No description available.

No description available.

Objective: To describe relationship between cord blood (representing fetal) myo-inositol concentrations and gestational age (GA) and to determine trends of blood concentrations in enterally and parenterally fed infants from birth to 70 days of age. Design/Methods: Samples were collected in 281 fed or unfed infants born in 2005 and 2006. Myo-inositol concentrations were displayed in scatter plots and analyzed with linear regression models of natural log-transformed values. Results: In 441 samples obtained from 281 infants, myo-inositol concentrations varied from nondetectable to 1494 μmol/L. Cord myo-inositol concentrations decreased an estimated 11.9% per week increase in GA. Postnatal myo-inositol concentrations decreased an estimated 14.3% per week increase in postmenstrual age (PMA) and were higher for enterally fed infants compared to unfed infants (51% increase for fed vs. unfed infants). Conclusions: Fetal myo-inositol concentrations decreased with increasing GA. Postnatal concentrations decreased with increasing PMA and were higher among enterally fed than unfed infants.

Bacteria are remarkably adaptable organisms with an innate ability to circumvent damage if exposed to a toxic environment. Antimicrobial-resistant bacteria are present worldwide, and many common infections are becoming more difficult to treat. Continued resistance is rapidly eliminating treatment options for patients, and the cost burden to treat a multidrug-resistant infection is climbing. Owing to the substantial costs associated with drug development, the introduction of novel antibiotics has lagged behind the increase in bacterial resistance. To address this crisis, pharmacists can take an active role in antimicrobial stewardship and foster understanding of how bacteria evade even the strongest available antimicrobial agents.

Inositol is a 6-carbon sugar alcohol that has been shown in limited studies to reduce retinopathy of prematurity and chronic lung disease in premature newborns. Developmentally it has a high concentration in the fetus that decreases with gestational age. It is transported from the fetus to the mother across the placenta. Although studies are underway to determine inositol kinetics in premature newborns treated therapeutically, the effects of gestational age, age after birth, and feeding on inositol concentrations after birth have not been studied adequately in premature newborns. Such studies would minimize blood removal and trauma in preterm newborns by using plasma samples scavenged from the clinical laboratory to measure inositol after birth, if they remain stable. This report describes a new high pressure liquid chromatographic assay for inositol and its use to study the stability of inositol in conditions of storage that might be encountered within the clinical laboratory. The assay is linear from 0 to 1000 Mm with a lower limit of quantitation of 50 μM. Inositol in human plasma remains stable in refrigeration and at room temperature for up to 14 days and is not affected by storage in red blood cells that are intact or lysed. Anticoagulants encountered in clinical blood samples do not interfere with the chromatograms. Thus, it is feasible to measure the changes in inositol concentrations in plasma from preterm newborns that is scavenged from the clinical laboratory after storage for as long as 14 days.

No description available.

No description available.

The way in which British community pharmacists work has been much talked about but, until now, not quantified. A review of work study techniques within the field of pharmacy revealed that community pharmacy had been largely neglected. In the light of recommendations to extend the community pharmacists' role to provide non-traditional services it was necessary to examine community pharmacy practice to investigate the feasibility of diversifying pharmacy roles. Utilising the technique of subjective evaluation, pharmacy managers from a national multiple chain were asked to estimate how much time they spent on each of sixteen activity categories that had been devised by the author to represent their work. Three hundred and twenty three managers replied to the study generating 1,084 usable responses. The findings showed that seven categories accounted for almost 80% of their time, of which dispensing [as defined in this thesis] occupied proportionally the greatest amount of time of any category [37%]. However, subjective evaluation relies on estimation and has been previously criticised as being imprecise. A further work study technique, work sampling, was chosen as the most appropriate validation tool to determine the accuracy of the subjective evaluation findings. Five pre-registration pharmacists recorded the work of five pharmacy managers, generating 2,682 observations. The results from the observed data set were compared with those from subjective evaluation. Only two categories were found to be significantly different, lending weight to the assumption that the results obtained from the subjective evaluation study were an accurate record of how community pharmacists spent their time. These results demonstrated that the work patterns of community pharmacists mainly centre on the supply of medicines. The final stage of the research programme attempted to alter pharmacist work patterns via a skill mix programme in an attempt to limit pharmacist involvement in technical tasks such as dispensing. A `pre-test post-test' design was employed to determine the success of the study on three outcome measuresthe change in work patterns after skill mix implementation; non-pharmacist acceptance of altering their way of working; the perceptions held by the pharmacists also on the new way of working. The results showed that pharmacists' work patterns were altered, although changes could not be directly attributable to the intervention. In addition, the principal aim of substantially reducing the time they spent dispensing was not achieved. Non-pharmacist staff, on the whole, accepted or preferred the change to work practice as too did pharmacists. However, barriers to change were identified which needed to be rectified before skill mixing can have a significant impact on freeing pharmacist time away from dispensing

