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[PMID]:28783816
[Au] Autor:Pasay D; Guirguis M; Shkrobot R; Slobodan J; Bresee L
[Ad] Endereço:Alberta Health Services, Vegreville, Alberta, Canada.
[Ti] Título:Association of Dissemination of an Educational Communication Tool With Docusate Administration.
[So] Source:JAMA Intern Med;177(10):1433-1436, 2017 Oct 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: A clear message and call to action can affect the use of a medication with limited efficacy. Objectives: To assess the association of the dissemination of an educational document about the lack of efficacy of docusate with docusate administration and whether changing docusate administration was associated with a change in administration of comparable laxatives. Design, Setting, and Participants: In this quasi-experimental, pre-post study of all acute care and continuing care facilities serviced by Alberta Health Services in Alberta, Canada, an interrupted time series analysis was performed to examine the association of an educational communication tool with docusate administration from June 1, 2014, through May 31, 2016. Interventions: A Drugs & Therapeutics Backgrounder was disseminated to all pharmacists in December 2014. Backgrounders are academic detailing tools to assist pharmacists in supporting drug stewardship and are supplemented by online, interactive webinars. Main Outcomes and Measures: This study examined whether a decrease in docusate administration across the organization occurred after release of the backgrounder. Messaging in the backgrounder stated that, unless clinically necessary, docusate should not be replaced by another medication. This study assessed whether that message was accepted by measuring administration of comparable laxatives. Study medication administration is reported as defined daily doses (DDDs) per 1000 inpatient-days (PDs). Rates were compared for the 6 months before the intervention and 3, 6, 12, and 18 months after intervention. Results: Among the 111 acute care facilities (8500 beds) and 24 000 long-term care beds of the Alberta Health Services, predicted docusate administration decreased from preintervention (474 DDDs/1000 PDs) to 3 months (321 DDDs/1000 PDs; 95% CI, 304-465 DDDs/1000 PDs), 6 months (296 DDDs/1000 PDs; 95% CI, 277-456 DDDs/1000 PDs), 12 months (251 DDDs/1000 PDs; 95% CI, 207-499 DDDs/1000 PDs), and 18 months (214 DDDs/1000 PDs; 95% CI, 148-536 DDDs/1000 PDs). Administration of the comparable laxatives did not statistically significantly change (preintervention: 627 DDDs/1000 PDs; 18 months after intervention: 702 DDDs/1000 PDs; 95% CI, 295-694 DDDs/1000 PDs; P = .13). Conclusions and Relevance: A communication document supported by live presentations was associated with decreased administration of docusate up to 6 months, with a leveling of the association after 1 year. Significant systemic change can be achieved without extensive and complex interventions if the evidence and messaging are aligned.
[Mh] Termos MeSH primário: Constipação Intestinal/tratamento farmacológico
Ácido Dioctil Sulfossuccínico/administração & dosagem
Conhecimentos, Atitudes e Prática em Saúde
Disseminação de Informação/métodos
Adesão à Medicação
[Mh] Termos MeSH secundário: Alberta/epidemiologia
Constipação Intestinal/epidemiologia
Seguimentos
Seres Humanos
Incidência
Estudos Retrospectivos
Tensoativos/administração & dosagem
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Surface-Active Agents); 10041-19-7 (Dioctyl Sulfosuccinic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170808
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.3605


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[PMID]:28347848
[Au] Autor:Hetényi G; Griesser J; Moser M; Demarne F; Jannin V; Bernkop-Schnürch A
[Ad] Endereço:Thiomatrix Forschungs-und Beratungs GmbH, Trientlgasse 65, Innsbruck, Austria.
[Ti] Título:Comparison of the protective effect of self-emulsifying peptide drug delivery systems towards intestinal proteases and glutathione.
