Cortezclements1517
There is no formal assessment to determine level of disability in the millions of patients with alcohol-induced impairment who present to emergency departments annually. Hack's Impairment Index (HII) is a standardized, serializable clinical tool designed to quantify ability. Nursing staff members at this center perform the HII and determine a score using paper prompts.
We developed an HII electronic application and investigated whether or not an electronic version on a mobile device would affect nursing performance.
A chart review-based quality improvement project compared the number, repetitions, and completeness of HII score documentation performed by nurses over 6.5 months. Group 1 paper-based HII scores for the 90-day period before intervention; group 2 iPad-based HII scores for the 90 days after intervention. There was a 2-week period for staff training and electronic version feedback between groups. Informal, ad hoc interviews were performed with nurses at investigation termination.
Group 1 476 cumentation with electronic format documentation. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
Although our study took place at 1 center, was a chart review, and not directly observed, we found that the mobile device-based HII application to determine a score did not interfere with nursing performance. Specifically, the repetition and completeness of nursing assessments of emergency department patients with impairment from alcohol use was not altered when comparing paper chart documentation with electronic format documentation. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).Background Atypical antipsychotics (AAPs) with mood stabilizers are recommended as a first-line treatment for patients with bipolar disorder. No studies have compared the inpatient health care resource utilization for patients with bipolar disorder treated with lurasidone as adjunctive therapy with mood stabilizers compared with other oral AAPs. Objective To compare the risk of hospitalization for adult Medicaid beneficiaries with bipolar I disorder when treated with lurasidone compared with other oral AAPs as adjunctive therapy with mood stabilizers. Methods This retrospective cohort study used the MarketScan Research Databases Multi-State Medicaid Database (IBM, Armonk, NY) claims data to assess patients with bipolar I disorder between January 1, 2014, and June 30, 2019. Adult patients who initiated oral AAP treatment with mood stabilizers (index date) and who were continuously enrolled 12 months before (pre-index) and 24 months after (post-index) the index date were included. Treatment categories assigned psychiatric aOR = 1.28, 95% CI, 1.02-1.59), and ziprasidone (all-causes aOR = 1.68, 95% CI, 1.05-2.66; psychiatric aOR = 1.55, 95% CI, 1.02-2.35) compared with lurasidone with mood stabilizers. The adjusted odds of all-cause and psychiatric hospitalizations were numerically lower for lurasidone compared with aripiprazole. The all-cause hospital length of stay per 100 patient-months was significantly higher for olanzapine (20.3 days) and quetiapine (16.0 days) compared with lurasidone (12.2 days, both P values less then 0.05). Conclusions In a Medicaid population, adults with bipolar I disorder treated with lurasidone as adjunctive therapy with mood stabilizers had significantly lower all-cause and psychiatric hospitalization rates compared with olanzapine, quetiapine, and ziprasidone. Fewer hospitalizations may reduce the economic burden associated with bipolar disorder. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
Clinical pharmacologists play an important role and have professional value in the field, especially regarding their role within precision medicine (PM) and personalized therapies.
In this work, we sought to stimulate debate on the role of clinical pharmacologists.
A literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, through electronic consultation of 2 databases, PubMed/Medline and Embase, and Google Scholar with manual research taking into account the peer-reviewed literature such as observational studies, reviews, original research articles, comments, mini-reviews, and opinion papers published in English between 2010 and February 2020. Titles and abstracts were screened by 1 author, and studies identified for full-text analysis and selected according to inclusion criteria were agreed on by 2 reviewers.
We identified a total of 535 peer-reviewed articles and the number of full texts eligible for the project was 43. Several papable of bringing together different multidisciplinary skills among health professionals will have to be implemented. Clinical pharmacologists could be the main drivers of this strategy because they already, with their multidisciplinary training, operate in a series of services in high-level hospitals, facilitating the clinical governance of the most challenging patients. The implementation of these strategies will lastly allow national health organizations to adequately address the management and therapeutic challenges related to the advent of new drugs and cell and gene therapies by facilitating the removal of economic and organizational barriers to ensure equitable access to PM. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
Subanesthetic ketamine has been used for treatment-resistant depression and is popular as an opioid-sparing agent.
The present study aimed to investigate the dose-dependent antinociceptive effect of intranasal ketamine (INK) along with behavioral and neurophysiological safety in mice.
Antinociceptive efficacy was evaluated in the terms of thermal nociceptive response and formalin test. The safety studies were carried out separately in healthy mice using telemetry-based cortical electroencephalography, hemodynamic changes, and spontaneous behavioral functions, including anxiety, stereotypic movement, and locomotor functions.
INK administration significantly augmented the thermal nociceptive threshold and alleviated the pain response in the tonic phase of the formalin test. The results showed the dose-independent effectiveness of ketamine for thermal nociceptive responses because there were no significant differences among different INK dose groups. Behavioral safety analysis using the open field explorxp. 2021; 82XXX-XXX)© 2021 Elsevier HS Journals, Inc.
