1.
Ekman, Elisabet, et al.
(författare)
Awareness among nurses about reporting of adverse drug reactions in Sweden
2012
Ingår i: Drug, Healthcare and Patient Safety. - 1179-1365. ; 4, s. 61-66
Tidskriftsartikel (refereegranskat) abstract
Background: The purpose of this study was to investigate awareness among nurses regarding their new role as reporters of adverse drug reactions in Sweden and factors that may influence reporting by nurses.Methods: In 2007, all nurses were included in the adverse drug reaction reporting scheme in Sweden. A questionnaire was sent to 753 randomly selected nurses in September 2010.Results: Of the 453 (60%) responding nurses, 265 (58%) were aware that nurses were included in the reporting of adverse drug reactions. Sixty-one nurses (14%) stated that they had reported an adverse drug reaction. Fifteen percent (n = 70) of the respondents had received training about reporting of adverse drug reactions. Almost one third of these (n = 21, 30%) had reported an adverse drug reaction on at least one occasion. Among nurses without training, a smaller proportion (n = 40, 11%, P < 0.05) had reported an adverse drug reaction on at least one occasion. The two factors considered most important by nurses for reporting were the severity of the adverse drug reaction and if the reaction was to a newly approved drug. A majority of the nurses (n = 397, 88%) were interested in a training course in pharmacology as part of their ongoing professional development. One third (32%) of all nurses stated that one reason for not reporting a suspected adverse drug reaction was that the physician responsible did not regard the reaction necessary to report.Conclusion: We found that more than half of the study population of nurses in Sweden were aware of their new role as reporters of adverse drug reactions, but few of the responding nurses had reported an adverse drug reaction. Given that training seems to be associated with high reporting frequency, we suggest more training in pharmacovigilance for nurses.
2.
Hovstadius, Bo, 1955-, et al.
(författare)
Prevalence and therapeutic intensity of dispensed drug groups for individuals with multiple medications : a register-based study of 2.2 million individuals
2010
Ingår i: Journal of Pharmaceutical Health Services Research. - : Royal Pharmaceutical Society. - 1759-8885. ; 1:4, s. 145-155
Tidskriftsartikel (refereegranskat) abstract
Objectives To assess the prevalence and the therapeutic intensity of dispensed drug groups for individuals receiving multiple medications.Methods The individual-based data of all dispensed outpatient prescriptions in Sweden in 2006 were analysed. Five or more dispensed drugs (DP ≥ 5) during a 12-month period were applied as an indicator of multiple medications. The drugs were categorized according to the second level of the World Health Organization's Anatomic, Therapeutic, Chemical classification. The defined daily dosage per individual during 12 months was applied as an indicator of the therapeutic intensity.Key findings For the 2.2 million individuals with DP ≥ 5, the drug groups with the highest prevalences were antibacterials (48.2%), analgesics (40.3%), psycholeptics (35.9%), antithrombotic agents (33.4%) and beta-blocking agents (31.7%). As examples, the level of prevalence increased with age for analgesics, psycholeptics, antithrombotic agents and diuretics, and decreased with age for antibacterials, drugs for obstructive airway diseases and antihistamines for systemic use. Substantial differences in the level of prevalence between women and men were observed for several drug groups; for example, thyroid therapy (13.3 vs 3.6%), psychoanaleptics (26.3 vs 18.2%), drugs used in diabetes (9.1 vs 15.7%) and lipid-modifying agents (18.1 vs 30.7%). Generally, the therapeutic intensity increased with the increasing number of dispensed drugs. For a third of the most common drug groups, the therapeutic intensity increased with an increasing age above the 60–69-year age group.Conclusion The number of drugs taken not only increases the potential risks associated with multiple drug use, but also increases the potential burden of an increased therapeutic intensity, especially for older people. The reported findings may enlighten physicians and healthcare stakeholders concerning the complex patterns of multiple drug use in the entire population and the associated expenses. The findings may also be used as a base for interventions aiming to bring about the most appropriate and balanced prescription of medicines to individuals with multiple diseases.
3.
4.
Libelius, Rolf, et al.
(författare)
Uptake of horseradish peroxidase in denervated skeletal muscle occurs primarily at the endplate region
1984
Ingår i: Journal of the Neurological Sciences. - 0022-510X .- 1878-5883. ; 66, s. 273-281
Tidskriftsartikel (refereegranskat) abstract
The spatial distribution of horseradish peroxidase (HRP) uptake has been studied by light- and electron microscopy in the denervated hemidiaphragm of the mouse. Segments with high HRP uptake were observed in a band centrally located in the denervated muscle. This distribution is similar to the well-known innervation pattern of the diaphragm. Ultrastructural studies demonstrated a high incidence of postsynaptic folds in close proximity of fibre areas with high intracellular content of HRP. 8–12 days after denervation a large number of fibres showed segments of high HRP uptake. 2–4 days after denervation very few such segments were observed. Biochemical studies also demonstrated an increase in HRP uptake after denervation occurring primarily in the endplate region. The activities of the lysosomal enzymes N-acetyl-β-d-glucosaminidase, acid phosphatase and cathepsin D all increased after denervation, most prominently in the endplate region.It is suggested that the observed segmental uptake of HRP and lysosomal activation reflects a process for rapid membrane turnover in denervated muscle.