[So] Source:Int J Pharm;523(1):357-365, 2017 May 15.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIM: The aim of this study was to evaluate the protective effect of self-emulsifying drug delivery systems (SEDDS) for therapeutic peptides towards intestinal proteases and reduced glutathione (GSH). METHODS: Sodium docusate was applied as anionic surfactant for hydrophobic ion pairing with leuprorelin (LEU), insulin (INS) and desmopressin (DES). The complexes were loaded into SEDDS that were characterized regarding droplet size distribution and zeta potential. The release profile of the peptides was examined by dialysis membrane method. Enzymatic digestion studies were performed by applying α-chymotrypsin, trypsin and elastase. Furthermore, the protective effect of SEDDS towards degradation through thiol-disulfide exchange reactions was examined by addition of GSH. RESULTS: SEDDS showed a mean droplet size of 0.27-3.9µm and a zeta potential of -25 to -33mV. All formulations provided a sustained release of the peptides over 6h. Degradation of the model peptides by intestinal proteases and GSH could only be observed in the release medium. In the oily phase of SEDDS neither any of the proteases nor GSH was soluble (≤0.1%). Furthermore, no degradation of the model peptides by proteases and GSH took place in the oily phase of SEDDS. CONCLUSION: SEDDS can provide a 100% protective effect towards protease degradation and deactivation by GSH. According to this, SEDDS might be promising tools for oral delivery of peptide drugs.
[Mh] Termos MeSH primário: Desamino Arginina Vasopressina/química
Sistemas de Liberação de Medicamentos
Glutationa/química
Insulina/química
Leuprolida/química
Peptídeo Hidrolases/química
[Mh] Termos MeSH secundário: Ácido Dioctil Sulfossuccínico/química
Liberação Controlada de Fármacos
Emulsificantes/química
Intestinos/enzimologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Emulsifying Agents); 0 (Insulin); 10041-19-7 (Dioctyl Sulfosuccinic Acid); EC 3.4.- (Peptide Hydrolases); EFY6W0M8TG (Leuprolide); ENR1LLB0FP (Deamino Arginine Vasopressin); GAN16C9B8O (Glutathione)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170807
[Lr] Data última revisão:
170807
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE


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[PMID]:28259740
[Au] Autor:Soper AK; Edler KJ
[Ad] Endereço:STFC Rutherford Appleton Laboratory, Harwell Campus, Didcot, OX11 0QX, UK. Electronic address: alan.soper@stfc.ac.uk.
[Ti] Título:Coarse-grained empirical potential structure refinement: Application to a reverse aqueous micelle.
[So] Source:Biochim Biophys Acta;1861(6):1652-1660, 2017 06.
[Is] ISSN:0006-3002
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Conventional atomistic computer simulations, involving perhaps up to 10 atoms, can achieve length-scales on the order of a few 10s of nm. Yet many heterogeneous systems, such as colloids, nano-structured materials, or biological systems, can involve correlations over distances up 100s of nm, perhaps even 1µm in some instances. For such systems it is necessary to invoke coarse-graining, where single atoms are replaced by agglomerations of atoms, usually represented as spheres, in order for the simulation to be performed within a practical computer memory and time scale. Small angle scattering and reflectivity measurements, both X-ray and neutron, are routinely used to investigate structure in these systems, and traditionally the data have been interpreted in terms of discrete objects, such as spheres, sheets, and cylinders, and combinations thereof. Here we combine the coarse-grained computer simulation approach with neutron small angle scattering to refine the structure of a heterogeneous system, in the present case a reverse aqueous micelle of sodium-dioctyl sulfosuccinate (AOT) and iso-octane. The method closely follows empirical potential structure refinement and involves deriving an empirical interaction potential from the scattering data. As in traditional coarse-grained methods, individual atoms are replaced by spherical density profiles, which, unlike real atoms, can inter-penetrate to a significant extent. The method works over an arbitrary range of length-scales, but is limited to around 2 orders of magnitude in distance above a specified dimension. The smallest value for this dimension is of order 1nm, but the largest dimension is arbitrary. This article is part of a Special Issue entitled "Recent Advances in Bionanomaterials" Guest Editor: Dr. Marie-Louise Saboungi and Dr. Samuel D. Bader.
[Mh] Termos MeSH primário: Simulação por Computador
Ácido Dioctil Sulfossuccínico/química
Modelos Químicos
Octanos/química
[Mh] Termos MeSH secundário: Micelas
Difração de Nêutrons
Tamanho da Partícula
Espalhamento a Baixo Ângulo
Difração de Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Micelles); 0 (Octanes); 10041-19-7 (Dioctyl Sulfosuccinic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE


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[PMID]:28188875
[Au] Autor:Griesser J; Hetényi G; Moser M; Demarne F; Jannin V; Bernkop-Schnürch A
[Ad] Endereço:Thiomatrix Forschungs-und Beratungs GmbH, Trientlgasse 65, Innsbruck, Austria.
