Infodemiological patterns in searching medication errors: Relationship with risk management and shift work

INTRODUCTION: Western world health care systems have been trying to improve their efficiency and effectiveness in order to respond properly to population aging and non-communicable diseases epidemic. Treatment of the elderly population is becoming complex due to the high number of prescribed drugs because of multimorbidity. Errors in drugs administration in different health care related settings are an actual important issue due to different causes. Aim of this observational study is to measure the online interest in seeking medication errors information related to risk management and shift work. MATERIALS AND METHODS: We investigated Google Trends® for popular search relating to medication errors, risk management and shift work. Relative search volumes (RSVs) were evaluated from 2008 to 2018. A comparison between RSV curves related to medication errors, risk management and shift work was carried out. Then, we compared the world to Italian search. RESULTS: RSVs were persistently higher for risk management than for medication errors (mean RSVs 069 vs. 48%) and RSVs were stably higher for medication errors than shift work (mean RSVs 48 vs. 22%). In Italy, RSVs were much lower compared to the rest of the world, and RSVs for medication errors during the study period were negligible. Mean RSVs for risk management and shift work were 3 and 25%, respectively. RSVs related to medication errors and clinical risk management were correlated (r=0.520, p<0.0001). CONCLUSIONS: Google Trends® search query volumes related to medication errors, risk management and shift work are different. RSVs for risk management are higher, and they are correlated with medication errors. Also, shift work search appears to be lower. These results should be interpreted in order to correctly evaluate how to decrease the number of medication errors in different health care related setting

Changes in anthropometric, biochemical, hematological, hormonal and cardiac markers in a group of late-adult amateur cyclist, afet continuous and prolonged exercise on an uncontrolled diet

Abstract: Purpose: to describe and compare the main biochemical and hematological parameters, markers of cardiac and stress suffering (cortisol), in an amateur group of 8 late-adult cyclists (average age 60.9 years s.d. 4.1 years) before and after a continuous bicycle course of 9 days with an actual duration of 7 days and a daily average of 103.5 Km (total of 725 km) on an uncontrolled diet. Results: body weight, BMI, systolic and diastolic pressure did not vary significantly in pre- and post-cycling performance (p> 0.05). There was no significant change in the pre- and post-red blood cell count in the hemochromocytometric hematological parameters (p = 0.57), while hemoglobin values decreased significantly after pedaling (p = 0.03), as did the average cellular hemoglobin values and the average cell concentration of hemoglobin (p = 0.002 and p = 0.0006, respectively). The number of platelets, white blood cells, the absolute number of neutrophils, lymphocytes, eosinophils, basophils and monocytes, and the percentage of neutrophils, eosinophilic lymphocytes, basophils and monocytes did not change significantly (p> 0.05). With regard to basic biochemistry, there was no significant variation in the values of glucose, urea, creatinine, alanine amino transferase, alkaline phosphatase, cholinesterase and creatinine kinase (p> 0.05). Aspartate amino transferase was found to be significantly greater after pedaling (p = 0.03). The values of albumin, total proteins, lactate dehydrogenase, total calcium, inorganic phosphorus, total magnesium, total iron, sodium and potassium were statistically non-significant between pre and post phases. The lipid profile, total cholesterol, triglycerides, lipases, HDL and LDL were also statistically non-significant even if HDL values increased on average after cycling performance (before 48.9 \ub1 9.5 and after 53.8 \ub1 12.4) while LDL values decreased on average (before 118.5 \ub1 28.8 and after 101.6 \ub1 10.3). In the hormone-labeling and vitamin group, ferritin was statistically non-significant. Pre and post changes in the stress hormone cortisol, PSA, vitamin B12 and natriuretic B-type NT-proBNP peptide were statistically non-significant. Instead, folate decreased significantly following the cycling performance (p = 0.017). In protein biochemistry, apolipoprotein A1 was statistically significant (p = 0.038) increasing after pedaling, while apolipoprotein B, C-reactive protein and transferrin were statistically non-significant. CK MB mass and troponin I in the cardiac markers did not undergo significant changes between pre and post phases. Conclusions: despite the small size of the chosen sample, parameters analyzed between pre and post continuous physical effort lead to the conclusion and confirmation of many data in the literature and, that is, that sporting activity conducted in an important way can improve the biochemical/functional state and, therefore, the health of practising subjects even in late adults and/or the elderly. This could postpone physical psychic decline caused by the natural progression of years

