Hydrolysis of cefazolin by enzymes produced by Pseudomonas aeruginosa after exposure to ceftazidime in vitro

Background/Aim. Sometimes resistance of Pseudomonas aeruginosa (Ps. aeruginosa) is developed during antibiotic treatment, in spite of the initial susceptibility in vitro. The aim of this study was to use an in vitro model for the study of the development of resistant strains of Ps. aeruginosa after a short exposure to ceftazidime, and to study the hydrolysing capacity of β-lactamases produced by the resistant strains. Methods. Among 563 clinical strains of Ps. aeruginosa, 37 multisensitive strains were collected for the study. After being identified, strains with simultaneous sensitivity to 5 expanded spectrum cephalosporins were chosen. For each strain, the minimal inhibitory concentration (MIC) of the 5 expanded spectrum cephalosporins was determined, and the production of extended spectrum β-lactamases (ESBL) was excluded by the double-disc synergy diffusion test. Strains non producing ESBL were cultivated in concentrations of ceftazidime equal to MIC×2 and MIC×4. After 24 hours of culture, the development of resistant strains was estimated and the cephalosporinase activity of the produced β-lactamases was determined by their ability to hydrolyse cefazolin. Hydrolysis of cefazolin was studied by measuring the change of its absorbance on 272 nm using a Shimadzu 160A spectrophotometer. The hydrolyzing capacity of the enzymes was expressed as the percentage of the antibiotic, which was hydrolysed in 10 sec. Results. A total of 60% and 50% of strains developed resistant strains after exposure to ceftazidime in concentration MIC×2 and MIC×4, respectively. The hydrolyzing capacity of the original strains was 15-36% while the hydrolyzing capacity of the resistant strains was 10-73%. Totally 64% of the resistant strains expressed higher hydrolyzing capacity than the original strains. Conclusion. Regardless of the susceptibility test results, Ps. aeruginosa presented a high tendency to develop resistant strains after a short exposure to ceftazidime in vitro. In most cases the resistant strains expressed higher cephalosporinase activity than the original strains, suggesting derepression of chromosomal β-lactamases. Our model offers a simple, inexpensive and rapid method for detecting resistance of Ps. aeruginosa developed due to derepression of β-lactamases, and for discriminating resistant strains with derepressed β-lactamases from strains that developed other mechanisms of resistance

Epidemiologic Study of the Sexually Dimorphic Second to Fourth Digit Ratio (2D:4D) and Other Finger Ratios in Greek Population

The 2nd to 4th digit ratio (2D:4D) is a sexually dimorphic biometric marker, related to prenatal estrogen and testosterone levels in utero, and determined genetically by the HOX genes. 2D:4D presents a population variation, which seems to be dependent on geographical position or ethnicity, and may reflect differences in prenatal steroid hormone levels among different ethnic groups. In view of its clinical importance, this study investigates the 2D:4D ratio, as well as other digit ratios, in Greek population. A sample of 60 Greek men and 60 Greek women (age range 19–25 years) was selected by random procedures. Fingers’ length was measured twice, using an electronic vernier calliper (precision 0.01 mm). Men had lower 2D:4D ratio (0.974 ± 0.035 for the right hand and 0.973 ± 0.044 for the left hand) than women (1.002 ± 0.04 for the right hand and 1.001 ± 0.045 for the left hand). This difference in 2D:4D ratio between sexes was statistically significant (p<0.0001 for the right hand and p<0.001 for the left hand). The other digit ratios were also lower in men than women for both hands; this difference was statistically significant for all digit ratios of the right hand and for the 2nd to 3rd (2D:3D) and 2nd to 5th (2D:5D) digit ratios of the left hand. The digit ratios are lateralized and sexually dimorphic in Greek population. The sexual dimorphism of all digit ratios (except 2D:3D) is stronger in right than left hand

Use of antidepressants in the area of Thessaloniki

The purpose of this work was to study the use of antidepressants, with an emphasis on the use of generics, in the greater area of Thessaloniki. Data were obtained from 14 pharmacies (9 pharmacies in eastern Thessaloniki and 5 pharmacies in western Thessaloniki). The data for the study were collected using the electronic records of executed prescriptions of the pharmacies. The amount of drugs was calculated in Defined Daily Doses (DDDs). The percentage of generics and brand-name medicines for each drug was also calculated. A total of 306,148 DDDs of antidepressants were consumed, of which the vast majority (74%) were selective serotonin reuptake inhibitors (SSRIs). The percentage of generic drugs was 32%. Citalopram (65%), venlafaxine (56%) and sertraline (52%) showed the highest rates of consumption of generics. The rates of use of SSRIs and generics were similar in both eastern and western Thessaloniki

Teaching resources for the European Open Platform for Prescribing Education (EurOP2E) : a nominal group technique study

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.The European Open Platform for Prescribing Education (EurOP2E) seeks to improve and harmonize European clinical pharmacology and therapeutics (CPT) education by facilitating international collaboration and sharing problem-based, online, open educational resources. The COVID-19 pandemic forced teachers to switch to virtual modalities, highlighting the need for high-quality online teaching materials. The goal of this study was to establish the online problem-based teaching resources needed to sustain prescribing education during the pandemic and thereafter. A nominal group technique study was conducted with prescribing teachers from 15 European countries. Results were analyzed through thematic analysis. In four meetings, 20 teachers from 15 countries proposed and ranked 35 teaching materials. According to the participants, the most necessary problem-based-online teaching materials related to three overarching themes. Related to learning outcomes for CPT, participants proposed creating prescription scenarios, including materials focusing on background knowledge and resources on personalized medicine and topical/ethical issues such as the prescription's impact on planetary health. Second, related to teaching, they proposed online case discussions, gamification and decision support systems. Finally, in relation to faculty development, they recommend teacher courses, a repository of reusable exam questions and harmonized formularies. Future work will aim to collaboratively produce such materials.This study was funded by the European Union under Erasmus+ grant 2020-1-NL01-KA203-083098info:eu-repo/semantics/publishedVersio

