Therapeutic Group Research Articles

Exploration of the barriers and enablers of benzodiazepines deprescribing in prisons: A qualitative study among health and social care professionals.

The prison environment is a place of high consumption of benzodiazepines (BZDs) due to the anxiety and sleep disturbances, mental disorders, detoxification and trafficking. The study aims to explore experiences of health and social care professionals on the use of BZDs in prisons, as well as the barriers and enablers to their deprescribing. Semistructured individual interviews with professionals working in a prison setting were performed between March and April 2022, based on an interview guide. They were recorded and transcribed using the NVivo software. A qualitative analysis using an inductive approach based on a thematic analysis was performed. Sixteen health professionals were interviewed, including psychiatrists, general practitioners, nurses, pharmacists, psychologists, musicologists and pharmacy technicians. The identified barriers to deprescribing BZDs were problems of coordination between prescribers, lack of time and alternatives. Concerning the enablers, therapeutic education groups, staff's awareness of the irrelevance of some medication and multi-professional advice were identified. This study highlights the similarities in deprescribing difficulties between prison and other settings. Some of the levers identified in our study have shown their effectiveness in different settings. Deprescribing is done most of the time in good conditions but requires an additional delay compared to the outside environment.

Peripheral intravenous catheter-associated phlebitis and drug administration: Retrospective incident analysis

Background: Phlebitis is a complication associated with peripheral intravenous catheters and an adverse event.Objective: To analyze peripheral intravenous catheter-associated phlebitis incidents associated and drug administration to adult inpatients and their consequences. Methodology: Quantitative, retrospective, descriptive, and cross-sectional study. Non-probabilistic convenience sampling technique was used, with 96 adult patients hospitalized in 2019 selected in the area of medicine at a Hospital Center in Lisbon. The type of phlebitis incident was characterized using the Visual Infusion Phlebitis scale adapted and translated to European Portuguese. Patient harm was categorized according to the International Classification for Patient Safety (ICPS). Results: Of the documented phlebitis incidents, 78% obtained a score 2 on the VIP PT-PT scale. According to the ICPS, 87.5% resulted in mild harm and 12.5% in moderate harm. Antibiotics were the most frequent therapeutic group. Conclusion: Phlebitis has an impact on patient safety. The importance of nursing care is reinforced, with a focus on surveillance and early detection of phlebitis to prevent complications.

Post-transplantation Cyclophosphamide-based Graft-versus-host-disease Prophylaxis Compared to Methotrexate-cyclosporine a in Matched-related Allogeneic Hematopoietic Stem Cell Transplantation.

Post-transplant cyclophosphamide (PTCy) has shown promising results with low rates of severe graft-versus-host-disease (GVHD), either alone or combined with conventional immunosuppression (CIS). However, studies comparing PTCy with CIS as a GVHD prophylaxis are scarce. The study aimed to determine the rates of GVHD and survival outcomes for patients undergoing peripheral blood stem cell transplant (PBSCT) from HLA-matched related donors (MRD) receiving PTCy-based GVHD prophylaxis and compare these outcomes with those of patients receiving methotrexate (MTX) and cyclosporine-A (CsA) as a GVHD prophylaxis. Seventy-five patients with advanced hematologic malignancies who underwent MRD allogeneic hematopoietic cell transplantation (allo-HCT) were analyzed prospectively. These patients received PTCy and CSA as a GVHD prophylaxis (therapeutic group) and their outcomes were compared with those of 75 retrospectively collected patients who received methotrexate and CsA as a GVHD prophylaxis (historical group) from the same two transplant centers. The median recipient age was significantly lower in the MTX/CsA group at 28 years compared to 34 years in the PTCy/CSA group. Peripheral blood was the only graft source used. All patients had a complete MRD, with two patients having a one-antigen mismatched related donor within the PTCy/CsA group. The 1-year cumulative incidence (CI) of chronic GVHD was 13.4% with PTCy/CsA and 38.6% with MTX/CsA (P = .001). Acute GVHD CI across all grades did not differ between the groups, with 10.7% for PTCy/CsA and 14.7% for MTX/CsA (P = .46). At two years, the overall survival (OS) (54.4% vs 67.2%, P = 0.282), disease-free survival (DFS) (54.1% vs 66.1%, P = 0.358), relapse rates (27.4% vs 20.1%, P = 0.245), and non-relapse mortality (NRM) (29.3% vs 25%, P = 0.904) did not differ between PTCy/CsA and MTX/CsA, respectively. PTCy-based GVHD prophylaxis in MRD transplant is feasible and leads to lower chronic GVHD rates without causing a significantly different risk of relapse or survival than MTX/CsA. More extensive studies are needed to confirm our results.

