Takotsubo cardiomyopathy is a stress-induced cardiovascular disease with symptoms comparable to those of an acute coronary syndrome but without coronary obstruction. Takotsubo was initially ...considered spontaneously reversible, but epidemiological studies revealed significant long-term morbidity and mortality, the reason for which is unknown. Here, we show in a female rodent model that a single pharmacological challenge creates a stress-induced cardiomyopathy similar to Takotsubo. The acute response involves changes in blood and tissue biomarkers and in cardiac in vivo imaging acquired with ultrasound, magnetic resonance and positron emission tomography. Longitudinal follow up using in vivo imaging, histochemistry, protein and proteomics analyses evidences a continued metabolic reprogramming of the heart towards metabolic malfunction, eventually leading to irreversible damage in cardiac function and structure. The results combat the supposed reversibility of Takotsubo, point to dysregulation of glucose metabolic pathways as a main cause of long-term cardiac disease and support early therapeutic management of Takotsubo.
The theory of planned behavior (TPB) postulates that behavioral performance is guided by the intention to perform that behavior, influenced by attitudes, subjective norms, and perceived behavioral ...control. This framework can be applied to studying interprofessional collaboration among healthcare professionals to enhance patient safety and public health within nursing homes.
This study aimed to explore the roles of physicians, pharmacists, and nurses in the interprofessional collaboration process while identifying facilitators and barriers to effective collaboration among healthcare professionals.
A qualitative interpretative phenomenological analysis (IPA) was carried out. Individual semi-structured interviews were conducted with 19 healthcare professionals. Qualitative data were then integrated and analyzed through the lens of the TPB.
The IPA revealed the ten following themes, considered as both facilitators and barriers to interprofessional collaboration among healthcare professionals in the nursing home setting: communication, roles and responsibilities, willingness and recognition of collaboration's importance, mutual knowledge, trust, confidence, support from decision-makers, protocols, and technology were considered as facilitators while distance was considered as a barrier.
Enhancing pharmacist-physician collaboration and refining pharmacist-nurse collaboration were essential goals. Intention for collaboration was influenced by attitudes (such as communication and mutual understanding), subjective norms (including support from decision-makers), and perceived behavioral control (such as confidence and adherence to protocols and technology). Addressing these factors could improve collaboration, enhancing residents' quality of life and professionals' sense of achievement.
•Enhanced quality of care within nursing homes necessitates effective interprofessional collaboration.•Exploration highlighted the need for pharmacist-physician collaboration and for refining pharmacist-nurse collaboration.•There is a need for more clarity between pharmacists and physicians, with each attributing the lack of willingness to collaborate to the other.•Recommendations proposed by practitioners focus on augmenting the pharmacist's role and enhancing communication among decision-makers.•Optimizing collaboration can yield multiple benefits, encompassing improved medication management and quality of life for health professionals.
Prevalence of type 2 diabetes is high in Belgium (estimated at over 10%, 1 patient out of 3 being unaware of their diagnosis). Management based on a change of lifestyle and the adoption of ...health-promoting behaviors, supplemented when needed with drug treatment, prevents complications, improves the patient's quality of life and reduces mortality. Multidisciplinary patient support is essential. In this, pharmacists have a key role, e.g. through therapeutic patient education activities, in which they are increasingly involved. Moreover, research suggests that the use of mobile technologies can be a useful tool for helping patients with their daily life and disease management.
This study aims at exploring the benefits of community pharmacist follow-up supported by the use of mobile technologies in the monitoring of individuals with type 2 diabetes. The presented intervention aimed to reinforce the patients' willingness to actively participate in the management of their disease and to adopt favorable health behaviors, in order to increase their level of medication adherence.
A quantitative quasi-experimental study was conducted in community pharmacies throughout Belgium over a 6-month period with 3 data collection periods (before, during and after the intervention). Primary outcomes, related to the level of medication adherence, and secondary outcomes, considered as markers of the patient's overall health, were analyzed. In addition, qualitative data concerning participants' opinions on their experience were collected.