[Ti] Título:Hydrophobic ion pairing: Key to highly payloaded self-emulsifying peptide drug delivery systems.
[So] Source:Int J Pharm;520(1-2):267-274, 2017 Mar 30.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIM: The aim of this study was the formation and characterization of various ion pairs of therapeutic peptides with different surfactants in order to reach a high payload in self-emulsifying drug delivering systems (SEDDS). METHODS: Hydrophobic ion pairs (HIP) were formed between the anionic surfactants sodium docusate, dodecylsulfate and oleate and the peptides leuprorelin (LEU), insulin (INS) and desmopressin (DES). The efficiency of HIP formation was evaluated by quantifying the amount of formed complexes, log P value determination in n-octanol/water via HPLC and zeta potential measurements. Solvents and surfactants were screened regarding their complex solubilizing properties. Subsequently, peptide complexes were incorporated into SEDDS followed by payload and stability determination. RESULTS: Independent from the type of peptide, docusate showed the most efficient HIP properties followed by dodecylsulfate and oleate. Ratios of 2:1 for LEU, 6:1 for INS and 1.5:1 for DES led to the highest quantity of formed complexes with docusate and log P increased at least by 3 units. The more docusate was added to each peptide, the more negative became the zeta potential of the resulting complex. Incorporating these optimized complexes into novel SEDDS containing Capryol 90, Labrafil M 2125 CS, Labrasol ALF, Peceol, propylene glycol, tetraglycol, Transcutol HP and Tween 20 allowed payloads of the LEU, DES and INS complexes above 10%. Moreover, SEDDS exhibited high stability and constant negative zeta potential over a 4h incubation time. CONCLUSION: Following the procedure described herein payloads >10% can be achieved for peptide drugs in SEDDS.
[Mh] Termos MeSH primário: Sistemas de Liberação de Medicamentos/métodos
Emulsificantes/química
Interações Hidrofóbicas e Hidrofílicas
Peptídeos/administração & dosagem
Peptídeos/química
[Mh] Termos MeSH secundário: Desamino Arginina Vasopressina/administração & dosagem
Desamino Arginina Vasopressina/química
Ácido Dioctil Sulfossuccínico/administração & dosagem
Ácido Dioctil Sulfossuccínico/química
Estabilidade de Medicamentos
Emulsificantes/administração & dosagem
Emulsões/administração & dosagem
Emulsões/química
Insulina/administração & dosagem
Insulina/química
Leuprolida/administração & dosagem
Leuprolida/química
Ácido Oleico/administração & dosagem
Ácido Oleico/química
Dodecilsulfato de Sódio/administração & dosagem
Dodecilsulfato de Sódio/química
Solubilidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Emulsifying Agents); 0 (Emulsions); 0 (Insulin); 0 (Peptides); 10041-19-7 (Dioctyl Sulfosuccinic Acid); 2UMI9U37CP (Oleic Acid); 368GB5141J (Sodium Dodecyl Sulfate); 399SL044HN (osteum); EFY6W0M8TG (Leuprolide); ENR1LLB0FP (Deamino Arginine Vasopressin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170212
[St] Status:MEDLINE


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[PMID]:28166854
[Au] Autor:Marquez L; Jones KN; Whaley EM; Koy TH; Revell PA; Taylor RS; Bernhardt MB; Wagner JL; Dunn JJ; LiPuma JJ; Campbell JR
[Ad] Endereço:1Department of Pediatrics,Baylor College of Medicine,Houston,Texas.
[Ti] Título:An Outbreak of Burkholderia cepacia Complex Infections Associated with Contaminated Liquid Docusate.
[So] Source:Infect Control Hosp Epidemiol;38(5):567-573, 2017 05.
