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In low-and middle-income countries, the burden of disease related to pregnancy and childbirth remains high. The health of the mother is intricately linked to that of the baby. Neonatal mortality is most likely to occur in the first week of life accounting for almost half of all deaths among children under 5-year old. Many babies are stillborn each year. It is important that healthcare is accessible, available, and of good quality. This requires a functioning health system with motivated, competent healthcare providers who were able to provide the continuum of care for mothers and babies. Pre- and in-service training is effective if it uses adult learning approaches, includes all members of the maternity team, and is focused on the core content of the care packages that are agreed for each setting. Most programmes that seek to build the capacity of the health system include training as one of the interventions to be implemented.

Weight loss medications have been shown to be effective for weight loss and reducing disease state risk in patients who are overweight or obese. However, it is unknown what impact pharmacists have on weight loss when providing medication management services.

To evaluate weight loss outcomes and clinic utilization of a pharmacist-run weight loss pharmacotherapy service at the VA Tennessee Valley Healthcare System (TVHS) in Nashville, TN.

Patients enrolled in the MOVE! weight loss program were referred to a clinical pharmacy specialist (CPS) who was able to assess comorbidities, prescribe weight loss medication, and provide ongoing follow-up via telehealth visits.

This is the first description of a pharmacist-run weight loss pharmacotherapy clinic. This model expanded the role of pharmacists at TVHS, where CPS involvement was previously limited to chart reviews when medication recommendations were requested.

This prospective quality improvement project evaluated patients seen by the CPS in the first 6ss services.

Community pharmacies are poised to see more veterinary prescriptions as a result of increased pet ownership especially during the coronavirus disease 19 pandemic. Concern has been raised about the lack of veterinary pharmacy training that community pharmacists receive, but no studies have evaluated the actual prevalence of errors in veterinary prescriptions including the prevalence of prescription writing errors.

This study identifies the prevalence of errors in veterinary prescriptions at independent community pharmacies.

An electronic form was used to ensure required information was pulled from the pharmacy software systems in a consistent manner. Information was pulled from the hard copy image and the prescription label corresponding to that fill. Prescribing trends, such as species and errors, were assessed using descriptive statistics for the overall sample. Error comparisons between written and verbal prescriptions and between weight-based and nonweight-based prescriptions were assessed using chi-acists to be competent in clinically evaluating veterinary prescriptions and training veterinarians on handwriting prescriptions to include both legally and clinically required information needed before dispensing.

"Meds-to-beds" programs are a quality improvement intervention that is gaining wider implementation throughout the United States. The University of Oklahoma hospital system did not have this program and sought to implement one. There are sufficient data on the benefits of meds-to-beds programs, but there is a lack of literature on describing the development and implementation process.

The objective of this article is to describe the planning process, implementation, and barriers encountered during the organization of a pharmacy-led meds-to-beds program operating within 2 large teaching hospitals.

The University of Oklahoma Health Sciences Center campus has 7colleges, multiple primary care and specialty clinics, and 2 hospitals. In addition, there are 3on-campus outpatient pharmacies operated by the University of Oklahoma College of Pharmacy (OUCOP).

The college implemented a meds-to-beds program primarily serving 2 on-campus hospitals, The Oklahoma Children's Hospital and University of Oklahoma Colleg opt-out model to increase program utilization.

The Plan-Do-Study-Act model allowed for many adjustments to be made throughout the process, including the conversion from an opt-in to an opt-out model to increase program utilization.Misuse of prescription opioids contributes to the ongoing crisis of opioid-related overdose and deaths in the United States. The failure of patients and caregivers to safely dispose of unused opioids contributes to the problems. In 2018, Public Law 115-271 provided the U.S. Food and Drug Administration (FDA) authority to mandate a Risk Evaluation and Mitigation Strategy (REMS) for safe disposal packaging or safe disposal solutions for opioid analgesic medications. The FDA has been collaborating with stakeholders to determine whether a new REMS is needed. see more A new or revised opioid REMS could substantially affect opioid packaging, pharmacist roles and services, and dispensing activities such as education, counseling, and product distribution. The pharmacy profession has provided limited input to FDA regarding a potential new or revised opioid REMS. In this commentary, we aim to (1) provide awareness and raise questions on pertinent issues regarding opioid use and safe home disposal, (2) offer considerations for regulators on needed research in the development and assessment of a new REMS, and (3) highlight actions for pharmacist engagement in patient care services to promote safe use and safe home disposal of opioids. Consideration of a potential mandate regarding enhanced safety packaging or safe disposal solutions for opioids presents opportunities to revisit professional roles and engage proactively with the FDA and other stakeholders. We hope this commentary stimulates timely feedback by pharmacy leaders, researchers, and practitioners on whether and how options for safe home disposal of opioids should be included in a REMS in contemplation of potential benefits, unintended consequences, expanded professional roles, timeline, assessment of program effectiveness, and adequate compensation. We support a shared opioid REMS that funds the counseling of patients and caregivers on safe opioid use and safe home opioid disposal options and provides appropriate education and products to facilitate that disposal.

