VARIABLES IMPACTING GFR ESTIMATION METHOD FOR DRUG DOSING IN CKD: ARTIFICIAL NEURAL NETWORK PREDICTION MODEL

Objective: This study aimed to measure concordance between different renal function estimates in terms of drug doses and determine the potential significant clinical differences. Methods: Around one hundred and eighty patients (≥ 18 y) with chronic kidney disease (CKD) were eligible for inclusion in this study. A paired-proportion cohort design was utilized using an artificial intelligence model. CKD patients refined into those who have drugs adjusted for renal function. For superiority of Cockcroft-Gault (CG) vs. modified diet in renal disease (MDRD) guided with references for concordance or discordance of the two equations and determined the dosing tiers of each drug. Validated artificial neural networks (ANN) was one outcome of interest. Variable impacts and performed reassignments were compared to evaluate the factors that affect the accuracy in estimating the kidney function for a better drug dosing. Results: The best ANN model classified most cases to CG as the best dosing method (79 vs. 72). The probability was 85% and the top performance was slightly above 93%. Creatinine levels and CKD staging were the most important factors in determining the best dosing method of CG versus MDRD. Ideal and actual body weights were second (24%). Whereas drug class or the specific drug was an important third factor (14%). Conclusion: Among many variables that affect the optimal dosing method, the top three are probably CKD staging, weight, and the drug. The contrasting CKD stages from the different methods can be used to recognize patterns, identify and predict the best dosing tactics in CKD patients

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED).Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health.Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses.Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk factor

Simultaneous determination of isoniazid and pyrazinamide in plasma by high performance liquid chromatography

Purpose: To develop and validate a new high performance liquid chromatographic (HPLC) method for the simultaneous determination of isoniazid (INH) and pyrazinamide (PZA) in plasma.Methods: A 150 μL aliquot of plasma was mixed with 75 μL of 10 % trichloroacetic acid containing 100 mg/L of acetanilide as the internal standard (IS). After vortex mixing and centrifugation, 100 μL of the supernatant was reacted with 20 μL of 0.1 % trans-cinnamaldehyde for 10 min, and then 40 μL of 1M ammonium acetate was added. Finally, 20 μL was injected into the HPLC system. HPLC analysis was performed on reversed phase C18 column. The initial composition of the mobile phase was 4 % acetonitrile, and 96 % of 20 mM 1-hexane sulfonic acid (PH 2.7) delivered at a flow rate 1 mL/min.Results: All calibration curves were linear (r2 > 0.997). The method was accurate, and relative error (RE) was < 4.5 % for both drugs. Intra-day and inter-day precision was good for both drugs, with the highest relative standard deviation (RSD) being 8.51 %. The lower limit of quantification was 0.60 mg/L for isoniazid and 3.00 mg/L for pyrazinamide.Conclusion: The method proposed here is precise, accurate, fast, simple and suitable for therapeutic drug monitoring of INH and PZA simultaneously.Keywords: HPLC, Isoniazid, Pyrazinamide, Plasma, Simultaneous analysi

The cost of mapping trachoma: Data from the Global Trachoma Mapping Project.