[Is] ISSN:1559-6834
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE To investigate an outbreak of Burkholderia cepacia complex and describe the measures that revealed the source. SETTING A 629-bed, tertiary-care, pediatric hospital in Houston, Texas. PATIENTS Pediatric patients without cystic fibrosis (CF) hospitalized in the pediatric and cardiovascular intensive care units. METHODS We investigated an outbreak of B. cepacia complex from February through July 2016. Isolates were evaluated for molecular relatedness with repetitive extragenic palindromic polymerase chain reaction (rep-PCR); specific species identification and genotyping were performed at an independent laboratory. The investigation included a detailed review of all cases, direct observation of clinical practices, and respiratory surveillance cultures. Environmental and product cultures were performed at an accredited reference environmental microbiology laboratory. RESULTS Overall, 18 respiratory tract cultures, 5 blood cultures, 4 urine cultures, and 3 stool cultures were positive in 24 patients. Among the 24 patients, 17 had symptomatic infections and 7 were colonized. The median age of the patients was 22.5 months (range, 2-148 months). Rep-PCR typing showed that 21 of 24 cases represented the same strain, which was identified as a novel species within the B. cepacia complex. Product cultures of liquid docusate were positive with an identical strain of B. cepacia complex. Local and state health departments, as well as the CDC and FDA, were notified, prompting a multistate investigation. CONCLUSIONS Our investigation revealed an outbreak of a unique strain of B. cepacia complex isolated in clinical specimens from non-CF pediatric patients and from liquid docusate. This resulted in a national alert and voluntary recall by the manufacturer. Infect Control Hosp Epidemiol 2017;38:567-573.
[Mh] Termos MeSH primário: Infecções por Burkholderia/transmissão
Complexo Burkholderia cepacia/isolamento & purificação
Infecção Hospitalar/microbiologia
Infecção Hospitalar/transmissão
Ácido Dioctil Sulfossuccínico/efeitos adversos
Contaminação de Medicamentos
[Mh] Termos MeSH secundário: Infecções por Burkholderia/diagnóstico
Complexo Burkholderia cepacia/genética
Criança
Pré-Escolar
Infecção Hospitalar/diagnóstico
Fibrose Cística
Surtos de Doenças
Feminino
Genótipo
Hospitais Pediátricos
Seres Humanos
Lactente
Masculino
Reação em Cadeia da Polimerase
Texas/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
10041-19-7 (Dioctyl Sulfosuccinic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171118
[Lr] Data última revisão:
171118
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1017/ice.2017.11


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[PMID]:28012994
[Au] Autor:Sigfridsson K; Skantze U; Skantze P; Johansson S; Grant I; Smedsrød B; Fuglesteg B; Elvevold K; Lindfors L
[Ad] Endereço:Pharmaceutical Sciences, AstraZeneca R&D, Gothenburg, S-431 83 Mölndal, Sweden. Electronic address: carl-gustav.sigfridsson@astrazeneca.com.
[Ti] Título:Nanocrystal formulations of a poorly soluble drug. 1. In vitro characterization of stability, stabilizer adsorption and uptake in liver cells.
[So] Source:Int J Pharm;518(1-2):29-40, 2017 Feb 25.
[Is] ISSN:1873-3476
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:In the present work, milled nanocrystals of a poorly soluble compound using different stabilizers were prepared and characterized. The aim of the study was to evaluate a fundamental set of properties of the formulations prior to i.v. injection of the particles. Two polyethylene oxide containing stabilizers; (distearoyl phosphatidylethanol amine (DSPE)) -PEG2000 and the triblock copolymer Pluronic F127, were investigated, with and without polyvinylpyrrolidone K30/Aerosol OT (PVP/AOT) present. The solubility in water was around 10nM for the compound, measured from nanocrystals, but 1000 times higher in 4% human serum albumin. The particles were physically stable during the time investigated. The zeta potential was around -30 and -10mV for DSPE-PEG2000 and Pluronic F127 stabilized particles, respectively, at the conditions selected. The dissolution rate was similar for all four formulations and similar to the theoretically predicted rate. Critical micelle concentrations were determined as 56nM and 1.4µM for DSPE-PEG2000 and Pluronic F127, respectively. The adsorption isotherms for the PEG lipid showed a maximum adsorbed amount of about 1.3mg/m , with and without PVP/AOT. Pluronic F127 showed a higher maximum amount adsorbed, at around 3.1mg/m , and marginally lower with PVP/AOT present. Calculated data showed that the layer of Pluronic F127 was thicker than the corresponding DSPE-PEG2000 layer. The total amount of particles distributed mainly to the liver, and the hepatocellular distribution in vitro (Liver sinusoidal endothelial cells and Kupffer cells), differed depending on the stabilizing mixture on the particles. Overall, DSPE-PEG2000 stabilized nanocrystals (with PVP/AOT) accumulated to a larger degree in the liver compared to particles with Pluronic F127 on the surface. A theoretical model was developed to interpret in vivo pharmacokinetic profiles, explaining the balance between dissolution and liver uptake. With the present, fundamental data of the nanocrystal formulations, the platform for forthcoming in vivo studies was settled.
