Different Types Of Patients Research Articles

Prevalence and Antibiotic Susceptibility Pattern of Enterococcus Spp. Isolated from Urine Samples

Enterococci are the most common cause of healthcare-associated urinary tract infections. Enterococcus spp. were isolated from each of Urine and differences for Enterococcus contamination in urine were determined. Because of its unimportant commensals, Enterococci have developed into diverse, deadly diseases due to the routinely prescribed antibiotics for the treatment of nosocomial UTIs are less effective, the developing antibiotic resistance is concerning. This study aimed to determine the prevalence and antibiotic susceptibility patterns of different enterococcal species isolated from urine samples and to observe the prevalence of microbes in urine samples among the different types of patients. The frequency of enterococci isolation from hospitalized patients' urinary tract has risen. This cross-sectional study was conducted from March 2021 to December 2021 at the Department of Microbiology, AMZ Hospital Dhaka, Bangladesh. A total of 439 urine samples were collected and 96 (21.87%) samples showed growth of different isolates, in growth isolates 29 (30.20%) samples were Enterococcus spp. In this study, the sample was sensitive against Linezolid (95.55%), Vancomycin (89.67%), Penicillin (68.98%), Gentamycin (68.96%), Imepenum (55.17%). From our study revealed that different strains of Enterococcus spp. are resistant to drugs at different rates.

Biomechanical validation of novel Nuss procedure simulations for patients with various morphological types of pectus excavatum.

A novel Nuss procedure simulation was developed for patients with pectus excavatum considering the displacement of a metal bar and a chest wall model, including the intercostal muscles. However, this simulation was developed for a typical symmetrical patient among the various morphological types of pectus excavatum. Accordingly, this study aimed to validate and confirm the novel simulation for patients with eccentric and imbalanced types, which are severe types of pectus excavatum, considering factors such as depression depth and eccentricity among others. Three-dimensional models of chest walls and metal bars were created for three different types of patients. The rotation-equilibrium displacement and chest wall with intercostal muscles were set according to the methods and conditions of the novel Nuss procedure simulation. The anterior sternal translation and the Haller index derived from the simulation results were compared and verified using medical data from actual postoperative patients. Additionally, maximum equivalent stresses and strains were derived to confirm the suitability of the novel Nuss procedure for each patient type. The severe types had similar precision to the typical type when compared to the actual postoperative patient. Relatively high maximum equivalent stresses and strains were observed on the metal bars and sternum in the severe type, thereby predicting and confirming the biomechanical characteristics of these types. In conclusion, a novel Nuss procedure simulation for severe types was numerically validated. This underscores the importance of biomechanical evaluation through a novel Nuss procedure simulation when planning actual surgeries for severe types of cases.

High density mapping of atrial tachycardia in patients post cardiac surgery.

Mapping and ablation of atrial tachycardia (AT) in patients who have had prior cardiac surgery can be a challenge for clinical electrophysiologists. High density mapping (HDM) technology has been widely used in these patients because it provides a better characterization of the substrate and the mechanisms with an unprecedented high resolution. In this review, we summarize how the latest HDM technologies can reveal the mechanism of AT in different types of patients post-cardiac surgery and guide a specifically tailored ablation strategy.

Does False Lumen Thrombosis Lead to Better Outcomes in Patients with Aortic Dissection: A Meta-Analysis and Systematic Review.

For a long time, the association of the false lumen status and the outcomes of patients suffering from aortic dissection has been unclear, so this review article aims to study whether the unobstructed of the false lumen is related to the outcome of patients suffering from aortic dissection. We performed this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyzes Protocols (PRISMA) statement 2009 and registered with PROSPERO (CRD42022381869). We searched PubMed, the Cochrane library, Web of Science and Embase to collect potential studies. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. The main outcome is long-term survival. Data included in the study were summarized using the risk ratio or mean difference and 95% confidence interval. There were 16 trials, 2829 patients in total, with a mean age of 62.1 years. Compared with completely thrombosed false lumen, patent group has better long-term survival (risk ratio (RR), 0.88; 95% CI, 0.79 to 0.97; p = 0.01; I2 = 58%) and smaller yearly aortic growth rate (mean difference (MD), 1.03; 95% CI, 0.23 to 1.82; p = 0.01; I2 = 98%). In addition, patients with a patent false lumen had a lower risk of aortic event (RR, 0.81; 95% CI, 0.68 to 0.97; p = 0.02; I2 = 37%), but higher risk of aortic rupture (RR, 7.02; 95% CI, 2.55 to 19.3; p = 0.0002; I2 = 0) and hospital death (RR, 2.72; 95% CI, 1.45 to 5.08; p = 0.002; I2 = 0). Completely thrombosed of the false lumen is more beneficial to the long-term survival of patients with aortic dissection. And the risk of aortic rupture and hospital death in patients with patent false lumen is 7 times and 3 times that of patients with complete thrombosed false lumen. It is expected to provide individualized medical care for different types of patients according to different false lumen status to minimize death and related complications.

