software usability emerged as the main themes. Participants identified a lack of confidence in vancomycin dosing and pharmacokinetic understanding and difficulty in accessing practice guidelines as key barriers that could be addressed through software implementation. Accessibility to information (eg, guidelines and pharmacokinetic resources) and information presentation (eg, graphical) within the dosing software were dependent on the needs and experience of the user. A software prototype with a speedometer-dial visual to convey optimal doses was well received by participants. CONCLUSIONS: The perspectives of health care professionals highlight the need for drug dosing software to be user centered and adaptable to the needs and workflow of end users. Continuous engagement with stakeholders on tool usability, training, and education is needed to promote the implementation in practice.


Asunto(s)
Monitoreo de Drogas , Vancomicina , Humanos , Programas Informáticos , Farmacéuticos
4.
J Clin Pharm Ther ; 46(6): 1687-1694, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34431531

RESUMEN

WHAT IS KNOWN AND OBJECTIVE: Proton pump inhibitors (PPIs), used to treat and prevent gastro-oesophageal conditions, are well-tolerated but have been associated with risk including pneumonia. The extent to which initiation of PPIs can contribute to other respiratory conditions such as chronic obstructive pulmonary disease (COPD) is largely unknown. METHODS: A sequence symmetry analysis (SSA) approach was applied to the Australian Department of Human Services, Pharmaceutical Benefits Scheme 10% extract. Participants were aged 45 years and older and were dispensed PPIs (ATC Codes A02BC01, A02BC02, A02BC03, A02BC04 and A02BC05) and long-acting bronchodilators (LABDs) for COPD (ATC Codes R03BB04 (PBS Item Code 10509D and 08626B), R03BB05, R03BB06, R03BB07 and R03AC18 (PBS Item Code 05137J and 05134F)) between 2013 and 2019. The analysis included patients initiated on an LABD within 12 months before or after their first prescription of a PPI. The crude sequence ratio (cSR) was calculated as the number of patients prescribed their first LABD after starting a PPI divided by the number of patients prescribed their first LABD before starting a PPI. Calculation of the adjusted sequence ratio (aSR) accounted for prescribing trends over time in initiation of each of the medicines. A signal was identified where the aSR lower 95% confidence interval (CI) was greater than one. RESULTS AND DISCUSSION: Initiation of omeprazole was associated with a 29% increased risk of initiating a LABD (ASR = 1.29 95% CI 1.22-1.36). Initiation of esomeprazole, rabeprazole, pantoprazole or lansoprazole was associated with 25%, 15%, 8% and 8% increased risk, respectively. WHAT IS NEW AND CONCLUSION: There is an established association between gastro-oesophageal reflux disease and COPD which has been confirmed by implementation of a sequence symmetry-based approach which demonstrated that PPI initiation is potentially associated with progression or exacerbation of COPD. The impact PPI use has directly on this association requires further investigation.


Asunto(s)
Broncodilatadores/administración & dosificación , Inhibidores de la Bomba de Protones/efectos adversos , Enfermedad Pulmonar Obstructiva Crónica/etiología , Anciano , Broncodilatadores/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de la Bomba de Protones/administración & dosificación , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Enfermedad Pulmonar Obstructiva Crónica/epidemiología
5.
Cancer Discov ; 11(10): 2620-2637, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34078620

