A survey of attitudes, practices, and knowledge regarding drug-drug interactions among medical residents in Iran

Background When prescribing medications, physicians should recognize clinically relevant potential drug–drug interactions (DDIs). To improve medication safety, it is important to understand prescribers’ knowledge and opinions pertaining to DDIs. Objective To determine the current DDI information sources used by medical residents, their knowledge of DDIs, their opinions about performance feedback on co-prescription of interacting drugs. Setting Academic hospitals of Mashhad University of Medical Sciences (MUMS) in Iran. Methods A questionnaire containing questions regarding demographic and practice characteristics, DDI information sources, ability to recognize DDIs, and opinions about performance feedback was distributed to medical residents of 22 specialties in eight academic hospitals in Iran. We analyzed their perception pertaining to DDIs, their performance on classifying drug pairs, and we used a linear regression model to assess the association of potential determinants on their DDI knowledge. Main Outcome Measure prescribers’ knowledge and opinions pertaining to DDIs. Results The overall response rate and completion rate for 315 distributed questionnaires were 90% (n = 295) and 86% (n = 281), respectively. Among DDI information sources, books, software on mobile phone or tablet, and Internet were the most commonly-used references. Residents could correctly classify only 41% (5.7/14) of the drug pairs. The regression model showed no significant association between residents’ characteristics and their DDI knowledge. An overwhelming majority of the respondents (n = 268, 95.4%) wished to receive performance feedback on co-prescription of interacting drugs in their prescriptions. They mostly selected information technology-based tools (i.e. short text message and email) as their preferred method of receiving feedback. Conclusion Our findings indicate that prescribers may have poor ability to prevent clinically relevant potential DDI occurrence, and they perceive the need for performance feedback. These findings underline the importance of well-designed computerized alerting systems and delivering performance feedback to improve patient safety

A sol-gel method for growing superconducting MgB2 films

In this paper we report a new sol-gel method for the fabrication of MgB2 films. Polycrystalline MgB2 films were prepared by spin-coating a precursor solution of Mg(BH_4)_2 diethyl ether on (001)Al2O3 substrates followed with annealing in Mg vapor. In comparison with the MgB2 films grown by other techniques, our films show medium qualities including a superconducting transition temperature of Tc ~ 37 K, a critical current density of Jc(5 K, 0 T) ~ 5 {\times} 10^6 A cm^{-2}, and a critical field of H_{c2}(0) ~ 19 T. Such a sol-gel technique shows potential in the commercial fabrication of practically used MgB2 films as well as MgB2 wires and tapes.Comment: 8 pages, 5 figure

Prevalence and Correlates of Diagnosed and Undiagnosed Hypertension in the Indigenous Kuna Population of Panamá

Background: To determine the prevalence of hypertension and investigate sociodemographic correlates in an indigenous Kuna community living on the San Blas islands of Panama. Methods: Data was collected from adults using a paper-based survey using a cross sectional study design. Blood pressure was measured, and hypertension defined at two cut-points: 130/80 mmHg and 140/90 mmHg. Individuals with undiagnosed hypertension had a blood pressure measurement that indicated hypertension, however, the individual had not been told by a doctor they had hypertension. Whereas individuals with diagnosed hypertension had been told by a healthcare provider that they had hypertension. Univariate tests compared diagnosed and undiagnosed hypertension by sociodemographic categories and logistic regression models tested individual correlates adjusting for all sociodemographic factors. Results: Two hundred and eleven adult indigenous Kuna participated in the study. Overall prevalence of hypertension was 6.2% (95%CI:3.32–10.30) as defined by 140/90 mmHg, and 16.6% (95%CI:11.83–22.31) as defined by 130/80 mmHg. Hypertension was significantly higher in men (31.6, 95% CI:19.90–45.24, compared to 11.0, 95% CI:6.56–17.09). Individuals with low income were 3 times more likely to be hypertensive (OR = 3.13, 95% CI:1.02–9.60) and 3.5 times more likely to have undiagnosed hypertension (OR = 3.42, 95% CI:1.01–11.52); while those with moderate income were 6 times more likely to be hypertensive (OR = 7.37, 95% CI:1.76–30.90) compared to those who were poor. Conclusion: The prevalence of diagnosed and undiagnosed hypertension is higher in men and those with higher income. Investigating these factors remains vitally important in helping improve the health of the Kuna through targeted interventions to address chronic disease

The effects of an intronic polymorphism in TOMM40 and APOE genotypes in sporadic inclusion body myositis.

