Medication errors with electronic prescribing (eP): Two views of the same picture

Background  

Quantitative prospective methods are widely used to evaluate the impact of new technologies such as electronic prescribing (eP) on medication errors. However, they are labour-intensive and it is not always feasible to obtain pre-intervention data. Our objective was to compare the eP medication error picture obtained with retrospective quantitative and qualitative methods.     

Distinct effects of short- and long-term leptin treatment on glucose and fatty acid uptake and metabolism in HL-1 cardiomyocytes

Alterations in cardiac glucose and fatty acid metabolism are possible contributors to the pathogenesis of heart failure in obesity. Here we examined the effect of leptin, the product of the obese (ob) gene, on metabolism in murine cardiomyocytes. Neither short-term (1 hour) nor long-term (24 hours) treatment with leptin (60 nmol/L) altered basal or insulin-stimulated glucose uptake and oxidation, glycogen synthesis, insulin receptor substrate 1 tyrosine, Akt, or glycogen synthase kinase 3beta phosphorylation. Extracellular lactate levels were also unaffected by leptin. However, leptin increased basal and insulin-stimulated palmitate uptake at both short and long exposure times and this corresponded with increased cell surface CD36 levels and elevated fatty acid transport protein 1 (FATP1) and CD36 protein content. Whereas short-term leptin treatment increased fatty acid oxidation, there was a decrease in oxidation after 24 hours. The former corresponded with increased acetyl coenzyme A carboxylase phosphorylation and the latter with increased expression of this enzyme. The discrepancy between uptake and oxidation of fatty acids led to a transient decrease in intracellular lipid content with lipid accumulation ensuing after 24 hours. In summary, we demonstrate that leptin did not alter glucose uptake or metabolism in murine cardiomyocytes. However, fatty acid uptake increased while oxidation decreased over time leading to intracellular lipid accumulation, which may lead to lipotoxic damage in heart failure.     

The fat mass- and obesity-associated locus and dietary intake in children

BACKGROUND: A region of chromosome 16 containing the fat mass-and obesity-associated gene (FTO) is reproducibly associated with fat mass and body mass index (BMI), risk of obesity, and adiposity. OBJECTIVES: We aimed to assess the possibility that appetite plays a role in the association between FTO and BMI. DESIGN: Detailed dietary report information from the Avon Longitudinal Study of Parents and Children allowed the exploration of relations between FTO variation and dietary intake. Analyses were performed to investigate possible associations between variation at the FTO locus and the intake of a range of micronutrients and macronutrients, with adjustment for the bias often found within dietary report data when factors related to BMI are assessed. To test the hypothesis that FTO may be influencing appetite directly, rather than indirectly via BMI and altered intake requirements, we also assessed associations between FTO and dietary intake independent of BMI. RESULTS: Relations between a single-nucleotide polymorphism characterizing the FTO signal (rs9939609) and dietary variables were found and can be summarized by the effect of each additional allele (per-allele effects) on total energy and total fat (P < 0.001 for both). These associations were attenuated, but they persisted specifically for fat and energy consumption after adjustment for BMI [total daily fat consumption: approximately 1.5 g/d (P = 0.02 for the per-allele difference); total daily energy consumption: approximately 25 kJ/d (P = 0.03 for the per-allele difference)]. CONCLUSION: These associations suggest that persons carrying minor variants at rs9939609 were consuming more fat and total energy than were those not carrying such variants. They also suggest that this difference was not simply dependent on having higher average BMIs among the former group.     

Dietary patterns in pregnancy and associations with nutrient intakes

Despite the recent popularity in the use of dietary patterns to investigate diet-disease associations, the associations between dietary patterns and nutrient intakes have not been fully explored. This paper determines the linear and non-linear associations between estimated nutrient intake (considered as both absolute and relative intake) and distinct dietary patterns, obtained during the third trimester of pregnancy using principal components analysis (PCA). It also examines the proportion of variability explained by the patterns in food and nutrient intakes. Pregnant women were asked to record the frequency of consumption of a variety of food items as part of regular self-completion questionnaires, the primary source of data collection in the Avon Longitudinal Study of Parents and Children, 12 035 cases were available. Individual dietary components were identified using PCA and scores on these components were related to estimated nutrient intakes. Five individual dietary patterns were established to best describe the types of diet being consumed in pregnancy. Scores on the 'processed' and 'confectionery' patterns were negatively related to the estimated intake of most nutrients with the exception of energy, fats and sugars, which increased with higher scores. Scores on the 'health-conscious' and 'traditional' components showed positive linear relationships with all nutrients. The results presented here suggest that dietary patterns adequately characterize dietary intake. There is, therefore, potential for dietary patterns to be used as a valid tool in assessing the relationship between diet and health outcomes, and dietary pattern scores could be used as covariates in specific nutrient-disease studies.