RESUMEN

Reduced protein levels of SMARCB1 (also known as BAF47, INI1, SNF5) have long been observed in synovial sarcoma. Here, we show that combined Smarcb1 genetic loss with SS18-SSX expression in mice synergized to produce aggressive tumors with histomorphology, transcriptomes, and genome-wide BAF-family complex distributions distinct from SS18-SSX alone, indicating a defining role for SMARCB1 in synovial sarcoma. Smarcb1 silencing alone in mesenchyme modeled epithelioid sarcomagenesis. In mouse and human synovial sarcoma cells, SMARCB1 was identified within PBAF and canonical BAF (CBAF) complexes, coincorporated with SS18-SSX in the latter. Recombinant expression of CBAF components in human cells reconstituted CBAF subcomplexes that contained equal levels of SMARCB1 regardless of SS18 or SS18-SSX inclusion. In vivo, SS18-SSX expression led to whole-complex CBAF degradation, rendering increases in the relative prevalence of other BAF-family subtypes, PBAF and GBAF complexes, over time. Thus, SS18-SSX alters BAF subtypes levels/balance and genome distribution, driving synovial sarcomagenesis. SIGNIFICANCE: The protein level of BAF component SMARCB1 is reduced in synovial sarcoma but plays a defining role, incorporating into PBAF and SS18-SSX-containing canonical BAF complexes. Reduced levels of SMARCB1 derive from whole-complex degradation of canonical BAF driven by SS18-SSX, with relative increases in the abundance of other BAF-family subtypes.See related commentary by Maxwell and Hargreaves, p. 2375.This article is highlighted in the In This Issue feature, p. 2355.


Asunto(s)
Proteínas de Fusión Oncogénica/genética , Proteína SMARCB1/genética , Sarcoma Sinovial/genética , Animales , Línea Celular Tumoral , Transformación Celular Neoplásica , Modelos Animales de Enfermedad , Femenino , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Transgénicos , Sarcoma Sinovial/patología
6.
J Pharm Pract ; 34(3): 386-396, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33969772

RESUMEN

BACKGROUND: Immune checkpoint inhibitors (ICIs) are an emerging treatment in cancer therapy for prolonging life, minimizing symptoms, and selectively targeting cancer. Program death 1 (PD-1) inhibitors, such as nivolumab, fall within this class, enabling the patient's immune system to detect and destroy cancer. The introduction of ICIs is changing cancer therapy, with new drugs and new toxicities-an evolving area encountered by pharmacists. OBJECTIVE: This study aims to compare the pattern of nivolumab-induced adverse events observed in practice, when compared with clinical trial and literature data. The secondary aim of the study is to identify the presentation and treatment modalities initiated in practice. METHODS: We performed a retrospective case note review across 2 South Australian hospitals to identify the common toxicities and symptomatic treatments experienced by patients receiving nivolumab. Results were compared with clinical trial data from product innovator Bristol-Myer Squib and other published literature. RESULTS: Seventy patients were included in the study; of these, 60 (86%) experienced any grade adverse event(s). A total of 59 (84%) of 70 experienced mild to moderate grade 1 to grade 2 adverse events and 10 (14%) of 70 patients experienced severe grade 3 to grade 4 adverse events, displaying some consistencies with clinical trial and published literature data. Together, the prevalence of adverse events with details on presentation and treatments illustrates possible pharmacy practice strategies and areas for intervention. CONCLUSIONS: The listed prevalence of adverse events and practice strategies identified throughout this study highlights how pharmacists may assist in the identification of predictable ICI toxicities associated with gastrointestinal, endocrine, dermatological toxicities, and fatigue.


Asunto(s)
Neoplasias , Nivolumab , Australia , Humanos , Inmunoterapia/efectos adversos , Neoplasias/tratamiento farmacológico , Nivolumab/efectos adversos , Farmacéuticos , Estudios Retrospectivos
7.
Br J Clin Pharmacol ; 87(11): 4461-4466, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-33852164

RESUMEN

The consumption of caffeine has been linked to osteoporosis, believed to be due to enhanced bone resorption as a result of increased calcium excretion in the urine. However, the amount of calcium in the urine may not necessarily reflect the true effect of caffeine on calcium clearance. This study therefore examined the impact of high-dose, short-term caffeine intake on renal clearance of calcium, sodium and creatinine in healthy adults. In a double-blind clinical study, participants chewed caffeine (n = 12) or placebo (n = 12) gum for 5 minutes at 2-hour intervals over a 6-hour treatment period (800 mg total caffeine). Caffeine increased renal calcium clearance by 77%. Furthermore, the effect was positively correlated with sodium clearance and urine volume, suggesting that caffeine may act through inhibition of sodium reabsorption in the proximal convoluted tubule. This study confirmed that caffeine does increase renal calcium clearance and fosters further investigation into safe consumption of caffeine.


