ABSTRACT
No disponible
Subject(s)
Aged, 80 and over , Aged , Female , Humans , Male , Drug Prescriptions/statistics & numerical data , Drug Prescriptions/standards , Inappropriate Prescribing/prevention & control , Inappropriate Prescribing/statistics & numerical data , Chronic Disease/drug therapy , Biomedical Enhancement/statistics & numerical data , Medication Errors/prevention & control , Drug Utilization Review/organization & administration , Drug Utilization Review/standardsABSTRACT
No disponible
Subject(s)
Aged, 80 and over , Aged , Female , Humans , Male , Translating , Drug Utilization Review/organization & administration , Drug Utilization Review/standards , Drug Utilization Review , Prescriptions/standards , Drug Utilization Review/ethics , Drug Utilization Review/legislation & jurisprudence , Drug Utilization Review/trends , Inappropriate Prescribing/prevention & control , Inappropriate Prescribing/trendsABSTRACT
An enterovirus 71 (EV71) vaccine for the prevention of hand, foot, and mouth disease (HMFD) is available, but it is not known whether the EV71 vaccine cross-protects against Coxsackievirus (CV) infection. Furthermore, although an inactivated circulating CVA16 Changchun 024 (CC024) strain vaccine candidate is effective in newborn mice, the CC024 strain causes severe lesions in muscle and lung tissues. Therefore, an effective CV vaccine with improved pathogenic safety is needed. The aim of this study was to evaluate the in vivo safety and in vitro replication capability of a noncirculating CVA16 SHZH05 strain. The replication capacity of circulating CVA16 strains CC024, CC045, CC090 and CC163 and the noncirculating SHZH05 strain was evaluated by cytopathic effect in different cell lines. The replication capacity and pathogenicity of the CC024 and SHZH05 strains were also evaluated in a neonatal mouse model. Histopathological and viral load analyses demonstrated that the SHZH05 strain had an in vitro replication capacity comparable to the four CC strains. The CC024, but not the SHZH05 strain, became distributed in a variety of tissues and caused severe lesions and mortality in neonatal mice. The differences in replication capacity and in vivo pathogenicity of the CC024 and SHZH05 strains may result from differences in the nucleotide and amino acid sequences of viral functional polyproteins P1, P2 and P3. Our findings suggest that the noncirculating SHZH05 strain may be a safer CV vaccine candidate than the CC024 strain.
Subject(s)
Humans , Anti-Infective Agents/therapeutic use , Drug Utilization Review , Anti-Infective Agents/adverse effects , Anti-Infective Agents/economics , Cost Control , Drug Costs , Drug Resistance, Microbial , Drug Utilization , Drug Utilization Review/methods , Drug Utilization Review/organization & administration , Drug Utilization Review/standards , Outcome and Process Assessment, Health Care , Patient SafetyABSTRACT
Bovine herpesviruses 1 (BoHV-1) and 5 (BoHV-5) share high genetic and antigenic similarities, but exhibit marked differences in tissue tropism and neurovirulence. The amino-terminal region of glycoprotein C (gC), which is markedly different in each of the viruses, is involved in virus binding to cellular receptors and in interactions with the immune system. This study investigated the genetic and antigenic differences of the 5′ region of the gC (5′ gC) gene (amino-terminal) of South American BoHV-1 (n=19) and BoHV-5 (n=25) isolates. Sequence alignments of 374 nucleotides (104 amino acids) revealed mean similarity levels of 97.3 and 94.2% among BoHV-1 gC (gC1), respectively, 96.8 and 95.6% among BoHV-5 gC (gC5), and 62 and 53.3% between gC1 and gC5. Differences included the absence of 40 amino acid residues (27 encompassing predicted linear epitopes) scattered throughout 5′ gC1 compared to 5′ gC5. Virus neutralizing assays testing BoHV-1 and BoHV-5 antisera against each isolate revealed a high degree of cross-neutralization between the viruses, yet some isolates were neutralized at very low titers by heterologous sera, and a few BoHV-5 isolates reacted weakly with either sera. The virus neutralization differences observed within the same viral species, and more pronounced between BoHV-1 and BoHV-5, likely reflect sequence differences in neutralizing epitopes. These results demonstrate that the 5′ gC region is well conserved within each viral species but is divergent between BoHV-1 and BoHV-5, likely contributing to their biological and antigenic differences.
Subject(s)
Humans , Anti-Infective Agents/therapeutic use , Drug Utilization Review , Organizational Policy , Ambulatory Care/organization & administration , Ambulatory Care/standards , Biomedical Research , Drug Resistance, Microbial , Drug Utilization Review/legislation & jurisprudence , Drug Utilization Review/organization & administration , Drug Utilization Review/standards , Program Evaluation , Societies, Medical , United StatesABSTRACT
This guideline covers safe and effective use of medicines in health and social care for people taking 1 or more medicines. It aims to ensure that medicines provide the greatest possible benefit to people by encouraging medicines reconciliation, medication review, and the use of patient decision aids.
Subject(s)
Drug Utilization Review/standards , Medication Therapy Management/standards , Social Support , Patient SafetyABSTRACT
It is kmown that antimicrobials are often prescribed inappropriately. One method used to deal with problem is to regulate antimicrobial use by monitoring prescriptions. We report a study of physician compliance with the request for antibiotic process which was prepared and reviewed by a special infection control committee in our hospital - the Nosocomial Infection Prevention Service (SCHI). The objective of this study was to identify the profile of inappropriate requests for restricted therapeutic antimicrobials used at Nossa Senhora da Conceiçäo (HNSC), in Porto Alegre, Brazil. All 3,389 requests for therapeutic antimicrobials made between May 20, and October 31, 1996, were assesed ans classified as appropriate and inappropriate. We determined that 17.8 percent of the requests were innapropriate (a total of 720 errors). These were categorized according to 12 reasons for inappropriateness. Of these, the 3 most frequent inappropriate requests were deviation from standard use (26.73 percent), inappropriate length of treatment (23.19 percent), and unfounded justification (13.61 percent). The reasons for inappropriateness were also arranged in three categories considering the following aspects:I.technical (59 percent);II.compability with the institucional program (32.36 percent), and III.administrative (8.61 percent). The 720 requests that were initially rejected were evaluated to see how antibiotic use was affected. In approximately 400 (55 percent), the forms could be appropriately modified after discussion with physician. We conclude from this study that most of the inappropriate requests for antimicrobials in our hospital can be remedied by educating the staff since the errors were largely technical in nature. Thus, the SCIH should focus more on its role as an educational rather than as a regulatory body. By expanding this educational role, we antecipate improved physician compliance with our guidelines, and more appropriate antimicrobial prescribing and and usage.