EurOP²E – the European Open Platform for Prescribing Education, a consensus study among clinical pharmacology and therapeutics teachers

Purpose Sharing and developing digital educational resources and open educational resources has been proposed as a way to harmonize and improve clinical pharmacology and therapeutics (CPT) education in European medical schools. Previous research, however, has shown that there are barriers to the adoption and implementation of open educational resources. The aim of this study was to determine perceived opportunities and barriers to the use and creation of open educational resources among European CPT teachers and possible solutions for these barriers. Methods CPT teachers of British and EU medical schools completed an online survey. Opportunities and challenges were identified by thematic analyses and subsequently discussed in an international consensus meeting. Results Data from 99 CPT teachers from 95 medical schools were analysed. Thirty teachers (30.3%) shared or collaboratively produced digital educational resources. All teachers foresaw opportunities in the more active use of open educational resources, including improving the quality of their teaching. The challenges reported were language barriers, local differences, lack of time, technological issues, difficulties with quality management, and copyright restrictions. Practical solutions for these challenges were discussed and include a peer review system, clear indexing, and use of copyright licenses that permit adaptation of resources. Conclusion Key challenges to making greater use of CPT open educational resources are a limited applicability of such resources due to language and local differences and quality concerns. These challenges may be resolved by relatively simple measures, such as allowing adaptation and translation of resources and a peer review system

EurOP2E – the European Open Platform for Prescribing Education, a consensus study among clinical pharmacology and therapeutics teachers

Purpose Sharing and developing digital educational resources and open educational resources has been proposed as a way to harmonize and improve clinical pharmacology and therapeutics (CPT) education in European medical schools. Previous research, however, has shown that there are barriers to the adoption and implementation of open educational resources. The aim of this study was to determine perceived opportunities and barriers to the use and creation of open educational resources among European CPT teachers and possible solutions for these barriers. Methods CPT teachers of British and EU medical schools completed an online survey. Opportunities and challenges were identified by thematic analyses and subsequently discussed in an international consensus meeting. Results Data from 99 CPT teachers from 95 medical schools were analysed. Thirty teachers (30.3%) shared or collaboratively produced digital educational resources. All teachers foresaw opportunities in the more active use of open educational resources, including improving the quality of their teaching. The challenges reported were language barriers, local differences, lack of time, technological issues, difficulties with quality management, and copyright restrictions. Practical solutions for these challenges were discussed and include a peer review system, clear indexing, and use of copyright licenses that permit adaptation of resources. Conclusion Key challenges to making greater use of CPT open educational resources are a limited applicability of such resources due to language and local differences and quality concerns. These challenges may be resolved by relatively simple measures, such as allowing adaptation and translation of resources and a peer review system

Key Learning Outcomes for Clinical Pharmacology and Therapeutics Education in Europe: A Modified Delphi Study.

Harmonizing clinical pharmacology and therapeutics (CPT) education in Europe is necessary to ensure that the prescribing competency of future doctors is of a uniform high standard. As there are currently no uniform requirements, our aim was to achieve consensus on key learning outcomes for undergraduate CPT education in Europe. We used a modified Delphi method consisting of three questionnaire rounds and a panel meeting. A total of 129 experts from 27 European countries were asked to rate 307 learning outcomes. In all, 92 experts (71%) completed all three questionnaire rounds, and 33 experts (26%) attended the meeting. 232 learning outcomes from the original list, 15 newly suggested and 5 rephrased outcomes were included. These 252 learning outcomes should be included in undergraduate CPT curricula to ensure that European graduates are able to prescribe safely and effectively. We provide a blueprint of a European core curriculum describing when and how the learning outcomes might be acquired

Epidemiologic Study of the Sexually Dimorphic Second to Fourth Digit Ratio (2D:4D) and Other Finger Ratios in Greek Population

The 2nd to 4th digit ratio (2D:4D) is a sexually dimorphic biometric marker, related to prenatal estrogen and testosterone levels in utero, and determined genetically by the HOX genes. 2D:4D presents a population variation, which seems to be dependent on geographical position or ethnicity, and may reflect differences in prenatal steroid hormone levels among different ethnic groups. In view of its clinical importance, this study investigates the 2D:4D ratio, as well as other digit ratios, in Greek population. A sample of 60 Greek men and 60 Greek women (age range 19–25 years) was selected by random procedures. Fingers’ length was measured twice, using an electronic vernier calliper (precision 0.01 mm). Men had lower 2D:4D ratio (0.974 ± 0.035 for the right hand and 0.973 ± 0.044 for the left hand) than women (1.002 ± 0.04 for the right hand and 1.001 ± 0.045 for the left hand). This difference in 2D:4D ratio between sexes was statistically significant (p<0.0001 for the right hand and p<0.001 for the left hand). The other digit ratios were also lower in men than women for both hands; this difference was statistically significant for all digit ratios of the right hand and for the 2nd to 3rd (2D:3D) and 2nd to 5th (2D:5D) digit ratios of the left hand. The digit ratios are lateralized and sexually dimorphic in Greek population. The sexual dimorphism of all digit ratios (except 2D:3D) is stronger in right than left hand