Applicability of Patient-Reported Outcome Measures to Aesthetic Medicine Patient Archetypes.

Patient-reported outcome measures (PROMs) are valuable in understanding patient motivations, setting expectations, and ensuring satisfaction. As the aesthetic industry expands globally, factors that motivate the treatment goals of the aesthetic patient reflect evolving social, cultural, and commercial influences. This article will assess the applicability of current PROMs used in aesthetic medicine to an increasingly diverse patient population and consider their ability to measure the underlying motives that drive different types of patients to pursue their specific goals. PubMed database was searched for studies using PROMs to evaluate the motivations and expectations of aesthetic patients. Seven validated aesthetic PROM tools were reviewed against a backdrop of different patient segments as represented by the 4 patient archetypes: Positive Aging, Beautification, Correction, and Transformation. None of the tools could universally represent the individual motivations and expectations of all 4 patient archetypes. There is a need for updated PROMs in aesthetics that are applicable to patients with different motivations or expected outcomes than the traditional rejuvenation patient. PROMs that help decode patient motivations and that are developed with more diverse patient involvement will help aesthetic clinicians better understand the goals and expectations of new patient segments.

Time indicators of pre-hospital emergency missions in Qazvin province in 2021-2022.

Pre-hospital emergency has a crucial role in providing timely care for patients. In this system, seconds and minutes mean the difference between life and death. Considering the importance of the role of pre-hospital emergency in providing services to different patients and the necessity of continuous evaluation of this system, the present study was conducted to investigate time indicators in pre-hospital emergency missions. This cross-sectional study was conducted in 2022 in Qazvin province, Iran. The research population was all the calls made to pre-hospital emergency bases in Qazvin province The required information, including time indicators and demographic characteristics of the patient, was obtained using the electronic registration system (Asayar). Data were Analysis using descriptive statistics and SPSS 20 software. Out of the 35,943 patients admitted to the hospital, 20,915 were male while the remaining were female. The mean age of the patients was 44.09 ± 21.82 years. Accidents (29.41%) were the most common reason for contacting the pre-hospital emergency. In all transfer missions, the mean delay time (0:02:23 ± 0:03:33), response time (0:15:02 ± 0:09:42), the time on the scene (0:18:33 ± 0:11:10), total run time (0:54:02 ± 0:25:20), transport time (0:20:25 ± 0:16:49), round trip time (1:32:43 ± 1:08: 43). The findings of the present study provided valuable information about the variety and number of missions in a pre-hospital emergency. The results showed that some indicators are within the standard range and some indicators are far from other regions of the country and the world. Increasing the number of bases, increasing the number of ambulances, and Implementation of continuous training courses for personnel can improve time indicators and increase the quality of service to different types of patients.

Diagnostic therapeutic assistance pathway (PDTA) of type 2 chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) is a complex and heterogeneous disorder whose etiopathogenetic picture is not yet completely known and is classically divided into CRS with (CRSwNP) and without nasal polyps (CRSsNP). But today the distinction is made with type 2 and nontype 2 variants. A rational and defined pathway for the diagnosis of chronic rhinosinusitis is an indispensable means to be able to arrive at a correct identification of the patient. This typing is essential to be able to arrive at the correct course of treatment, which turns out to be different for different types of patients. For this reason, the realization of a diagnostic therapeutic pathway represents a fundamental way for the otolaryngologist specialist but not only, since today diagnostics has a multidisciplinary framework. In the present work, precise indications have been developed to arrive at a correct diagnosis. The various diagnostic pathways and processes to arrive at a correct therapeutic framing have been highlighted. Therapy ranging from medical therapy to surgical therapy without neglecting the new biological therapies. It does not represent a guideline but a diagnostic method that can be adapted to all the various territorial realities.