A previous study showed that, in carriers of the apolipoprotein E (APOE) genotype ε3/ε3 or ε3/ε4, the presence of a very long (VL) polyT repeat allele in "translocase of outer mitochondrial membrane 40" (TOMM40) was less frequent in patients with sporadic inclusion body myositis (sIBM) compared with controls and associated with a later age of sIBM symptom onset, suggesting a protective effect of this haplotype. To further investigate the influence of these genetic factors in sIBM, we analyzed a large sIBM cohort of 158 cases as part of an International sIBM Genetics Study. No significant association was found between APOE or TOMM40 genotypes and the risk of developing sIBM. We found that the presence of at least 1 VL polyT repeat allele in TOMM40 was significantly associated with about 4 years later onset of sIBM symptoms. The age of onset was delayed by 5 years when the patients were also carriers of the APOE genotype ε3/ε3. In addition, males were likely to have a later age of onset than females. Therefore, the TOMM40 VL polyT repeat, although not influencing disease susceptibility, has a disease-modifying effect on sIBM, which can be enhanced by the APOE genotype ε3/ε3

Catalytic intramolecular hydroamination of aminoallenes using titanium and tantalum complexes of sterically encumbered chiral sulfonamides

Catalysis using earth abundant metals is an important goal due to the relative scarcity and expense of precious metal catalysts. It would be even more beneficial to use earth abundant catalysts for the synthesis of common pharmaceutical structural motifs such as pyrrolidine and pyridine. Thus, developing titanium catalysts for asymmetric ring closing hydroamination is a valuable goal. In this work, four sterically encumbered chiral sulfonamides derived from naturally occurring amino acids were prepared. These compounds undergo protonolysis reactions with Ti(NMe₂)₄ or Ta(NMe₂)₅ to give monomeric complexes as determined by both DOSY NMR and X-ray crystallography. The resulting complexes are active for the ring closing hydroamination hepta-4,5-dienylamine to give a mixture of tetrahydropyridine and pyrrolidine products. However, the titanium complexes convert 6-methylhepta-4,5-dienylamine exclusively to 2-(2-methylpropenyl)pyrrolidine in higher enantioselectivity than those previously reported, with enantiomeric excesses ranging from 18–24%. The corresponding tantalum complexes were more selective with enantiomeric excesses ranging from 33–39%

Diagrammatic analysis of the two-state quantum Hall system with chiral invariance

The quantum Hall system in the lowest Landau level with Zeeman term is studied by a two-state model, which has a chiral invariance. Using a diagrammatic analysis, we examine this two-state model with random impurity scattering, and find the exact value of the conductivity at the Zeeman energy $E = \Delta$. We further study the conductivity at the another extended state $E = E_1$ ($E_1 > \Delta$). We find that the values of the conductivities at $E = 0$ and $E = E_1$ do not depend upon the value of the Zeeman energy $\Delta$. We discuss also the case where the Zeeman energy $\Delta$ becomes a random field.Comment: 14P, Late

Spontaneous coherence and the quantum Hall Effect in triple-layer electron systems

We investigate spontaneous interlayer phase coherence and the occurrence of the quantum Hall effect in triple-layer electron systems. Our work is based on a simple tight-binding model that greatly facilitates calculations and whose accuracy is verified by comparison with recent experiments. By calculating the ground state in an unrestricted Hartree-Fock approximation and the collective-mode spectrum in a time-dependent Hartree-Fock approximation, we construct a phase diagram delimiting regions in the parameter space of the model where the integer quantum Hall effect occurs in the absence of interlayer tunneling.Comment: To appear in Phys. Rev. B, 20 pages, 5 PostScript figures uuencoded with TeX fil

Global phase diagram of bilayer quantum Hall ferromagnets

We present a microscopic study of the interlayer spacing d versus in-plane magnetic field $B_\parallel$ phase diagram for bilayer quantum Hall (QH) pseudo-ferromagnets. In addition to the interlayer charge balanced commensurate and incommensurate states analyzed previously, we address the corresponding interlayer charge unbalanced "canted" QH states. We predict a large anomaly in the bilayer capacitance at the canting transition and the formation of dipole stripe domains with periods exceeding 1 micron in the canted state.Comment: 4 RevTeX pgs, 2 eps figures, submitted to PR