HSD20 The Changes of Prescription Patterns after Providing Therapeutic Duplication Dur(DRUG UTILIZATION REVIEW) Information in Outpatient Veterans at Vhs Medical Center

Therapeutic duplication (TD) information is one of the drug utilization review (DUR) system provided by Health Insurance Review and Assessment Service (HIRA). TD provides information about duplicated agents in same therapeutic group used together in one patient over the same period. It cannot expect any additional medical effect and the risk of adverse effects could be increased. We figure out the changes in TD prescribing pattern through DUR in VHS medical center.

Image du corps et estime de soi des patients VIH au Gabon

ObjectiveThe study proposes the analysis of the relationship between body image, self-esteem and body shame (dependent variables) in HIV patients according to their age, gender, level of education, HIV status and year of their HIV screening. We also wanted to see how independent variables (gender and age) affect self-esteem, body image and body shame. MethodsParticipants included 158 HIV patients (men and women) who completed a battery of self-report measures: the Rosenberg Self-Esteem Scale (1965), the Bruchon-Schweitzer Body Image Scale (BIS) (1990), and the body shame subscale from the Shame Experience Scale (ESS) by Andrews et al. (2002). ResultsThe first hypothesis, which tests the link between self-esteem, body image and body shame and the sociodemographic variables (age, gender, level of education, HIV status and year of screening), showed a significant relationship among Gabonese HIV patients. The second hypothesis, which evaluates the influence of age and gender on all our dependent variables (self-esteem, body image and body shame), indicated that women are no more likely to express more body dissatisfaction and shame about their bodies and their level of self-esteem is no lower than that of men. Finally, an intergroup comparison demonstrated that self-esteem is lower among youth in certain age groups. ConclusionThere are significant links between self-esteem, body image and body shame with a lower level of self-esteem in young HIV patients. For clinicians involved in the management of HIV patients, knowledge of the level of self-esteem, body dissatisfaction and body shame would allow for the development of appropriate care and therapeutic intervention goals (therapeutic group, self-efficacy group).

Clinical characteristics, survival outcomes, and prognostic factors in extranodal natural killer/T-cell lymphoma, nasal type: The National Cancer Database study (2004-2019).

