Search Results (39)

The current paper examines the sustainable possibility for recycling unused or expired Metoprolol (MET), a benzodiazepine derivative, as an effective corrosion inhibitor for carbon steel in saline solutions. Repurposing expired medicinal drugs aligns with green chemistry concepts and supports circular economy initiatives by reducing pharmaceutical waste and averting the production of new synthetic inhibitors. The technical benefit of recycling expired MET drugs pertains to the elimination of costs associated with organic inhibitor manufacturing and the decrease in disposal expenses for the expired medication. A combination of electrochemical techniques (potentiodynamic polarization and electrochemical impedance spectroscopy) and quantum chemical calculations was employed to evaluate the inhibitory mechanism and efficacy of MET. At a concentration of 10⁻³ M, MET reduced the corrosion current density from 19.38 to 5.97 μA cm⁻², achieving a maximum IE of 69.1%. Adsorption Gibbs free energy, determined using different adsorption isotherms, revealed that interactions between metal atoms and MET adsorbed molecules have a chemical character with a ∆G^o_ads value of −50.7 kJ·mol⁻¹. Furthermore, quantum chemistry calculations indicate that the investigated drug, owing to its molecular structure (E_HOMO = −9.12 eV, E_LUMO = 0.21 eV, µ = 3.95 D), possesses the capacity to establish an adsorption layer on the metal surface, thereby impeding the diffusion of molecules and ions involved in the overall corrosion process. The results obtained using the different techniques were in good agreement and highlighted the effectiveness of MET in the corrosion inhibition of carbon steel. Full article

Background/Objectives: Accurately estimating survival times is critical for clinical decision-making, treatment evaluation, resource allocation, and other purposes. Yet data from relatively recent diagnosis cohorts is strongly affected by right censoring that biases average survival times downward. For example, 5-, 10-, or 20-year survival time averages are not available until 5, 10, or 20 years later, which may be in the future, thus presenting a challenge to obtain in the present. An approach to addressing this problem is described in this report. Here it is demonstrated for kidney cancer survival but could also be applied to survival questions for other types of cancer, other diseases, stage progression times, and similar problems in medicine and other fields in which there is a need for up-to-date analyses of survival improvement trends. Methods: This study introduces STETI, an approach to survival estimation that integrates information about survival times of diagnosis year cohorts with information about survival times of death year cohorts. By leveraging data from death year cohorts in addition to the more familiar diagnosis year cohorts, STETI incorporates recent survival data often excluded by traditional approaches due to right censoring, caused when the post-diagnosis time period of interest has not yet elapsed. Using data from SEER, we explain how the proposed approach integrates diagnosis year cohorts with the death year cohorts of recent years. We demonstrate that incorporating death year cohorts addresses an important source of right censorship that is inherent in diagnosis year cohorts from relatively recent years. This permits survival time trend analysis that accounts for recent improvements in survival time that would be difficult to account for using diagnosis year cohorts alone. We tested linear and exponential models to demonstrate the method’s ability to derive survival time trends using valuable data that would otherwise risk being left unused. Conclusions: Improved survival estimation can better support personalized treatment planning, healthcare benchmarking, and research into cancer subtypes as well as other domains. To this end, we introduce a hybrid analytical approach that addresses an important source of right censorship. Demonstrating it within the domain of kidney cancer is expected to help pave the way to other applications in oncology and beyond, and offers a case study of STETI, an approach to quantifying and projecting trends in survival time associated with therapeutic advancements. Full article

