Impact of clinical pharmacist-led intervention for drug-related problems in neonatal intensive care unit a randomized controlled trial

Introduction: Drug-related problems (DRPs) incidence is higher in neonatal intensive care units (NICUs), compared to other pediatric wards due to aspects like off-label medications, pharmacokinetic/dynamic variability, or organ dysfunction/immaturity. This study aimed to determine whether and to what extent a clinical pharmacist intervention improves medication safety and prevents DRPs [medication errors (MEs), adverse drug reactions (ADRs), drug-drug interactions (DDIs)]. Methods: A prospective, randomized, double blind, controlled study in NICU-admitted neonates was conducted. NICU patients were randomly assigned to the intervention (clinical pharmacist-led) (IG) or control group (standard care such as clinical diagnosis, pharmacotherapy) (CG). The clinical pharmacist was involved in the IG to identify-prevent-intervene MEs, or identify and monitor ADRs and DDIs. The primary outcome was the number of neonates who developed at least one DRP compared with those seen across IG and CG. Secondary outcomes included length of hospital stay, total number of drugs or DRP type. Results: Neonates were randomly assigned to CG (n = 52) or IG (n = 48). In total, 45%, 42%, and 16% of patients had at least 1 MEs, ADRs, and clinically significant DDIs, respectively. The number of patients with at least 1 ME was 28 (53%) and 17 (35%) in the CG and IG (p&gt;0.05). The median (range) number of ME was higher in CG [1 (0–7)] than in IG [0 (0–4)] (p = 0.003). Applying regression analysis, the CG had 2.849 times more MEs than the IG (p&lt;0.001). Furthermore, the number of patients (CG to IG) with at least one detected ADR or clinical DDI was 19 (36%) to 23 (47%) (p&gt;0.05) and 4 (7%) to 12 (25%), respectively (p = 0.028). Conclusion: Clinical pharmacist availability to systematically and standardized identify, prevent and resolve DRPs among NICU patients is effective. Daily detailed clinical pharmacist observations and interventions enables prevention and monitoring of DRPs. Clinical Trial Registration ClinicalTrials.gov, identifier NCT04899960.</p

Extracorporeal photopheresis in the treatment of acute and chronic graft-versus-host disease: A position statement from the Turkish Society of Apheresis (TSA)

Graft versus host disease (GVHD) is still the most important cause of mortality and morbidity after allogeneic stem cell transplantation. Though perfect response rates are not achieved, steroids are still the first-line treat-ment. In the face of the presence of the drugs approved by FDA in recent years for acute and chronic GVHD as second-line therapy in the steroid-refractory group, there exists no standard approach. Extracorporeal photopheresis (ECP) with an immunomodulatory effect, is favored in the treatment of both acute and chronic steroid refractory GVHD as it does not increase the risk of relapses or infections. Having a low profile of side effects, ECP is also generally well-tolerated by patients. Being a time requiring procedure, the fact is that it is not able to be practiced in all health centers and requires central venous catheters in patients unfit for venous access may be enumerated among its shortcomings. No complete standard is available with respect to ECP application frequency-time; it varies from one center to another. The Turkish Society of Apheresis established the Turkish ECP (TECP) group and sought some answers to the questions regarding the use of ECP in the treatment of GVHD, and issued a position statement

Impact of clinical pharmacist-led intervention for drug-related problems in neonatal intensive care unit a randomized controlled trial

