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41.
Jeroen M. van de Pol Jurjen G. Geljon Svetlana V. Belitser Geert W.J. Frederix Anke M. Hövels Marcel L. Bouvy 《Research in social & administrative pharmacy》2019,15(1):70-76
Introduction
The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice.Methods
Self-reporting work sampling was used to register the activities of community pharmacists. A smartphone application, designed specifically for this purpose, alerted participants to register their current activity five times per working day for 6 weeks. Participants also completed an online survey about baseline characteristics.Results
Ninety-one Dutch community pharmacists provided work-sampling data (7848 registered activities). Overall, 51.5% of their time was spent on professional activities, 35.4% on semi-professional activities, and 13.1% on non-professional activities. The proportion of time devoted to CPS decreased during the workweek, whereas the time spent on traditional task increased.Discussion and conclusion
This study shows it is feasible to collect work-sampling data using smartphone technology. Community pharmacists spent almost half of their time on semi-professional and non-professional activities, activities that could be delegated to other staff members. In practice, the transition to CPS is hampered by competing traditional tasks, which prevents community pharmacists from profiling themselves as pharmaceutical experts in daily practice. 相似文献42.
43.
44.
Rubens Souza de OLIVEIRA Lanna Jamile Corrêa da COSTA Fernanda Atanaena Gon?alves de ANDRADE Wilson UIEDA Luzia Fátima Alves MARTORELLI Ana Paula de Arruda Geraldes KATAOKA Elizabeth Salbé Travassos da ROSA Pedro Fernando da Costa VASCONCELOS Armando de Souza PEREIRA Ant?nio Ismael Barros do CARMO Marcus Emanuel Barroncas FERNANDES 《Revista do Instituto de Medicina Tropical de S?o Paulo》2015,57(6):497-503
The outbreaks of rabies in humans transmitted by Desmodus rotundus in 2004 and 2005,
in the northeast of the Brazilian State of Para, eastern Amazon basin, made this a
priority area for studies on this zoonosis. Given this, the present study provides
data on this phenomenon in an urban context, in order to assess the possible
circulation of the classic rabies virus (RABV) among bat species in Capanema, a town
in the Amazon basin. Bats were collected, in 2011, with mist nets during the wet and
dry seasons. Samples of brain tissue and blood were collected for virological and
serological survey, respectively. None of the 153 brain tissue samples analyzed
tested positive for RABV infection, but 50.34% (95% CI: 45.67-55.01%) of the serum
samples analyzed were seropositive. Artibeus planirostris was the most common
species, with a high percentage of seropositive individuals (52.46%, 95% CI: 52.31
52.60%). Statistically, equal proportions of seropositive results were obtained in
the rainy and dry seasons (c2 = 0.057, d.f. = 1, p = 0.88). Significantly
higher proportions of males (55.96%, 95% CI: 48.96-62.96%) and adults (52.37%, 95%
CI: 47.35-57.39%) were seropositive. While none of the brain tissue samples tested
positive for infection, the high proportion of seropositive specimens indicates that
RABV may be widespread in this urban area. 相似文献
45.
S. Natoli V. Oliveira P. Calabresi L. F. Maia A. Pisani 《European journal of neurology》2020,27(9):1764-1773
The current coronavirus disease (COVID‐19) outbreak, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has raised the possibility of potential neurotropic properties of this virus. Indeed, neurological sequelae of SARS‐CoV‐2 infection have already been reported and highlight the relevance of considering the neurological impact of coronavirus (CoV) from a translational perspective. Animal models of SARS and Middle East respiratory syndrome, caused by structurally similar CoVs during the 2002 and 2012 epidemics, have provided valuable data on nervous system involvement by CoVs and the potential for central nervous system spread of SARS‐CoV‐2. One key finding that may unify these pathogens is that all require angiotensin‐converting enzyme 2 as a cell entry receptor. The CoV spike glycoprotein, by which SARS‐CoV‐2 binds to cell membranes, binds angiotensin‐converting enzyme 2 with a higher affinity compared with SARS‐CoV. The expression of this receptor in neurons and endothelial cells hints that SARS‐CoV‐2 may have higher neuroinvasive potential compared with previous CoVs. However, it remains to be determined how such invasiveness might contribute to respiratory failure or cause direct neurological damage. Both direct and indirect mechanisms may be of relevance. Clinical heterogeneity potentially driven by differential host immune‐mediated responses will require extensive investigation. Development of disease models to anticipate emerging neurological complications and to explore mechanisms of direct or immune‐mediated pathogenicity in the short and medium term is therefore of great importance. In this brief review, we describe the current knowledge from models of previous CoV infections and discuss their potential relevance to COVID‐19. 相似文献
46.