[Mh] Termos MeSH primário: Ácido Dioctil Sulfossuccínico/química
Nanopartículas/química
Fosfatidiletanolaminas/química
Poloxâmero/química
Polietilenoglicóis/química
Polivinil/química
Pirrolidinas/química
Tensoativos/química
[Mh] Termos MeSH secundário: Adsorção
Animais
Células Cultivadas
Ácido Dioctil Sulfossuccínico/farmacologia
Estabilidade de Medicamentos
Células Endoteliais/metabolismo
Feminino
Macrófagos do Fígado/metabolismo
Fígado/citologia
Camundongos Endogâmicos C57BL
Fosfatidiletanolaminas/farmacologia
Poloxâmero/farmacologia
Polietilenoglicóis/farmacologia
Polivinil/farmacologia
Pirrolidinas/farmacologia
Solubilidade
Tensoativos/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-methoxy-poly(ethylene glycol 2000)); 0 (Phosphatidylethanolamines); 0 (Polyvinyls); 0 (Pyrrolidines); 0 (Surface-Active Agents); 0 (poly(N-vinylpyrrolidine)); 10041-19-7 (Dioctyl Sulfosuccinic Acid); 106392-12-5 (Poloxamer); 30IQX730WE (Polyethylene Glycols)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170607
[Lr] Data última revisão:
170607
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161226
[St] Status:MEDLINE


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[PMID]:27757748
[Au] Autor:Ushani U; Kavitha S; Johnson M; Yeom IT; Banu JR
[Ad] Endereço:Department of Civil Engineering, Regional Centre of Anna University, Tirunelveli, 627007, India.
[Ti] Título:Upgrading the hydrolytic potential of immobilized bacterial pretreatment to boost biogas production.
[So] Source:Environ Sci Pollut Res Int;24(1):813-826, 2017 Jan.
[Is] ISSN:1614-7499
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:In this study, surfactant dioctyl sodium sulphosuccinate (DOSS)-mediated immobilized bacterial pretreatment of waste activated sludge (WAS) was experimentally proved to be an efficient and economically feasible process for enhancing the biodegradability of WAS. The maximal floc disruption with negligible cell cleavage was achieved at surfactant dosage of 0.009 g/g SS. Results of the outcome of bacterial pretreatment of sludge biomass revealed that chemical oxygen demand (COD) solubilization for deflocculated (EPS removed-bacterially pretreated) sludge was 20 %, which was higher than that of flocculated (14 %) or control (5 %). The pretreatment was swift in deflocculated sludge with a rate constant of about 0.064 h . Biochemical methane potential (BMP) assay resulted in significant methane yield at 0.24 gCOD/gCOD for deflocculated sludge. Economic assessment of the proposed method showed a net profit of about 57.39 USD/ton of sludge.
[Mh] Termos MeSH primário: Biocombustíveis/análise
Ácido Dioctil Sulfossuccínico/química
Esgotos/microbiologia
Tensoativos/química
Purificação da Água/métodos
[Mh] Termos MeSH secundário: Anaerobiose
Biodegradação Ambiental
Análise da Demanda Biológica de Oxigênio
Biomassa
Floculação
Hidrólise
Metano/análise
Modelos Teóricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biofuels); 0 (Sewage); 0 (Surface-Active Agents); 10041-19-7 (Dioctyl Sulfosuccinic Acid); OP0UW79H66 (Methane)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE
[do] DOI:10.1007/s11356-016-7819-2


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[PMID]:27618714
[Au] Autor:Sathiakumar N; Tipre M; Turner-Henson A; Chen L; Leader M; Gohlke J
[Ad] Endereço:Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, 1665 Univ. Blvd. RPHB, Birmingham, AL 35294, USA. Electronic address: nalini@uab.edu.
[Ti] Título:Post-deepwater horizon blowout seafood consumption patterns and community-specific levels of concern for selected chemicals among children in Mobile County, Alabama.
[So] Source:Int J Hyg Environ Health;220(1):1-7, 2017 Jan.