7575 Background: Extranodal natural killer/T-cell lymphoma (ENKTL), nasal type, is a rare and aggressive Epstein-Barr virus driven lymphoma, which is most prevalent in East Asia and Latin America. There have been very few large studies outside of Asia. Therapeutic and survival outcomes have not been well characterized in the US. Methods: The National Cancer Database was queried for patients who were diagnosed at aged ≥18 years between 2004 and 2019. Patients who were lost to follow-up were excluded. Kaplan-Meier and multivariate Cox regression analyses were performed. Results: The cohort consists of 2,036 evaluable patients with 68% males, 74% Caucasian, 22% Hispanic Caucasian and 9% African American. The median age at diagnosis was 54 (18-90) years. The median follow up was 71 months (95% CI 66.8-75.7). Early-stage disease (I and II) was reported in 64% while advanced stage disease (III and IV) constituted 36%. Treatment groups include chemotherapy alone (29%), radiation alone (10%), combined modality therapy (CMT-chemoradiation) (42%). The median overall survival (OS) for the whole cohort was 27 months (95% CI 20.6-33.7). Median OS was better in patients with early stage compared to advanced stage disease (90 vs. 6 months, P < 0.001). Among therapeutic groups in early-stage disease, CMT (N = 616) had significantly better median OS than radiation alone (N = 152) or chemotherapy alone (N = 168) (194 vs. 34 vs. 14 months, P < 0.001). No significant difference was seen between radiation alone and chemotherapy alone (P = 0.617). Among patients treated with CMT, chemotherapy-first CMT (N = 134) had better OS than radiation-first CMT (N = 347) (median OS not reached vs. 194 months, P = 0.017). In the advanced stage disease, chemotherapy-treated patients (N = 418) had better median OS compared to patients who did not receive chemotherapy (N = 103) (7.6 vs 1.3 months, P < 0.001). Among patients who received chemotherapy, patients consolidated with SCT (N = 59) had better median OS compared to the patients who received chemotherapy only (N = 353) (63 vs 6 months, P < 0.001) In multivariate analysis, factors associated with worse OS were age (HR 1.021 95% CI 1.015-1.026; P < 0.001) and B-symptoms (HR 1.463 95% CI 1.276-1.678; P < 0.001). Whereas factors associated with better OS were early stage (HR 0.450 95% CI 0.387-0.524, P < 0.001), radiation therapy (HR 0.526 95% CI 0.458-0.603, P < 0.001) and chemotherapy (HR 0.546 95% CI 0.473-0.630, P < 0.001). Conclusions: The study represents one of the largest studies on ENKTL in the US. Early-stage disease is highly curable with CMT with chemotherapy-first sequencing being superior to radiation-first sequencing. Advanced stage disease is associated with extremely poor prognosis overall but is associated with a significant improvement in OS with consolidative SCT with possible role of consolidative RT in advanced stage.

Separation and identification of different therapeutic pharmaceutical drugs on humic acid-based HPLC column: Method optimization using central composite design.

Multimode chromatographic separations are highly desirable in pharmaceutical and environmental sciences. Current study deals with the application of newly developed mixed-mode end capped-immobilized humic acid onto an aminopropyl silica based chromatographic column for separation and identification of six drugs belonging to different therapeutic groups for its applicability in pharmaceutical industries. For this, central composite design was used to evaluate the separation and resolution by optimization of three most effective parameters (acetonitrile%, flow rate, and pH of mobile phase). Second-order quadratic model was used to evaluate their effect on resolution of peaks; the probability value (<0.05) obtained from analysis of variance suggested the best applicability of the model. Desirability function was applied to calculate optimum conditions (44.8% acetonitrile, 1.75mL/min of flow rate, and 7.5pH) required to achieve maximum separation with good resolution within 11 min. The method was validated for linearity, precision accuracy, selectivity, and sensitivity. The results revealed a highly precise (coefficient of variance>1%), linear (R2 =0.99), and highly selective method. Moreover, the limit of detection/quantification values revealed acceptable sensitivity of the method. The developed column was compared for its efficiency with a commercially available column and found to be highly applicable for industrial applications.

A retrospective study of postoperative targeted therapy in ALK-positive lung cancer

In this study, we aim to investigate the therapeutic effect and safety of ALK inhibitor in ALK-positive lung cancer patients. 59 patients with ALK-positive lung cancer from August 2013 to August 2022 were retrospectively recruited. The basic information, pathological type, clinical stage and treatment strategy were collected. These patients were divided into two groups, including 29 patients of conventional adjuvant chemotherapy, and 30 cases of targeted therapy. The patients in the targeted therapy group underwent adjuvant targeted therapy with crizotinib for 2 years. The observation indicators include curative effects and adverse events. The disease-free survival (DFS) and overall survival (OS) were also analyzed. We analyzed the pathological stages after adjuvant chemotherapy and targeted therapy in lung cancer, no significant difference in the p stage N and T was found between the two therapeutic groups. However, the DFS events, DFS median time and OS median time showed significant improvement in the targeted therapy group when compared with adjuvant chemotherapy (all P < 0.05). Besides, the patients under both therapeutic regimens presented some adverse events, among them elevated aspartate transaminase/alanine aminotransferase was the most common adverse event in all the patients, followed by nausea and vomiting. Our study identified that crizotinib-based postoperative targeted therapy helps improve the prognosis of patients with ALK-positive lung cancer, confirming that postoperative targeted therapy can be considered an effective and feasible therapeutic alternative.