(1) Background: Although Sri Lanka is a developing country and boasts of having a well-established healthcare system along with good healthcare indices, we are still lagging in certain aspects of healthcare. One such aspect is the deficiencies in guidelines and practices related to the handling of pharmaceutical waste. (2) Methods: This was a qualitative study performed using in-depth interviews with the help of a semi-structured questionnaire conducted among staff who are working at a ministry complex in Galle, Sri Lanka. Data analysis was performed using thematic analysis, (3) Results: There were 40 participants which included 29 (72.5%) females. Three main themes were identified, namely, (I) current knowledge, (II) perceptions, and (III) practices towards storage, disposal, and misuse of pharmaceutical waste. The death of the patient, forgetting, relieving symptoms, and adverse effects were some reasons for the accumulation of unused pharmaceuticals at home. Most of the participants did not believe that the reuse of unused medications can cause various health hazards. Moreover, all participants practiced unsafe methods such as flushing down toilets, pouring into a sink, burning, etc. (4) Conclusions: The incorrect practices and poor knowledge in the handling of pharmaceutical waste and less concern for the environment highlight the need for awareness programs to the general public and establishing proper medication waste management such drug take-back systems. Full article

With the rapid development of the pharmaceutical industry and constant growth of drug usage, ecopharmacovigilance (EPV) has emerged as a way of coping with and minimizing the effects that drugs have on the environment. EPV concerns and describes unwanted effects that the use of a specific drug could have on the environment. The US, EU and Cananda are the improving position of EPV, both in legislation and practice. EPV requires further development as previous studies have shown that neither the general population nor healthcare professionals have enough knowledge about the subject. Improving awareness and knowledge about this topic is a key task for the future of EPV. The main objective was to determine students’ level of knowledge about ecopharmacovigilance and to examine ways of storing and disposing of unused and expired drugs. Students’ knowledge and habits were examined by a previously published survey. The survey contains twenty questions divided into three parts and the possibility of writing an additional note. There was no difference in the level of knowledge between the students of different studies. Also, students who had a family member working as healthcare professional did not show a higher level of knowledge compared to the others. Pharmacy students had a greater intention to educate their environment about EPV when compared to students of the other studies. This is in the line with a previous study which showed that the general public expects that pharmacists and physicians educate them about EPV. Medicine and dental medicine students will become prescribers after finishing their studies, and as such, they should be informed about eco-directed sustainable prescribing (EDSP) as part of an EPV strategy. More than half of the participants reported good adherence to prescribers’ instruction, which decreased the amount of unused drugs. Most of the students found that the drug expiration date was legible, but they did not check it often. In comparison with similar studies, Croatian students had more knowledge and better practices concerning EPV and drug disposal. Structured learning strategies and curriculum implementation for EPV are much needed for further raising awareness about the subject among healthcare professionals and the public. Full article

Pharmaceutical waste management represents a global issue. There is a significant gap in consumers’ education regarding the proper disposal of pharmaceutical waste. A significant amount of pharmaceutical waste is generated in health care facilities, including expired medicines, unused doses, and contaminated materials. Inadequate disposal of pharmaceutical waste can have effects on human health and on the environment. Managing pharmaceutical waste requires coordinated efforts from policymakers, health care providers, pharmaceutical manufacturers, waste management companies, and consumers. The purpose of this paper is to examine the current state of activities that may impact the efficiency of Romanian pharmacists in collecting and disposing of pharmaceutical waste, as well as the intentions of pharmacists/technicians to recycle this type of waste. Furthermore, this paper aims to identify institutional and behavioral barriers that affect effective waste management. This research was conducted using quantitative and qualitative research methods. An exploratory factor analysis was used to identify the elements of satisfaction and their attribution levels in the pharmaceutical industry. The statistical significance of the differences across different occupations regarding satisfaction with pharmacists’ activities to reduce waste at each stage was tested using an analysis of variance. Cross-tabulation and a Pearson’s chi-square test were used to analyze the relationship between occupational segments and intention regarding recycling and reusing pharma waste. This research was augmented using qualitative analysis based on the Delphi technique, focused on the barriers to waste management in the pharmaceutical sector. This study presents a general perspective on the current situation of pharmaceutical waste in Romania. The results indicate that the selection of appropriate pharmaceutical waste practices is primarily determined by the attitude of individuals and organizations, followed by regulatory, economic, and technical criteria. In developing sustainable pharmaceutical waste policies, this research provides practical implications for governments, organizations, and citizens. A comprehensive approach to overcoming barriers in pharmaceutical waste management was developed by combining institutional strategies that focus on organizational policies and infrastructure with behavioral strategies that target individuals and communities. Full article