Biomechanical Comparison between Rotational Scarf Osteotomy and Translational Scarf Osteotomy: A Finite Element Analysis.

Rotational Scarf osteotomy has its unique advantages in treating hallux valgus, but it also has certain drawbacks. The biomechanical differences between rotational Scarf and translational Scarf osteotomy are not clear evaluates the correction ability and biomechanical difference of two surgical methods for hallux valgus by finite element analysis. The computerized tomography data of a hallux valgus patient were selected to establish a finite element model. The standard Scarf osteotomy was simulated based on the model, and the rotation and translation were performed, respectively. The size of the intermetatarsal angle, contact area, distal metatarsal articular angle and the absolute length of the first metatarsal was compared between the two groups. We completed the cartilage, ligament and other tissues on the bone model to establish a full foot model. We analyzed the troughing, plantar aponeurosis tension, plantar soft tissue, and ground stress and also observed the stability of the fracture site by a three-point bending test. Both surgical methods may effectively correct the intermetatarsal angle. After rotational osteotomy, the contact area increased, and the length of the first metatarsal bone initially increased and then decreased compared to that in the translational group. Furthermore, rotational Scarf significantly increased the distal metatarsal articular angle. Mechanical analysis showed that the cancellous bone in the contact part of the fracture site in the translation group had greater stress, which was the reason for the occurrence of the troughing. Stress distribution of plantar aponeurosis, plantar soft tissue, and the ground showed no significant difference. The three-point bending test showed that the separation of the broken ends of the rotational Scarf osteotomy model (0.133 mm) was slightly smaller than the translational group (0.147 mm). Both surgical methods can successfully correct intermetatarsal angle (IMA). Compared to traditional translational Scarf osteotomy, rotational Scarf osteotomy is more conducive to postoperative stability and healing, but it also has certain drawbacks. In clinical practice, individualized surgical methods still need to be selected for different types of patients with hallux valgus.

Ambulance location routing problem considering all sources of uncertainty: Progressive estimating algorithm

The main concern of any emergency medical services (EMS) in the world is to provide quality services to emergency calls in the shortest possible time. In this paper, the Ambulance Location Routing problem (ALRP) is proposed that is a mathematical attempt to obtain optimal cost-oriented strategic decisions (locating EMS centers and allocating ambulance fleet) in a way that guarantees service quality factors like response time, service level, and definite treatment time through optimal ambulance routing. In response to the concerns that emergency medical services deal with, in this research, a novel mixed-integer two-stage stochastic programming model is developed that can consider the uncertain nature of parameters like emergency calls, travel times, and pathways, simultaneously. Considering a heterogeneous fleet of ambulances to provide specialized out-of-hospital services and to use the treatment golden time, and considering different types of patients in terms of the need to be transferred to the hospital, are among the most vital innovations of the proposed ALRP. To tackle the computational complexity, a new decomposition-based heuristic method called the Progressive Estimating Algorithm (PEA) is developed. PEA is a modified version of the classic PHA and solves its drawbacks, like the possibility of being placed in a loop or prolonging the solution time by changing the method of calculating the first stage variables in each iteration. Therefore, by considering a large number of scenarios, PEA can reach feasible near-optimal solutions more efficiently. We have employed the actual data of a city with nearly 800.000 population, as a case study to validate the proposed ALRP model and the PEA method. The obtained results demonstrate that the proposed ALRP solution is valid, and the PEA can reach the near-optimal solution, in a very reasonable time, and with no exception, outperform the PHA. The results also show that the ALRP model reduces costs on average by 30% compared to a benchmark model. In addition, it is found that the solution obtained for the case study can reduce costs by 58% compared to the current state of the EMS in this city while guaranteeing the quality of services. Furthermore, the need to use a heterogeneous fleet of ambulances and scattered stations in the region is recommended to improve the performance of EM services. Finally, the unique way of looking at the integrated problem of location, allocation, and routing in the proposed ALRP and the idea of PEA are attractive for further studies in the field of EMS planning and other optimization problems, and several suggestions for future studies are mentioned in Conclusion Section.