The diagnostic and evaluation value of plasma interleukin 9 in the mucosal healing in patients with inflammatory bowel disease treated with biological agents

Objective: To investigate the diagnostic and evaluation value of plasma interleukin 9 (IL9) in the mucosal healing (MH) in patients with inflammatory bowel disease (IBD) treated with biological agents. Methods: Cohort study. IBD patients (137 cases) treated in the Affiliated Suzhou Hospital to Nanjing Medical University (Suzhou Municipal Hospital) from September 2019 to January 2022 were prospective selected. Each patient was treated with biological agents [Infliximab (IFX, 56 cases), Adalimumab (ADA, 20 cases), Ustekinumab (UST, 18 cases), Vedolizumab (VDZ, 43 cases)]. According to different therapeutic drugs, the IFX, ADA, UST, and VDZ group were divided. Clinical symptoms, inflammatory indicators and imaging examinations etc. were evaluated every 8 weeks, and the degree of MH was evaluated by endoscopy at the 54th week. The expression of plasma IL9 was detected by ELISA after initial enrollment (W 0) and 8 weeks of biological treatment (W 8). Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of IL9 for MH. Select the cut off value for the optimal ROC threshold based on the highest value of the Youden index. Spearman's rank correlation was used to analyze the correlation between IL9 and Simple Endoscopic Score for CD (SES-CD) and Mayo Endoscopic Score (MES), so as to evaluate the predictive value of IL9 for MH in IBD patients treated with biologic agents. Results: Among the 137 patients, there were 97 Crohn's disease (CD) patients, 53 males and 44 females, aged (31.6±10.3) years (18-60 years). There were 40 ulcerative colitis (UC) patients, 22 males and 18 females, aged (37.5±14.7) years (18-67 years). Among the CD patients, 42 cases (43.3%) achieved MH on endoscopy at the 54th week, and 60 patients (61.9%) achieved clinical remission. Among the UC patients, 22 cases (55.0%) achieved MH and 30 cases (75.0%) achieved clinical remission. At W 0, the relative expression of IL9 in patients in IBD patients who achieved MH after 54 weeks of biological treatment was lower than that in the non-MH patients [x¯±s, (127.42±34.43) vs (146.82±45.64) ng/L, (113.01±44.88) vs (146.12±48.66) ng/L, respectively, both P<0.05]. At W 8, the relative expression of IL9 in the MH group was lower than that in the non-MH patients (both P<0.05). The relative expression of IL9 in the MH patients after IFX treatment was lower than that in the non-MH group (P<0.05). There was no significant difference among the other groups between MH and non-MH patients (all P>0.05). IL9 at W 8 showed high value in predicting MH in IBD [CD patients: area under curve (AUC)=0.716(95%CI: 0.616-0.817, P<0.001), sensitivity and specificity were 80.77%(95%CI:67.64%-88.45%) and 48.89%(95%CI: 35.53%-64.47%), respectively; UC patients: AUC=0.821, sensitivity and specificity were 77.78% and 72.73%, respectively]. At W 8, the cut off values for CD and UC patients were IL9>80.77 ng/L and IL9>77.78 ng/L, respectively. IL9 was positively correlated with endoscopic MH score parameters [M(Q1,Q3),SES-CD: 3.0(8.5, 18.5); MES: 2.0(1.0, 3.0)] (r=0.55, 0.72, respectively, both P<0.001) at W8. Conclusion: The plasma IL-9 at the week 8 after biological agents treatment can be used to diagnose and evaluate the MH of patients with IBD.

