Levels of adenosine deaminase in some experimental animal tumours and the possible therapeutic effect of the ADA inhibitor 2-deoxy-coformycin.

The intracellular adenosine deaminase activities (ADA) in 12 different experimental animal tumours were measured. Unlike the leukaemic lymphoblasts of man, those of two spontaneous rat leukaemias did not have elevated levels of the enzyme. Very high levels were found in a rat plasma-cell tumour (IR 461) and an attempt was made to treat such tumours with the specific enzyme inhibitor, 2-deoxy-coformycin. The shortage of this drug prevented a systematic study, but a daily dose of 8 mg/kg had a significant inhibitory effect on the growth of tumours

Role of telavancin in treatment of skin and skin structure infections

Skin and skin structure infections (SSSIs) are a common diagnosis encountered by ambulatory and inpatient practitioners across the country. As the SSSIs become more complicated, they require increased health care resources and often involve hospitalization and intravenous antimicrobials. Complicated SSSIs are caused by a variety of pathogens, including Gram-positive, Gram-negative, and anerobic bacteria. Empiric broad-spectrum antibiotic coverage is warranted, taking into account area disease-state epidemiology and antimicrobial susceptibility data. Telavancin is an antimicrobial agent with a broad Gram-positive spectrum of activity which was recently approved for the treatment of SSSIs. It may especially benefit patients with resistant organisms, such as methicillin-resistant Staphylococcus aureus. This article reviews telavancin and its pharmacology, efficacy, and safety data to enhance the practitioner’s knowledge base on the appropriateness of telavancin for the treatment of SSSIs

EAHP European Statements baseline survey 2015

Objectives The 2015 EAHP European Statements survey was related to sections 2, 5 and 6 of the European Statements of Hospital Pharmacy (Statements). In addition to collection of statistical data about the level of implementation of the Statements, it was also intended to identify important barriers to their implementation. Methods The online questionnaire was sent to all hospital pharmacies in EAHP member countries. Data were analysed by researchers from Keele University School of Pharmacy, UK and the EAHP Survey Group. Results There were a total of 949 responses (response rate 18%). In the first part of the survey, data was collected on hospital pharmacy setting. While almost half of hospital pharmacies served over 500 beds, 80% of hospital pharmacies had 10 or less pharmacists. In section B, we gathered evidence about the degree of implementation of sections 2, 5 and 6 of the Statements and the main barriers to and drivers of implementation. Five questions with the lowest implementation level were then further analysed. Only five countries had 50% or more of hospital pharmacies reporting that the hospital pharmacists routinely publish hospital pharmacy practice research. 67% of participants stated that they had contingency plans for medicines shortages. The majority of countries (n=20) have less than half of respondents using computerised decision support to reduce the risk of medication errors. When asked if an audit had been undertaken in the past 3 years to identify priorities in medicines use processes, the mean percentage of positive responses for a country was 58%. Conclusions EAHP has gained an informative overview of the implementation level as well as the barriers to and drivers of implementation in sections 2, 5 and 6. This is essential to inform the plans for EAHP to best support their implementation

Evidence based approach to the treatment of community-associated methicillin-resistant Staphylococcus aureus

Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have increased dramatically over the last two decades. The types of infections can range from complicated skin and skin structure infections (cSSSI) to pneumonia and endocarditis. Oral antimicrobial therapy, such as trimethoprim-sulfamethoxazole, clindamycin, long-acting tetracyclines, or linezolid may provide enhanced benefit to those with uncomplicated cutaneous lesions when used in conjunction with incision and drainage in an outpatient setting. However, resistance, susceptibilities, patient-specific circumstances, and adverse effects can impact a healthcare professional’s choice of antibiotics. In patients with complicated infections requiring hospitalization or parenteral treatment, vancomycin remains the drug of choice, even though increased resistance and decreased efficacy have crept into clinical practice. Linezolid, quinupristin/dalfopristin, daptomycin, and tigecycline are alternative intravenous agents for the treatment of CA-MRSA. Investigational agents such as dalbavancin, telavancin, oritivancin, iclaprim, ceftobiprole, ceftaroline, and others may expand our therapeutic armamentarium for the treatment of infections caused by CA-MRSA in the future

Playing the long game: exploring the phenomenon of dementia friendly golf

As individuals age, participation in previously accessible leisure activities can be compromised through diminished capabilities and negative societal expectations. This study investigates the unexplored accessibility of golf for older people with dementia using interviews and observations of Scottish participants in social enterprise–led golfing activities. The resulting thematic analysis concluded that golf is an accessible activity for people living with dementia, and continued participation generates social connectedness and enhances well-being. However, there remain social barriers to participation including societal stigma surrounding the perceived abilities of people living with dementia and the perception of golf as a middle-class and male-dominated sport

State-of-the-art in product service-systems

A Product Service-System (PSS) is an integrated combination of products and services. This western concept embraces a service-led competitive strategy, environmental sustainability, and the basis to differentiate from competitors who simply offer lower priced products. This paper aims to report the state-of-the-art of PSS research by presenting a clinical review of literature currently available on this topic. The literature is classified and the major outcomes of each study are addressed and analysed. On this basis, this paper defines the PSS concept, reports on its origin and features, gives examples of applications along with potential benefits and barriers to adoption, summarises available tools and methodologies, and identifies future research challenges

PHarmacist Avoidance or Reductions in Medical Costs in CRITically Ill Adults: PHARM-CRIT Study

OBJECTIVES: To comprehensively classify interventions performed by ICU clinical pharmacists and quantify cost avoidance generated through their accepted interventions. DESIGN: A multicenter, prospective, observational study was performed between August 2018 and January 2019. SETTING: Community hospitals and academic medical centers in the United States. PARTICIPANTS: ICU clinical pharmacists. INTERVENTIONS: Recommendations classified into one of 38 intervention categories (divided into six unique sections) associated with cost avoidance. MEASUREMENTS AND MAIN RESULTS: Two-hundred fifteen ICU pharmacists at 85 centers performed 55,926 interventions during 3,148 shifts that were accepted on 27,681 adult patient days and generated $23,404,089 of cost avoidance. The quantity of accepted interventions and cost avoidance generated in six established sections was adverse drug event prevention (5,777 interventions;$5,822,539 CA), resource utilization (12,630 interventions; $4,491,318), individualization of patient care (29,284 interventions;$9,680,036 cost avoidance), prophylaxis (1,639 interventions; $1,414,465 cost avoidance), hands-on care (1,828 interventions;$1,339,621 cost avoidance), and administrative/supportive tasks (4,768 interventions; $656,110 cost avoidance). Mean cost avoidance was$418 per intervention, $845 per patient day, and$7,435 per ICU pharmacist shift. The annualized cost avoidance from an ICU pharmacist is $1,784,302. The potential monetary cost avoidance to pharmacist salary ratio was between$3.3:1 and $9.6:1. CONCLUSIONS: Pharmacist involvement in the care of critically ill patients results in significant avoidance of healthcare costs, particularly in the areas of individualization of patient care, adverse drug event prevention, and resource utilization. The potential monetary cost avoidance to pharmacist salary ratio employing an ICU clinical pharmacist is between$3.3:1 and $9.6:1