Jerry Fahrni

Author: Jerry Fahrni

  • Changes to Twitter finally hit home

    I’ve read quite a bit lately about all the changes to Twitter. The incessant complaining, the non-stop blood-clot cryin’, the “Twitter has gone too far” rhetoric, and so on. Whatever Twitter has done has irritated a lot of people, but doesn’t seem to have hurt them much, if at all. I don’t really care one way or the other. I use the native Twitter client on my Samsung Galaxy Nexus and Samsung Tab 7.0 Plus; seems to work just fine.  No problems noted. I use the Silver Bird add on for Google Chrome to handle my Tweeting when I’m online, and I use Buffer when I’m inside Google Reader. Haven’t seen any problems there either.

    I’ve been using a service called IFTTT – awesome tool by the way – to send all my Tweets directly to an Evernote Notebook where they’re archived for all eternity, or until something happens to the cloud. So each time I compose a new Tweet it’s automatically captured and appended to my “IFTTT Twitter” Notebook in Evernote. It’s great.

    Unfortunately it looks like that’s all about to come to an end. I received the following email yesterday:

    It’s a real bummer. It won’t stop me from using Twitter, but it’s still a bit frustrating that something so incredibly effective at automating the archiving of my Tweets is being shut down.

  • PEG coated nanoparticles improves drug delivery into the brain

    Delivering drugs into the brain is notoriously difficult. Researchers at Johns Hopkins have published a report in the August 29 issue of Science Translational Medicine that they have designed nanoparticles that can safely and predictably infiltrate deep into the brain. Pretty cool.

    A Dense Poly(Ethylene Glycol) Coating Improves Penetration of Large Polymeric Nanoparticles Within Brain Tissue Elizabeth A. Nance, Graeme F. Woodworth, Kurt A. Sailor, Ting-Yu Shih, Qingguo Xu, Ganesh Swaminathan, Dennis Xiang, Charles Eberhart, and Justin Hanes Sci Transl Med 29 August 2012

    ABSTRACT
    Prevailing opinion suggests that only substances up to 64 nm in diameter can move at appreciable rates through the brain extracellular space (ECS). This size range is large enough to allow diffusion of signaling molecules, nutrients, and metabolic waste products, but too small to allow efficient penetration of most particulate drug delivery systems and viruses carrying therapeutic genes, thereby limiting effectiveness of many potential therapies. We analyzed the movements of nanoparticles of various diameters and surface coatings within fresh human and rat brain tissue ex vivo and mouse brain in vivo. Nanoparticles as large as 114 nm in diameter diffused within the human and rat brain, but only if they were densely coated with poly(ethylene glycol) (PEG). Using these minimally adhesive PEG-coated particles, we estimated that human brain tissue ECS has some pores larger than 200 nm and that more than one-quarter of all pores are ≥100 nm. These findings were confirmed in vivo in mice, where 40- and 100-nm, but not 200-nm, nanoparticles spread rapidly within brain tissue, only if densely coated with PEG. Similar results were observed in rat brain tissue with paclitaxel-loaded biodegradable nanoparticles of similar size (85 nm) and surface properties. The ability to achieve brain penetration with larger nanoparticles is expected to allow more uniform, longer-lasting, and effective delivery of drugs within the brain, and may find use in the treatment of brain tumors, stroke, neuroinflammation, and other brain diseases where the blood-brain barrier is compromised or where local delivery strategies are feasible.

  • Cool Pharmacy Technology – RxAdmix

    In this issue of The Imaginary Journal of Pharmacy Automation and Technology (IJPAT) we take a look at RxAdmix, a system designed to provide barcode scan verification in the IV room. Now why didn’t I think of that? Great concept when you consider the dangers associated with compounding an intravenous medication incorrectly. Doxorubicin? Daunorubicin? Eh, what’s the difference.
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  • Saturday morning coffee [September 15 2012]

    So much happens each and every week that it’s hard to keep up sometimes. Here are some of the tabs that are open in my browser this morning along with some random thoughts….

    The coffee mug to the right is from UCLA, obviously. I accompanied my daughter down to UCLA a couple of weeks ago to attend her orientation. It’s a beautiful campus. While I was creeping around I ran into Jim Mora, head coach of the UCLA Bruins football team, sitting on the steps outside of Ackerman Union. I’ll admit, I thought it was pretty cool to see him. I made eye contact and gave him “the nod”, i.e. the male equivalent to saying hello. He blew me off completely. Nice to know he has standards.

    The Possession was #1 at the box office again last weekend. Still haven’t seen it, and still have no intentions to. And Lawless was #2 at the box office again last weekend. Still haven’t seen it either, but would like to. Maybe today or tomorrow.
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  • Pharmacists’ Recommendations to Improve Care Transitions [article]

    No big surprise here. An study that used pharmacists to “[provide] perspectives on admission and discharge medication reconciliation, in-hospital patient counseling, provision of simple medication adherence aids (eg, pill box, illustrated daily medication schedule), and telephone follow-up” found that “pharmacists are well positioned to participate in hospital-based medication reconciliation, identify patients with poor medication understanding or adherence, and provide tailored patient counseling to improve transitions of care“. Makes sense, don’t you think? After all, that’s what pharmacist do. They deal with medications. All things to do with medications, which includes medication reconciliation.