BACKGROUND: The Global Trachoma Mapping Project (GTMP) was implemented with the aim of completing the baseline map of trachoma globally. Over 2.6 million people were examined in 1,546 districts across 29 countries between December 2012 and January 2016. The aim of the analysis was to estimate the unit cost and to identify the key cost drivers of trachoma prevalence surveys conducted as part of GTMP. METHODOLOGY AND PRINCIPAL FINDINGS: In-country and global support costs were obtained using GTMP financial records. In-country expenditure was analysed for 1,164 districts across 17 countries. The mean survey cost was $13,113 per district [median:$11,675; IQR = $8,365-$14,618], $17,566 per evaluation unit [median:$15,839; IQR = $10,773-$19,915], $692 per cluster [median:$625; IQR = $452-$847] and $6.0 per person screened [median:$4.9; IQR = $3.7-$7.9]. Survey unit costs varied substantially across settings, and were driven by parameters such as geographic location, demographic characteristics, seasonal effects, and local operational constraints. Analysis by activities showed that fieldwork constituted the largest share of in-country survey costs (74%), followed by training of survey teams (11%). The main drivers of in-country survey costs were personnel (49%) and transportation (44%). Global support expenditure for all surveyed districts amounted to $5.1m, which included grant management, epidemiological support, and data stewardship. CONCLUSION: This study provides the most extensive analysis of the cost of conducting trachoma prevalence surveys to date. The findings can aid planning and budgeting for future trachoma surveys required to measure the impact of trachoma elimination activities. Furthermore, the results of this study can also be used as a cost basis for other disease mapping programmes, where disease or context-specific survey cost data are not available

Occurrence of vancomycin-resistant Staphylococcus aureus in the oral cavity of patients with dental caries

Oral streptococci are the major group of microbes isolated from oral microflora. They represent frequent pathogens of infective endocarditis (IE), and it is assumed that in most of the cases oral streptococci are acquired via mucosa layer of oral cavity. Staphylococcus aureus is also frequently isolated from IE as it accounts for 20%–30% of all cases. Vancomycin has been the most reliable therapeutic agent against infections caused by methicillin-resistant S. aureus (MRSA). The main objective of this study was to examine the occurrence of S. aureus species in dental caries specimens. Antimicrobial susceptibility testing of S. aureus to four antibiotics namely vancomycin, linezolid, teicoplanin, and daptomycin was performed. Detection of vancomycin resistance was conducted using polymerase chain reaction. Among the tested 150 strains, 98 were MRSA and of that 54 were vancomycin sensitive and 27 were resistant. All 98 MRSA strains were positive for mecA and 36 yielded pvl, whereas 13 carried vanA and only 2 were positive for vanB. Majority of the isolates showed sensitivity toward daptomycin and linezolid. Strains of S. aureus exhibiting decreased susceptibility to different antibiotics like vancomycin, daptomycin, and linezolid severely compromise the therapeutic alternatives and require a considerable amount of time, public awareness, and integrative health-care strategies to prevent the emergence of resistance to these compounds

Computer Vision for Substrate Detection in High‐Throughput Biomaterial Screens Using Bright‐Field Microscopy

High-throughput screening (HTS) can be used when ab initio information is unavailable for rational design of new materials, generating data on properties such as chemistry and topography that control cell behavior. Biomaterial screens are typically fabricated as microarrays or “chips,” seeded with the cell type of interest, then phenotyped using immunocytochemistry and high-content imaging, generating vast quantities of image data. Typically, analysis is only performed on fluorescent cell images as it is relatively simple to automate through intensity thresholding of cellular features. Automated analysis of bright-field images is rarely performed as it presents an automation challenge as segmentation thresholds that work in all images cannot be defined. This limits the biological insight as cell response cannot be correlated to specifics of the biomaterial feature (e.g., shape, size) as these features are not visible on fluorescence images. Computer Vision aims to digitize tasks humans do by sight, such as identify objects by their shape. Herein, two case studies demonstrate how open-source approaches, (region-based convolutional neural network and algorithmic [OpenCV]), can be integrated into cell-biomaterial HTS analysis to automate bright-field segmentation across thousands of images, allowing rapid, spatial definition of biomaterial features during cell analysis for the first time

The Scottish Bladder Cancer Quality Performance Indicators Influencing Outcomes, Prognosis, and Surveillance (Scot BC Quality OPS) Clinical Project

The aim of the Scot BC Quality OPS clinical project is to create a reliable prospective data set for evaluating real-world effectiveness and efficiency consequent to standardisation and monitoring of bladder cancer treatment (through the national Quality Performance Indicator programme) and streamlined surveillance in Scotland. Several work packages have been created, reflecting wide clinical and research collaboration