Asunto(s)
Cafeína , Calcio , Adulto , Cafeína/efectos adversos , Creatinina , Humanos , Pruebas de Función Renal , Sodio
8.
Int J Gynecol Pathol ; 40(5): 470-476, 2021 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-33075019

RESUMEN

Extraskeletal myxoid chondrosarcoma of the vulva is a very rare tumor, with less than 10 cases reported in the literature. We report a case of a 45-yr-old woman with extraskeletal myxoid chondrosarcoma of the vulva confirmed by EWSR1 fluorescence in situ hybridization. Given the unusual site and prominent myxoid morphology, a broad differential diagnosis and a variety of ancillary testing was required. This article aims to review extraskeletal myxoid chondrosarcoma of the vulva, the differential diagnosis of a myxoid spindle cell neoplasm of the vulva, and the diagnostic importance of immunohistochemistry and EWSR1 fluorescence in situ hybridization.


Asunto(s)
Condrosarcoma/diagnóstico por imagen , Neoplasias de los Tejidos Conjuntivo y Blando/diagnóstico por imagen , Proteína EWS de Unión a ARN/metabolismo , Neoplasias de la Vulva/diagnóstico por imagen , Condrosarcoma/patología , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Persona de Mediana Edad , Neoplasias de los Tejidos Conjuntivo y Blando/patología , Proteína EWS de Unión a ARN/genética , Vulva/diagnóstico por imagen , Vulva/patología , Neoplasias de la Vulva/patología
9.
CPT Pharmacometrics Syst Pharmacol ; 8(1): 26-33, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30426719

RESUMEN

Palivizumab for respiratory syncytial virus (RSV) immunoprophylaxis in premature infants poses a significant economic challenge. Although standard dosing of palivizumab results in unnecessary drug accumulation without additional clinical benefit, some clinicians have moved outside of evidence-based practice by implementing untested dose modifications, potentially jeopardizing efficacy. Using an industry-developed population pharmacokinetic model, this study evaluated the previously published alternate dosing regimens and developed a revised regimen that minimizes palivizumab dose requirements while maintaining established therapeutic concentrations. All published dose modifications resulted in unacceptably high proportions of infants not attaining minimum protective concentrations, compromising efficacy. Through intelligent dose regimen design, a clinically practical palivizumab regimen was devised that reduces drug use by 25%, while enabling a greater proportion of infants attaining early season target concentrations, particularly those at greatest risk of the consequences of RSV infection. This novel regimen has the potential to substantially change clinical practice and increase drug availability.


Asunto(s)
Antivirales/administración & dosificación , Palivizumab/administración & dosificación , Infecciones por Virus Sincitial Respiratorio/prevención & control , Antivirales/farmacocinética , Cálculo de Dosificación de Drogas , Medicina Basada en la Evidencia , Humanos , Lactante , Recién Nacido , Recien Nacido Prematuro , Modelos Teóricos , Palivizumab/farmacocinética , Infecciones por Virus Sincitial Respiratorio/inmunología
10.
Curr Top Med Chem ; 18(26): 2230-2238, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30569859

RESUMEN

Poor profiles of potential drug candidates, including pharmacokinetic properties, have been acknowledged as a significant hindrance to the development of modern therapeutics. Contemporary drug discovery and development would be incomplete without the aid of molecular modeling (in-silico) techniques, allowing the prediction of pharmacokinetic properties such as clearance, unbound fraction, volume of distribution and bioavailability. As with all models, in-silico approaches are subject to their interpretability, a trait that must be balanced with accuracy when considering the development of new methods. The best models will always require reliable data to inform them, presenting significant challenges, particularly when appropriate in-vitro or in-vivo data may be difficult or time-consuming to obtain. This article seeks to review some of the key in-silico techniques used to predict key pharmacokinetic properties and give commentary on the current and future directions of the field.