Impact of Direct Acting Antiviral (DAA) Agents on Hematological and Hepatic Statuses of Patients with Chronic Hemolytic Anemias and Chronically Infected with Hepatitis C Virus (HCV)

Abstract Background Different combinations of Direct Antiviral Agents (DAAs) have been used against different Hepatitis C Virus (HCV) genotypes and in different types of patients. Aim and objectives To investigate the impact of DAA-based regimens on hematological and hepatic statuses of patients with chronic hemolytic anemias and chronically infected with HCV. Subjects and Methods This is a cross sectional study, was carried out at viral hepatitis research and treatment center of Ain Shams University Hospitals, on 50 patients with chronic hemolytic anemias and has HCV infection, from December 2019 till June 2020. Result There was high statistically significant difference before treatment, first month, third month and sixth month follow up in chronic liver disease group as regard HGB, statistically significant in Hemolytic anemia group (no splenectomy) as regard HGB and there was high statistically significant difference between the studied groups as regard HGB. Conclusion DAAs therapy is effective and tolerable in patients with chronic HCV patients. It improves liver necro-inflammatory changes in patients, evidenced by decreased liver enzymes' level, but still require careful observation during DAAs therapy for being more susceptible for hemolytic anemia.

The value of the 12-lead electrocardiogram in the prediction of sudden cardiac death.

Sudden cardiac death (SCD) can be caused by several clinical conditions, overt or misconceived, which recognize different pathophysiologies determining the development of fatal arrhythmic events. In the various forms of structural heart disease such as ischaemic heart disease, cardiomyopathies (e.g. hypertrophic cardiomyopathy, dilated cardiomyopathy, and arrhythmogenic cardiomyopathy), channelopathies (e.g. long-QT syndrome, congenital short QT, Brugada syndrome, early repolarization (ER) syndrome, and idiopathic ventricular fibrillation) but also in the apparently healthy subject, the 12-lead electrocardiogram (ECG) has proved, over the years, to be a reliable and readily available method for stratifying the risk of adverse arrhythmic events and consequently SCD. Several electrocardiographic markers have been shown to be associated with adverse outcomes in different types of patients. Although with different sensitivity and specificity in each clinical condition, depolarization abnormalities, such as QRS fragmentation, Q waves, QRS duration, left posterior fascicular block, low QRS voltage, and left ventricular hypertrophy and similarly repolarization abnormalities as ER pattern, T wave alternans, QT interval, and QT dispersion, have shown significant efficacy in predicting SCD. Despite the advancement of techniques especially in the field of imaging, the correct interpretation of the 12-lead ECG remains, therefore, an effective tool for assessing the possible prognostic outcome in terms of arrhythmic risk and SCD in different types of patients.

Correlation Between Contrast Variability and Refractive Error

Background: Contrast sensitivity, is defined as the ability to detect the lowest lumination difference between an object and the background. It is one of the main requisites for good quality vision as the eye works by perceiving an object by comparing the difference between the target and the background contrast difference. Aims and Objectives: To assess patterns of contrast sensitivity functions in patients in different types of refractive errors using Pelli Robson chart and also to measure the severity of refractive error within each group and compared the contrast sensitivity function with severity in different types of refractive errors. Material and Method: This cross-sectional study was conducted on 500 patients (Age range from 10 to 80 years) who presented with chief complaint of refractive errors mainly myopia and hypermetropia. Patients who had previous history of ocular surgery and other ocular co- morbidity were excluded from study. Selected patients were enrolled for the study after taking a written informed consent. The patterns of contrast sensitivity function in different types of refractive errors were recorded on a prescribed proforma with respect to: Visual acuity, type of refractive error, severity of refractive error, duration of refractive error, age of the patient, fundus examination and Contrast sensitivity. Statistical analysis was undertaken with P<0.05 significant. Results: A mild decrease in contrast sensitivity was recorded in majority of patients i.e 250 patients (50%). Maximum decrease in contrast sensitivity was seen in 31-60 years age group. A statistically significant direct correlation (P<0.05) was observed between duration and variation in contrast sensitivity. Both the refractive error showed definite decrease in contrast sensitivity and compound astigmatism showed severe decrease in contrast sensitivity. Conclusion: Despite having BCVA of 6/6, patients showed reduced contrast sensitivity, even without any retinal pathology, making it an essential part of a routine ophthalmic examination.