[Is] ISSN:1618-131X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The goal of the study was to characterize risk pertaining to seafood consumption patterns following the Deepwater Horizon oil spill, among school children (K to 4th grade) residing in close proximity to the Gulf of Mexico in Mobile County, Alabama. METHODS: Responses on seafood consumption pattern including the type of seafood and intake rate during the pre and post oil spill periods, from parents of 55 school children from three schools located <20mile radius from the Gulf of Mexico shoreline (coastal group) were compared with those from parents of 55 children from three schools located ≥20miles away from the shoreline (inland group). We also estimated levels of concern (LOCs) in seafood for selected chemicals found in crude oil including heavy metals, and polycyclic aromatic hydrocarbons (PAH), and dioctyl sodium sulfosuccinate (DOSS), the primary compound in dispersants. RESULTS: The coastal group ate more seafood consisting primarily of crustaceans (62% vs. 42%, p=0.04) and fin fish (78% vs. 58%, p=0.02) from the Gulf of Mexico compared to the inland group, while the inland group ate more fin fish not found in the Gulf of Mexico (62% vs. 33%, p<0.01). In the post-oil spill time period, both groups substantially reduced their consumption of sea food. On average, the coastal group ate ≥2 seafood meals per week, while the inland group ate ≤1 meal per week; these frequency patterns persisted in the post oil-spill period. Comparison of the estimated LOCs with contaminant levels detected in the seafood tested by the Food and Drug Administration and National Oceanic and Atmospheric Administration, post-oil spill, found that the levels of PAHs, arsenic, and DOSS in seafood were 1-2 orders of magnitude below the LOCs calculated in our study. Levels of methyl mercury (MeHg) in the seafood tested pre- and post- oil spill were higher than the estimated LOCs suggesting presence of higher levels of MeHg in seafood independent of the oil spill. CONCLUSION: In sum, the study found higher than average seafood consumption among children along the Mobile coastal area when compared to the inland children and the National Health and Nutrition Examination Survey (NHANES) estimates. Risk characterization based on the LOCs indicated no increase in risk of exposure despite higher seafood consumption rates among the study population compared to the general population.
[Mh] Termos MeSH primário: Contaminação de Alimentos/análise
Poluição por Petróleo
Alimentos Marinhos/análise
Poluentes Químicos da Água/análise
[Mh] Termos MeSH secundário: Alabama
Animais
Arsênico/análise
Criança
Pré-Escolar
Crustáceos
Ácido Dioctil Sulfossuccínico/análise
Monitoramento Ambiental
Feminino
Peixes
Inocuidade dos Alimentos
Golfo do México
Seres Humanos
Masculino
Metais Pesados/análise
Compostos de Metilmercúrio/análise
Inquéritos Nutricionais
Petróleo
Hidrocarbonetos Aromáticos Policíclicos/análise
Medição de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Metals, Heavy); 0 (Methylmercury Compounds); 0 (Petroleum); 0 (Polycyclic Aromatic Hydrocarbons); 0 (Water Pollutants, Chemical); 10041-19-7 (Dioctyl Sulfosuccinic Acid); N712M78A8G (Arsenic)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170525
[Lr] Data última revisão:
170525
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160913
[St] Status:MEDLINE


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[PMID]:27500338
[Au] Autor:Edenfield AL; Siddiqui NY; Wu JM; Dieter AA; Garrett MA; Visco AG
[Ad] Endereço:Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina; the Departments of Obstetrics and Gynecology and Gastroenterology, Duke University, Durham, and the Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
[Ti] Título:Polyethylene Glycol 3350 and Docusate Sodium Compared With Docusate Sodium Alone After Urogynecologic Surgery: A Randomized Controlled Trial.
[So] Source:Obstet Gynecol;128(3):543-9, 2016 Sep.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare time to first bowel movement and additional gastrointestinal outcomes between women receiving polyethylene glycol 3350 (PEG3350) and docusate sodium and docusate sodium alone after urogynecologic surgery. METHODS: Participants received twice-daily 100 mg docusate sodium and were randomized to daily 1) PEG3350 or 2) inert placebo for 5 days after urogynecologic surgery. They completed bowel diaries, Bristol stool scale, validated Patient Assessment of Constipation Symptom Questionnaire, and Patient Assessment of Constipation Quality-of-Life Questionnaire preoperatively and 1 week after surgery. Our primary outcome was time to first bowel movement after surgery. To detect a 1-day difference in time to first bowel movement (4 compared with 3 days), 63 participants were needed in each group. RESULTS: From September 2012 through March 2015, 145 women were randomized and 131 (90%) analyzed: 66 received PEG3350, and 65 received placebo. Polyethylene glycol 3350 did not significantly reduce time to first bowel movement after surgery compared with placebo (2.77 days [interquartile range 1.86-3.40] compared with 2.92 days [interquartile range 1.85-4.02] P=.25). Women in the PEG3350 group were less likely to take additional laxatives postoperatively, and the PEG3350 group was more adherent to the study drug regimen. Questionnaire scores, fecal incontinence, and urgency were similar between groups. CONCLUSION: In women taking routine docusate sodium after urogynecologic surgery, adding PEG3350 postoperatively did not reduce time to first bowel movement. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01691742.
