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Biomedical subjects

Guido R Zanni

Publications and source records attributed to Guido R Zanni.

At least 19 recordsLinked to original sources
PubMed2006

Challenges and obstacles in measuring outcomes.

Numerous factors contribute to the need for consultant pharmacists to understand and measure outcomes. Consumer groups, legislatures, regulatory and certification agencies, among others, are interested in this information. The science of quality improvement is still young. Distinguishing among three terms--quality indicators, quality measures, and benchmarks--is easy enough once they become familiar. The roots of most long-term care quality models rest on the Donabedian model. Care is necessary when selecting outcomes measures because several pitfalls exist. When carefully selected, outcomes measures can improve care immensely and decrease the risk of adverse events.

Humans↗
PubMed2006

Long-term care: changing demographics, changing residents.

Long-term care facilities have tracked resident data for decades. Using those data, researchers have been able to identify and track trends. Resident demographics, facility information, and types of deficiencies uncovered by state surveys are three types of data of interest to consultant pharmacists. Examining trends can provide clues about areas where improved training, greater scrutiny, or targeted interventions may next be needed.

Aged↗
PubMed2006

Biogenerics: potential benefits and obstacles.

Stakeholders in the prescription drug process are familiar with the savings possible when generic substitution is available. When drugs that enjoy a large market share come off patent, multiple generic manufacturers usually are ready to market a lower-cost generic. Today, the fastest growing segment of the pharmaceuticals market is biologics. Although the patents for several costly and successful biologics have expired or will expire in the near future, no biogenerics have yet been approved. The scientific difficulties of replicating large sugar- and protein-based molecules and related safety issues represent obstacles to an abbreviated biologics approval process.

Biological Products↗
PubMed2006

Ostomy care and the consultant pharmacist.

Many long-term care residents have ostomies. Three types of ostomy are most common: ostomies of the small bowel (ileostomies/jejunostomies), ostomies of the large bowel (colostomy), and urostomies. Ostomates (people who have had an ostomy) must deal with their physical and psychological repercussions. Complications may include dermatological problems, short-bowel syndrome, and vitamin deficiencies. When the ostomy involves the bowel, medication absorption may be affected. Pharmacists should be aware of contraindicated medications, as well as those that change the color or odor of effluent or stool.

Aged↗
PubMed2006

Search for solutions: animal models of disease.

Disease researchers use animal models to study potential etiologies, pathophysiologies, and treatments. Responsive models must be predictable, emulating human conditions, and produce results that can be extrapolated and transposed. These models are often better than in vitro study or computer models, but still have limitations. Animal models can be difficult to maintain and are usually quite costly. Numerous methods are used to develop animal models including chemical exposure, genetic "knockout or knock in," or forward genetic modeling. Recently, more accurate animal models of Alzheimer's disease, osteoporosis, cancer, and mental illness have been developed. The strengths and limitations of each are discussed.

Animals↗
PubMed2006

Outbreak: 10 tips to make scabies scamper.

PROBLEM: Most nursing homes are aware of the pandemonium an outbreak of scabies can cause-the laundry alone occupies staff for days. Debilitated residents and those who have poor selfcare skills require considerable help with the activities associated with the eradication of Sarcoptes scabiei. How can a consultant pharmacist help? SOLUTION: Consultant pharmacists should cultivate a "high index of suspicion" for scabies. Scabies mites live their entire lives on the human host as obligate parasites. They are able to survive elsewhere for only up to 48 hours, making transmission via fomite (blankets, towels, or any object that can transmit infectious agents) possible, but unlikely. Transmission follows close personal contact, and passing contact like handshaking is insufficient to pass the mites. Crowded living conditions, such as those associated with emergency shelters, and close and repeated contact, like that which occurs in classrooms, fuel cluster outbreaks.

Animals↗
PubMed2006

Cancers: progress and challenges in the elderly.

Cancer is a growing concern in the long-term care facility. The most common cancers long-term staff are apt to encounter include breast, lung, bladder, prostate, brain, and colorectal. Each cancer subtype and its treatment options are reviewed; they will vary with patients' level of functioning and tolerability. Since treatment guidelines were developed for younger cohorts, issues and side effects unique to elders require an ongoing alliance with oncology specialists. Screening guidelines and end-of-life issues are discussed.

Aged↗
PubMed2006

Aimless excursions: wandering in the elderly.

One in five people with dementia wander. Long-term care facilities must deal with wandering while simultaneously protecting residents, complying with life-safety codes, maintaining a home-like environment, and respecting resident rights. Wanderers tend to be physically healthier than those who do not wander, but more behaviorally disturbed. Experts indicate that 72% of patients who elope will attempt to elope again. Strategies like using commercial security systems, landscaping to direct wanderers' attention back to the facility, keeping resident albums with recent pictures and facts about the resident, and having a research-based policy help prevent serious outcomes.

Aged↗
PubMed2006

Vertigo: few new spins on a common problem.

Vertigo is a common balance deregulation symptom among elders. Its etiology may be peripheral vestibular disease or a central vestibular disorder. Symptom onset, severity, and duration are distinguishing characteristics. The majority of peripheral vestibular disorders include benign paroxysmal positional vertigo, vestibular neuronitis, Meniere's disease, and perilymph fistula. Medication regimen review is necessary to identify possible drug-induced etiology. Treatment options include pharmacotherapy, canalith repositioning procedures, surgery, vestibular rehabilitation therapy, and dietary interventions.

Diet↗
PubMed2005

Disinhibition: clinical challenges in the long-term care facility.

Clinicians use the word disinhibition and its derivatives to describe a resident's behavior. Up to 30% of people with dementia may manifest behavioral disinhibition; sexual disinhibition is also a problem, but less frequently. Several causal relationships have been hypothesized, with frontal lobe deterioration among the best documented. Lobar lesions or trauma, seizure activity, cerebellar dysfunction, and drugs have been implicated as well. Behavioral disinhibition creates clinical challenges in the long-term care facility, and to date, no drug treatment has been approved for this indication. Behavioral interventions are the strategies of first choice. Reports of drug treatment are limited to case reports and very small studies.

Journal Article↗
PubMed2005

From chronobiology to chronotherapeutics.

Chronobiology focuses on variations in biological rhythms across time. This article describes biologic cycles, particularly circadian cycles and their underlying neuroanatomy. Metabolic rhythms are reviewed and their impact on disease and symptom variation discussed. Clinical and chronopharmacological implications and diagnostic applications are presented, highlighting chronotherapy's perspective.

Journal Article↗
PubMed2005

Understanding sarcopenia in the elderly.

The prevalence of sarcopenia, involuntary muscle loss, accelerates after age 60, leading to dependency and disability. Etiology is poorly understood, and numerous theories have been expounded. Resistance weight training is the only agreed upon strategy for altering sarcopenia's progression.

Journal Article↗
PubMed2005

Physiological and psychological factors may be involved in remarkable recovery.

Although rare, spontaneous remissions or remarkable recoveries occur and are sometimes documented in the medical literature. In the past, researchers who examined remarkable recoveries were able to identify some components of cellular healing. Modern day examination could identify previously unknown interventions or keys to self-healing. Today's researchers suspect that physiological and psychological factors may be involved.

Journal Article↗