Introduction: Drug-related problems (DRPs) incidence is higher in neonatal intensive care units (NICUs), compared to other pediatric wards due to aspects like off-label medications, pharmacokinetic/dynamic variability, or organ dysfunction/immaturity. This study aimed to determine whether and to what extent a clinical pharmacist intervention improves medication safety and prevents DRPs [medication errors (MEs), adverse drug reactions (ADRs), drug-drug interactions (DDIs)].Methods: A prospective, randomized, double blind, controlled study in NICU-admitted neonates was conducted. NICU patients were randomly assigned to the intervention (clinical pharmacist-led) (IG) or control group (standard care such as clinical diagnosis, pharmacotherapy) (CG). The clinical pharmacist was involved in the IG to identify-prevent-intervene MEs, or identify and monitor ADRs and DDIs. The primary outcome was the number of neonates who developed at least one DRP compared with those seen across IG and CG. Secondary outcomes included length of hospital stay, total number of drugs or DRP type.Results: Neonates were randomly assigned to CG (n = 52) or IG (n = 48). In total, 45%, 42%, and 16% of patients had at least 1 MEs, ADRs, and clinically significant DDIs, respectively. The number of patients with at least 1 ME was 28 (53%) and 17 (35%) in the CG and IG (p&gt;0.05). The median (range) number of ME was higher in CG [1 (0–7)] than in IG [0 (0–4)] (p = 0.003). Applying regression analysis, the CG had 2.849 times more MEs than the IG (p&lt;0.001). Furthermore, the number of patients (CG to IG) with at least one detected ADR or clinical DDI was 19 (36%) to 23 (47%) (p&gt;0.05) and 4 (7%) to 12 (25%), respectively (p = 0.028).Conclusion: Clinical pharmacist availability to systematically and standardized identify, prevent and resolve DRPs among NICU patients is effective. Daily detailed clinical pharmacist observations and interventions enables prevention and monitoring of DRPs.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT04899960

Küsküt (cuscuta campestris Yuncker)'ün biyolojisi ve savaşımına ilişkin incelemeler

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.SUMMARY THE STUDIES ON THE BIOLOGY AND CONTROL OF CUSCUTA SPP. (Cuscuta campestris Yunck.) The results of the studies conducted on the biology and control of Ccampestris which is troublesome in about 55 crops including especially Sugar beet, alfalta, tomato, pepper and eggplant are summerized as fallows: 1. Optimal temperature of the germination of Ccampestris seeds is 30 to 33 C. At the lower temperatures, the rate of seed germina tion is less. 2. Ccampestris can easily emerge from the soil depths of 1-4 cm. The rate of germination is at maximum level in the soil layers near to soilsurface, where as this parasitic weed can not germinate in the soil depths of over 4 cm. 3. The seeds of Ccampestris begin to germinate 3-4 days after sowing depending on soil depth and temperature and this weed produces its new seeds within about 60 days, so, under climatic condition of Aegean Region, it can show two generation in a year. 4. According to the results of experiments carried out in different structures of soil, the seeds of Ccampestris can germinate at the highest rates in clay soil. 5. All of the herbicides in our studies hove controlled Ccampestris at high level. Moreover, it is observed that the herbicides in question with the exception of Trifluralin, has become no phytotoxic effects to alfalfa.19. 6. ÖZET: Başta pancar, yonca, domates, biber, patlıcan olmak üzere yaklaşık 55 konukçuya zarar yapan C.campestris'in biyolojisi ve savaşımına ilişkin yapılan bu araştırmadan elde edilen sonuçları aşağıdaki gibi özetleyebiliriz; 1. Ccampestris'in çimlenebilmesi için optimal sıcaklık 30-33 C dir. Düşük sıcaklıklarda çok zor çimlenebilmektedir. 2. C.campestris 1-4 cm toprak derinlikleri arasında çimlenme gösterir. Toprağın yüzeyine yakın kısımlarda maksimum çimlenme gösterirken 4 cm 'den daha fazla toprak derinliklerinde çimlenme göstermemek- t edir. 3. C.campestris tohumu, derinliğe ve sıcaklığa bağlı olarak ekiminden 3-4. gününden itibaren çimlenmeye başlar ve yaklaşık 60 günde tekrar tohum oluşturur. Bu durumda C.campestris bölgemiz iklim koşullarında yılda 2 döl verebilmektedir. 4. Farklı yapıya sahip olan topraklarda yürütülen denemeler sonucunda C.campestris en yüksek oranda killi toprakta çimlendiği görülmüştür. 5. Denemelerde kullanılan herbisidlerin tümü C.campestris'i yüksek oranda kontrol etmiştir. Trifluralin dışındaki herbisidlerin yoncaya fitotoksik olmadığı gözlenmişti