ABSTRACT
Aim: A suspicion about adverse drug reactions is sufficient for adverse drug reactions reporting. However, assessing the causal drug-disturbance(s) relation is the primary issue in physicians’ clinical practice, due to their principal responsibility among health care workers for patients' health, including patients' safety, while the far more studied adverse drug reactions reporting is the secondary one. Thus, adverse drug reactions, and the need for introducing activities for physicians toward adverse drug reactions. Study Design: It was a prospective, multicentric, questionnaire based, self-administered, and anonymous study, conducted during two months among physicians employed in five public (state) primary health care centers in the Republic of Serbia settled in Sombor, Mladenovac, Pozarevac, Cacak and Pirot. Results: It was questionnaired 238 out of 461 employed physicians. Doctors declared to diagnose adverse drug reactions (n = 213) but rarely report them (n = 49). They usually withdrew the drug suspected for adverse drug reactions (n = 212) and seldom introduce it to the same patient in the future (n = 5). They claimed to have difficulties in both the adverse drug reactions diagnosing (n = 146) and treating (n = 113). Almost all considered the improvement of the knowledge about adverse drug reactions beneficial for their clinical practice, adverse drug reactions diagnosing and treating (P < .001 for all the statements). With a very few exceptions, answers were not influenced by physicians’ ages and medical education. Conclusion: Physicians recognized the dimension of their problems in the field of adverse drug reactions, especially diagnosing, which is crucial for patient health. Better education and training are the most important strategies for improving existing weaknesses, which have to be translated into routine clinical practice.
ABSTRACT
Background & objectives: Aluminum (Al) toxicity is closely linked to the pathogenesis of Alzheimer’s disease (AD). This experimental study was aimed to investigate the active avoidance behaviour of rats after intrahippocampal injection of Al, and biochemical and immunohistochemical changes in three bilateral brain structures namely, forebrain cortex (FBCx), hippocampus and basal forebrain (BF). Methods: Seven days after intra-hippocampal (CA1 sector) injection of AlCl3 into adult male Wistar rats they were subjected to two-way active avoidance (AA) tests over five consecutive days. Control rats were treated with 0.9% w/v saline. The animals were decapitated on the day 12 post-injection. The activities of acetylcholinesterase (AChE) and glucose-6-phosphate dehydrogenase (G6PDH) were measured in the FBCx, hippocampus and BF. Immunohistochemical staining was performed for transferrin receptors, amyloid β and tau protein. Results: The activities of both AChE and G6PDH were found to be decreased bilaterally in the FBCx, hippocampus and basal forebrain compared to those of control rats. The number of correct AA responses was reduced by AlCl3 treatment. G6PDH administered prior to AlCl3 resulted in a reversal of the effects of AlCl3 on both biochemical and behavioural parameters. Strong immunohistochemical staining of transferrin receptors was found bilaterally in the FBCx and the hippocampus in all three study groups. In addition, very strong amyloid β staining was detected bilaterally in all structures in AlCl3-treated rats but was moderate in G6PDH/AlCl3-treated rats. Strong tau staining was noted bilaterally in AlCl3-treated rats. In contrast, tau staining was only moderate in G6PDH/AlCl3-treated rats. Interpretation & conclusions: Our findings indicated that the G6PDH alleviated the signs of behavioural and biochemical effects of AlCl3-treatment suggesting its involvement in the pathogenesis of Al neurotoxicity and its potential therapeutic benefit. The present model could serve as a useful tool in AD investigations.