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Copyright of Canadian Journal of Hospital Pharmacy / Journal Canadien de la Pharmacie Hospitalière is the property of Canadian Society of Hospital Pharmacists and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Brain‐derived extracellular vesicles (EVs) play an active role in Alzheimer's disease (AD), relaying important physiological information about their host tissues. The internal cargo of EVs is protected from degradation, making EVs attractive AD biomarkers. However, it is unclear how circulating EVs relate to EVs isolated from disease‐vulnerable brain regions. We developed a novel method for collecting EVs from the hippocampal interstitial fluid (ISF) of live mice. EVs (EVISF) were isolated via ultracentrifugation and characterized by nanoparticle tracking analysis, immunogold labelling, and flow cytometry. Mass spectrometry and proteomic analyses were performed on EVISF cargo. EVISF were 40–150 nm in size and expressed CD63, CD9, and CD81. Using a model of cerebral amyloidosis (e.g., APPswe, PSEN1dE9 mice), we found protein concentration increased but protein diversity decreased with Aβ deposition. Genotype, age, and Aβ deposition modulated proteostasis‐ and immunometabolic‐related pathways. Changes in the microglial EVISF proteome were sexually dimorphic and associated with a differential response of plaque associated microglia. We found that female APP/PS1 mice have more amyloid plaques, less plaque associated microglia, and a less robust‐ and diverse‐ EVISF microglial proteome. Thus, in vivo microdialysis is a novel technique for collecting EVISF and offers a unique opportunity to explore the role of EVs in AD. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular complications can occur in oncology patients secondary to certain cancer therapies. Pharmacists are involved in the care of oncology patients who are at risk of or experiencing cardiotoxicity related to their cancer therapy. Our study aimed to understand how pharmacists in Canada care to these patients and to explore their experiences, perceptions, and challenges. Methods: Canadian pharmacists currently involved in the care of patients receiving cancer treatments and at risk of or experiencing cardiotoxicity were invited to participate in a 30-min telephone interview using an interview guide. A combination of inductive and deductive reasoning was applied using two coders who independently reviewed the transcribed interviews and identified key concepts and themes. Results: Eight pharmacists were interviewed. Perceived benefits included sharing specialized knowledge and conducting safety assessments. Perceived challenges were the lack of role recognition and resources and fractured continuity of care. Proposed future directions were to play a more substantial role in direct medication management, creation of specific guidance and tools to support the clinical decision-making process, and to understand how pharmacists at other sites were providing care through the creation of a community of practice. Conclusions: As patient-focused medication specialists, pharmacists help guide clinical decision-making, assess cardiac risk factors, and offer individualized education to meet the holistic needs of oncology patients at risk of or experiencing cardiotoxicities. The creation of a cardio-oncology community of practice may allow pharmacists with a common interest to connect, share learnings, and collaborate on how to continue to advance the delivery of care. [ABSTRACT FROM AUTHOR]

Pesticides are widely used for agricultural and non-agricultural purposes and are posing serious environmental impacts. Green/biogenic synthesis of functionalised nanoparticles as an absorbent to treat pesticides and other organic pollutants has been described in the present study. Green synthesis of magnetic nanoparticles from Green tea and Black tea waste extract and their physical and chemical properties were studied. Magnetic/Iron Nanoparticles (FeNp) were prepared by reduction reaction between Green tea and Black tea waste extract and FeCl3 and FeSO4. The physical, chemical, functional, and morphological properties were characterised by Ultraviolet Visible Spectroscopy (UV-Vis.), X-Ray Differaction (XRD) The synthesised crystalline magnetic nanoparticles showed high degrading efficiency of 99% towards Lufenuron (insecticide) and 89% towards Fipronil (pesticide) from contaminated wastewater using high-performance liquid chromatography (HPLC). Thus, biogenically synthesised magnetic nanoparticles can develop a novel, ecofriendly, and economically beneficial strategy for the degradation of pesticides and wastewater treatment. [ABSTRACT FROM AUTHOR]

