Effect of eliglustat on the pharmacokinetics of digoxin, metoprolol, and oral contraceptives and absorption of eliglustat when coadministered with acid-reducing agents
Publication date: Available online 7 January 2020Source: Molecular Genetics and MetabolismAuthor(s): Nathan Thibault, Jennifer Ibrahim, Judith Peterschmitt, Ana Cristina Puga, Leorah Ross, Lucie Vu, Yong Xue, Sandrine TurpaultAbstractEliglustat is an oral substrate reduction therapy indicated for patients with Gaucher disease type 1. Based on in vitro data, clinical trials were conducted to assess the potential for drug-drug interactions between eliglustat and digoxin (P-glycoprotein substrate), metoprolol (sensitive CYP2D6 substrate), a combined oral contraceptive (CYP3A substrate), and acid-reducing agents. Healthy subjects were enrolled in four Phase 1 clinical studies to evaluate the effect of eliglustat on the pharmacokinetics, safety, and tolerability of digoxin (N = 28), metoprolol (N = 14), and a combined oral contraceptive (N = 30) and the effect of acid-reducing agents on eliglustat pharmacokinetics, safety, and tolerability (N = 24). Coadministration resulted in increased exposure to digoxin (1.49-fold) and metoprolol (2-fold) with eliglustat, negligible effects on oral contraceptive pharmacokinetics with eliglustat, and a negligible effect of acid-reducing agents on eliglustat pharmacokinetics. Across all studies, eliglustat was well-tolerated. One serious adverse event (spontaneous abortion) and one discontinuation due to an adverse event (urinary tract infection) were reported, both during the acid-reducing agents study. When eliglustat is coadmi...
A nation-wide initiative has been established for antibiotic stewardship in an effort to reduce over-treatment and over-diagnosis of infections. In our Skilled Nursing Facility (SNF), there are minimal guidelines for ordering urinalyses (UAs) in patients suspected of urinary tract infections (UTIs). Chart review demonstrated that UAs were ordered without systematic guidelines. We designed a project to educate SNF staff on a diagnostic algorithm adapted from McGeer criteria for UTIs
Concerns of urinary tract infections (UTI) are widespread in long-term care (LTC) settings. Non-specific symptoms can lead to unnecessary testing and inappropriate antibiotic use. There have been numerous protocols developed to standardize diagnosis of UTIs, including the McGeer criteria. At our LTC facility, we initiated a modified McGeer criteria for ordering urinalyses (UA) and culture. Our project examines the knowledge retention of the complexities of urinary tract symptoms and the comfort level of nursing staff when communicating with providers.
A Deep Dive into Urinary Tract Infections
Conclusions IUC insertion can be safely performed by medical students in the operating room. Simulation-based skills curricula for medical students can be effectively implemented and achieve clinically relevant improvements in patient outcomes.
Condition: Recurrent Urinary Tract Infection Interventions: Drug: Intravesical antibiotic instillation; Drug: Antibiotic oral suppressive therapy Sponsor: Atlantic Health System Not yet recruiting
Publication date: Available online 25 February 2020Source: Clinical Epidemiology and Global HealthAuthor(s): Gagan Chooramani, Bhawana Jain, Prashant Singh Chauhan
Publication date: Available online 24 February 2020Source: Blood Cells, Molecules, and DiseasesAuthor(s): David J. Kuter, Michael Wajnrajch, Betina Hernandez, Rong Wang, Raul Chertkoff, Ari Zimran
Authors: Hussein EI, Al-Batayneh K, Masadeh MM, Dahadhah FW, Al Zoubi MS, Aljabali AA, Alzoubi KH Abstract Proteus mirabilis is the third most common bacterium that can cause complicated UTI, especially in catheterized patients. Urovirulence genes of P. mirabilis strains are poorly identified among UTI patients. The aims of the present study were to determine the prevalence of the uropathogenic P. mirabilis strains isolated from UTI patients by the detection of several P. mirabilis virulence genes and to characterize the antibiotic susceptibility profile of P. mirabilis isolates. P. mirabilis isolates were collecte...
ConclusionCombined approaches for complete excision of transobturator slings, including bilateral inguinal dissection, are relatively morbid with prolonged recovery time and in most centres will require involvement of plastic surgeons. The laparoscopic approach not only allows for the mesh to be removed in total (including the intramural portion of the mesh), but also provides magnified views compared with open surgery and thus allows for better identification of planes and dissection. It also has the added benefit of avoiding vaginal incisions and therefore reducing the risk of fistula formation between the urethra/bladder and vagina.
This study included 792 couples who underwent PGT-A after multiple pregnancy failures. Subgroup analyses were used to compare the blastocyst aneuploidy rate (BAR), implantation rate (IR), early miscarriage rate (EMR), and live birth rate (LBR). Multiple linear and logistic regression models were used to evaluate the associations. The control group comprised couples with ≤ 2 IFs, ≤ 1 BPL, ≤ 1 EM, and no LM.ResultsNotably, a history of ≥ 4 IFs was significantly associated with an increase in aneuploid blastocysts (42.86% vs. 33.05%,P = 0.044, B = 10.23 for 4...