Asunto(s)
Ibuprofeno/farmacocinética , Modelos Moleculares , Warfarina/farmacocinética , Administración Oral , Humanos , Ibuprofeno/administración & dosificación , Ibuprofeno/química , Relación Estructura-Actividad Cuantitativa , Albúmina Sérica Humana/química , Albúmina Sérica Humana/efectos de los fármacos , Warfarina/administración & dosificación , Warfarina/química
11.
Ther Adv Drug Saf ; 9(10): 577-584, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30283625

RESUMEN

Dyspnoea, a common and multifactorial symptom in patients with acute coronary syndrome, has been associated with lower quality of life and hospital readmission. Prescriber preference for antiplatelet therapy, the standard of care in this patient group, is shifting to ticagrelor due to mortality benefits demonstrated in trials compared with clopidogrel. In these trials, dyspnoea was more commonly reported in patients prescribed ticagrelor but the aetiology is still debated. An observational cohort study was conducted to quantify the rates and severity of dyspnoea reported in patients with acute coronary syndrome and newly prescribed ticagrelor compared with those prescribed clopidogrel. Dyspnoea was more commonly reported in patients prescribed ticagrelor at each follow up post-discharge (p = 0.016). Rates were higher than previously reported in clinical trials. In some patients, dyspnoea necessitated drug therapy change and was associated with readmission to hospital (p = 0.046). As ticagrelor is widely prescribed as a first-line antiplatelet agent for a range of patients with acute coronary syndrome, the incidence of dyspnoea in a generalized patient cohort may result in higher rates of drug discontinuation. This in turn could lead to higher rates of rehospitalisation and potential treatment failure than that reported from the controlled setting of a clinical trial.

12.
Drug Metab Dispos ; 45(5): 569-575, 2017 05.
Artículo en Inglés | MEDLINE | ID: mdl-28188296

RESUMEN

The aim of this study was to determine the effects of garlic and ginkgo herbal extracts on the pharmacokinetics of the P-glycoprotein (P-gp)/organic anion-transporting polypeptides (Oatps) substrate fexofenadine. Male rats were dosed orally with garlic (120 mg/kg), ginkgo (17 mg/kg), St. John's wort (SJW; 1000 mg/kg; positive control), or Milli-Q water for 14 days. On day 15, rats either were administered fexofenadine (orally or i.v.), had their livers isolated and perfused with fexofenadine, or had their small intestines divided into four segments (SI-SIV) and analyzed for P-gp and Oatp1a5. In vivo, SJW increased the clearance of i.v. administered fexofenadine by 28%. Garlic increased the area under the curve0-∞ and maximum plasma concentration of orally administered fexofenadine by 47% and 85%, respectively. Ginkgo and SJW had no effect on the oral absorption of fexofenadine. In the perfused liver, garlic, ginkgo, and SJW increased the biliary clearance of fexofenadine with respect to perfusate by 71%, 121%, and 234%, respectively. SJW increased the biliary clearance relative to the liver concentration by 64%. The ratio of liver to perfusate concentrations significantly increased in all treated groups. The expression of Oatp1a5 in SI was increased by garlic (88%) and SJW (63%). There were no significant changes in the expression of P-gp. Induction of intestinal Oatp1a5 by garlic may explain the increased absorption of orally administered fexofenadine. Ginkgo had no effect on the expression of intestinal P-gp or Oatp1a5. A dual inductive effect by SJW on opposing intestinal epithelial transport by Oatp1a5 and P-gp remains a possibility.