Water is a necessity for life but the increase in industrialisation has significantly degraded the quality of water. Almost a hundred tons of dyes are becoming a part of the hydrosphere each year as a result of anthropogenic activities causing ecological disturbance and aesthetic pollution. So, there is a dire need for an eco-friendly technique to remove these dyes from wastewater without putting much pressure on the environment. Research work presented here targeted the green synthesis of TiO2 nanoparticles using vegetable waste (radish leaves) and characterised by FTIR, XRD, and SEM. TiO2 nanoparticles were then used along with sunlight, AlCl3, AgCl, H2O2, and UV light in a hybrid catalytic system to decolourise Yellow Merl. Thereafter the optimisation of various operational parameters to enhance decolourisation efficiency measured by UV-vis. spectrophotometer was carried out. By using biogenic TiO2 nanoparticles with hydrogen peroxide 93% of Yellow Merl was efficiently decolourised under optimised conditions. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of a single-dose, oral vitamin D supplementation (soft gel capsule of 200,000 IU) in subjects with painful diabetic neuropathy (PDN) in Pakistan. Design: Randomized control trial. Materials and Methods: This randomized control trial was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE), Pakistan from November 2021 to August 2022. Subjects with diabetes without any signs of vitamin D deficiency were included. Baseline details were obtained by a predesigned questionnaire. Douleur neuropathy 4 (DN4) score was used for diagnosing PDN. Biochemical tests include serum 25-hydroxyvitamin D (OH)D and HbA1c for screening at baseline and at 3 months follow-up were analyzed. Subjects were categorized into two: a control group and an intervention group. The intervention group was given a single soft gel vitamin D capsule (200,000 IU) after screening by expert paramedical staff. Based on baseline serum vitamin D levels, the intervention group was further categorized into insufficient vs. deficient groups, and the control group was categorized into insufficient vs. sufficient. Results: Of 159 participants, 19.5% vs. 44.7% subjects were with insufficient vs. deficient vitamin D levels in the intervention group, and 10.7% vs. 25.1% were with insufficient vs. sufficient vitamin D levels in the control group, respectively. Though the findings are insignificant, DN4 score at follow-up in intervention groups and control groups was reduced compared to the baseline DN4 score. Furthermore, we observed a reduction in post-HbA1c levels in both the intervention groups (insufficient vs. deficient) and the control-sufficient group. Conclusion: Treatment with vitamin D supplementation in people with PDN helps to improve vitamin D levels, DN4 score, and HbA1c levels, though doseresponse is yet to be compared. [ABSTRACT FROM AUTHOR]

Objective: Measure and quantify the extent of functional limitations in knee osteoarthritis patients under 50. This could include a range of motion, mobility, and activities of daily living (ADLs). Method: This observational study was conducted at the Baqai Institute of Diabetology and Endocrinology (BIDE) in its specialized foot clinic from 2015 to 2016. Data were collected from 80 participants of all genders who were under the age of 50. Individuals with a history of road traffic accidents (RTA), osteomyelitis, tuberculosis of joints, tumors, or those who had undergone ligament surgery were excluded from the study. The collected data were subjected to descriptive analysis using statistical package for social sciences to determine the frequency of various parameters. Result: Participants were 80 (male + female) with an average age of 45.1 years and a standard deviation of 4.2. Regarding pain, the mean score was 6.5 with a standard deviation of 1.2. In terms of pain frequency, 56.3% reported constant pain. About mobility, 70% could walk normally. Of the participants, 25% had a limping gait. For descending stairs, 35% could do so without difficulty. Moreover, nearly all 98.8% experienced discomfort when squatting. Regarding muscle range of motion, active motion was associated with pain in flexion 35%, extension 7.5%, and both flexion and extension 47.5%. These unexpected results suggest a higher level of impairment than anticipated. Conclusion: Our study revealed no statistically significant difference in the intensity of stiffness. However, there was a gender difference in the pain and physical function limitations. [ABSTRACT FROM AUTHOR]

