Comparison of Immunoglobulin G Subclass Concentrations in Severe Community-Acquired Pneumonia and Severe Pandemic 2009 Influenza A (H1N1) Infection

We compared immunoglobulin G (IgG) subclasses in patients with severe noninfluenza community-acquired pneumonia (CAP) to those in patients with severe pandemic 2009 influenza (H1N1) virus infection. Low IgG1 and IgG2 levels occurred often in the CAP group; however, H1N1 patients had lower IgG1 and IgG2 levels (5.4 versus 3.3 g/liter [P = 0.008] and 2.5 versus 1.2 g/liter [P < 0.001], respectively). Low IgG2 levels may be specifically linked to severe H1N1; however, it is not clear whether this association is related to H1N1 or to other features of severity.     

Interventions for alcohol-related brain damage (ARBD): Do specific approaches restrict the evolution of comprehensive patient care?

Aims: The prevalence of alcohol-related brain damage (ARBD) is recognized to be increasing in the Western world. The aim of this article is to review the evidence concerning interventions in ARBD. Design and methods: Systematic review. Findings: About 469 papers were identified of which 49 were suitable for inclusion. About 20 concerned neuropsychological interventions; 5 detailed psychosocial interventions; and 24 focussed on pharmacological interventions. The findings suggest that a range of cognitive rehabilitation strategies can facilitate new learning and improve memory functioning, while psychosocial interventions and supported accommodation can improve mental and physical health. Conclusions: This review demonstrates the need for a comprehensive approach to ARBD rehabilitation and indicates that the management of this condition has not been investigated in a holistic manner.     

Adaptation of the health literacy universal precautions toolkit for rheumatology and cardiology – Applications for pharmacy professionals to improve self-management and outcomes in patients with chronic disease

Over a decade of research in health literacy has provided evidence of strong links between literacy skills of patients and health outcomes. At the same time, numerous studies have yielded insight into efficacious action that health providers can take to mitigate the negative effects of limited literacy. This small study focuses on the adaptation, review and use of two new health literacy toolkits for health professionals who work with patients with two of the most prevalent chronic conditions, arthritis and cardiovascular disease. Pharmacists have a key role in communicating with patients and caregivers about various aspects of disease self-management, which frequently includes appropriate use of medications. Participating pharmacists and staff offered suggestions that helped shape revisions and reported positive experiences with brown bag events, suggestions for approaches with patients managing chronic diseases, and with concrete examples related to several medicines [such as Warfarin^©] as well as to common problems [such as inability to afford needed medicine]. Although not yet tested in community pharmacy sites, these publically available toolkits can inform professionals and staff and offer insights for communication improvement.