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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.
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BACKGROUND: Bacteriocin-producing Lactic acid bacteria (LAB) have vast applications in human and animal health, as well as in food industry. The structural, immunity, regulatory, export and modification genes are required for effective bacteriocin biosynthesis. Variations in gene sequence, composition and organisation will affect the antimicrobial spectrum of bacteriocin greatly. Lactobacillus plantarum I-UL4 is a novel multiple bacteriocin producer that harbours both plw and plnEF structural genes simultaneous which has not been reported elsewhere. Therefore, molecular characterisation of bacteriocin genes that harboured in L. plantarum I-UL4 was conducted in this study. RESULTS AND DISCUSSION: Under optimised conditions, 8 genes (brnQ1, napA1, plnL, plnD, plnEF, plnI, plnG and plnH) of plnEF locus and 2 genes (plw and plwG) of plw locus were amplified successfully from genomic DNA extracted from L. plantarum I-UL4 using specific primers designed from 24 pln genes selected randomly from reported plw, plS, pln423 and plnEF loci. DNA sequence analysis of the flanking region of the amplified genes revealed the presence of two pln loci, UL4-plw and UL4-plnEF loci, which were chromosomally encoded as shown by Southern hybridisation. UL4-plw locus that contained three ORFs were arranged in one operon and possessed remarkable amino acid sequence of LMG2379-plw locus, suggesting it was highly conserved. Interestingly, the UL4-plnEF locus appeared to be a composite pln locus of JDM1-plnEF and J51-plnEF locus in terms of genetic composition and organisation, whereby twenty complete and one partial open reading frames (ORFs) were aligned and organised successfully into five operons. Furthermore, a mutation was detected in plnF structural gene which has contributed to a longer bacteriocin peptide. CONCLUSIONS: Plantaricin EF and plantaricin W encoded by plnEF and plnW loci are classified as class I bacteriocin and class II bacteriocin molecules respectively. The concurrent presence of two pln loci encoding bacteriocins from two different classes has contributed greatly to the broad inhibitory spectrum of L. plantarum I-UL4. The new genetic composition and organisation of plnEF locus and concurrent presence of plnEF and plnW loci indicated that L. plantarum I-UL4 is a novel multiple bacteriocin producer that possesses vast potentials in various industries.
Subject(s)
Bacterial Proteins/genetics , Bacteriocins/biosynthesis , Lactobacillus plantarum/genetics , Amino Acid Sequence , Bacterial Proteins/chemistry , Bacterial Proteins/metabolism , Bacteriocins/genetics , Base Sequence , Lactobacillus plantarum/chemistry , Lactobacillus plantarum/metabolism , Molecular Sequence Data , Open Reading Frames , Sequence AlignmentABSTRACT
<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.
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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.
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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.
