From Molecular Biology to Novel Immunotherapies and Nanomedicine in Uveal Melanoma

Molecular biology studies of uveal melanoma have resulted in the development of novel immunotherapy approaches including tebentafusp-a T cell-redirecting bispecific fusion protein. More biomarkers are currently being studied. As a result, combined immunotherapy is being developed as well as immunotherapy with bifunctional checkpoint inhibitory T cell engagers and natural killer cells. Current trials cover tumor-infiltrating lymphocytes (TIL), vaccination with IKKb-matured dendritic cells, or autologous dendritic cells loaded with autologous tumor RNA. Another potential approach to treat UM could be based on T cell receptor engineering rather than antibody modification. Immune-mobilizing monoclonal T cell receptors (TCR) against cancer, called ImmTAC TM molecules, represent such an approach. Moreover, nanomedicine, especially miRNA approaches, are promising for future trials. Finally, theranostic radiopharmaceuticals enabling diagnosis and therapy with the same molecule bring hope to this research.

Medication Adherence and the Role of Pictograms in Medication Counselling of Chronic Patients: a Review

Pharmaceutical care requires a patient-centered approach, focusing on the ability of patients to understand drug-related information and follow the instructions delivered by pharmacists as well as other health-care providers included in the circle of care. With the goal of ensuring the prescribed use of medications, called medication adherence, health-care providers have to consider many risk factors such as geography (culture), social economic status, age, and low literacy that may predispose patients to non-adherence, and considerations have to be made for chronic patients living with life-long disease states. The aim of this review is to provide a balanced and comprehensive review outlining a number of different medication counselling and education approaches that have been used to try to improve medication adherence and health outcomes with the use of clear and concise graphic illustrations—called pictograms. By highlighting the current landscape of the general use and efficacy of pharmaceutical pictograms to aid in the knowledge and recall of drug-related information, as well as outlining specific medication adherence outcomes with pharmaceutical pictograms in chronic patients, the current review describes the need for health-care providers to move beyond the traditional didactic methods of oral and verbal communication with patients regarding medication-taking behavior.

The Role of Nutritional Support in Malnourished Patients With Lung Cancer

This review aimed to aggregate and describe the available data about clinical nutrition in lung cancer and the role of the dietitian in multidisciplinary patient care. Scientific literature was searched in order to summarize key aspects related to clinical nutrition in lung cancer. This information can be used to arrange a proper nutritional therapy that can enhance patient treatment responses, prevent side-effects, shorten recovery time, improve prognosis and increase quality of life. An anti-inflammatory diet rich in antioxidants, immunomodulatory compounds, dietary fibre and an appropriate intake of protein can reduce the risk of initiation and progression of lung cancer, support the regeneration of tissues (also after surgery) and improve the nutritional status during the disease and after remission. A correct intake of nutrients is significant prior to disease occurrence and at every stage of treatment and recovery.

Ozone disinfection of community pharmacies during the COVID-19 pandemic as a possible preventive measure for infection spread

The COVID-19 pandemic is currently one of the major global health and economic challenges. An efficient method for reducing the transmission of the virus is a still unmet medical need. Existing experimental data have shown that coronavirus survival is negatively impacted by ozone, high temperature, and low humidity. Therefore, it is feasible to use area ozonation in pharmacies - the front line of the healthcare system. Nevertheless, further work is needed to evaluate the effectiveness of ozone disinfection to reduce the transmission of this virus in pharmacies, hospitals, and other public environments. Med Pr. 2021;72.

Community pharmacy during the COVID-19 pandemic: a cross-sectional study

INTRODUCTION

The COVID-19 pandemic has proved that community pharmacies play a pivotal role in providing medicines, information and safety measures to prevent the spread of SARS-CoV-2.

PURPOSE

The study aimed to get to know opinions of pharmacy staff and owners on the functioning of the community pharmacy during the outbreak of the COVID-19 pandemic.

MATERIALS AND METHODS

To collect opinions about functioning of the community pharmacy during the pandemic, we conducted cross-sectional study among pharmacy staff and owners of pharmacies.

RESULTS

The study group included 456 respondents mostly associated with independent pharmacies (55.7%), from cities less than 100,000 inhabitants (38.8%). The number of patients as well as filled prescriptions increased during the pandemic. Respondents provided patients with advice on cold (81.6%), sore throat (77.0%) and acherelated complaints (68.6%). Most of participants (64.5%) declared that they informed patients about COVID-19. The safety measures in community pharmacies included: a safety regulations poster during the pandemic (97.1%), handwashing in accordance with recommended guidelines (96.3%) and using protective gloves by the pharmacy staff (89.9%). According to 60.7% of participants, the community pharmacy was properly prepared for the pandemic by the owner, however, respondents from independent pharmacies indicate this more frequently (p=0.0001).

CONCLUSIONS

Respondents are aware of the role of community pharmacies in the healthcare system during the pandemic, nevertheless, more attention needs to be paid by public authorities and governmental institutions to patient safety in the community pharmacy.

The legal extension of the role of pharmacists in light of the COVID-19 global pandemic

BACKGROUND

The COVID-19 epidemic has affected every area of life. The greatest challenge has been to adapt the functioning of the health service to prevent the spread of the epidemic and to help infected patients. This has required the involvement of not only doctors and nurses, but also pharmacists. In the face of this pandemic, governments in many countries have granted pharmacists greater authority.