To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both.

Randomized, clinical study.

A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy.

Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg

), anaesthesia was induced with midazolam (0.06 mg kg

IV) and ketamine (2.2 mg kg

IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If PaO

was < 100 mmHg (13.3 kPa), either a CPAP-M (50 cmH

O for 45 seconds) or salbutamol (0.002 mg kg

) was administered. The intervention was considered successful if PaO

reached 100 mmHg (13.3 kPa). If PaO

remained < 100 mmHg (13.3 kPa), treatments were switched. PaO

/FiO

ratio and estimated shunt fraction (F-shunt) were derived from data obtained from arterial blood gas measurements. Dynamic compliance (C

) was calcun anaesthetized horses with PaO2 less then 100 mmHg (13.3 kPa). link2 Whether combining both treatments might be beneficial needs to be confirmed on a larger number of horses.

Intravascular lithotripsy (IVL) is a novel tool for the treatment of calcified vascular stenosis. Recently, IVL has been successfully used for modification of calcified plaque in coronary and lower extremity peripheral arteries with promising results. However, experience in subclavian and innominate peripheral arterial disease is limited. This study aims to report our initial experience of IVL use in calcified subclavian and innominate vasculature.

This was a retrospective review of all the cases of IVL performed in subclavian and innominate arteries at the Miriam Hospital, Providence, between January 2019 and May 2020. Data on the baseline and procedural characteristics were collected. The primary endpoint was procedural success defined as residual stenosis of <20% after stenting. Other endpoints of interest were; 1) procedural complications, including dissections, perforations, abrupt closure, slow or no-reflow, thrombosis, and distal embolization; 2) in-hospital major adverse cardiac events (MACE) df the subclavian and innominate vasculature. Larger studies with an active comparator and longer follow-up are needed to establish the relative efficacy and safety of IVL use in this vascular bed.

The role of cytomegalovirus (CMV) infection for disease reactivation in ulcerative colitis (UC) patients remains controversial and diagnostic tests are yet to be standardized. We aimed to define the clinical relevance of CMV detection by mucosal polymerase chain reaction (PCR) in UC patients by comparing the clinical course of UC in CMV-treated and CMV-untreated groups in tissue CMV-PCR positive cases.

In this retrospective study, 141 patients diagnosed with moderate-to-severe UC admitted to our clinic with disease flare, colonic tissue CMV PCR was assessed.

The median age of the study population was 39years, and 99 (70.2%) patients were male. Eighty-eight (62.4%) patients were CMV-PCR (+) and 53 (37.6%) were CMV PCR (-). The CMV-PCR (+) and CMV PCR (-) groups showed no significant difference concerning age, sex, disease duration, site of involvement and disease activity and administered treatments. The median tissue CMV-PCR was 41,098IU/mL (IQR2,344.25-136,192). Thirty-four of 88 CMV-PCR (+) patients re for only a minority of cases of UC flares and all are steroid-resistant cases. link3 Most of the patients non-responsive to antiviral treatment respond to increased anti-inflammatory treatment. Hesitancy in the decision of escalating immunsuppresive treatment rather than CMV disease may be responsible for worsening disease course and increased colectomy rate in a significant number of the patients who are tissue CMV-PCR (+).CD95/Fas/APO-1 can trigger apoptotic as well as nonapoptotic pathways in immune cells. CD95 signaling in humans can be inhibited by several mechanisms, including mutations in the gene encoding CD95. CD95 mutations lead to autoimmune disorders, such as autoimmune lymphoproliferative syndrome (ALPS). Gaining further insight into the reported mutations of CD95 and resulting alterations of its signaling networks may provide further understanding of their presumed role in certain autoimmune diseases. For illustrative purposes and to better understand the potential outcomes of CD95 mutations, here we assign their positions to the recently determined 3D structures of human CD95. Based on this, we make certain predictions and speculate on the putative role of CD95 mutation defects in CD95-mediated signaling for certain autoimmune diseases.

AUA Urotrauma guidelines for renal injury recommend initial nonoperative management followed by repeat CT imaging for stable patients with deep lacerations or clinical signs of complications. Particularly in pediatric patients where caution is taken to limit radiation exposure, it is not known whether routine repeat imaging affects clinical outcomes.

Our objective was to determine whether routine repeat imaging is associated with urologic intervention or complications in nonoperatively managed pediatric renal trauma.

We retrospectively analyzed 337 pediatric patients with blunt and penetrating renal trauma from a prospectively collected database from 2005 to 2019at a Level I trauma center. Exclusion criteria included age >18 years old, death during admission (N=39), immediate operative intervention (N=28), and low-grade renal injury (AAST grades I-II, N=91). Routine repeat imaging was defined as reimaging in asymptomatic patients within 72h of initial injury. Patients were placed into three imaging groups consisting of (A) those with routine repeat imaging, (B) those reimaged for symptoms, or (C) those not reimaged.