Using classification trees to identify psychotherapy patients at risk for poor treatment adherence

Objective To determine the relative importance of a wide variety of personality and psychopathology variables in influencing patients’ adherence to psychotherapy treatment. Method Two classification trees were trained to predict patients’ (1) treatment utilization (i.e., their likelihood of missing a given appointment) and (2) termination status (i.e., their likelihood of dropping out of therapy prematurely). Each tree was then validated in an external dataset to examine performance accuracy. Results Patients’ social detachment was most influential in predicting their treatment utilization, followed by affective instability and activity/energy levels. Patients’ interpersonal warmth was most influential in predicting their termination status, followed by levels of disordered thought and resentment. The overall accuracy rating for the tree for termination status was 71.4%, while the tree for treatment utilization had a 38.7% accuracy rating. Conclusion Classification trees are a practical tool for clinicians to determine patients at risk of premature termination. More research is needed to develop trees that predict treatment utilization with high accuracy across different types of patients and settings.

Analysis of the Waiting Time in Clinic Registration of Patients with Appointments and Random Walk-Ins.

Healthcare institutions generally use an appointment system. However, patients often need to receive medical services unexpectedly. If they visit a clinic without an appointment, they may have to wait for a long time, as their priority is low. In this study, we investigated whether the clinic registration system can be improved by separating the queues and resources for different types of patients. From our simulation results, we found that under a certain setup, the separation policy does not effectively reduce the walk-ins' waiting time, nor improve the service. The study gives valuable managerial insights into the factors affecting patients' waiting times. As the number of random walk-ins is relatively higher, the service times are longer, and the no-show rate of appointments is lower, separation may reduce the waiting time of walk-in patients.

Stroke-related early seizures: clinical and neurophysiological study in a sample of Egyptian population

BackgroundAvailable data collected from patients of different types of acute cerebrovascular strokes can detect risk factors, clinical data (including semiology of seizures), EEG findings and functional outcome of these patients. Stroke, both ischemic and hemorrhagic, has been considered an essential cause of epilepsy, especially in the elderly. Complications of acute stroke during the early days after the insult determine the ultimate outcome of events. The aim of this study is to determine the clinical and neurophysiological characteristics of stroke patients with or without clinical evident fits for early detection and better management.ResultsThe brain imaging of the cases group who developed seizures showed that 50% of the cases have arterial ischemic infarction, 30% venous infarction, 6.67% ischemic infarction with haemorrhagic transformation, 6.67% intracerebral haemorrhage and 6.67% have subarachnoid haemorrhage. Based on the 2017 ILAE criteria, 43.33% of the patients developed focal to bilateral tonic clonic seizures, 33.33% developed focal aware seizures, 16.67% of the patients developed generalized tonic clonic seizures and 6.67% of the patient developed status epilepticus. EEG findings of the group of patients who developed seizures showed, focal slowing in 46.67%, focal epileptiform activity in 13.33%, focal activity with secondary generalization in 10%, PLEDS in 6.67%, generalized epileptiform activity in 6.67%, generalized slowing in 6.67% and normal EEG in 10% of the patients. Non convulsive status was found in 2 patients (6.67%) of the group with altered mental status. There was no PLEDS in EEG of group of patients without clinical seizures. This study did not find age and sex differences in patients with and without seizures. In addition, it was found that there was no statistically significant difference between the three groups as regard history of diabetes mellitus, hypertension, heart diseases, atrial fibrillation, carotid stenosis and collagen diseases. There was no significant relationship between seizures and early treatment with Rtpa and thrombectomy.ConclusionsFocal to bilateral tonic clonic and focal aware seizures were the most prevalent type of early onset seizures after stroke, followed by generalized tonic clonic seizures and status epilepticus. Most EEG findings in this study were focal slowing, focal epileptiform activities, generalized epileptiform activities and PLEDS.

