Notes

Resveratrol supplement and its particular kind pterostilbene attenuate oxidative stress-induced colon injury by increasing mitochondrial redox homeostasis and function through SIRT1 signaling.
rather than IV formulations for hospitalized patients.
Past research on disciplinary action by pharmacist regulatory bodies has shown that most cases concern community pharmacists, with few occurring in a hospital setting.

To investigate how discipline-related issues involving pharmacists are dealt with by hospital pharmacy departments in Canada.

Hospital pharmacy directors and managers from small, medium, and large hospitals across Canada were invited to participate in semi-structured telephone interviews. The interview questions focused on the discipline process in participants' organizations, the situations when reporting to the regulatory body is deemed to be warranted, possible penalties, and recommendations for improving the regulatory body or organizational discipline process.

Ten participants, from British Columbia, Saskatchewan, Ontario, New Brunswick, Prince Edward Island, and Newfoundland and Labrador, agreed to be interviewed. Five key themes emerged as contributing to lower rates of hospital pharmacist discipline cases being escalated to the lator and a lack of transparency, given that many cases are handled internally within hospitals. Environmental supports for competence and employee protections (e.g., through a union) may also reduce discipline cases.
Drug-drug interactions (DDIs) can cause adverse drug events, leading to hospitalizations and an increase in the risk of morbidity and mortality. Until now, patients' perceptions of DDIs have represented an understudied area of research.

To explore patients' perceptions of DDIs and identify factors important to patients' understanding of their medications.

Participants were recruited from 2 ambulatory clinics (heart function and transplant) in Vancouver, British Columbia. Participants engaged in key informant interviews and were asked to provide their demographic information, rate their understanding of their own medications, and define a DDI. Afterward, participants were interviewed to gather their perceptions of DDIs and factors important to their understanding of their medications.

A total of 7 patients were recruited. Participants struggled to define a DDI and were unsure if they had ever experienced a DDI. There was a reliance on health care professionals to help manage DDIs. Participants did not not identify barriers to accessing medication information, their pervasive use of the internet suggests that there are unidentified barriers preventing patients from speaking directly to their health care professionals regarding their medication therapy.
The most recent vancomycin monitoring guideline recommends targeting a value for area under the curve (AUC) of 400 to 600 mg*h/L, with an assumed minimum inhibitory concentration (MIC) of 1 mg/L. Few studies have investigated the effect of this method on vancomycin dosing regimens, relative to a target trough concentration of 15 to 20 mg/L.

To compare vancomycin dosing regimens generated with the 2 monitoring methods.

This retrospective chart review included hospitalized patients who received vancomycin between May 2019 and April 2020. The dosing regimens were compared, with the paired Student
test, in terms of unit dose, daily dose, and dosing interval. Variables of interest were collected from electronic medical charts. A pharmacy resident used first-order pharmacokinetic equations to determine dosing regimens based on AUC monitoring. Local pharmacists retrospectively determined dosing regimens for trough-based monitoring.

Of 100 courses of treatment initially identified, 66 were included in the analysis. The unit dose was similar with the 2 methods (1086 mg with AUC-based monitoring versus 1100 mg with trough-based monitoring;
= 0.62). AUC monitoring was associated with a 12.8% lower daily dose (2294 mg versus 2630 mg;
< 0.001) and a 13.5% longer dosing interval (13.24 h versus 11.67 h;
< 0.001) relative to trough-based monitoring. AUC monitoring also generated a lower extrapolated trough concentration (12.90 mg/L versus 16.22 mg/L;
< 0.001).

A target trough concentration of 15 to 20 mg/L was confirmed as being unnecessarily high. AUC monitoring could allow a reduction in daily vancomycin dose and an extension of the dosing interval relative to trough-based monitoring.
A target trough concentration of 15 to 20 mg/L was confirmed as being unnecessarily high. AUC monitoring could allow a reduction in daily vancomycin dose and an extension of the dosing interval relative to trough-based monitoring.
Three large cardiovascular outcome trials have investigated the safety of sodium glucose cotransporter 2 (SGLT2) inhibitors.

To analyze the nationwide dispensing of SGLT2 inhibitors before and after the publication of these trials.

A cross-sectional study was conducted of monthly prescription dispensing of SGLT2 inhibitors from May 23, 2014, to April 30, 2019, using nationwide data for Canada. An autoregressive integrated moving average (ARIMA) model was fitted to the monthly number of tablets dispensed for each SGLT2 inhibitor; the model included a ramp intervention function at the publication dates of interest to estimate the impact on SGLT2 inhibitor dispensing patterns.

The rate of canagliflozin and dapagliflozin dispensing declined after publication of results of the empagliflozin cardiovascular trial in September 2015. MPP+ iodide After publication of results of the canagliflozin trial in June 2017, which indicated a reduction in cardiovascular events and an increase in the risk of lower-limb amputation, canagliflozin remained the most commonly dispensed SGLT2 inhibitor, but its rate of dispensing declined further. In contrast, the rate of empagliflozin dispensing increased, while the rate of dapagliflozin dispensing was unchanged. After publication of the dapagliflozin trial in November 2018, which indicated no clear reduction in cardiovascular events, short-term trends in dispensing of canagliflozin, empagliflozin, and dapagliflozin were largely unaffected.

