Inappropriate prescribing in hospitalized elderly patients

Inappropriate prescribing (IP) is a major healthcare problem in elderly patients. The risk of this problem increases during hospitalization. This is due to increase morbidity and thus increases the use of medications by the inpatients. This study will clarify the problem of IP for elderly people during hospitalization and will identify the different types of it. It also will highlight some tools that are used to assess the different types of IP and the prevalence of it in elderly patients during hospitalization. Finally, the study will address the consequences of IP in the elderly inpatients and the risks associated with the use of some potentially inappropriate medications (PIMs) in the elderly.

Evaluation of inappropriate prescribing to the hospitalized elderly patients in Al Shifa hospital, Gaza, Palestine

Background: The current study aimed to assess the prevalence of inappropriate prescribing (IP) for hospitalized elderly patients at Al Shifa Hospital, Gaza, Palestine.Methods: This study was a retrospective cross-sectional study. A total of 2385 prescribed drugs for 380 elderly inpatients in internal, cardiology, and respiratory departments were screened for IP. Four criteria were used to detect IP using chart review method; Drug-drug interactions (DDIs), drug contra-indications (CI), duplication of therapy and Beers' criteria 2012.Results: The results showed that 44.2% of patients had at least one IP. Around 33.2% of the patients had DDIs, 19.2% had IP according to Beers' criteria and 1.1% had drug CI. There was no duplication of therapy. A total of 323 IP instances were detected. Of them, 74% for DDIs and 24.8% for Beers' criteria. The prevalence of overall IP was significantly influenced by age (p-value=0.024), polypharmacy (p-value<0.001), degree of morbidity (p-value<0.001), and departments (p-value=0.018). The prevalence of DDIs was influenced by polypharmacy (p-value<0.001), degree of morbidity (p-value=0.001), and departments (p-value=0.005). Finally, the prevalence of IP according to Beers' criteria was significantly influenced by departments with the highest in the cardiology department (29.7%) (P-value=0.007).Conclusions: Although the overall IP was common, it was not far higher than that reported worldwide. The majority of IP was DDIs. Age, polypharmacy, degree of morbidity and departments influenced the occurrence of IP

Multiplexed five-color molecular imaging of cancer cells and tumor tissues with carbon nanotube Raman tags in the near-infrared

Single-walled carbon nanotubes (SWNTs) with five different C13/C12 isotope compositions and well-separated Raman peaks have been synthesized and conjugated to five targeting ligands in order to impart molecular specificity. Multiplexed Raman imaging of live cells has been carried out by highly specific staining of cells with a five-color mixture of SWNTs. Ex vivo multiplexed Raman imaging of tumor samples uncovers a surprising up-regulation of epidermal growth factor receptor (EGFR) on LS174T colon cancer cells from cell culture to in vivo tumor growth. This is the first time five-color multiplexed molecular imaging has been performed in the near-infrared (NIR) region under a single laser excitation. Near zero interfering background of imaging is achieved due to the sharp Raman peaks unique to nanotubes over the low, smooth autofluorescence background of biological species.Comment: Published in Nano Researc

Ancient Migratory Events in the Middle East: New Clues from the Y-Chromosome Variation of Modern Iranians

Knowledge of high resolution Y-chromosome haplogroup diversification within Iran provides important geographic context regarding the spread and compartmentalization of male lineages in the Middle East and southwestern Asia. At present, the Iranian population is characterized by an extraordinary mix of different ethnic groups speaking a variety of Indo-Iranian, Semitic and Turkic languages. Despite these features, only few studies have investigated the multiethnic components of the Iranian gene pool. In this survey 938 Iranian male DNAs belonging to 15 ethnic groups from 14 Iranian provinces were analyzed for 84 Y-chromosome biallelic markers and 10 STRs. The results show an autochthonous but non-homogeneous ancient background mainly composed by J2a sub-clades with different external contributions. The phylogeography of the main haplogroups allowed identifying post-glacial and Neolithic expansions toward western Eurasia but also recent movements towards the Iranian region from western Eurasia (R1b-L23), Central Asia (Q-M25), Asia Minor (J2a-M92) and southern Mesopotamia (J1-Page08). In spite of the presence of important geographic barriers (Zagros and Alborz mountain ranges, and the Dasht-e Kavir and Dash-e Lut deserts) which may have limited gene flow, AMOVA analysis revealed that language, in addition to geography, has played an important role in shaping the nowadays Iranian gene pool. Overall, this study provides a portrait of the Y-chromosomal variation in Iran, useful for depicting a more comprehensive history of the peoples of this area as well as for reconstructing ancient migration routes. In addition, our results evidence the important role of the Iranian plateau as source and recipient of gene flow between culturally and genetically distinct population