Lorcaserin represents a new serotonergic medication used as an adjunct to a reduced-calorie diet and increased physical activity treatment plan for chronic weight management in adult patients with an initial body mass index ≥ 30 kg/m 2 or in adult patients with an initial body mass index ≥ 27 kg/m 2 who have ≥ 1 comorbid condition associated with weight (eg, hypertension, dyslipidemia, or type 2 diabetes mellitus). In 2012, lorcaserin became the first obesity treatment medication to gain US Food and Drug Administration (FDA) approval since 1999. Lorcaserin is a centrally acting, selective serotonin C (5-HT2C) receptor full agonist that is associated with increased satiety and decreased food consumption in patients. The selectivity of lorcaserin for 5-HT2C receptors should reduce patient risk for the serious adverse complications that are associated with nonselective 5-HT agonist therapies, such as cardiac valvulopathy and pulmonary hypertension. The safety and efficacy of lorcaserin (10 mg twice daily) for ≥ 52 weeks has been evaluated in 3 separate Phase 3 trials. The primary outcome of patient weight loss in the 3 trials satisfied the FDA categorical benchmark but patient outcomes in the trials failed to achieve the FDA mean benchmark of patient weight loss. Secondary patient outcomes after lorcaserin therapy were favorable. Lorcaserin appears to be well tolerated in patients and the most common adverse events reported did not include serious complications. The incidence of FDA-defined valvulopathy in patients after 1 year of treatment was low and nonsignificant, but the statistical analysis of this safety endpoint was limited due to the small size of the study populations and high patient dropout rates. Continued post-marketing surveillance of patients taking lorcaserin is warranted.

Lorcaserin represents a new serotonergic medication used as an adjunct to a reduced-calorie diet and increased physical activity treatment plan for chronic weight management in adult patients with an initial body mass index ≥ 30 kg/m 2 or in adult patients with an initial body mass index ≥ 27 kg/m 2 who have ≥ 1 comorbid condition associated with weight (eg, hypertension, dyslipidemia, or type 2 diabetes mellitus). In 2012, lorcaserin became the first obesity treatment medication to gain US Food and Drug Administration (FDA) approval since 1999. Lorcaserin is a centrally acting, selective serotonin C (5-HT2C) receptor full agonist that is associated with increased satiety and decreased food consumption in patients. The selectivity of lorcaserin for 5-HT2C receptors should reduce patient risk for the serious adverse complications that are associated with nonselective 5-HT agonist therapies, such as cardiac valvulopathy and pulmonary hypertension. The safety and efficacy of lorcaserin (10 mg twice daily) for ≥ 52 weeks has been evaluated in 3 separate Phase 3 trials. The primary outcome of patient weight loss in the 3 trials satisfied the FDA categorical benchmark but patient outcomes in the trials failed to achieve the FDA mean benchmark of patient weight loss. Secondary patient outcomes after lorcaserin therapy were favorable. Lorcaserin appears to be well tolerated in patients and the most common adverse events reported did not include serious complications. The incidence of FDA-defined valvulopathy in patients after 1 year of treatment was low and nonsignificant, but the statistical analysis of this safety endpoint was limited due to the small size of the study populations and high patient dropout rates. Continued post-marketing surveillance of patients taking lorcaserin is warranted.