Medicinal and aromatic plants, such as wild garlic (Allium ursinum), are valuable sources of bioactive compounds in traditional and modern medicine. However, the challenges in cultivating wild garlic and its seasonality limit its availability primarily to early spring. To maintain the quality of wild garlic, effective postharvest practices are essential, considering the delicate nature of its leaves and their susceptibility to rapid decay. This study focuses on implementing eco-friendly postharvest practices to address the seasonality and perishability of wild garlic. Optimizing storage conditions and drying processes is essential for extending its shelf life and preserving bioactive components. Two postharvest approaches were evaluated, with vacuum packaging at 4 °C demonstrating the most effective preservation of sensory attributes and bioactive composition over a 9-day period. Additionally, different drying methods, including convective and vacuum drying at various temperatures, were investigated. When the best drying temperature was selected, the results revealed that convective drying is more efficient at preserving phenolic compounds in wild garlic leaves at 60 °C. Conversely, vacuum drying shows superior preservation of alliinase activity and total thiosulfinate content at 70 °C. Furthermore, this study explores the utilization of unused wild garlic, which is typically discarded as waste during storage. By employing suitable drying methods, this material can be preserved and provide a valuable source of phenolic compounds (7.17–10.12 g GAE/100 g) and thiosulfinate (9.35–12.72 mg AC/110 g) compounds for various extraction processes. Accordingly, this research presents significant implications for the integration of wild garlic into diverse industries, particularly in the fields of food and pharmaceutical sectors. The findings offer opportunities for sustainable utilization, economic benefits, and a more environmentally friendly and economically viable approach to wild garlic production and processing. Full article

The translational research community, in general, and the Clinical and Translational Science Awards (CTSA) community, in particular, share the vision of repurposing EHRs for research that will improve the quality of clinical practice. Many members of these communities are also aware that electronic health records (EHRs) suffer limitations of data becoming poorly structured, biased, and unusable out of original context. This creates obstacles to the continuity of care, utility, quality improvement, and translational research. Analogous limitations to sharing objective data in other areas of the natural sciences have been successfully overcome by developing and using common ontologies. This White Paper presents the authors’ rationale for the use of ontologies with computable semantics for the improvement of clinical data quality and EHR usability formulated for researchers with a stake in clinical and translational science and who are advocates for the use of information technology in medicine but at the same time are concerned by current major shortfalls. This White Paper outlines pitfalls, opportunities, and solutions and recommends increased investment in research and development of ontologies with computable semantics for a new generation of EHRs. Full article

Probiotics are among those products, the use of which is increasing, and they are available primarily as food/dietary supplements, as well as in the form of medicines. This study aims to assess the attitudes and practices of health professionals and students of health sciences, give a short overview of the probiotics currently on the market, and conduct a screening of five food supplements and one drug with respect to antibiotic resistance. Nearly half of the respondents in our survey state that probiotics have no side effects, while only 6.3% believe that the use of probiotics can lead to antibiotic resistance. In addition, more than 40% of the participants throw unused probiotics into municipal waste. The market analysis results indicate that probiotic products on the Serbian market have highly variable CFU counts, while the declared health claims cover numerous beneficial health effects, and they are sometimes even registered as medicines. Lactobacilli are frequently present in probiotic supplements, and are sold in pharmacies and online. The experimental results showed that antibiotic resistance is present in different types of lactobacilli in probiotic products. The risk of using probiotics, regardless of their beneficial health effects, should be taken into account in the future. An update to the regulations governing probiotics, including a stipulation for antimicrobial resistance (AMR) testing, should be established, and guidelines for their proper use and disposal put into place. Full article