Asunto(s)
Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/metabolismo , Ajo/química , Ginkgo biloba/química , Hypericum/química , Transportadores de Anión Orgánico Sodio-Independiente/metabolismo , Extractos Vegetales/farmacología , Terfenadina/análogos & derivados , Miembro 1 de la Subfamilia B de Casetes de Unión a ATP/genética , Administración Oral , Animales , Interacciones Farmacológicas , Inyecciones Intravenosas , Mucosa Intestinal/metabolismo , Hígado/metabolismo , Masculino , Transportadores de Anión Orgánico Sodio-Independiente/genética , Perfusión , Extractos Vegetales/aislamiento & purificación , Ratas , Especificidad por Sustrato , Terfenadina/administración & dosificación , Terfenadina/sangre , Terfenadina/farmacocinética , Distribución Tisular
13.
Nanotoxicology ; 11(2): 184-200, 2017 03.
Artículo en Inglés | MEDLINE | ID: mdl-28055265

RESUMEN

Autophagy is the catabolic process involving the sequestration of the cytoplasm within double-membrane vesicles, which fuse with lysosomes to form autolysosomes in which autophagic targets are degraded. Since most endocytic routes of nanomaterial uptake converge upon the lysosome and the possibility that autophagy induction by NMs may be an attempt by the cell to self-preserve following the external challenge, this study investigated the role of autophagy following exposure to a panel of widely used metal-based NMs with high toxicity (Ag and ZnO) or low toxicity (TiO2) in a pulmonary (A549) and hepatic (HepG2) cell line. The in vitro exposure to the Ag and ZnO NMs resulted in the induction of both apoptosis and autophagy pathways in both cell types. However, the progression of autophagy was blocked in the formation of the autolysosome, which coincided with morphologic changes in the actin cytoskeleton. This response was not observed following the exposure to low-toxicity TiO2 NMs. Overall, the results show that high toxicity NMs can cause a dysfunction in the autophagy pathway which is associated with apoptotic cell death.


Asunto(s)
Apoptosis/efectos de los fármacos , Autofagia/efectos de los fármacos , Hígado/efectos de los fármacos , Pulmón/efectos de los fármacos , Nanoestructuras/toxicidad , Células A549 , Técnicas de Cultivo de Célula , Células Hep G2 , Humanos , Hígado/patología , Pulmón/patología , Lisosomas/efectos de los fármacos , Lisosomas/patología , Nanoestructuras/química , Tamaño de la Partícula , Plata/química , Plata/toxicidad , Propiedades de Superficie , Titanio/química , Titanio/toxicidad , Óxido de Zinc/química , Óxido de Zinc/toxicidad
14.
Chemosphere ; 168: 1317-1323, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-27919539

RESUMEN

The present work represents a new approach for the isolation of uniform nano particulate hydroxyapatite (HAp). The chemical characterization of a calcium phosphate product obtained from industrial trout farm aquaculture wastewater by two different routes, washing either with a basic aqueous medium (washNaOH) or followed by a further washing with ethanol (washEtOH), is explored. Characterization of the isolated materials includes morphology studies (SEM and TEM), structural (XRD, electron diffraction), compositional (EDX) and thermogravimetric analysis (TGA). The obtained products are a mixture of different compounds, with hydroxyapatite the predominant phase. The morphology is unusually nanometric size with fusiform shaped particles, such characteristics are ordinarily only obtained by synthetic routes. This process of phosphate precipitation represents a unique self-sufficient process to be compared to conventional chemical or biological practices for precipitating phosphate.


Asunto(s)
Acuicultura , Durapatita/química , Nanoestructuras/química , Aguas Residuales/química , Precipitación Química , Difracción de Rayos X
15.
Nano Lett ; 17(2): 687-694, 2017 02 08.
Artículo en Inglés | MEDLINE | ID: mdl-28001420

RESUMEN

Selecting the electrical properties of nanomaterials is essential if their potential as manufacturable devices is to be reached. Here, we show that the addition or removal of native semiconductor material at the edge of a nanocontact can be used to determine the electrical transport properties of metal-nanowire interfaces. While the transport properties of as-grown Au nanocatalyst contacts to semiconductor nanowires are well-studied, there are few techniques that have been explored to modify the electrical behavior. In this work, we use an iterative analytical process that directly correlates multiprobe transport measurements with subsequent aberration-corrected scanning transmission electron microscopy to study the effects of chemical processes that create structural changes at the contact interface edge. A strong metal-support interaction that encapsulates the Au nanocontacts over time, adding ZnO material to the edge region, gives rise to ohmic transport behavior due to the enhanced quantum-mechanical tunneling path. Removal of the extraneous material at the Au-nanowire interface eliminates the edge-tunneling path, producing a range of transport behavior that is dependent on the final interface quality. These results demonstrate chemically driven processes that can be factored into nanowire-device design to select the final properties.

