Evaluation of drug therapy knowledge in liver transplant patients after pharmacy counseling

The analysis of the literature demonstrated that pharmacy counselling influenced patient outcome after transplantation. This was the reason we established pharmacy consultation in 1999. The aim of this study was to determine patient knowledge before and after pharmacy counselling. Twenty-nine patients were questioned about the identification, role and dosage of prescribed drugs. The mean duration of pharmacy counselling was 54 minutes. Before pharmacy consultation, the knowledge score was 53.7%. Afterwards, the mean score value reached 75% and seven patients had a score of 100%. The anti-rejection therapy was understood by 93% of patients. However, the associated drugs were poorly known: less than 15% of patients initially knew about the purpose of the antimicrobial agent, compared with 50-60% after counselling. During counselling, two women were identified as regularly using St John's Wort and were informed that this herbal medicine can endanger the success of organ transplantation. Five patients or family members called the pharmacist to obtain additional information. Among these, two medication errors, both with corticosteroid drugs, were reported by family members of patients of foreign origin who had difficulty in understanding and speaking French. Pharmacy counselling improved patient knowledge about therapy after transplantation.     

Comparison of day 3 FSH serum values as determined by six different immunoassays

BACKGROUND: The accurate assessment of FSH concentration is important for evaluating ovarian function prior to IVF. However, a number of different assay techniques are currently in use, leading to inconsistencies in the hormone data being reported. To address this problem, we measured FSH concentration using a number of commercially available systems. METHODS: Day 3 serum FSH levels were measured in 215 healthy fertile women using six different immunoassays: Coatria (125)I (Bio-Mérieux), ACS-180 (Bayer Diagnostics), Advia-Centaur (Bayer Diagnostics), Vitros ECi (Ortho-Clinical Diagnostics), Architect i2000 (Abbott) and Elecsys 2010 (Roche Diagnostics). RESULTS: According to the immunoassay, means +/- SD of FSH concentrations were: 6.5 +/- 2.2 mIU/ml for Coatria (125)I, 6.8 +/- 2.7 mIU/ml for Advia-Centaur, 6.7 +/- 3.0 mIU/ml for Vitros ECi, 7.6 +/- 3.0 mIU/ml for ACS-180, 8.2 +/- 3.3 mIU/ml for Architect i2000 and 8.8 +/- 3.0 mIU/ml for Elecsys 2010. CONCLUSION: Day 3 FSH values determined by six different immunoassays were significantly different (P < 0.01, paired t-test). Physicians must take care when interpreting results from different clinical laboratories.     

Phospholipid scramblase,a new effector of FcepsilonRI signaling in mast cells

The signaling network of the high-affinity receptor for IgE in mast cells involves tyrosine phosphorylation of a number of proteins. Here we report evidence that phospholipid scramblase, a protein involved in the distribution of phospholipids between the two leaflets of the plasma membrane, is a target for tyrosine kinases in this signal. The implication of this observation is briefly discussed.     

Unilateral CHARGE association

A case with a predominantly unilateral CHARGE association is reported. The CHARGE association refers to a combination of congenital malformations. This boy had left-sided anomalies consisting of choanal atresia, coloboma and peripheral facial palsy. The infant had a frontal encephalocele, an anomaly not included in the definitions of CHARGE association. CONCLUSION: even when anomalies are predominantly unilateral, the CHARGE association should be considered in the differential diagnosis.     

Diet-related adaptation of the small intestine at weaning in pigs is functional rather than structural

BACKGROUND: Incidence of diarrhea at weaning in commercial pigs is an important problem, and diet is thought to be a predisposing factor. The aim of this study was to determine the impact of switching from milk-based to cereal-based diets on the morphology and function of the small intestine of piglets using a model of delayed weaning to isolate the influence of the diet from that of environmental and social factors. METHODS: Forty-five piglets received a milk-based diet for 5 weeks after weaning. Thirty piglets were then switched from milk-based to wheat- or barley-based diets, mimicking the dietary change that occurs at weaning. The last 15 piglets remained on the milk-based diet. Piglets were killed 4 days after the dietary switch. Jejunal mucosa morphometry and enzyme activities were measured. Ussing chambers were used to measure intestinal permeability to macromolecules, basal electrical properties, glucose absorption, and induced chloride-secretion. RESULTS: Alkaline phosphatase- and sucrase-specific activities were higher in both groups of cereal-fed piglets than in milk-fed piglets. Dipeptidylpeptidase IV activity was higher in wheat-fed piglets than in the other groups. Na + -dependent glucose absorption was 1.7-fold higher in cereals-fed piglets than in milk-fed piglets. Serotonin-induced and vasoactive intestinal polypeptide-induced chloride secretion was doubled in cereals-fed piglets. Dietary transition did not influence the other parameters. CONCLUSIONS: These results indicate that switching from milk to cereals increased some mucosal enzyme activities, intestinal Na + -dependent glucose absorption, and response to secretagogues. This supports the hypothesis that dietary factors could initiate diarrhea in the presence of other aggravating factors, such as pathogens or environmental stress.