ABSTRACT
Objective: The wrong dose of high-risk drugs such as oral steroids is a serious issue that needs to be addressed. This study aims to determine the appropriate upper tolerable dose threshold and to develop a multi-variable logistic regression model to detect dose-errors in oral prednisolone tablets.Methods: Data on Prednisolone prescriptions were obtained from a single center. Out of the data collected, positive cases consisted of cases where dose-related modifications were made. A univariate logistic regression model was developed with the current daily dose. In the model, the Youden Index was used to determine the upper tolerable dose threshold. The investigation was done to determine whether the performance of the multivariate model was improved by adding clinical department and previous prescription information as variables.Results: Univariate models (AUC: 0.645) with only current daily doses and estimated optimal thresholds of 6 mg/day or 11 mg/day, respectively were determined to be appropriate. Including variables improved the performance of the predictive model; the best performing model (AUC: 0.840) was derived when the following variables were entered: “current daily dose,” “current prescription days,” “clinical department,” “daily dose of the previous prescription,” and “prescription days of the previous prescription”.Conclusion: A single upper tolerance limit is insufficient to determine dose adequacy for prednisolone tablets owing to their broad clinical dose range. Itmay be possible to develop a high-performance dose audit support model by adding information.
ABSTRACT
<b>Objective: </b>We aimed to develop software that could provide drug information off-line using a smart device. Therefore, FileMaker Go® was examined and evaluated as a mobile drug information application.<br><b>Methods: </b>A mobile drug information database (Mobile DI-DB) application was created using FileMaker Go®. The function, search performance, and characteristics of Mobile DI-DB were evaluated. In addition, question and answer time with Mobile DI-DB was compared with that existing drug information database (existing DI-DB) of the Soka Municipal Hospital.<br><b>Results: </b>Mobile DI-DB can be viewed on an iPad®and iPhone®. The software is full-text searchable, has good search performance, and is characterized by a small file size. Furthermore, question and answer times were found to be shorter about 1/3 with Mobile DI-DB than with existing DI-DB.<br><b>Conclusion: </b>A mobile drug information database prepared with Filemaker Go® can now be viewed on a smart device, making drug information easier to access than ever before. Although this study focused on increasing operational efficiency of pharmacists through the use of the Mobile DI-DB application, we believe that this application can benefit other users too.
ABSTRACT
Objective:To investigate the immune defence against acute encephalitis induced by the highly neurovirulent recombinant R404BP strain of influenza A virus.Methods:A murine model system for a lethal encephalitis due to influenza has been established by stereotaxic microinjection with the recombinant R404BP strain of influenza A virus into the olfactory bulb of the senescence-accelerated mouse(SAM) strain P1 mice. The mortality of infected mice, clearance of infected neurons and induced cellular immune responses were investigated.Results:The SAM-P1 mice showed a higher rate of mortality with prolonged virus shedding. The increased susceptibility was associated with impaired activity of both NK cells and virus-specific cytotoxic T lymphocytes.Conclusion:The decreased Th1 immune responses in the senescence-accelerated mouse might be responsible for the low defence system against neurovirulent recombinant influenza A virus.
ABSTRACT
Objective:To investigate the effect of perforin-mediated cytotoxicity in primary influenza virus infection.Methods:Perforin-deficient and wild-type C57BL/6 mice were infected intranasally with influenza virus A/PR/8/34. Pulmonary viral growth was determined at various days after infection by pfu experiment. Perforin-mediated apoptotic degeneration was observed by Immunohistochemical staining. LDH-release method was used for detection of specific CTL and NK cell activity from spleen cells.Results:Mice deficient in the perforin gene showed an increased virus growth and prolonged virus shedding. The appearance of apoptotic degeneration in virally infected lung cells was delayed in perforin-deficient mice. The cytolytic activities of natural killer cells and virus-specific cytotoxic T lymphocytes were significantly lower than that of wild-type mice.Conclusion:Perforin plays a critical role in the host defense system against primary influenza virus infection.