Child, parent, and service predictors of psychotropic polypharmacy among adolescents and young adults with an autism spectrum disorder

Objectives: This study examined the child, parent, and service factors associated with polypharmacy in adolescents and young adults with ASD. Methods: As part of an online survey examining health service utilization patterns among individuals with ASD, parents provided demographic and clinical information pertaining to their child. This included information on current medication use, as well as information on clinical services received, clinical history, and parent wellbeing. Analyses examined the bivariate association between individual child, parent, and service variables and polypharmacy. Variables significantly associated with polypharmacy were included in a multiple variable logistic regression. Results: Of the 363 participants sampled, approximately one quarter were receiving two or more psychotropic drugs concurrently. The child’s psychiatric co-morbidity, history of hurting others, therapy use, and parent burden were predictors of polypharmacy. Conclusion: Adolescents and young adults with ASD are a highly medicated population with multiple factors associated with psychotropic polypharmacy. While there may be circumstances where polypharmacy is necessary, a richer understanding of what predicts polypharmacy may lead to targeted interventions to better support these individuals and their families. Findings also highlight the need to support families of children with ASD prescribed multiple psychotropic medications.The Canadian Institutes of Health Research (funding reference number 102677) and the Centre for Addiction and Mental Health Postdoctoral Fellowship Award

Concurrent use of prescription drugs and herbal medicinal products in older adults: A systematic review

This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The use of herbal medicinal products (HMPs) is common among older adults. However, little is known about concurrent use with prescription drugs as well as the potential interactions associated with such combinations. Objective Identify and evaluate the literature on concurrent prescription and HMPs use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. Methods Systematic searches in MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults (≥65 years). Quality was assessed using the Joanna Briggs Institute checklists. The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) three stage approach to mixed method research was used to synthesise data. Results Twenty-two studies were included. A definition of HMPs or what was considered HMP was frequently missing. Prevalence of concurrent use by older adults varied widely between 5.3% and 88.3%. Prescription medicines most combined with HMPs were antihypertensive drugs, beta blockers, diuretics, antihyperlipidemic agents, anticoagulants, analgesics, antihistamines, antidiabetics, antidepressants and statins. The HMPs most frequently used were: ginkgo, garlic, ginseng, St John’s wort, Echinacea, saw palmetto, evening primrose oil and ginger. Potential risks of bleeding due to use of ginkgo, garlic or ginseng with aspirin or warfarin was the most reported herb-drug interaction. Some data suggests being female, a lower household income and less than high school education were associated with concurrent use. Conclusion Prevalence of concurrent prescription drugs and HMPs use among older adults is substantial and potential interactions have been reported. Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals can appropriately identify and manage patients at risk.Peer reviewedFinal Published versio

Long-term microbiological and chemical changes in bee pollen for human consumption: influence of time and storage conditions

In order to evaluate if bee pollen properly processed could be conserved for more than 12 months without suffering alterations on its microbiological and chemical qualities, 48 dried bee pollen samples from Argentina were stored at room (23 ± 2 °C) and at refrigerated temperatures (4 °C) during two years. The microbiological (culturable heterotrophic mesophilic bacteria, yeasts and filamentous fungi, Enterobacteriaceae, coliforms, spore-forming bacteria, Salmonella sp., Escherichia coli, Staphylococcus aureus and Clostridium perfringens) and chemical qualities (moisture, pH, ash, proteins and carbohydrates) of three samples from each treatment were evaluated every three months over two years. In bee pollen samples, human pathogenic bacteria were not detected. In general, the count of yeasts, culturable heterotrophic mesophilic bacteria and filamentous fungi were statistically lower at room temperature compared to refrigerated temperature over the storage period. Aerobic spore-forming bacteria populations did not show significant changes at the different storage periods neither at room nor at refrigerated temperatures. The protein and the ash content did not differ while carbohydrate content, moisture and pH changed over the storage period. The results show that microorganisms do not multiply in dried bee pollen although they can be present after a long period of storage at both studied temperatures. Bee pollen has maintained its microbiological and chemical qualities for more than six months at both temperatures, however, at room temperature, its sensory properties were altered after nine months from the beginning of the storage. The shelf life could be longer if it was preserved at fridge temperature.Fil: Fernandez, Leticia Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca; Argentina. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina. Universidad Nacional del Sur. Departamento de Agronomía. Laboratorio de Estudios Apícolas; ArgentinaFil: Rodríguez, María Agustina. Universidad Nacional del Sur. Departamento de Agronomía. Laboratorio de Estudios Apícolas; ArgentinaFil: Sanchez, Romina Magali. Universidad Nacional del Sur. Departamento de Biología, Bioquímica y Farmacia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; ArgentinaFil: Perez, Monica Beatriz. Universidad Nacional del Sur. Departamento de Química; ArgentinaFil: Gallez, Liliana María. Universidad Nacional del Sur. Departamento de Agronomía. Laboratorio de Estudios Apícolas; Argentin