[Mh] Termos MeSH primário: Defecação/efeitos dos fármacos
Ácido Dioctil Sulfossuccínico/uso terapêutico
Polietilenoglicóis/uso terapêutico
Tensoativos/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Constipação Intestinal/induzido quimicamente
Ácido Dioctil Sulfossuccínico/efeitos adversos
Método Duplo-Cego
Quimioterapia Combinada
Incontinência Fecal/induzido quimicamente
Feminino
Procedimentos Cirúrgicos em Ginecologia/métodos
Seres Humanos
Meia-Idade
Prolapso de Órgão Pélvico/cirurgia
Polietilenoglicóis/efeitos adversos
Período Pós-Operatório
Tensoativos/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Incontinência Urinária/cirurgia
Procedimentos Cirúrgicos Urológicos/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Surface-Active Agents); 10041-19-7 (Dioctyl Sulfosuccinic Acid); 30IQX730WE (Polyethylene Glycols); GM27P15E5P (polyethylene glycol 3350)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170523
[Lr] Data última revisão:
170523
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160809
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000001565


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[PMID]:27154771
[Au] Autor:MacMillan TE; Kamali R; Cavalcanti RB
[Ad] Endereço:Division of General Internal Medicine, University Health Network, Toronto, Ontario, Canada; Division of General Internal Medicine, Department of Medicine, University of Toronto, Ontario, Canada; HoPingKong Centre for Excellence in Education and Practice, University Health Network, Toronto, Ontario, Canada. Electronic address: tom.macmillan@uhn.ca.
[Ti] Título:Missed Opportunity to Deprescribe: Docusate for Constipation in Medical Inpatients.
[So] Source:Am J Med;129(9):1001.e1-7, 2016 Sep.
[Is] ISSN:1555-7162
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Hospital admissions provide an opportunity to deprescribe ineffective medications and reduce pill burden. Docusate sodium is a stool softener that is frequently prescribed to treat constipation despite poor evidence for efficacy, thus providing a good target for deprescription. The aims of this study were to characterize rates of use and discontinuation of docusate among internal medicine inpatients, as well as use of other laxatives. METHODS: We conducted a retrospective observational study over 1 year on all patients admitted to internal medicine at 2 urban academic hospitals to determine rates of docusate use. We also evaluated laxative and opioid medication use on a random sample of 500 inpatients who received docusate to characterize patterns of prescription and deprescription. RESULTS: Fifteen percent (1169/7581) of all admitted patients received 1 or more doses of docusate. Among our random sample, 53% (238/452) received docusate before admission, and only 13% (31/238) had docusate deprescribed. Among patients not receiving docusate before admission, 33.2% (71/214) received a new prescription for docusate on discharge. Patients receiving opioids were frequently prescribed no laxatives or given docusate monotherapy (28%, 51/185). CONCLUSIONS: Docusate was frequently prescribed to medical inpatients despite its known ineffectiveness, with low deprescription and high numbers of new prescriptions. Docusate use was common even among patients at high risk of constipation. One third of patients not receiving docusate before admission were prescribed docusate on discharge, potentially exacerbating polypharmacy. Among patients already receiving docusate, 80% had it continued on discharge, indicating significant missed opportunities for deprescribing. Given the availability of effective alternatives, our results suggest that quality-improvement initiatives are needed to promote evidence-based laxative use in hospitalized patients.
[Mh] Termos MeSH primário: Constipação Intestinal/tratamento farmacológico
Desprescrições
Ácido Dioctil Sulfossuccínico/uso terapêutico
Laxantes/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Alta do Paciente/estatística & dados numéricos
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Laxatives); 10041-19-7 (Dioctyl Sulfosuccinic Acid)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170508
[Lr] Data última revisão:
170508
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160508
[St] Status:MEDLINE



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