(390) Therapeutic Groups of Men With Penile or Testicular Cancer

Abstract Introduction Testicular cancer (TC) primarily affects men aged 15 to 40 years, and the incidence is around 5/100000. Tumors are usually aggressive and have a great psychological impact on patients. Penile cancer (PC) represents 2 of all types of tumors that affect men in Brazil Most of the affected population are elderly men. Usually, the tumor is identified at an advanced stage, when the only treatment available is total or partial penectomy, causing a great emotional impact. Objective This work aims to evaluate the impact of psychotherapy, in an open group, on Health Related Quality of Life (HRQOL) and Sexuality in patients with TC and PC who have been diagnosed, are undergoing treatment - surgery, radiotherapy, chemotherapy or hormone therapy - or who are being followed up after treatment Methods Data is been collected through an initial interview (Identification, Anamnesis, Health Anamnesis, Degree of Satisfaction with Life and Sexuality, Affective Emotional Assessment and Treatment Data), SF 36 short form and IIEF 5 short form questionnaire, in patients who are diagnosed, who have undergone treatment - surgery, radiotherapy or supervised monitoring - or who are being monitored at the clinic, and reapplication after 12 sessions At each session 5 questions related to the perception of the previous session will be answered. The group will be available for 2 years, once a week, and the patient will attend 12 sessions. The sessions last 90 minutes, conducted by the same psychologist. The research will be developed considering the ethical principles of secrecy, privacy, confidentiality and non identification of the interviewees' data. The study will not pose risks to the subjects and invasive techniques of the body or psychological suffering will not be used Before starting the process, the Informed Consent Form (will be delivered, as well as the provision of all details regarding the research It will also be explained that participation is voluntary and that the participant can leave the research at any time, without prejudice to their treatment and monitoring. Only patients who meet all these criteria will be included, after signing the informed consent. Results Currently, the screening of patients is being carried out to offer the possibility of participating in the open group. The project was on hold due to developments related to the COVID-19 pandemic. Conclusions As the work is at the beginning of development, there are still no preliminary conclusions. Disclosure No

Prescribed Drugs and Self-Directed Violence: A Descriptive Study in the Spanish Pharmacovigilance Database.

Self-inflicted violence is a major and growing public health problem and its prediction and prevention is challenging for healthcare systems worldwide. Our aim was to identify prescribed drugs associated with self-directed violent behaviors in Spain. A descriptive, longitudinal and retrospective study of spontaneous reports of adverse drug reactions corresponding to self-directed violence was recorded in the Spanish Pharmacovigilance Database (FEDRA®) from 1984 to 31 March 2021. A total of 710 cases were reported in the study period. The mean age was 45.52 years (range 1-94). There were no gender differences except in children, where most reports were of male children. The main therapeutic groups that were involved included drugs for the nervous system (64.5%) and anti-infectives for systemic use (13.2%). The most commonly reported drugs were varenicline, fluoxetine, lorazepam, escitalopram, venlafaxine, veralipride, pregabalin, roflumilast and bupropion. There were reports of montelukast, hydroxychloroquine, isotretinoin, methylphenidate, infliximab, natalizumab, ribavirin and efavirenz, which were less known to be involved in self-directed violence. This study shows that self-directed violence is a rare adverse drug reaction, and can be related to the use of some medicines. It is important for healthcare professionals to consider this risk in their clinical praxis, implementing person-centred approaches. Further studies are needed, considering comorbidities and potential interactions.

