BACKGROUND:Hospital discharge is a critical step in transitions of care, exposing patients to adverse drug events. Community pharmacists play a key role in post-discharge medication management. However, they often face challenges clarifying hospital discharge prescriptions due to limited access to relevant information and communication gaps between hospital and ambulatory care. OBJECTIVES:This study aims to investigate how hospital pharmacy hotlines can improve communication and support community pharmacists in resolving drug-related problems (DRPs) on hospital discharge prescriptions. METHODS:Pharmaceutical hotlines answered by hospital pharmacists were implemented in three regional hospitals. Community pharmacists could use the hotline when facing DRPs or to obtain additional information about the hospital discharge prescriptions. For each query, the rate of resolution without physician involvement and the type of DRP were documented. Satisfaction was assessed through online questionnaires at the end of the study. RESULTS:The hotlines were implemented during 2 months in two hospitals and 6 months in the third. Community pharmacists raised 185 questions using the hotlines, 54 % of which were resolved without the need to contact the physician. The most common DRPs were unclear or incomplete prescriptions (n = 60, 32 %), medication unavailability (n = 29, 16 %), and drug-drug interactions (n = 22, 12 %). Of the 95 community pharmacies surveyed, 46 responded, with 87 % expressing satisfaction with the hospital pharmacy hotlines. CONCLUSION:The hospital pharmacy hotlines proved to be an effective tool to improve intraprofessional collaboration and support community pharmacists in managing hospital discharge prescriptions, with more than half of DRPs resolved without the need to contact the physician.
Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, is a form of transient left ventricular systolic dysfunction that typically mimics acute coronary syndrome (ACS). Although increasingly recognized, its diagnosis remains challenging due to heterogeneous clinical presentations, evolving pathophysiological concepts, and significant overlap with other acute cardiac conditions. Contemporary criteria, including the InterTAK diagnostic framework, aim to refine case identification, yet distinctions from myocardial infarction, myocarditis, and other cardiomyopathies often remain blurred. Advances in multimodal imaging, biomarkers, and artificial intelligence hold promise for improving diagnostic precision. This review explores current diagnostic challenges in TTS, integrating clinical presentation, mechanistic understanding, and management implications. By bridging mimics, mechanisms, and management, we highlight the need for a nuanced, multidisciplinary approach that balances clinical vigilance with emerging diagnostic tools to optimize patients’ outcomes.
Pneumocystis jirovecii (PJ) causes pneumonia primarily in immunocompromised individuals. Although direct immunofluorescence (IF) remains widely used in routine diagnostics, PCR assays are increasingly being adopted because they offer higher sensitivity and reduced observer dependency. This study evaluates the ELITe InGenius PJ PCR assay compared with IF for PJ detection in respiratory specimens. Respiratory samples submitted for IF-based PJ testing at the University Hospital Zurich over a 19-month period were retrospectively analyzed using the ELITe InGenius PCR assay. Diagnostic accuracy was assessed using IF as the reference method, and performance was evaluated by receiver operating characteristic (ROC) analysis. A total of 222 samples from 213 patients were included (70 sputum, 152 bronchoalveolar lavage). PCR and IF results were concordant in 175 (78.8
Objective:Magnetic nanoparticles (MNPs) show promise in many biomedical applications, including magnetic resonance imaging (MRI). Iron carbide compounds are good theragnostic contrast agents. Being nanosized might enable passage through a placenta, posing risks to embryonic development. This study investigates the biodistribution of intravenously injected carbon coated iron nanoparticles (ICNP) in chicken embryos. Materials and methods:Carbon coated iron nanoparticles (300 μg or 600 μg) were injected into a blood vessel on the chorioallantoic membrane (CAM) of chicken embryos (stages 23 to 26) according to Hamburger-Hamilton (H&H). 24 h after ICNP injection, embryos were formalin-fixed and imaged with T2-weighted MRI. Eighteen embryos (three per H&H stage 24-26 and dosage) were further analysed for ICNP deposits via MRI, histology, scanning electron microscopy (SEM) and X-ray spectroscopy (EDX). Results:Strong signal void artefacts were observed when treated with 600 μg and more pronounced with advancing stages. Deposits were prominent around the vascular system, however all developing organs showed ICNP deposits. Histological and SEM microscopy confirmed inter- and intracellular ICNP uptake in the developing brain. Iron was quantitatively verified in spots of histological sections by EDX. The overall tissue architecture remained intact. Conclusion:The ICNPs are distributed into most embryo organs and cells without causing damage to the tissue and cells. Their potential to affect embryogenesis warrants further long-term investigation. If proven safe, ICNPs may be used as effective theragnostic agents in MRI as well as for personalized medicine because they can be functionalized with specific proteins or antibodies tailored at patient-specific targets.