Real-time cell analysis by xCELLigence®: a new method for dynamic, quantitative measurement of adhesion and proliferation of cell lines

Objectives. In this study, we report the use of a real-time cell analysis (RTCA) test system, the xCELLigence® RTCA, as efficient tool for a fast growth kinetics analysis of cell lines. This new dynamic real-time monitoring and impedance-based assay allows for a combined measurement of cell adhesion, spreading and proliferation. Methods. We used four representative human OSCC derived cell lines, PE49, HSC2, HSC3 and PE15 cells. The measured impedance values could be correlated to characteristic cell culture behaviours. In parallel, were evaluated proliferation and cell viability of the cell lines by the 3-[4,5-dimethylthizol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay. Results. Through the analysis we were able to quantitatively characterize the growth kinetics of the cell lines. The results are in agreement with the analysis MTT and for us will be the basis for future studies with respect to these lines.Conclusions. The advantage of impedance-based measurements is mainly based on these continuous monitoring of cell responses for a broad range of different cells and with different parameters of culture. Therefore, the xCELLigence system can be used as a rapid monitoring tool for cellular viability and used for multiple applications, such as toxicity testing of xenobiotics, biocompatibility of dental materials, tests of invasion and migration using in vitro cell cultures

Dietary fiber and gut microbiota in renal diets

Nutrition is crucial for the management of patients affected by chronic kidney disease (CKD) to slow down disease progression and to correct symptoms. The mainstay of the nutritional approach to renal patients is protein restriction coupled with adequate energy supply to prevent malnutrition. However, other aspects of renal diets, including fiber content, can be beneficial. This paper summarizes the latest literature on the role of different types of dietary fiber in CKD, with special attention to gut microbiota and the potential protective role of renal diets. Fibers have been identified based on aqueous solubility, but other features, such as viscosity, fermentability, and bulking effect in the colon should be considered. A proper amount of fiber should be recommended not only in the general population but also in CKD patients, to achieve an adequate composition and metabolism of gut microbiota and to reduce the risks connected with obesity, diabetes, and dyslipidemia

Oral mucositis: a survey on changes in the proteomic profile

Objectives. Oral mucositis is the most severe complication of anticancer therapy. It occurs in 40-85% of patients during chemotherapy and radiotherapy but also in patients who have undergone hematopoietic stem cell transplantation. The symptoms for oral mucositis are burning and severe pain oral, spontaneous bleeding, dysphagia, dysarthria and odynophagia; especially pain and burning sensation on swallowing contribute to decreased quality of life for oncologic patients and, in severe cases, may also force the patient to feed parenterally (1). Furthermore, if the mucositis is severe it can lead to partial or complete interruption of radiotherapy before completion of the treatment protocol with consequent worsening of the prognosis (2, 3). Dentists must be familiar with the necessary intervents, in order to help the patient during the course of the treatment and prevent the interruption. Certain measures may help minimize the symptoms associated with oral mucositis; however, further research is required, focusing on lesion prevention prior to treatment initiation. To this end, it has been investigated the salivary proteome of cancer patients who developed oral mucositis, post chemotherapy and/or radiotherapy. In addition, we compared the salivary proteome of the same subjects before developing oral mucositis and immediately after the treatment for the mucositis. The analysis was made with SELDI technology. Methods. In the current study, 55 saliva samples of patients suffering from different types of cancer were analyzed. The saliva was collected in three times: before the development of mucositis, when it was diagnosed and after the resolution of this pathology. All samples were analyzed by SELDI-TOF/MS analysis. It was possible to create cluster peaks in spectra obtained using BIORAD DataManagerTM software (Ver 3.5). Results. From this analysis we identified a list of differently expressed mass peaks (clusters). We have selected some significant peaks in a range of values between 3000 m/z 15000 m/z. In particular, five were found to be differentially expressed: 3343, 3486, 3732, 4132 and 4786 m/z. The analysis of the cluster, we evaluated different patterns of peaks in the three groups; some of these were up regulated, as the peak 3732 m/z in samples pre mucositis, and down regulated, such as the 7101 m/z in the samples pre mucositis. It is noted, moreover, an important increase of the peak 4132 m/z in samples of mucositis. Conclusions. Oral mucositis is one of the most frequent complications of cancer therapies. It is, therefore, extremely important that the mucositis is prevented whenever possible, or at least treated to reduce its severity and possible complications. Knowing the salivary proteome and its variations in a state of pre mucositis, mucositis and post mucositis can be useful in order to intervene with preventive tools and better therapies. The association of the peaks 3343, 3486, 3732, 4132 and 4786 m / z, in particular the increase in expression of the peak 4132 m / z in samples of mucositis makes us think that it can be used as biomarker of this condition. Therefore, if these data will be confirmed on a larger series of patients could identify these proteins and study of targeted therapies. Furthermore, it would be helpful to understand whether these variations are associated with a particular chemotherapy and evaluate longer available cancer therapies replacement