As a nation with relatively low levels of AMR, due to both community and agricultural stewardship, as well as geographical isolation, Australia is somewhat unique. As this advantage is being eroded, this project aimed to investigate the spectrum of human behaviours that could be modified in order to slow the spread of AMR, building upon the argument that doable actions are the best-targeted and least complex to change. We conducted a workshop with a panel of diverse interdisciplinary AMR experts (from sociology, microbiology, agriculture, veterinary medicine, health and government) and identified twelve behaviours that, if undertaken by the public, would slow the spread of AMR. These were then assessed by a representative sample of the public (285 Australians) for current participation, likelihood of future participation (likelihood) and perceived benefits that could occur if undertaken (perceived impact). An impact-likelihood matrix was used to identify four priority behaviours: do not pressure your doctor for antibiotics; contact council to find out where you can safely dispose of cleaning products with antimicrobial marketing; lobby supermarkets to only sell antibiotic free meat products; and return unused antibiotics to a pharmacy. Among a multitude of behavioural options, this study also highlights the importance of tailoring doable actions to local conditions, increasing community education, and emphasizing the lack of a one-size fits all approach to tackling this global threat. Full article

Nowadays, the contamination caused by emerging pollutants is a global concern due to the lack of scientific evidence to demonstrate the risk or toxicity to humans due to the presence of pharmaceutical residues in the environment. This study aimed to identify and describe the disposal practices of unused and unwanted medications, as well as to analyze and identify the most frequent drugs determined on water bodies adjacent to the biggest urban population in Mexico. A two-phase study with an epidemiological and an ecological assessment was performed. The epidemiological phase was carried out with a descriptive cross-sectional study among citizens from Mexico City and the metropolitan area using an electronic survey applied to 719 subjects aimed to assess practices in which pharmaceutical products are disposed. The ecological phase included a review of scientific reports. The results show that nearly 83.5% of those surveyed use inappropriate practices for disposal medicines, the main ones are through the municipal dump or directly in the drain. The ecological approach was carried out by a systematic literature review of original reports published between 2013 to 2023; information about the class of drugs, active substance, environmental compartments, location, and concentration was extracted and presented. Fifty-one different types of pharmaceutical residues were detected in wastewater in Mexico City in the last decade. The results of this study can contribute to the application of public policies for waste management authorities to mitigate the socio-environmental risks due to the inappropriate disposal of medicines. Full article

Antimicrobial resistance (AMR) is a major public health threat. The hoarding, sharing and unsafe disposal of unused or expired antibiotics in domestic waste streams or sewage systems by patients may contribute to the risk of acquiring or spreading antibiotic-resistant bacteria. Community pharmacies in the UK accept returned medicines for safe disposal, including antibiotics, but awareness of this is low. We organised an antibiotic amnesty campaign in the Midlands region of England; the aim of the campaign was to raise awareness of the risks of AMR and highlight the safe disposal of antibiotics via community pharmacy, timed to coincide with World Antimicrobial Awareness Week in November 2021. Full article

Natural polymers are very widespread in the world, which is why it is so important to know about the possibilities of their use. Chitin is the second most abundant reproducible natural polymer in nature; however, it is insoluble in water and basic solvents. Chitin is an unused waste of the food industry, for which there are possibilities of secondary management. The research led to obtaining a soluble, environmentally friendly form of chitin, which has found potential applications in the many fields, e.g., medicine, cosmetics, food and textile industries, agriculture, etc. The deacetylated form of chitin, which is chitosan, has a number of beneficial properties and wide possibilities of modification. Modification possibilities mean that we can obtain chitosan with the desired functional properties, facilitating, for example, the processing of this polymer and expanding the possibilities of its application, also as biomimetic materials. The review contains a rich description of the possibilities of modifying chitin and chitosan and the main directions of their application, and life cycle assessment (LCA)—from the source of the polymer through production materials to various applications with the reduction of waste. Full article