16.
Clin Pharmacokinet ; 55(10): 1171-1177, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27085335

RESUMEN

Tyrosine kinase inhibitors have been marketed as a fixed dose, 'one size fits all' treatment strategy. Physicians have also been interested in this method of dosing, knowing the complex planning of other current cancer therapies administered on a mg/m(2) or mg/kg basis and subsequent occurrence of dosing error or concern for underdosing. The 'simple and safe' strategy of a single dose of tyrosine kinase inhibitor for cancer has thus been widely adopted. However, the benefits purported to exist in the clinical trials do not appear to be borne out in clinical practice, particularly in solid tumours. In order to investigate whether pharmacokinetic variability is a contributor to the variable outcomes, pharmacokinetic targets to enable individualisation of tyrosine kinase inhibitor administration are now emerging. Evidence suggests there is not a clear relationship of a single dose to maximum plasma concentration (C max), steady-state trough concentration (C trough) or area under the curve (AUC). Furthermore, a significant number of questions remain related to the specific timing and frequency of sample collection required to achieve optimal outcomes. This article reviews the wide variability in the literature on this topic, specifically the different pharmacokinetic targets of the same drug for different cancers, for different states of cancer, and changing pharmacokinetic parameters over a treatment interval in cancer. It appears the optimal sampling times to enable appropriate dose recommendations across patients and diseases may vary, and are not always trough concentrations at steady state. Importantly, the need to be pragmatic in a clinical setting is paramount. Lastly, international collaborations to increase sample size are highly recommended to ensure enough patients are sampled to be sure of a clinical benefit from this concentration-directed methodology.


Asunto(s)
Ensayos Clínicos como Asunto/métodos , Monitoreo de Drogas/métodos , Neoplasias/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/farmacocinética , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Área Bajo la Curva , Relación Dosis-Respuesta a Droga , Humanos , Proyectos de Investigación
17.
Int Psychogeriatr ; 28(6): 977-82, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-26775538

RESUMEN

BACKGROUND: Antipsychotic agents have limited efficacy for Behavioral and Psychological Symptoms of Dementia (BPSD) and there are concerns about their safety. Despite this, they are frequently used for the management of BPSD. This study aimed to assess the use of antipsychotics among people on anti-dementia medicines in Australian residential aged care facilities. METHODS: Data were obtained from an individual patient unit dose packaging database covering 40 residential aged care facilities in New South Wales, Australia. Residents supplied an anti-dementia medicine between July 2008 and June 2013 were included. Prevalence of concurrent antipsychotic use was established. Incident antipsychotic users between January 2009 and December 2011 were identified. We examined initial antipsychotic dose, maximum titrated doses, type and duration of antipsychotic use, and compared use with Australian guidelines. RESULTS: There were 291 residents treated with anti-dementia medicines, 129 (44%) of whom received antipsychotics concomitantly with an anti-dementia medicine. Among the 59 incident antipsychotic users, risperidone (73%) was the most commonly used antipsychotic agent. Amongst the risperidone initiators, 43% of patients had initial doses greater than 0.5 mg/day and 6% of patients exceeded 2.0 mg/day for their maximum dose. 53% of concomitant users received daily treatment for greater than six months. CONCLUSIONS: Our study using records of individual patient unit dose supply, which represents the intended medication consumption schedule, shows high rates of concurrent use of antipsychotics and anti-dementia medicines and long durations of use. The use of antipsychotics in patients with dementia needs to be carefully monitored to improve patient outcomes.


