Application of PBPK Models in Personalized Healthcare

Personalized Healthcare is known as customization of healthcare, where medical decisions, and/or products are being tailored to the individual patient need with focus on special population based on different physiological and disease conditions. Personalized healthcare is a paradigm that exists more in conceptual terms thanin reality, with only a few marketed drug–test companion products and not very many actual clinical practices set up to personalize healthcare in the way that supporters have intended. In the past decades the main challenge is to manage the expectations of the medical community and the public at large that have already been set by speculation, and promises, to benefit the special populations, which includes pediatric, pregnancy, geriatric, and/or diseased conditions. 

These classes of populations were generally kept away from drug research to avoid potential harm, whereas the ratio of off-label prescription in these populations is high, ignoring lack of information. In recent yearsthere is renewed surge of interests in the applications of Physiological basedPharmacokinetic Modeling and Simulations (PBPK M&S) by pharmaceutical industry and regulatory agencies. This research is focused on the application of Physiological based Pharmacokinetic Modeling and Simulations in personalized healthcare with emphasize on pediatric populations pregnant population,population with special disease conditions including geriatric.

A Case Report of Prototheca Meningitis in China

Prototheca infections were mainly seen in animals, while In humans, prototheca mostly cause cutaneous infections, 25% cases were olecranon bursitis, and systemic infection including Chronic peritonitis in peritoneal dialysis patients, secondary infection of AIDS or Chronic meningitis, etc., were rare disseminated diseases. Davies et al. reported thefirst human infection with this specie in 1964 and since then sporadic cases ofprototheca infection were described in different parts of the world. And then, the first descript of prototheca meningitis was reported by Kaminski in 1992. In 1996, the second case of meningitis was described in Japan and the infection persisted for 6 years. In China, the first detailed report of meningitis was caused by P. wickerhamii which occurred in 2007 and was successfully treated with AMB and ITZ. And Prototheca wickerhamii as a cause of neuroinfection in a child with congenital hydrocephalus was the first case of human protothecosis in Poland. To our knowledge, we reported the 5th case of human prototheca meningitis in the literature.

A 23 year old young man was admitted to department of infectious disease of the third affiliated hospital of Sun Yat-sen university, complaining of fever, headache and vomiting. Beforeadmission, he had been diagnosed as tuberculous meningitis. After taking chemical therapy with antituberculous drugs combined with adrenocortical hormones for two months, his condition deteriorated.

Upper Gastrointestinal Bleeding Treatment in Children - A Difficult Challenge for the Doctor

In order to make the appropriate treatment is necessary an accurate diagnosis. This is also true for upper gastrointestinal bleeding in children. It is not always easy to sustain the diagnosis, but using current methods we can reach etiologic diagnosis. After diagnosis the best treatment options are choosing. 

These must be both efficient and with fewer side effects. Upper gastrointestinal haemorrhage treatment takes into account two situations: patients with hemo dynamic instability with large blood loss and patients with hemo dynamic stability. Patients with important upper gastrointestinal bleeding with hemorrhagic shock need resuscitation and should be stabilized prior to endoscopy.

Impact of Medication Reconciliation upon Discharge on Reducing Medication Errors

Medication Reconciliation is a process of identifying the most accurate list of all medications a patient is taking-including name, dosage, frequency, and route and using this list to provide correct medicationsfor patients anywhere within the health care system. It involves comparing the patient’s current list of medications against the physician’s admission, transfer, and/or discharge orders.

This reconciliation is done whenever new medications are ordered or existing orders are rewritten at every transition of care, in orderto avoid medication errors such as omissions, duplications, dosing errors, ordrug interactions.Reconciliation is considered a Hospitals’ National Patient Safety Goal since 2005 established by the Joint Commission on Accreditation of Health Care Organizations (JCAHO)