Multimodality Imaging of β-Cells in Mouse Models of Type 1 and 2 Diabetes

Objectiveβ-Cells that express an imaging reporter have provided powerful tools for studying β-cell development, islet transplantation, and β-cell autoimmunity. To further expedite diabetes research, we generated transgenic C57BL/6 "MIP-TF" mice that have a mouse insulin promoter (MIP) driving the expression of a trifusion (TF) protein of three imaging reporters (luciferase/enhanced green fluorescent protein/HSV1-sr39 thymidine kinase) in their β-cells. This should enable the noninvasive imaging of β-cells by charge-coupled device (CCD) and micro-positron emission tomography (PET), as well as the identification of β-cells at the cellular level by fluorescent microscopy.Research design and methodsMIP-TF mouse β-cells were multimodality imaged in models of type 1 and type 2 diabetes.ResultsMIP-TF mouse β-cells were readily identified in pancreatic tissue sections using fluorescent microscopy. We show that MIP-TF β-cells can be noninvasively imaged using microPET. There was a correlation between CCD and microPET signals from the pancreas region of individual mice. After low-dose streptozotocin administration to induce type 1 diabetes, we observed a progressive reduction in bioluminescence from the pancreas region before the appearance of hyperglycemia. Although there have been reports of hyperglycemia inducing proinsulin expression in extrapancreatic tissues, we did not observe bioluminescent signals from extrapancreatic tissues of diabetic MIP-TF mice. Because MIP-TF mouse β-cells express a viral thymidine kinase, ganciclovir treatment induced hyperglycemia, providing a new experimental model of type 1 diabetes. Mice fed a high-fat diet to model early type 2 diabetes displayed a progressive increase in their pancreatic bioluminescent signals, which were positively correlated with area under the curve-intraperitoneal glucose tolerance test (AUC-IPGTT).ConclusionsMIP-TF mice provide a new tool for monitoring β-cells from the single cell level to noninvasive assessments of β-cells in models of type 1 diabetes and type 2 diabetes

Characterization of densified fully stabilized nanometric zirconia by positron annihilation spectroscopy

Fully-stabilized nanometric zirconia samples with varying degrees of porosity and grain sizes were analyzed using the coincidence Doppler broadening mode of the positron annihilation spectroscopy (PAS). A decrease in the low momentum fraction was observed and coincided with a decrease in porosity. In addition to pores, it is proposed that defects in the negatively charges grain boundary space region act as positron trapping centers; their effectiveness decreases with an increase in grain size. It is shown that PAS is sensitive to small grain size differences within the nanometric regime in these oxide materials

Borrelia Burgdorferi Induces a Type I Interferon Response During Early Stages of Disseminated Infection in Mice

BACKGROUND: Lyme borrelia genotypes differ in their capacity to cause disseminated disease. Gene array analysis was employed to profile the host transcriptome induced by Borrelia burgdorferi strains with different capacities for causing disseminated disease in the blood of C3H/HeJ mice during early infection. RESULTS: B. burgdorferi B515, a clinical isolate that causes disseminated infection in mice, differentially regulated 236 transcripts (P \u3c 0.05 by ANOVA, with fold change of at least 2). The 216 significantly induced transcripts included interferon (IFN)-responsive genes and genes involved in immunity and inflammation. In contrast, B. burgdorferi B331, a clinical isolate that causes transient skin infection but does not disseminate in C3H/HeJ mice, stimulated changes in only a few genes (1 induced, 4 repressed). Transcriptional regulation of type I IFN and IFN-related genes was measured by quantitative RT-PCR in mouse skin biopsies collected from the site of infection 24 h after inoculation with B. burgdorferi. The mean values for transcripts of Ifnb, Cxcl10, Gbp1, Ifit1, Ifit3, Irf7, Mx1, and Stat2 were found to be significantly increased in B. burgdorferi strain B515-infected mice relative to the control group. In contrast, transcription of these genes was not significantly changed in response to B. burgdorferi strain B331 or B31-4, a mutant that is unable to disseminate. CONCLUSIONS: These results establish a positive association between the disseminating capacity of B. burgdorferi and early type I IFN induction in a murine model of Lyme disease

Cell tracking in cardiac repair: what to image and how to image

Stem cell therapies hold the great promise and interest for cardiac regeneration among scientists, clinicians and patients. However, advancement and distillation of a standard treatment regimen are not yet finalised. Into this breach step recent developments in the imaging biosciences. Thus far, these technical and protocol refinements have played a critical role not only in the evaluation of the recovery of cardiac function but also in providing important insights into the mechanism of action of stem cells. Molecular imaging, in its many forms, has rapidly become a necessary tool for the validation and optimisation of stem cell engrafting strategies in preclinical studies. These include a suite of radionuclide, magnetic resonance and optical imaging strategies to evaluate non-invasively the fate of transplanted cells. In this review, we highlight the state-of-the-art of the various imaging techniques for cardiac stem cell presenting the strengths and limitations of each approach, with a particular focus on clinical applicability