Caregiver Concerns About Child Development During the COVID-19 Pandemic Among Those With Missed Appointments: Preliminary Results

To examine caregiver's perception of their child falling behind on developmental milestones after canceled or delayed appointments in metropolitan Chicago during stay-at-home orders, from March 21-May 7, 2020. We fielded a web-based caregiver survey to understand the impact of the early weeks of the COVID-19 pandemic on children's health care experiences characterizing proportions of caregiver perceptions of children falling behind in developmental milestones by canceled or delayed appointment types. Multivariable logistic regression was used to estimate the likelihood of falling behind in milestones . Overall, 229 (7.5%) caregivers reported children with canceled or delayed appointments falling behind in developmental milestones. Approximately 25.4% of caregivers reported children falling behind on milestones in the Missed Therapeutic group, compared with the Other Missed group (2.9%) (p<0.001). Children in the Missed Therapeutic group (adjusted odds ratio (aOR) 10.3, 95% confidence interval (CI) 7.60-14.0)) and caregivers who experienced job loss (aOR 1.59, CI 1.11-2.28) or reduced hours or pay (aOR 1.90, CI 1.28-2.82) had higher odds of falling behind on developmental milestones. Implementation of new strategies to address the social needs of families should be develop when disruptions in developmental or therapeutic services among children occurs, particularly among children living in households with job insecurity.

A Risk-Based Approach to Planning the Elaboration of Pharmacopoeial Monographs

Scientific relevance. This article describes a risk-based analysis of the need for elaborating pharmacopoeial requirements for 6 therapeutic groups of medicines, including an evaluation of the range and number of batches of these medicines put into the stream of commerce in the Russian Federation and a comparison of the corresponding product specification files and quality standards. The article presents a set of criteria for planning the elaboration of monographs for the State Pharmacopoeia of the Russian Federation according to a risk-based approach, which is used in a variety of other fields.Aim. The study aimed to develop a comprehensive multivariate risk-based system providing criteria for planning the elaboration of monographs for the State Pharmacopoeia of the Russian Federation.Materials and methods. This study focused on medicines for human use under a range of international non-proprietary names. The authors analysed entries in the Russian State Register of Medicines, data on the number of batches released to the pharmaceutical market, and product specification files and quality standards. The study was conducted using literature search, data analysis, and system-oriented methods.Results. According to the results, a multivariate risk-based analysis is needed for planning the elaboration of monographs for the State Pharmacopoeia of the Russian Federation and the subsequent prioritisation of therapeutic groups or individual medicines for their standardisation.Conclusions. The suggested risk-based system for planning the elaboration of monographs for the State Pharmacopoeia of the Russian Federation includes the following criteria: the social significance of a medicinal product and its value for the health care system; the percentage of medicinal products not tested by the national regulatory authority at the level of active pharmaceutical ingredients; the substantial number of batches and the significant range of medicinal products and the respective active pharmaceutical ingredients by different manufacturers present in the pharmaceutical market; and the analytical procedures and requirements established in product specification files and quality standards.

Prioritization of pharmaceuticals and personal care products in the surface waters of Korea: Application of an optimized risk-based methods

The occurrence of PPCPs in aquatic environments and their potential adverse effects on aquatic organisms have raised worldwide concerns. To address this issue, a study was conducted to analyze 137 selected PPCPs in Korean surface waters, and an optimized risk-based prioritization was performed. The results revealed that 120 PPCPs were detected, with 98 quantified at concentrations ranging from few ng/L to 42,733 ng/L for metformin. The 95% upper confidence limit (UCL95) of the mean value of the measured environmental concentration (MEC) for Metformin was about eight times higher than the second highest compound, dimethyl phthalate, indicating that antidiabetic groups had the highest concentration among the therapeutic groups. An optimized risk-based prioritization was then assessed based on the multiplication of two indicators, the Frequency of Exceedance and the Extent of Exceedance of Predicted No-Effect Concentrations (PNECs), which can be calculated using the traditional risk quotient (RQ) approach. The study found that clotrimazole had the highest risk quotient value of 17.4, indicating a high risk to aquatic organisms, with seven and 13 compounds showing RQ values above 1 and 0.1, respectively. After considering the frequency of exceedance, clotrimazole still had the highest novel risk quotient (RQf) value of 17.4, with 99.6% of its MECs exceeding PNECs. However, the number of compounds with RQf values above 1 decreased from seven to five, with cetirizine and flubendazole being excluded. Furthermore, only 10 compounds exhibited RQf values above 0.1. The study also observed significant differences in the results between risk-based and exposure-based prioritization methods, with only five compounds, cetirizine, olmesartan, climbazole, sulfapyridine, and imidacloprid, identified in both methods. This finding highlights the importance of considering multiple methods for prioritizing chemicals, as different approaches may yield different results.