N. SUVAJD
I V. EMERIKI‐MARTINOVI . ARANOVI M. PETROVI M. POPOVI V. ARTIKO M. UPI I. ELEZOVI 《International journal of laboratory hematology》2006,28(5):317-320
We report the case of a littoral‐cell angioma of the spleen, a recently described benign vascular tumour, whose imaging and pathological characteristics have been discussed only by a few authors. The diagnosis was made after elective splenectomy. The CT images, scintigraphy and histological specimens are presented, and differential diagnoses discussed. 相似文献
47.
48.
49.
Steven V Koenen Anjoke J M Huisjes Jules Dings Yolanda van der Graaf Gerard H A Visser Hein W Bruinse 《The journal of maternal-fetal & neonatal medicine》2006,19(2):93-99
OBJECTIVE: To determine if there is a diurnal pattern in the clinical symptoms of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelets) syndrome. STUDY DESIGN: A retrospective study was performed in 134 pregnancies complicated by HELLP syndrome. The medical records were reviewed to describe each HELLP episode. Time of day was divided into three periods, day, evening, and night. The following parameters were categorized according to the time of day: onset of symptoms, consultation by the doctor, initial blood sampling, diagnosis and decrease of symptoms. Biochemical parameters at clinical presentation and consecutive changes within 24 h were recorded. RESULTS: In 65 pregnancies 77 HELLP episodes were well documented. Times of onset of symptoms and consultation by the doctor were significantly higher during the evening and night (p < 0.001), whereas times of diagnosis and decrease of symptoms occurred significantly more during the day (p < 0.001). In only 49.3% of the cases were diagnostic laboratory criteria met at clinical presentation. This was mainly due to platelet values in excess of 100 x 10(9)/l. Several hours later (median 8 h, range 2-23) the decrease in platelets occurred. CONCLUSIONS: A diurnal pattern exists in the clinical symptoms of HELLP syndrome that is characterized by an exacerbation during the night and recovery during the day. There is a considerable delay between the onset of symptoms and the fulfillment of diagnostic laboratory criteria. 相似文献
50.
R. Watson T. Kozlowski V. Nickeleit J. T. Woosley J. L. Schmitz S. L. Zacks J. H. Fair D. A. Gerber K. A. Andreoni 《American journal of transplantation》2006,6(12):3022-3029
Antibody-mediated rejection (AMR) after liver transplantation is recognized in ABO incompatible and xeno-transplantation, but its role after ABO compatible liver transplantation is controversial. We report a case of ABO compatible liver transplantation that demonstrated clinical, serological and histological signs of AMR without evidence of concurrent acute cellular rejection. AMR with persistently high titers of circulating donor specific antibodies resulted in graft injury with initial centrilobular hepatocyte necrosis, fibroedematous portal expansion mimicking biliary tract outflow obstruction, ultimately resulting in extensive bridging fibrosis. Immunofluorescence microscopy demonstrated persistent, diffuse linear C4d deposits along sinusoids and central veins. Despite intense therapeutic intervention including plasmapheresis, IVIG and rituximab, AMR led to graft failure. We present evidence that an antibody-mediated alloresponse to an ABO compatible liver graft can cause significant graft injury independent of acute cellular rejection. AMR shows distinct histologic changes including a characteristic staining profile for C4d. 相似文献