66 patients participated in the study, with 50 remaining after 3 months and 46 completing the entire study. Statistical analyses did not show an improvement in the level of medication adherence. This parameter was high from the beginning, reflecting patients with controlled diabetes. However, statistically significant results were observed for systolic blood pressure and waist circumference (both improved), while other outcomes showed a positive trend or remained stable. Patient follow-up by the pharmacist was a positive experience for both parties which noted their interest and satisfaction for the project.
Although clinical results are not conclusive, patients were motivated and the attrition rate was low. Participants showed their interest in participating in this kind of project, opening up opportunities for further studies in the community pharmacy setting. As front-line health professionals, community pharmacists certainly have a key-role to play in therapeutic patient education and mobile technologies could be additional tools in this process.
As a result of the SARS-COV-2 pandemic, a new competence for pharmacists has been introduced in Belgium by the law of the 28 February 2022. Community pharmacists are now allowed to prepare and ...administer vaccines for the prophylaxis of COVID-19. To be allowed to vaccinate inside the pharmacy they legally need to follow and pass a specific 8-hour training course on vaccination. The aim of this study is to evaluate if a simulation-based vaccination training course can provide future pharmacists to develop an interest in practicing vaccination in their future professional life, self-confidence to do it and the necessary skills.
No long-term maintenance therapy has been tested in patients with seborrheic dermatitis (SD).
We sought to compare the efficacy and tolerance of tacrolimus 0.1% ointment versus ciclopiroxolamine 1% ...cream as maintenance therapy for severe SD.
This double-blind randomized controlled study was conducted from 2014 to 2017 in 5 Dermatology Departments and 15 dermatology practices in France. Consecutive patients with severe and chronic facial SD were included. Patients were initially treated with desonide 0.05% cream twice daily for 7 days. Patients cleared after this open phase were randomized to receive tacrolimus 0.1% or ciclopiroxolamine 1% cream 2 times a week 24 weeks. The primary endpoint was disease-free-duration, defined as the time from randomization to first relapse.
One hundred fourteen patients were randomized (tacrolimus, n = 57; ciclopiroxolamine, n = 57). Twelve patients relapsed in the tacrolimus group after a median delay of 91.5 days (range 15-195 days) versus 23 patients in the ciclopiroxolamine group (median delay, 27 days range 13-201 days). Comparison of disease-free duration curves showed that patients in the tacrolimus group had a longer duration of complete remission than those in the ciclopiroxolamine group (P = .018), corresponding to a hazard ratio of relapse of 0.44 (95% confidence interval 0.22-0.89; P = .022).
The theoretical sample size was not reached.
Tacrolimus 0.1% is more effective than ciclopiroxolamine 1% as maintenance therapy for patients with facial SD.
Nickel ion-exchanged MCM-36 and MCM-22 zeolites were prepared, characterized, and tested in the ethylene oligomerization reaction performed in slurry semi-batch mode (
T
=
70–150
°C,
p
=
4
MPa). ...NiMCM-36 catalysts, with large accessibility in the mesoporous structure and mild acidity, showed an excellent activity (46
g of oligomers/g
catalyst
h) and selectivity in this reaction.
▪
Nickel ion-exchanged MCM-36 and MCM-22 zeolites were prepared, characterized, and tested in the ethylene oligomerization reaction performed in slurry semi-batch mode (
T
=
70–150
°C,
p
=
4
MPa). The behavior of catalysts was evaluated in relation to their texture and nickel cations/acid sites ratio. NiMCM-36 catalysts, with large accessibility in the mesoporous structure and mild acidity, showed an excellent activity (46
g of oligomers/g
catalyst
h) and selectivity (100% olefins with even number of carbon atoms) in ethylene oligomerization, while lower catalytic activity and selectivity were observed over NiMCM-22 possessing microporous structure and high acid sites concentration.