    When I was in pharmacy school at UCSF fourth year pharmacy students were responsible for medication reconciliation. Each “general medicine” team had a fourth year pharmacy student on it, and when there was a new admission the student would interview the patient and reconcile their medication lists. Then we’d simply place the reconciled list in the chart for the attending. When it was time for discharge we’d do it all over again. Often times we’d go as far as to get the discharge prescriptions filled at the outpatient pharmacy and deliver them to the patient bedside where we would provide consultation and education before the patient went home. Pretty cool stuff. This is how it should be done at every hospital. Just sayin’.

  • Nice presentation on NFC development [Slide deck from SlideShare]

    Here’s a nice slidedeck on NFC stuff, and it’s recent.

    Slides 1-26 are pretty much just an introduction and various tid-bits about NFC. Slide 26 shows some of the NFC enabled phones over the past several years. That particular slide is already out of date though. Almost all new smartphones coming to market today are NFC enabled.

    Slides 27-97 contain some pretty extensive informaiton about NFC development, apps, testing, platforms, etc. Good place to start if you’re interested.

  • Tight glycemic control has no proven benefits for children in the cardiac ICU [article]

    It looks like we’re still beating this dead horse. I thought we put the tight glycemic control issue to bed a while back. Then again I’ve been out of the game for quite some time, so it’s quite possible that I’ve missed something. Actually, it’s likely I’ve missed something.

    Tight glycemic control was all the rage in intensive care units (ICUs) all over the country in the late 90’s early 2000’s. Tight control was supposed to reduce infection, promote healing, improve outcomes, etc. Then we found out that tight control really didn’t do that, but it did cause a lot of adverse effects, namely severe hypoglycemia. Makes sense when you thing about it. Giving patient aggressive insulin infusions to keep blood glucose less than 110 mg per deciliter is bound to lead you down the path to hypoglycemia. Just sayin’.

    Every once in a while a new study shows up looking at tight glycemic control in the ICU. The most recent is a study in children. The nuts and bolts of the study? Basically there was no indication that tight blood glucose control showed any benefit in pediatric patients undergoing heart surgery. The results are from the Safe Pediatric Euglycemia in Cardiac Surgery (SPECS) trial, which was conducted at Boston Children’s and at the University of Michigan C.S. Mott Children’s Hospital. The full article appears in the September 7 online edition of the New England Journal of Medicine. It’s free to read, so I would encourage you to get it while you can. The article should be available in the September 27 print edition as well.

    SPECS examined tight glycemic control with insulin compared to standard glucose management in 980 children hospitalized in the cardiac intensive care unit (CICU). Results from the research showed that maintaining “normal” blood glucose levels [80 to 100 mg per deciliter] with insulin had no demonstrable impact on the incidence of care-related infections (such as surgical site infections and pneumonia), length of stay in the CICU, organ failure or mortality. And as expected, the glycemic-control group had a higher rate of severe hypoglycemia (<40 mg per deciliter) than did the standard-care group; 3% versus 1%, respectively. The rate of total hypoglycemia (<60 mg per deciliter) followed a similar pattern; 19% for the glycemic-control group versus 9% for the standard-care group.  Not surprising.

    Hey, it wasn’t all for nothing. The primary author of the article, Dr. Michael Agus had this to say, “There were two successes for this trial. One was that we were able to show that children and adults are different when it comes to the benefit of glucose control in an CICU. We were also able to demonstrate that we can safely control glucose in a young, vulnerable, sick population.” And there you have it, children are not adults and we can safely treat children under our care. Who knew.

     


  • Saturday morning coffee [September 8 2012]

    It’s obviously not Saturday morning. My daughter had a volleyball tournament today. We were out of the house at 6:00am so I obviously didn’t have much time to put this together. Nonetheless I have a cup of coffee in my hand, there are still many tabs open in my browser, and I have some things to say. Let’s begin …

    The coffee mug to the right is another from the great state of Texas. I picked it up in Austin while on vacation with my family. We had a great time in Austin. The capital building in Austin is huge and beautiful. We spent the better part of a couple of hours roaming through the building taking in the rich history of the state. After getting our fill of the State Capital we swung over to the University of Texas, home of Longhorns Football. My family and I also found some time to get in some great food from the likes of The Salt Lick in Driftwood, Tx just outside Austin and Gourdough’s Donuts. Both were awesome.

    The Possession was #1 at the box office last weekend. Haven’t seen it, and have no intentions to. Not my kind of flix. Lawless was #2 at the box office. Haven’t seen it either. I’m behind.
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  • NFC & RFID with Android [Slide deck from SlideShare]

    I came across this presentation while surfing the SlideShare superhighway of information. It gives a nice little overview of both RFID and NFC technologies, including hardware, software, and potential uses. It also provides information on how to use the Android SDK to build NFC enabled applications. Thinking about giving it a go.

  • More RFID refrigerator stuff – Cubixx and myCubixx

    The video below gives a brief overview of Cubixx and myCubixx from ASD Healthcare, an AmerisouceBergen Specialty Group. Cubixx is a large RFID refrigerator solution like you’d see in a pharmacy, and myCubixx is its little brother that is used by patients as a personal RFID controlled refrigerator at home. Pretty cool concept.

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