The cardiovascular outcome trials appeared to have an important impact on the dispensing of SGLT2 inhibitors in Canada.
The cardiovascular outcome trials appeared to have an important impact on the dispensing of SGLT2 inhibitors in Canada.
This proof-of-concept study aimed to investigate atrial and ventricular lesion formation by a 20-mm linear laser ablation catheter, regarding lesion depth and tissue damage.

In total, 6 female swines underwent standard femoral vein access to introduce a novel 20-mm linear laser ablation catheter in the right atrium to perform endocardial cavotricuspid isthmus (CTI) ablations. The navigation took place under fluoroscopy with additional visualization by intracardiac echocardiograph.
a sternotomy, epicardial ablations were performed on the surface of the left ventricle (LV), right ventricle (RV), and right atrial appendage (RAA). Procedural safety was assessed by registration of intraprocedural adverse events and by macroscopic examination of the excised hearts for the presence of charring or tissue disruption at the lesion site.

Altogether 39 lesions were created, including 8 endocardial CTI (mean lesion length 20.6 ± 1.65 mm), 26 epicardial ventricle (mean lesion length LV 25.3 ± 1.35 mm, RV 24.9 ± 2.procedural safety.
Intra-articular infiltration of platelet-rich plasma (PRP) is an alternative therapeutic option to classic hyaluronic acid for the treatment of symptomatic knee osteoarthritis (KOA). However, variation in preparation methods and quality assessment of PRP makes the study of its real clinical efficacy difficult.

To (1) evaluate the clinical efficacy of a characterized PRP product prepared in a standardized manner and in a closed-system for the treatment of KOA and to (2) evaluate the association of the clinical response to PRP-related variables.

Case series; Level of evidence, 4.

We recruited 130 patients with nonoperative KOA and evaluated them for 1 year. PRP was prepared from a donation of autologous blood, obtaining 3 aliquots of approximately 10mL of product, which were frozen, allowing platelet disruption, platelet factor release, and long-term storage, until administration. Patients were treated 3 consecutive times every 4 weeks with an intra-articular PRP knee injection under sterile conditions.ient.
This standardized PRP production method resulted in improved WOMAC scores at 1 year postoperatively in 70% of patients with KOA. This technique was safe and affordable and ensured consecutive infiltrations with the same product to each patient.
Delays from the time of an anterior cruciate ligament (ACL) tear to surgical reconstruction are associated with an increased incidence of meniscal and chondral injuries.

To evaluate the association between delays in ACL reconstruction (ACLR) and risk factors for intra-articular injuries across 8 patient demographic subsets.

Cross-sectional study; Level of evidence, 3.

We performed a retrospective chart review of all patients who underwent ACLR from January 2009 to May 2015 at a single institution. Variables collected were age, sex, body mass index, time from injury to surgery, and presence of meniscal tears and chondral injuries. Demographic subsets were created according to sex, age (<27 vs ≥27 years), body mass index (<25 vs ≥25 kg/m
), and injury setting (sports vs non-sports related). Subsets were divided by time from injury to ACLR 0 to <6 months (control group), 6 to <12 months, and ≥12 months. Multivariate logistic regression-generated odds ratios (ORs) were calculated.

Overall, incidence of MMTs and medial chondral injuries was associated with ≥6-month delays in ACLR, and an increased incidence of lateral chondral injuries was associated with ≥12-month delays. Female patients and patients with non-sports-related ACL tears had less risk of injuries with delayed ACLR.
When analyzing patients who were symptomatic enough to eventually require surgery, an increased incidence of MMTs and medial chondral injuries was associated with ≥6-month delays in ACLR, and an increased incidence of lateral chondral injuries was associated with ≥12-month delays. Female patients and patients with non-sports-related ACL tears had less risk of injuries with delayed ACLR.
While many factors inform the choice of operative versus nonoperative treatment of injuries to the anterior cruciate ligament (ACL) of the knee, socioeconomic status influences this decision, as has been reported with other procedures.

To identify any associations between insurance status and likelihood of operative treatment of ACL injuries.

Cross-sectional study; Level of evidence, 3.

The Nationwide Inpatient Sample database was queried using
codes for ACL injuries and reconstruction from 2001 to 2013. Chi-square analysis was performed to determine significant predictors of operative intervention. Binary logistic regression was used to account for demographic and significant predictor variables. Results were recorded as odds ratios (ORs) and 95% CIs. Significance was defined as
< .05.

A total of 32,541 patients with ACL injuries were included in the final analysis. Overall incidence of surgical reconstruction was 85.4% (n = 27,805). Multivariable regression revealed that nonprivate insurance types were associated with lower likelihoods of operative reconstruction compared with private insurance the lowest likelihood of operation was seen in uninsured patients (OR, 0.
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