5.
Norrby, Marlene, et al.
(författare)
Mitogen-activated protein kinase-activated protein kinase 2 (MK2) in skeletal muscle atrophy and hypertrophy
2010
Ingår i: Journal of Cellular Physiology. - : Wiley-Liss, Inc.. - 0021-9541 .- 1097-4652. ; 223:1, s. 194-201
Tidskriftsartikel (refereegranskat) abstract
Skeletal muscle is a highly plastic tissue. Overall muscle growth (hypertrophy) or muscle wasting (atrophy) results from alterations in intracellular signaling pathways with important regulatory steps occurring in the nucleus as well as in the cytoplasm. Previous studies have identified components of the Akt/mTor pathway as well as the p38 MAPK pathway as important for skeletal muscle hypertrophy and/or atrophy. The present study tests the hypothesis that MK2, a substrate of p38 which following phosphorylation, can be exported from the nucleus in a complex with p38, may be important for skeletal muscle growth. The expression of MK2 was examined in denervated mouse hind-limb (atrophic) and hemidiaphragm (transiently hypertrophic) muscles. MK2 mRNA expression decreased after denervation in both atrophic (48% of innervated controls, P < 0.001) and hypertrophic muscle (34% of innervated controls, P < 0.01) but MK2 protein expression decreased only in atrophic muscle (32% of innervated controls, P < 0.01). The level of T205 phosphorylated MK2 increased after denervation in both atrophic (fourfold increase, P < 0.01) and hypertrophic muscles (almost sevenfold increase, P < 0.001) whereas the level of T317 phosphorylated MK2 (necessary for nuclear export) increased after denervation in hypertrophic muscle (nearly threefold increase, P < 0.001) but not in atrophic muscle. Logarithmically transformed relative changes in MK2 phosphorylated at T317 correlated well (r2 = 0.7737) with relative changes in muscle weight. The results suggest a role for MK2 in the regulation of muscle mass, a role which, at least in part, may be related to determining the subcellular localization of p38 in muscle fibers. J. Cell. Physiol. 223: 194–201,
6.
Sellin, L C, et al.
(författare)
Membrane and biochemical alterations after denervation and during reinnervation of mouse skeletal muscle
1980
Ingår i: Acta Physiologica Scandinavica. ; 110:2, s. 181-186
Tidskriftsartikel (refereegranskat) abstract
Denervation of the extensor digitorum longus (EDL) muscle of the mouse by either nerve crush or nerve section produced: a reduction of the resting membrane potential (Em), alterations in the properties of muscle fibre action potentials and the development of tetrodotoxin (TTX)-resistant action potentials. These changes in membrane electrical properties were accompanied by an increase in the endocytic activity of the muscle and an increase in the activities of the lysosomal enzymes cathepsin D and N-acetylglucosaminidase (NAGA). Reinnervation of muscle was indicated at 9 days after nerve crush by the presence of miniature end-plate potentials. The recovery of membrane electrical properties, beginning with the onset of reinnervation, were not temporally related. The Em increased in two stages: an early rapid repolarization and a later slower repolarization. The muscle fibers were sensitive to the blocking action of TTX by 12 days after nerve crush, whereas the rate of rise (dV/dt) of the action potential did not approach values of innervated muscles until 21 days. Reinnervation resulted in a decrease in endocytosis and a decrease in the activities of cathepsin D and NAGA toward innervated values by 21 days after nerve crush. The results suggest that membrane alterations after denervation and during reinnervation may occur by endo- and exocytosis of membrane constituents and that the lysosomal system may play a role in the breakdown and/or recycling of these structures.
7.
Svensson, Anna, et al.
(författare)
Galectin-1 expression in innervated and denervated skeletal muscle
2009
Ingår i: Cellular & Molecular Biology Letters (Druk). - : Walter de Gruyter GmbH. - 1425-8153 .- 1689-1392. ; 14:1, s. 128-138
Tidskriftsartikel (refereegranskat) abstract
Galectin-1 is a soluble carbohydrate-binding protein with a particularly high expression in skeletal muscle. Galectin-1 has been implicated in skeletal muscle development and in adult muscle regeneration, but also in the degeneration of neuronal processes and/or in peripheral nerve regeneration. Exogenously supplied oxidized galectin-1, which lacks carbohydrate-binding properties, has been shown to promote neurite outgrowth after sciatic nerve sectioning. In this study, we compared the expression of galectin-1 mRNA and immunoreactivity in innervated and denervated mouse and rat hind-limb and hemidiaphragm muscles. The results show that galectin-1 mRNA expression and immunoreactivity are up-regulated following denervation. The galectin-1 mRNA is expressed in the extrasynaptic and perisynaptic regions of the muscle, and its immunoreactivity can be detected in both regions by Western blot analysis. The results are compatible with a role for galectin-1 in facilitating reinnervation of denervated skeletal muscle.