Pharmaceuticals in Coastal Waters: An UHPLC-TOF-MS Multi-Residue Approach

Anthropogenic chemical contamination represents a key stressor of natural environments with pharmaceuticals comprising a particular group of emerging pollutants with the potential to induce biological responses in non-target organisms. Therefore, an analytical method based on ultra-high-performance liquid chromatography coupled to time-of-flight tandem mass spectrometry (UHPLC-TOF-MS) was developed for estuarine and seawaters, targeting 63 globally used pharmaceuticals (including amoxicillin, ciprofloxacin, sulfamethoxazole, trimethoprim and venlafaxine included in the Surface Water Watch List) from 8 therapeutic groups: antibiotics, analgesic, NSAIDs, antidepressants, β-blockers, lipid regulators, anticonvulsants and antihypertensive drugs. The method presents high selectivity and sensitivity, with the limits of detection ranging from 0.01 to 8.92 ng/L and the limits of quantification from 0.02 to 29.73 ng/L. Considering precision, the highest value was achieved for amoxicillin (20.9%) and the lower for ofloxacin (2.6%), while recoveries ranged from 80.6 to 112.6%. Overall, the quantification method was highly efficient for multi-residues quantification in such complex environmental samples.

Use Pattern of Ophthalmic Antiglaucoma Agents with and without Preservatives: A Cross-Sectional Study.

Different drugs have been approved to reduce the intraocular pressure. However, most of them contain preservatives to maintain sterility and these can be toxic to the ocular surface. The aim was to determine the patterns of use of antiglaucoma agents and ophthalmic preservatives in a group of patients from Colombia. A cross-sectional study that identified ophthalmic antiglaucoma agents from a population database of 9.2 million. Sociodemographic and pharmacological variables were considered. Descriptive and bivariate analyses were performed. A total of 38,262 patients were identified, with a mean age of 69.2 ± 13.3 years, and 58.6% were women. A total of 98.8% were prescribed antiglaucoma drugs in multidose containers. The most widely used were prostaglandin analogs (59.9%), especially latanoprost (51.6%) and β-blockers (59.2%). A total of 54.7% of patients received combined management, especially with fixed-dose combination (FDC) drugs (41.3%). A total of 94.1% used antiglaucoma drugs with preservatives (benzalkonium chloride, 68.4%). The pharmacological treatment of glaucoma was very heterogeneous, but the most commonly used therapeutic groups were in accordance with the recommendations of clinical practice guidelines but with differences by sex and age. Most of the patients were exposed to preservatives, especially benzalkonium chloride, but the wide use of FDC drugs can minimize toxicity on the ocular surface.

Anti-tumor necrosis factor therapy is associated with attenuated humoral response to SARS-COV-2 vaccines in patients with inflammatory bowel disease

