Drug utilization evaluation of vancomycin in pediatric department

Background: Increasing reports of Vancomycin resistance have raised concerns about effectiveness of this drug. One of the most important factors of resistance emergence is no adherence of physician to principles of antibiotic therapy. This study is a drug utilization evaluation [DUE] of Vancomycin in pediatric ward to assess appropriateness of drug regimens and to find possible problems in clinical practices that may necessitate reconciliation to improve Vancomycin use

Materials and Methods: This prospective study was done for 1year from October 2014 to September 2015 at Khalij Fars General Hospital in Bandar Abbas. Data including patients' demographics, paraclinic, diagnosis, vancomycin dose, and treatment duration were collected. The concordance of practice with standard guidelines [CDC, ASHP, and IDSA] and principles of antibiotic therapy was assessed. Results were analyzed by SPSS 20

Results: 102 medical records were reviewed in this study. Pneumonia [60=59%] and sepsis [22=21.5%] were the most common diagnosis. Sampling was done in 6% of patients with 2% antibiogram. Vancomycin was administered appropriately in 56.9% percent of patients with no sex difference [PV= 0.55] but age with significant difference [PV= 0.017]. Over use was in a great proportion of patients [36cases=35%] as unnecessary, improper combination and broad spectrum regimen

Conclusion: Vancomycin was overused irrationally in a great proportion of patients. There was no serum level monitoring. Microbial resistance, serum trough level monitoring programs and continuous medical education for physicians can be effective in rational use of antibiotic

Effect of TGF-beta/smad signaling pathway blocking on expression profiles of miR-335, miR-150, miR-194, miR-27a, and miR-199a of hepatic stellate cells [HSCs]

Aim: The aim of this study was to determine the effect of inhibition of TGF-beta/smad signaling on the expression profiles of miR-335, miR-150, miR-194, miR-27a, miR-199a of hepatic stellate cells [HSCs]

Background: Liver fibrosis is excessive deposition of extracellular matrix proteins due to ongoing inflammation and HSC activation that occurs in most types of chronic liver diseases. Recent studies have shown the importance of microRNAs in the pathogenesis of chronic liver diseases

Methods: In this study, for inhibition of TGF-beta smad-signaling pathway, expressing Smad4 shRNA plasmids were transfected into HSCs. Subsequently, using Real Time-PCR, we measured the expression levels of miR-335, miR-150, miR-194, miR-27a and miR- 199a

Results: Gene expression analysis showed that downregulation of Smad4 by vector Smad4shRNA significantly increased the expression levels of miR-335 [P<0.01] and miR-150 [P<0.001] and decreased the expression level of miR-27a [P<0.05]

Conclusion: The results of this study suggest that blocking TGF-beta smad-signaling can also differentially modulate microRNA expression in support of activation and fibrogenesis of HSCs

Blocking of SMAD4 expression by shRNA effectively inhibits fibrogenesis of human hepatic stellate cells

In this study, to clarify the SMAD4 blocking impact on fibrosis process, we investigated its down regulation by shRNA on activated human LX-2 cell, in vitro. Liver fibrosis is a critical consequence of chronic damage to the liver that can progress toward advanced diseases, liver cirrhosis and hepatocellular carcinoma [HCC]. Different SMAD proteins play as major mediators in the fibrogenesis activity of hepatic stellate cells through TGF-beta pathways, but the extent of SMAD4 as a co-SMAD protein remained less clear. vector expressing verified shRNA targeting human SMAD4 gene was transfected into LX-2 cells. The GFP expressing plasmid was transfected in the same manner as a control group while leptin treated cells were employed as positive controls. Subsequently, total RNA was extracted and real-time PCR was performed to measure the mRNA levels of SMAD4, COL-1A1, alpha-SMA, TGF-beta and TIMP-1. Furthermore, trypan blue exclusion was performed to test the effect of plasmid transfection and SMAD4 shutting-down on cellular viability. The results indicated that the expression of SMAD4was down-regulated following shRNA transfection into LX-2 cells [P<0.001]. The gene expression analysis of fibrotic genes in LX-2 cells showed that SMAD4 blocking by shRNA significantly reduced the expression level of fibrotic genes when compared to control plasmids [P<0.001]. Vector expressing SMAD4-shRNA induced no significant cytotoxic or proliferative effects on LX-2 cells as determined by viability assay [P<0.05]. The results of this study suggested that knockdown of SMAD4 expression in stellate cell can control the progression of fibrogenesis through TGF-beta pathway blocking