The COVID-19 Impact on Inpatient Hospital Admissions in Indiaa Cross-Sectional Study

Health is a subject of state as per the constitution of India. Hence different states of India have autonomy in deciding and reserving different percentages of beds for the COVID-19 cases as per their needs as well as availability of beds. As an example, Delhi had reserved 50% of ICU (intensive care unit) beds for COVID-19 patients. Due to the novel corona virus disease 2019 (COVID-19), we found that there have been widespread changes in healthcare access by different types of patients suffering from different diseases. Besides fear of COVID-19 Nosocomial infection, this new arrangement and prioritization of the sudden needs of huge number of COVID-19 patients it is anticipated that this situation may have reduced the IPD patients suffering from other diseases. The key researcher has observed significant change in period prevalence of IPD patients during his duties at health centres in the COVID-19 era which tempted him to find out answer to title research question. This study was done to assess that, does the COVID-19 era has affected IPD services utilization by patient (positively or negatively) of other disease on a large countrywide basis? This study will definitely help policy and decision makers to visualize the health services delivery to IPD patients of diseases other than COVID-19. This research study is an attempt to highlight the COVID-19 impacts on IPD patients of other diseases. We have started this novel study with key aim to assess positive or any negative impact of COVID-19 situation on IPD (other than COVID-19) hospital admissions count in India to assess IPD services utilization by them. We included all (public/ private/rural/urban) health facilities across 36 states and union territories of India. The data were obtained from online HMIS (Health Management Information System) of Ministry of Health and Family Welfare, GoI (Government of India). This study was not a sample survey and we included all IPDs (indoor patients) of 36 states and union territories of India. The GoI enforced an obligatory nationwide lockdown from 25th March 2020, ending on 31st May 2020. This study revealed that the mean IPD admission reduced during COVID-19 pandemic period of this study by 2048459 numbers or in percentage it was reduced by 27.55%. This study found that there is a significant reduction in various IPD admissions for medical conditions other than COVID-19, during the COVID-19 period which must be a matter of concern to important stakeholders of the health system, in the light of our knowledge that it is not possible to reduce the burden of disease in India in a small period or overnight. Governments of India should make strategies on priority to trim down burden of morbidity and mortality due to CDs as well as NCDs, in order to reap the benefits of Demographic Dividend. The COVID-19 or any such pandemic and distress management should not be prioritized at the cost of other NCDs and CDs management.

Optimising patient revisit intervals for virtual and office appointments in chronic care

Virtual appointments are cost-effective alternatives to the traditional office appointments where patients receive the required care remotely. Virtual appointments are used to complement or substitute for office appointments due to the limitations on the availability of office appointments. They improve patients' access to care and provide convenient care for the patients. However, it is challenging to integrate these appointments with traditional appointments and to decide the visit frequency of patients for different types of appointments since these appointments have different effectiveness. In this paper, we consider a clinic that provides both virtual and office appointments in a chronic care setting. We develop an open migration network to simulate the patients' flow in the clinic system and build mathematical models to investigate the optimal follow-up rates (i.e., revisit intervals) for both virtual and office appointments. With the model developed, more systematic decisions can be made to determine follow-up rates.

Investigating Laboratory Biochemical Factors in Different Types of Patients With Cardiovascular Diseases

Background: Due to the destructive effect of cardiovascular disease on vital organs, the study of laboratory biochemical factors in the most common heart diseases is essential to accelerate the treatment of cardiovascular patients. Materials and Methods: This study was cross-sectional and analytical. By referring to the hospital information system of educational hospitals of the Abadan University of Medical Sciences, the necessary information of 565 patients with cardiovascular diseases (e.g., demographic information and laboratory diagnostic markers) from March 21, 2019, to March 19, 2020, was extracted through the hospital information system and completed checklist. Data analysis was performed using SPSS software version 22. Results: In this study, fasting blood sugar (FBS), international normalized ratio (INR), erythrocyte sedimentation rate (ESR), Serum glutamate pyruvate transaminase (SGPT), serum glutamate oxalate transaminase (SGOT), creatinine, blood urea nitrogen (BUN), total bilirubin, creatine kinase (CK)- MB, and prothrombin time (PT) were higher than normal in patients with cardiovascular diseases. SGOT was significantly different between age groups (P=0.006), and the highest value was observed in the age group over 75 years. Moreover, FBS was significantly different between the male and female groups (P=0.002). Conclusion: FBS and some diagnostic markers such as renal markers, liver, coagulation, and inflammatory markers are abnormal in patients with cardiovascular diseases.

