Comparison of Customized Cutting Block and Conventional Cutting Instrument in Total Knee Arthroplasty: A Randomized Controlled Trial

Background

Customized cutting block (CCB) was designed to ensure the accurate alignment of knee prostheses during total knee arthroplasty. Given the paucity of CCB efficacy data, we compare CCB with conventional cutting guide using a randomized controlled trial.

A Training Program for Pharmacy Students on Providing Diabetes Care

Objective. To compare second- and third-year pharmacy students’ competence, attitudes, and self-confidence in providing diabetes care before and after completing a hand-on diabetes training program and to determine if the program had an impact on students’ attitude and self-confidence based on their year in the curriculum.Design. The program included classroom lectures and hands-on learning sessions in 5 facets of diabetes care. Pre- and post-test instruments measured students’ competence, attitudes, and confidence in diabetes care.Assessment. Students’ competence and the mean overall confidence score significantly improved after completing the program, while mean overall attitude score did not. Third-year students had significantly higher confidence scores than did second-year students on both pre- and post-program tests. No significant difference was found for attitude scores between second- and third-year students.Conclusion. The hands-on learning program was an effective approach to training pharmacy students in diabetes care, improving both their competence and confidence.     

Impact of the Copper Transporter Protein 1 (CTR1) Polymorphism on Adverse Events among Advanced NonSmall Cell Lung Cancer Patients Treated with a Carboplatin/Gemcitabine Regimen

Background: Platinum-based regimens are effective treatments for advanced non-small cell lung cancer (NSCLC), but the five-year survival rate is still less than 20%. One possible factor appears to be resistance involving polymorphisms in the CTR1 gene which plays an importance role in accumulation of platinum in the cytoplasm. Purpose: To establish both prevalence of CTR1 polymorphism and its impact on treatment related toxicity in Thai advanced NSCLC patients. Materials and Methods: Thirty-two advanced NSCLC participants received carboplatin and gemcitabine during January to June 2016 at King Chulalongkorn Memorial Hospital (KCMH) were recruited for analysis of the CTR1 rs12686377 genotype. These participants were planning to be treated with platinum-based chemotherapy for at least two cycles. Results: Allele frequency of CTR1 polymorphism G?T was found to be 25%. The results showed that genetic polymorphism at CTR1 rs12686377 was associated with emesis side effects (P 0.020) and neuropathic symptoms (P 0.010). In addition, hematologic side effects in terms of anemia also tended to be related to this polymorphism. Conclusions: This is the first study suggesting that polymorphism at CTR1 rs12686377 may be associated with toxicity from platinum-based regimens. Therefore, it could be a factor to aid in treatment decision-making.     

Preparation of single donor platelet with low antibody titers for all patients

Platelet concentrates from ABO-identical donors are the components of choice for patients. However, since inventories are generally insufficient and because there is usually a relative abundance of group O donors, perfect matches are not always possible. It is therefore the accepted practice for platelets to be transfused out of the ABO group when ABO-identical platelets are unavailable. Notwithstanding, the transfusion of platelets containing high titers of antibodies to the antigens on the red blood cells of the patient can cause clinically significant hemolysis. The way to improve the safety of group O platelets has focused on defining a safe level of antibodies or reducing the volume of incompatible plasma. In the current study, 107 group O single donor platelets (SDP) were modified after collecting the platelet pellet in a bag. The AB plasma was added instead of the donor's own plasma. The direct agglutination titers of anti-A/anti-B in the original group O SDPs' plasma were performed by doing a gel test, resulting in from 1:4 to 1:1024. The prevalence of high titers (i.e., at least 1:64 in our study) was relatively high, ～63% for anti-A and 78% for anti-B. The titer of residual anti-A/anti-B in the modified SDPs ranged from negative to 1:8. In most of the modified SDPs anti-A/anti-B could not be detected in the plasma (58.9% and 52.3%, respectively). The results indicate that our modified SDPs have very low titers; that is, acting as a universal SDP which is safe for all ABO patients. This modified SDP form is a more convenient way to overcome the risk from incompatible plasma or loss of platelets during the process of volume reduction and can help effectively manage our inventory.