BackgroundImmunosuppressive therapy used in the treatment of inflammatory bowel disease (IBD) is known to reduce vaccine immunogenicity. AimsThis study aimed to 1) predict the humoral response elicited by SARS-CoV-2 vaccination in IBD patients based on their ongoing treatment and other relevant patient and vaccine characteristics and 2) assess the humoral response to a booster dose of mRNA vaccine. MethodsWe conducted a prospective study in adult IBD patients. Anti-spike (S) IgG antibodies were measured after initial vaccination and again after one booster dose. A multiple linear regression model was created to predict anti-S antibody titer following initial complete vaccination in different therapeutic groups (no immunosuppression, anti-TNF, immunomodulators and combination therapy). A two-tailed Wilcoxon test for two dependent groups was performed to compare anti-S values before and after the booster dose. ResultsOur study included 198 IBD patients. The multiple linear regression identified anti-TNF and combination therapy (versus no immunosuppression), current smoking, viral vector (versus mRNA) vaccine and interval between vaccination and anti-S measurement as statistically significant predictors of the log anti-S antibody levels (p < 0.001). No statistically significant differences were found between no immunosuppression and immunomodulators (p = 0.349) and between anti-TNF and combination therapy (p = 0.997). Statistically significant differences for anti-S antibody titer before and after the booster dose of mRNA SARS-CoV-2 vaccine were found, both for non-anti-TNF and anti-TNF groups. ConclusionsAnti-TNF treatment (either alone or in combination therapy) is associated with lower anti-S antibody levels. Booster mRNA doses seem to increase anti-S both in non-anti-TNF and anti-TNF treated patients. Special attention should be paid to this group of patients when planning vaccination schemes.

An internet-based photography therapy intervention into the grief of persons who have lost a loved one

ABSTRACT Persons who have lost a loved one by death are increasingly searching for support from online peer groups to process their grief. One approach involves sharing photographs with peers online. The purpose of this study was to assess the impact of a four-week internet-based photography therapy intervention concerning participants’ grief reactions using the Hogan Grief Reaction Checklist (HGRC). Another aim was to assess the role of the moderator and describe development targets in the internet-based photography therapy group based on the participants’ experiences. The participants were individuals who had lost a loved one divided into an intervention group (n = 101) and a comparison group (n = 55). The changes in the dimensions of grief of the intervention group members were slightly greater than in the comparison group. The dimension of panic behaviour declined statistically significantly more in the intervention than in the comparison group during the follow-up period. While the participants from the intervention group valued the expertise of the moderator, the moderator’s role could have been more visible. The participants also wished that the therapeutic photography group would have included more active involvement. Additionally, the participants made suggestions on modifying intervention content and developing a platform better suited for sharing photographs.

Updates in molecular genetics of therapy-related myeloid neoplasms.

Therapy-related myeloid neoplasms (t-MN) are a heterogeneous group of aggressive myeloid neoplasms that arise following exposure to various cytotoxic therapeutic agents and/or ionizing radiation for treatment of prior non-myeloid malignancy or autoimmune disease. Each therapeutic group has been associated with varying latency intervals from the time of therapy exposure to onset of t-MN, as well as certain recurrent genetic alterations. This review will focus on the molecular genetic alterations that have been described in t-MNs, as well as recent updates regarding diagnostic classification.

Artículo traducido] Conciliación de la medicación en el alta desde la unidad de cuidados intensivos a la planta de hospitalización

ObjectivesThe aim of this study was to determine whether the transition of care from the intensive care unit to the ward would pose a high risk for reconciliation errors. The primary outcome of this study was to describe and quantify the discrepancies and reconciliation errors. Secondary outcomes included classification of the reconciliation errors by type of medication error, therapeutic group of the drugs involved and grade of potential severity. MethodsWe conducted a retrospective observational study of reconciliated adult patients discharged from the Intensive Care Unit to the ward. Before a patient was discharged from the intensive care unit, their last intensive care unit’s prescriptions were compared with their proposed medication list in the ward. The discrepancies between these were classified as justified discrepancies or reconciliation errors. Reconciliation errors were classified by type of error, potential severity, and therapeutic group. ResultsWe found that 452 patients were reconciliated. At least one discrepancy was detected in 34.29% (155/452), and 18.14% (82/452) had at least one reconciliation errors. The most found error types were a different dose or administration route (31.79% [48/151]) and omission errors (31.79% [48/151]). High alert medication was involved in 19.20% of reconciliation errors (29/151). ConclusionsOur study shows that intensive care unit to non-intensive care unit transitions are high-risk processes for reconciliation error. They frequently occur and occasionally involve high alert medication, and their severity could require additional monitoring or cause temporary harm. Medication reconciliation can reduce reconciliation errors.