Pharmacist-led olaparib follow-up service for ambulatory ovarian cancer patients: A prospective study in a tertiary specialized cancer hospital in China.

Purpose: To establish a pharmacist-led olaparib follow-up program for ovarian cancer patients, provide patient education, get information on adverse drug reactions (ADRs), and identify and manage drug-related problems. Methods: Ambulatory adult patients with ovarian cancer receiving olaparib were enrolled. At least one follow-up session was conducted by clinical pharmacists. Pharmacists collected data on the type and grade of ADRs, drug adherence, olaparib dosing, concomitant medications, and pharmacists' suggestions. Results: 83 patients were enrolled with the median age of 58. The average number of the follow-up sessions provided to each patient was 1.31, and the average duration of each follow-up was 17.78min. The olaparib starting dose for most patients (97.59%) was 600mg/d. 36.14% of the patients had missed olaparib doses and 27.71% of the patients had dose adjustments due to ADRs. The most common ADRs (incidence≥10%) were: fatigue (40.96%), anemia (36.14%), leukopenia (36.14%), nausea (28.92%), thrombocytopenia (16.87%), anorexia (16.87%), dyspepsia (15.66%). The tolerability profiles were generally similar between patients treated for "first-line maintenance" and those treated for "recurrence maintenance" (p > .05). There were 42% of the patients who were concomitantly taking medications without exact chemical contents (such as formulated Chinese medicines and Chinese decoctions), and common types of concomitant medications with exact drug names were antihypertensive, anti-hyperglycemic, and anti-hyperlipidemic medications. The pharmacists identified 4 clinically significant drug-drug interactions (DDIs) in two patients. Pharmacists made 196 suggestions mainly related to rational use of the medications and management of ADRs. Conclusion: The study provides the first report about pharmacist-led follow-up service for olaparib. The types of ADRs were similar to those previously observed in clinical trials, and the profiles of ADRs in different types of patients (first-line maintenance vs. recurrence maintenance) were also similar. Pharmacists identified drug-related problems (such as adherence, DDIs and management of ADRs) and offer suggestions for the patients.

Correlation between Extracellular Matrix Metalloproteinase Inducer in Peripheral Blood and Serum MMPs in patients with Acute Coronary Syndrome.

This research aimed to investigate the expression level of Extracellular matrix metalloproteinase inducer (EMMPRIN) in peripheral blood and matrix metalloproteinases (MMPs) in the serum of patients with acute coronary syndrome, and to clarify the relationship between them, so as to analyze the pathogenesis of the coronary syndrome. For this purpose, 232 patients (patient group) with the acute coronary syndrome (ACS) diagnosed in the cardiology department of our hospital from May 2020 to March 2021 were collected, and the coronary angiography results of 76 healthy people (healthy group) were collected at the same time, and the index differences between the two groups were compared. First, compare the EMMPRIN expression level of the two groups of subjects, including EMMPRIN on the surface of platelets and monocytes. Second, analyze the difference in MMPs expression level between the two groups, and compare the difference of EMMPRIN and MMPs expression levels in different types of patients according to the disease type. Finally, correlation analysis was used to evaluate the correlation between EMMPRIN and MMPs expression levels in patients, and the ability of mutual regulation between them was analyzed. Results showed that The expression levels of EMMPRIN and MMPs in patients were significantly different from those in healthy patients (P<0.05), and the expression levels of EMMPRIN and MMPs in different types of patients were significantly different (P<0.05). The distribution of coronary plaque in different types of patients was significantly different, and the expression levels of EMMPRIN and MMPs in patients with a different coronary plaque were significantly different (P<0.05). There was a positive correlation between EMMPRIN on the platelet surface and MMPs expression in serum, and a positive correlation between EMMPRIN on the monocyte surface and MMPs expression in serum. In conclusion, the peripheral blood EMMPRIN and serum MMPs in patients with acute coronary syndrome were significantly higher than those in healthy people, and the expression of EMMPRIN in patients with the acute coronary syndrome was positively correlated with serum MMPs.