Pain is an unpleasant emotional and sensory experience that is associated with actual or potential tissue damage. Providing comfort and relief of pain of clients are the fundamental role of nurses in nursing practices. learn more However, inadequate knowledge of appropriate pain management has been reported to be a major obstacle to implementing effective pain management by nurses.
The objective of this study was to assess knowledge of pain management techniques in nurses working in referral hospitals in northwest Ethiopia.
An institution-based, cross-sectional, interviewer-administered questionnaire study of the pain treatment knowledge of 411 nurses was conducted in 2018 in Northwest Referral Hospitals in Ethiopia. The sample size was allocated to each selected referral hospital. A systematic sampling technique was used to select study participants. The descriptive data were presented in frequency tables. Binary and multivariable logistic regression analyses were undertaken to identify associated factors to paine of pain management techniques were inadequate. Lack of pain training in their institution, lack of pain education in their academic curriculum, and professional rank were predictors of these nurses' pain management knowledge. Providing pain management training and employing higher service rank nurses are likely to result in increased nurses' knowledge of proper pain management techniques. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX)© 2021 Elsevier HS Journals, Inc.
There are differences of opinion about both the most effective combined therapeutic strategy and the clinical benefit of inhaled corticosteroids in nonasthmatic patients with chronic obstructive pulmonary disease. Furthermore, many inflammatory cytokines are reportedly correlated with severity of the disease.
To compare the effectiveness of long acting β-agonist + long-acting muscarinic antagonist (LABA + LAMA) versus LABA + inhaled corticosteroid and LAMA + inhaled corticosteroid in nonasthmatic patients with moderate-to-severe chronic obstructive pulmonary disease. To assess the changes that occurred in plasma concentrations of tumor necrosis factor α, fibrinogen, and interleukin 6, and correlate these with disease activity.
In this pilot study, 45 nonasthmatic patients with moderate to severe chronic obstructive pulmonary disease were randomized into 3 groups with 15 patients in each group. Group I (LABA + inhaled corticosteroid) received formoterol/budesonide, group II (LAMA + inhaled corticosteroidally similar after 4 and 12 weeks (4 weeks after treatment
= 0.358,
= 0.284,
= 0.155, and
= 0.155, respectively, and 12 weeks after treatment
= 0.710,
= 0.773,
= 0.240, and
= 0.076, respectively).
In nonasthmatic patients with moderate to severe chronic obstructive pulmonary disease, the 3 therapeutic combinations showed similar effectiveness. The results of this pilot study also suggest that inflammatory markers can be used to track disease activity. Clinicaltrials.gov identifier NCT04520230. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
In nonasthmatic patients with moderate to severe chronic obstructive pulmonary disease, the 3 therapeutic combinations showed similar effectiveness. The results of this pilot study also suggest that inflammatory markers can be used to track disease activity. Clinicaltrials.gov identifier NCT04520230. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
Isocorydine (ICD) has anticancer effects; however, its suboptimal bioactivity has driven the production of ICD derivatives, including 8-amino-isocorydine (8-NICD).
This study explored the antitumor effects of 8-NICD on a variety of tumor cell lines to detect tumors sensitive to 8-NICD and investigated the mechanisms by which it suppresses tumor cell growth.
Human gastric carcinoma (GC) cells (MGC-803) were used to evaluate the effects of 8-NICD on cell proliferation and apoptosis. The in vivo action of 8-NICD in a nude mouse xenograft model was also investigated. The antioxidant activity of 8-NICD was evaluated using a 1,1-diphenyl-2-picrylhydrazyl radical scavenging assay.
8-NICD exerted significant antitumor activity against several tumor cell lines with IC
between 8.0 and 142.8 µM and was not toxic to healthy fibroblasts and epithelial cells at concentrations up to 100 µM. Moreover, 8-NICD strongly inhibited the proliferation of MGC803 cells without causing toxicity to human umbilical vein endothlarly high sensitivity of MGC803 cells suggest that the potential of 8-NICD to treat GC should be further explored. (Curr Ther Res Clin Exp. 2021; 82XXX-XXX).
Aerosolized drug therapy administered to mechanically ventilated patients is a standard part of pulmonary critical care medicine. Aerosol particle size and distribution are important factors in the optimal delivery of aerosolized drugs to ventilated patients.
The objective of this study was to characterize aerosol droplet size and distribution with laser diffraction for nebulized 3% sodium chloride, albuterol, and epoprostenol sodium (containing glycine) delivered via Aeroneb Solo Mesh Nebulizers (Aerogen, Mountain View, California).
A series of functional flow tests were run on each of 8 Solo mesh nebulizers before the study to verify accuracy of flow rates in milliliters per minute. Aerosolized droplets exiting the nebulizer heads were then measured using a phase Doppler particle analyzer. Data collected during delivery of 3% sodium chloride, albuterol, and epoprostenol sodium included aerosol droplet size distribution, mass median aerodynamic diameter (MMAD), and geometric standard deviation. For each Solo nebulizer, droplet size measurements were taken 2 cm away from the nebulizer head and 2 cm away from the wye of a heated, humidified adult ventilator circuit.