8.
Svensson, Anna, et al.
(författare)
Secreted frizzled related protein 1 (Sfrp1) and Wnt signaling in innervated and denervated skeletal muscle.
2008
Ingår i: Journal of Molecular Histology. - : Springer Science and Business Media LLC. - 1567-2379 .- 1567-2387. ; 39:3, s. 329-337
Tidskriftsartikel (refereegranskat) abstract
Wnts are secreted proteins with functions in differentiation, development and cell proliferation. Wnt signaling has also been implicated in neuromuscular junction formation and may function in synaptic plasticity in the adult as well. Secreted frizzled-related proteins (Sfrps) such as Sfrp1 can function as inhibitors of Wnt signaling. In the present study a potential role of Wnt signaling in denervation was examined by comparing the expression levels of Sfrp1 and key proteins in the canonical Wnt pathway, Dishevelled, glycogen synthase kinase 3 beta and beta-catenin, in innervated and denervated rodent skeletal muscle. Sfrp1 mRNA and immunoreactivity were found to be up-regulated in mouse hemidiaphragm muscle following denervation. Immunoreactivity, detected by Western blots, and mRNA, detected by Northern blots, were both expressed in extrasynaptic as well as perisynaptic parts of the denervated muscle. Immunoreactivity on tissue sections was, however, found to be concentrated postsynaptically at neuromuscular junctions. Using beta-catenin levels as a readout for canonical Wnt signaling no evidence for decreased canonical Wnt signaling was obtained in denervated muscle. A role for Sfrp1 in denervated muscle, other than interfering with canonical Wnt signaling, is discussed.
9.
Thesleff, S, et al.
(författare)
Tetrahydroaminoacridine (tacrine) stimulates neurosecretion at mammalian motor endplates
1990
Ingår i: British Journal of Pharmacology. - 0007-1188 .- 1476-5381. ; 100:3, s. 487-490
Tidskriftsartikel (refereegranskat) abstract
1. Tacrine (20 microM) induced, like 4-aminoquinoline (4-AQ, 200 microM), the appearance of a population of miniature endplate potentials (m.e.p.ps) with more than twice the normal amplitude or time-to-peak. The times-to-peak of nerve impulse-evoked endplate potentials were not similarly affected. 2. Cholinesterase inhibition by edrophonium (25 microM) did not prevent tacrine or 4-AQ from inducing this population of m.e.p.ps. 3. Nerve-muscle preparations in which the normal calcium-sensitive quantal release of acetylcholine had been blocked by botulinum neurotoxin type A also responded to tacrine by an increase in the frequency of giant or slow m.e.p.ps. 4. Reduction of the temperature from 30 degrees to 14 degrees C reduced the frequency of giant or slow m.e.p.ps induced either by tacrine or by 4-AQ. A similar effect was obtained by colchicine (5 mM). This supports the idea that proximo-distal axonal transport is required for the secretory activity. 5. The neurosecretion evoked by tacrine could explain the therapeutic effects of the drug claimed in the treatment of Alzheimer's type of dementia.
10.
Tågerud, Sven, et al.
(författare)
An ultrastructural study of the segmental uptake of horseradish peroxidase in the endplate region of denervated skeletal muscle fibres
1986
Ingår i: Journal of the Neurological Sciences. - 0022-510X .- 1878-5883. ; 75:2, s. 141-157
Tidskriftsartikel (refereegranskat) abstract
The segmental uptake of horseradish peroxidase (HRP) in the endplate region of denervated skeletal muscle fibres has been studied ultrastructurally using a method for selecting single muscle fibres with high segmental peroxidase staining from denervated mouse tibialis anterior muscle.Segments containing large peroxidase positive phagosomes could already be seen 10–15 min after i.v. injection of HRP. Such segments were still present 24 h after HRP injection. The localization of phagosomes, deep in the fibres rather than immediately under the sarcolemma, suggests that the uptake occurs from t-tubuli. Vivid proliferation of t-tubuli, consisting of vesiculation, enlargement and encircling of cytoplasmic components, was also observed. The HRP accumulates in phagosomes of varying size and shape. Similar membrane-limited bodies without or with very weak peroxidase staining were also observed. The peroxidase-positive phagosomes participate in autophagic processes as suggested by their content of undegraded cellular material. Golgi profiles, which occurred deep in the muscle fibres, and enlarged components of the sarcoplasmic reticulum were frequently encountered in the segments. Myofibrillar degeneration occurs in the segments and progresses with time after denervation.The described segments may be related to the increased membrane turnover in denervated muscle fibres and/or they may be related to processes aimed at establishing new synaptic contacts.