Osteonecrosis of the jaw after adjuvant endocrine therapy plus alendronate in a breast cancer patient

Background. Bisphosphonates-associated osteonecrosis of the jaws (BRONJ) is a serious complication, which has been defined by Bedogni et al. (1) as an adverse drug reaction consisting of progressive destruction and death of bone that affects the mandible and/or maxilla of patients exposed to the treatment with nitrogen-containing bisphosphonates (NBPs) in absence of a previous radiation treatment. Generally, IV NBPs have a strong association with BRONJ than oral NBPs as evidenced by the higher incidence of BRONJ (0-10%) in patients treated with IV drugs than in patients in oral therapy (<1%). Objectives. The aim of this study was to report a clinical case of BRONJ in an oncologic patient who has been treated with anastrozole and oral NBPs for secondary osteoporosis. Case report. In February 2014 a 75-year-old woman was referred because of history of pain in the left posterior mandibular region and hypoesthesia/anesthesia of the homolateral inferior lip and chin. In the anamnesis, she had referred to be in therapy with alendronate since 2004, for a history of severe osteoporosis and, in multimodal chemotherapy and anastrazole since 2010 for a diagnosis of breast cancer. Furthermore, left lower molar extraction was performed on March 2013. Clinical examination revealed swelling of the extraoral soft tissue in the left emimandible; intraorally, the presence of a mucosal fistula on the left mandibular angle was identified. CT was performed and BRONJ diagnosis was defined with a stage 2A according to Bedogni et al. Conclusions. Administration of NBP is indicated to treat also osteoporosis anastrazole-induced in oncological patients, showing that patients with hormone receptor-positive early-stage breast cancer taking oral BP could represent a subset in which it would be useful to apply BRONJ prevention protocols

Malignant pilomatricoma with multiple bone metastases in a dog: Histological and immunohistochemical study.

An eleven year-old mongrel dog was referred with a history of left forelimb lameness and an ulcerated mass on the neck. Histologically, the cutaneous neoplasm revealed cystic lobules composed of basaloid cells with abrupt transition to central keratotic material, containing pycnotic and shadow cells. Approximately 3 months after primary diagnosis, a lesion of the cortical bone on the left humerus was observed using X-ray. Samples obtained from the humerus were processed for histopathological examination and the neoplastic tissue was observed to be similar to the type identified in the neck. Based on these findings, the tumor was diagnosed as a malignant pilomatricoma (MP) with bone metastasis. MP is a rare skin tumor that originates from hair matrix cells. To date, only nine reports have been presented in dogs. In the present study, we discuss the cytological and histological patterns of MP, confirmed by immunohistochemistry using β catenin antibody