Management of Hypertensive Emergencies in Pediatrics

As hypertension becomes more prevalent in the pediatric population, clinicians are more likely to encounter hypertensive emergencies in children, which require pharmacists and physicians to be educated on the therapeutic options for these emergencies. However, the strict governmental requirements on the testing of these drugs in pediatric patients have limited the amount of available evidence on which to base clinical decisions. This review will highlight the available evidence and preferred treatment options for the management of pediatric hypertensive emergencies

An Update on Gestational Diabetes

Gestational diabetes is a concern for a large number of pregnant women due to the potential for long-term complications for both the mother and the fetus. With the increasing prevalence of obesity and diabetes in the general public, the number of pregnant women with undiagnosed type 2 diabetes mellitus has also increased. In order to adequately educate their patients, it is important for pharmacists to be aware of the general practices of treating gestational diabetes. This review will highlight recent updates to initial screening, the criteria for diagnosing gestational diabetes, and current management strategies

Assessment of Pharmacist Attitudes Regarding Introductory Pharmacy Practice Experience Hours

Introductory pharmacy practice experience (IPPE) hours are a means of integrating experiential education as a key role early on in pharmacy education. The Accreditation Council for Pharmacy Education (ACPE) has offered little guidance on mandatory and specific objectives to accomplish during IPPE hours, thus it is possible that preceptors do not feel adequately prepared, nor do they have a full understanding of what is required of them when they agree to precept an IPPE student. Given the lack of previous research conducted, the objective of this study was to obtain an understanding of the general attitude that preceptors have toward IPPE hours. A self-administered Internet-based questionnaire was completed by 100 respondents. The survey included multiple choice, Likert-type scale (1 =strongly disagree to 7 =strongly agree), sliding scale, and open-ended questions assessing preceptor\u27s knowledge of academic IPPE hour requirements, college of pharmacy expectations, time commitment and work site issues, expectations of the student, formality of IPPE hours, personal experience as a preceptor, an open-ended response and demographic information. Upon analyzing the data, researchers found that respondents presented with a generally positive attitude regarding IPPE hours (5.79 ± 1.03). Respondents expressed a desire to receive a zero to two hour online preceptor training (5.17 ± 1.25). In general, pharmacists indicated sufficient staffing to accommodate IPPE students (3.92 ± 1.38) and were undecided regarding monetary reimbursement (4.39 ± 1.53). Survey participants preferred receiving a guided checklist of activities for completion (S.45 ± 1.27), student resume (5.19 ± 1.30) and previous didactic course work (S.33 ± 1.41); however, survey participants expressed a desire for flexibility in determining the specifics of the experience (5.41 ± 1.11) while having students complete hours in a more concentrated time frame (5.19 ± 1.44). This exploratory research project was conducted to serve as baseline data to stimulate further investigation regarding IPPE hours

A common variant near TGFBR3 is associated with primary open angle glaucoma

Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array (Illumina) analysis on 3504 POAG cases and 9746 controls with replication of the most significant findings in 9173 POAG cases and 26 780 controls across 18 collections of Asian, African and European descent. Apart from confirming strong evidence of association at CDKN2B-AS1 (rs2157719 [G], odds ratio [OR] = 0.71, P = 2.81 × 10−33), we observed one SNP showing significant association to POAG (CDC7–TGFBR3 rs1192415, ORG-allele = 1.13, Pmeta = 1.60 × 10−8). This particular SNP has previously been shown to be strongly associated with optic disc area and vertical cup-to-disc ratio, which are regarded as glaucoma-related quantitative traits. Our study now extends this by directly implicating it in POAG disease pathogenesis

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Abstract Primary open angle glaucoma (POAG), a major cause of blindness worldwide, is a complex disease with a significant genetic contribution. We performed Exome Array ), we observed one SNP showing significant association to POAG (CDC7-TGFBR3 rs1192415, OR G-allele = 1.13, P meta = 1.60 × 10 −8 ). This particular SNP has previously been shown to be strongly associated with optic disc area and vertical cup-to-disc ratio, which are regarded as glaucoma-related quantitative traits. Our study now extends this by directly implicating it in POAG disease pathogenesis

A common variant mapping to <i>CACNA1A </i>is associated with susceptibility to exfoliation syndrome

Author manuscript available from PMC http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605818/Exfoliation syndrome (XFS) is the most common recognizable cause of open-angle glaucoma worldwide. To better understand the etiology of XFS, we conducted a genome-wide association study (GWAS) of 1,484 cases and 1,188 controls from Japan and followed up the most significant findings in a further 6,901 cases and 20,727 controls from 17 countries across 6 continents. We discovered a genome-wide significant association between a new locus (CACNA1A rs4926244) and increased susceptibility to XFS (odds ratio (OR) = 1.16, P = 3.36 × 10−11). Although we also confirmed overwhelming association at the LOXL1 locus, the key SNP marker (LOXL1 rs4886776) demonstrated allelic reversal depending on the ancestry group (Japanese: ORA allele = 9.87, P = 2.13 × 10−217; non-Japanese: ORA allele = 0.49, P = 2.35 × 10−31). Our findings represent the first genetic locus outside of LOXL1 surpassing genome-wide significance for XFS and provide insight into the biology and pathogenesis of the disease

Genetic Association Study Of Exfoliation Syndrome Identifies A Protective Rare Variant At Loxl1 And Five New Susceptibility Loci

Exfoliation syndrome (XFS) is the most common known risk factor for secondary glaucoma and a major cause of blindness worldwide. Variants in two genes, LOXL1 and CACNA1A, have previously been associated with XFS. To further elucidate the genetic basis of XFS, we collected a global sample of XFS cases to refine the association at LOXL1, which previously showed inconsistent results across populations, and to identify new variants associated with XFS. We identified a rare protective allele at LOXL1 (p.Phe407, odds ratio (OR) = 25, P = 2.9 x 10(-14)) through deep resequencing of XFS cases and controls from nine countries. A genome-wide association study (GWAS) of XFS cases and controls from 24 countries followed by replication in 18 countries identified seven genome-wide significant loci (P < 5 x 10(-8)). We identified association signals at 13q12 (POMP), 11q23.3 (TMEM136), 6p21 (AGPAT1), 3p24 (RBMS3) and 5q23 (near SEMA6A). These findings provide biological insights into the pathology of XFS and highlight a potential role for naturally occurring rare LOXL1 variants in disease biology.Wo

Genome-wide association study identifies five new susceptibility loci for primary angle closure glaucoma.

Primary angle closure glaucoma (PACG) is a major cause of blindness worldwide. We conducted a genome-wide association study (GWAS) followed by replication in a combined total of 10,503 PACG cases and 29,567 controls drawn from 24 countries across Asia, Australia, Europe, North America, and South America. We observed significant evidence of disease association at five new genetic loci upon meta-analysis of all patient collections. These loci are at EPDR1 rs3816415 (odds ratio (OR) = 1.24, P = 5.94 × 10(-15)), CHAT rs1258267 (OR = 1.22, P = 2.85 × 10(-16)), GLIS3 rs736893 (OR = 1.18, P = 1.43 × 10(-14)), FERMT2 rs7494379 (OR = 1.14, P = 3.43 × 10(-11)), and DPM2-FAM102A rs3739821 (OR = 1.15, P = 8.32 × 10(-12)). We also confirmed significant association at three previously described loci (P < 5 × 10(-8) for each sentinel SNP at PLEKHA7, COL11A1, and PCMTD1-ST18), providing new insights into the biology of PACG