OBJECTIVES

The purpose of this paper is to review the legal extension of the role of pharmacists in light of the COVID-19 pandemic. The review considers recent changes in European countries, Canada, and the United States.

METHODS

A literature review was performed to summarise knowledge about the extension of the role of pharmacists during the pandemic period. Key articles were retrieved mainly from PubMed and Google Scholar, using the terms "COVID-19", "2019-nCoV", "coronavirus", and "pandemic" in combination with "pharmacist" as keywords for our search. We included scientific publications from February 1, 2019 to May 15, 2020.

RESULTS

Pharmacists have been given numerous opportunities so that they can actively join in the fight against the virus. Some of the novel legal extensions aimed at aiding overloaded healthcare systems are as follows: authorisation to prepare hand and surface disinfectants, eligibility to renew chronic treatment prescriptions, as well as filling pro auctore and pro familia prescriptions by pharmacists, performing COVID-19, influenza, and Group A Streptococcus screening tests, and vaccine administration. Moreover, many countries have facilitated Internet services, such as virtual medical consultations, e-prescriptions, and home drug delivery - to promote social distancing among patients. To mitigate drug shortages, the following strategies have been implemented: alternative sourcing, strength, generic, or therapeutic substitution, and preparing compounded formulations at the pharmacy.

CONCLUSIONS

Novel legal extensions have allowed exploitation of the full potential ofpharmacists worldwide, aiding the limited resources of overloaded healthcare systems.

In vitro ultrasound experiments: Standing wave and multiple reflections influence on the outcome

The purpose of this work was to determine the influence of standing waves and possible multiple reflections under the conditions often encountered in examining the effects of ultrasound exposure on the cell cultures in vitro. More specifically, the goal was to quantitatively ascertain the influence of ultrasound exposure under free field (FF) and standing waves (SW) and multiple reflections (MR) conditions (SWMR) on the biological endpoint (50% cell necrosis). Such information would help in designing the experiments, in which the geometry of the container with biological tissue may prevent FF conditions to be established and in which the ultrasound generated temperature elevation is undesirable. This goal was accomplished by performing systematic, side-by-side experiments in vitro with C6 rat glioma cancer cells using 12 well and 96 well plates. It was determined that to obtain 50% of cell viability using the 12 well plates, the spatial average, temporal average (I_SATA) intensities of 0.32W/cm² and 5.89W/cm² were needed under SWMR and FF conditions, respectively. For 96 well plates the results were 0.80W/cm² and 2.86W/cm² respectively. The corresponding, hydrophone measured p_RMS maximum pressure amplitude values, were 0.71MPa, 0.75MPa, 0.75MPa and 0.73MPa, respectively. These results suggest that p_RMS pressure amplitude was independent of the measurement set-up geometry and hence could be used to predict the cells' mortality threshold under any in vitro experimental conditions or even as a starting point for (pre-clinical) in vivo tests. The described procedure of the hydrophone measurements of the p_RMS maximum pressure amplitude at the λ/2 distance (here 0.75mm) from the cell's level at the bottom of the dish or plate provides the guideline allowing the difference between the FF and SWMR conditions to be determined in any experimental setup. The outcome of the measurements also indicates that SWMR exposure might be useful at any ultrasound assisted therapy experiments as it permits to reduce thermal effects. Although the results presented are valid for the experimental conditions used in this study they can be generalized. The analysis developed provides methodology facilitating independent laboratories to determine their specific ultrasound exposure parameters for a given biological end-point under standing waves and multiple reflections conditions. The analysis also permits verification of the outcome of the experiments mimicking pre- and clinical environment between different, unaffiliated teams of researchers.

Impact of thermal effects induced by ultrasound on viability of rat C6 glioma cells

In order to have consistent and repeatable effects of sonodynamic therapy (SDT) on various cancer cells or tissue lesions we should be able to control a delivered ultrasound energy and thermal effects induced. The objective of this study was to investigate viability of rat C6 glioma cells in vitro depending on the intensity of ultrasound in the region of cells and to determine the exposure time inducing temperature rise above 43 °C, which is known to be toxic for cells. For measurements a planar piezoelectric transducer with a diameter of 20 mm and a resonance frequency of 1.06 MHz was used. The transducer generated tone bursts with 94 μs duration, 0.4 duty-cycle and initial intensity ISATA (spatial averaged, temporal averaged) varied from 0.33 W/cm(2) to 8 W/cm(2) (average acoustic power varied from 1 W to 24 W). The rat C6 glioma cells were cultured on a bottom of wells in 12-well plates, incubated for 24h and then exposed to ultrasound with measured acoustic properties, inducing or causing no thermal effects leading to cell death. Cell viability rate was determined by MTT assay (a standard colorimetric assay for assessing cell viability) as the ratio of the optical densities of the group treated by ultrasound to the control group. Structural cellular changes and apoptosis estimation were observed under a microscope. Quantitative analysis of the obtained results allowed to determine the maximal exposure time that does not lead to the thermal effects above 43 °C in the region of cells for each initial intensity of the tone bursts used as well as the threshold intensity causing cell death after 3 min exposure to ultrasound due to thermal effects. The averaged threshold intensity was found to be about 5.7 W/cm(2).