Asunto(s)
Antipsicóticos/uso terapéutico , Demencia/tratamiento farmacológico , Risperidona/uso terapéutico , Anciano , Instituciones de Vida Asistida , Australia/epidemiología , Estudios Transversales , Demencia/complicaciones , Demencia/epidemiología , Esquema de Medicación , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Prevalencia , Instituciones Residenciales , Estudios Retrospectivos
18.
Pharmacol Biochem Behav ; 138: 9-13, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26363312

RESUMEN

There is a complex relationship between drug dependence and stress, with alcohol and other drugs of abuse both relieving stress and potentially inducing physiological stress responses in the user. Opioid drugs have been shown to modulate hypothalamic-pituitary-adrenal (HPA) activity in animal models and individual response to this modulation may play a role in continuation of drug use. Healthy young Caucasian adults were administered a single dose of immediate release oxycodone (20mg, n=30) or assigned to a control group (n=19) that was not administered the drug. At 0, 1, 2, 4 and 6h post-administration, blood and saliva samples were collected along with assessment of pupil diameter. The HPA response was determined by measurement of salivary cortisol through a commercially available enzyme-linked immunosorbent assay (ELISA). The results were compared to genotype at the -511 and -31 positions in the interleukin1B (IL1B) gene. No difference in cortisol production was initially observed between the two groups, however, when participants were separated based on their genotype for two single nucleotide polymorphisms in the promoter of the IL1B gene, which have been shown to occur at a higher frequency in opioid-dependent populations, individuals carrying the -511T and -31 C alleles (-511 C/T, -31 C/T or -511 T/T, -31 C/C) had a significantly (p<0.05) higher cortisol levels compared to individuals homozygous for the -511 C and -31T alleles. These results suggest that individuals carrying the -511T and -31 C alleles experience HPA activation in response to opioid administration and therefore may be less likely to undertake subsequent self-administration.


Asunto(s)
Analgésicos Opioides/farmacología , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Interleucina-1beta/genética , Oxicodona/farmacología , Sistema Hipófiso-Suprarrenal/efectos de los fármacos , Alelos , Femenino , Variación Genética , Genotipo , Humanos , Hidrocortisona/metabolismo , Masculino , Trastornos Relacionados con Opioides/genética , Polimorfismo de Nucleótido Simple/genética , Pupila/efectos de los fármacos , Adulto Joven
19.
Data Brief ; 4: 34-9, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26217758

RESUMEN

Legislation arising from health and environmental concerns has intensified research into finding suitable alternatives to lead-based piezoceramics. Recently, solid solutions based on sodium potassium niobate (K,Na)NbO3 (KNN) have become one of the globally-important lead-free counterparts, due to their favourable dielectric and piezoelectric properties. This data article provides information on the ferroelectric properties and core-shell grain structures for the system, (1-y)[(1-x)Na0.5K0.5NbO3 - xLiTaO3] - yBiScO3 (x=0-0.1, y=0.02, abbreviated as KNN-xLT-2BS). We show elemental analysis with aid of TEM spot-EDX to identify three-type grain-types in the KNN-LT-BS ternary system. Melting behaviour has been assessed using a tube furnace with build-in camera. Details for the ferroelectric properties and core-shell chemical segregation are illustrated.

20.
Nano Lett ; 15(7): 4248-54, 2015 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-26042356

RESUMEN

The ability to control the properties of electrical contacts to nanostructures is essential to realize operational nanodevices. Here, we show that the electrical behavior of the nanocontacts between free-standing ZnO nanowires and the catalytic Au particle used for their growth can switch from Schottky to Ohmic depending on the size of the Au particles in relation to the cross-sectional width of the ZnO nanowires. We observe a distinct Schottky to Ohmic transition in transport behavior at an Au to nanowire diameter ratio of 0.6. The current-voltage electrical measurements performed with a multiprobe instrument are explained using 3-D self-consistent electrostatic and transport simulations revealing that tunneling at the contact edge is the dominant carrier transport mechanism for these nanoscale contacts. The results are applicable to other nanowire materials such as Si, GaAs, and InAs when the effects of surface charge and contact size are considered.

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