Objective To determine the efficacy of intradermal injection of platelet rich plasma in combination with methotrexate in patients of chronic plaque psoriasis. Methods It was a descriptive case series performed in department of dermatology, FJMU/SGRH Lahore from April 4, 2018 till Oct 4, 2018. A total number of 73 patients enrolled from outpatient department, after acceptance from ethical review board and written informed consent, patients fulfilling the inclusion and exclusion criteria. The demographic information like age, gender, address was collected and recorded as per proforma. All cases were treated under supervision of consultant dermatologist having more than 5 years of clinical experience to avoid bias. The study was conducted for 16 weeks, in which patients were treated for a period of 15 weeks and results were calculated by the end of 16th week. All cases were treated with PRP and MTX both. Autologous PRP was prepared from patient's peripheral blood through 2-stage centrifugation process as per established protocol. Each patient was given intra-lesional PRP in psoriatic plaques on 1st week, 0.1 ml of PRP was given at each point with 2cm spacing followed by 15mg of intralesional MTX weekly for 4 weeks i.e. 2nd, 3rd, 4th and 5th week' after 1 week of PRP injection, 15 mg of MTX were divided among the plaques so that 1.25mg was given at each point with a space of 2cm between two points. Second administration of intralesional PRP was done in the psoriatic plaques on 6th week followed by similar administration of intra-lesional MTX on 7th, 8th, 9th and 10th week. Third intralesional PRP was given on 11th week and then intra-lesional MTX was given again on 12th, 13th, 14th and 15th week. Both PRP and MTX were given through intra-lesional route to avoid toxicity associated with systemic administration. All cases were observed for the effect of treatment by the end of 16th week and PASI was calculated. Efficacy was labeled as per operational definition. Results The mean age of cases was 39.60 ±12.15 years in range of 18 and 60 years. There were 24 (32.88%) male and 49 (67.12%) female cases, with higher female cases. According to operational definition 60 (82.19%) had efficacy while 13 (17.81%) cases did not meet the criteria of efficacy. Conclusion The efficacy of intradermal injection of platelet rich plasma in combination with methotrexate in patients of chronic plaque psoriasis is highly effective. This combination can be utilized for substantial improvement in term of improvement of PASI score. [ABSTRACT FROM AUTHOR]

Background: Sacubitril/valsartan has been shown to significantly reduce cardiovascular mortality and hospitalizations due to heart failure in adult patients with reduced ejection fraction when compared to enalapril. To the best of our knowledge, the combination of sacubitril (neprilysin inhibitor) and valsartan (angiotensin receptor blocker) has not been evaluated in patients with chemotherapy-induced cardiomyopathy, as these patients were excluded from the recent pivotal trial, PARADIGM-HF. However, current guidelines for the evaluation and management of cardiovascular complications of cancer therapy, published by the Canadian Cardiovascular Society, direct clinicians to the Canadian Cardiovascular Society Heart Failure Guidelines for the management of cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction (e.g. >10% reduction from baseline or left ventricular ejection fraction <53%), which could include the use of sacubitril/valsartan. Methods: Retrospective descriptive comparative case study of two patients treated with sacubitril/valsartan. Results: We present data from two patients who experienced anthracycline-induced cardiomyopathy and were successfully managed with sacubitril/valsartan after suboptimal responses to traditional evidence-based heart failure therapies. Both patients demonstrated some recovery of function and normalization of N-terminal pro B-type natriuretic peptide levels. Sacubitril/valsartan was well tolerated with minimal side effects. To date, neither patient has required hospitalization or additional clinic interventions for heart failure. Conclusions: While further large scale studies are required to determine a comprehensive safety and efficacy profile, we report two cases of anthracycline-induced cardiomyopathy survivors managed with sacubitril/valsartan with minimal side effects and no hospitalizations. [ABSTRACT FROM AUTHOR]

Objective: To describe a possible case of capecitabine-induced myopericarditis in a patient at the Cardio-Oncology Clinic in Calgary, AB. Design: A literature search and adverse drug reaction assessment with the Naranjo tool was conducted. Results: A 39-year-old male with recurrent locally advanced rectal adenocarcinoma presented two days after adjuvant treatment with capecitabine and oxaliplatin complaining of intermittent, severe interscapular pain. Based on symptoms, laboratory investigations, and imaging, the patient was diagnosed with acute myopericarditis. Management included aspirin, colchicine, and discontinuing adjuvant chemotherapy. A literature review revealed one case report of capecitabine-induced myopericarditis; however, more data were found regarding the cardiotoxicity of fluorouracil, for which capecitabine is a pro-drug. No case reports were found for oxaliplatin. Conclusion: Due to the timeline of capecitabine administration, symptom onset, and improvement upon medication discontinuation, capecitabine is the probable cause of the myopericarditis. Although rare, it is important to consider the possibility of myopericarditis in patients receiving a fluoropyrimidine who present with cardiovascular symptoms. [ABSTRACT FROM AUTHOR]