The reissuing, redispensing, redistributing, or even recycling of the returned unused stored medicines is referred to as medicine reuse. A few studies have examined people’s willingness to reuse unused stored medicines. This study aims primarily to explore the public’s willingness to reuse unused stored medicines in the future and the factors affecting their decisions, and to assess the pharmacological types and formulations of the unused stored medicines by the public. A cross-sectional study was conducted using a convenient sampling technique over three weeks (February–March 2022) among Jordanian populations. Data were collected from 681 participants who agreed to fill out a questionnaire, which was distributed online. Participants showed a positive perception of reusing any of the unused stored medicines in the future; of those, 79.6% (n = 400) believed that reusing “unused medicines” has economic benefits and 50% (n = 251) believe there are environmental benefits. Moreover, more than half of the participants believed that reusing “unused medicines” is safe (n = 256, 51%), but provided that a pharmacist or a doctor evaluates their quality or that the unused medicines are stored well. Results from this study show that the public positively endorses the idea of reusing unused stored medicines if the quality and safety are assured. However, future studies are needed to evaluate the Jordanian healthcare professionals’ perceptions towards medicine reuse and pharmaceutical companies’ willingness to be a part or facilitator of medicine reuse. Full article

This descriptive cross-sectional study aimed to assess the knowledge and practices of pharmacy and nursing students at a medical college in Kosovo concerning unused and expired medications. A self-administered questionnaire was distributed to 500 randomly selected students of pharmacy (200 questionnaires) and nursing students (300 questionnaires). Overall, 336 returned the filled forms and the response rate was 67.2. SPSS version 26.0 was utilized for statistical analysis. The results showed that 89.2% of pharmacy students and 82.2% of nursing students check the expiration date of medications before purchasing them and a considerable number of students stated that they possess unused medicines at home (78.4% of pharmacy and 74% of nursing students). Regarding disposal practice, over 50% of both nursing and pharmacy students dispose of unused and expired medications in the trash. A small proportion of students returned unused or expired medicines to the pharmacy (11.4% of pharmacy students and 10.7% of nursing students return unused medications, whereas 14.4% of pharmacy respondents and 10.1% of nursing respondents reported returning expired medicines). There was a statistically significant difference in the ways pharmacy and nursing students purchase pharmaceuticals and in their opinions regarding institutions in charge of disposing of unused and expired medicines (p = 0.000). Students are aware of the detrimental effects improper disposal of unused and expired medicines has on the environment and public health, but lack information regarding the return of unused and expired medicines to the pharmacy. To change the existing practice the most appropriate method would be to add additional lectures on safe disposal practices into existing modules. It is recommended for involved stakeholders in Kosovo to organize training, seminars, and workshops for health professionals especially pharmacists and nurses, since they pass the information to patients/consumers as well as the government to make amendments to current legislation to ameliorate the returning procedures for patients/consumers in pharmacies. Full article

Background: Biomaterials and biotechnology are becoming increasingly important fields in modern medicine. For cranial bone defects of various aetiologies, artificial materials, such as poly-methyl-methacrylate, are often used. We report our clinical experience with poly-methyl-methacrylate for a novel in vivo bone defect closure and artificial bone flap development in various neurosurgical operations. Methods: The experimental study included 12 patients at a single centre in 2018. They presented with cranial bone defects after various neurosurgical procedures, including tumour, traumatic brain injury and vascular pathologies. The patients underwent an in vivo bone reconstruction from poly-methyl-methacrylate, which was performed immediately after the tumour removal in the tumour group, whereas the trauma and vascular patients required a second surgery for cranial bone reconstruction due to the bone decompression. The artificial bone flap was modelled in vivo just before the skin closure. Clinical and surgical data were reviewed. Results: All patients had significant bony destruction or unusable bone flap. The tumour group included five patients with meningiomas destruction and the trauma group comprised four patients, all with severe traumatic brain injury. In the vascular group, there were three patients. The average modelling time for the artificial flap modelling was approximately 10 min. The convenient location of the bone defect enabled a relatively straightforward and fast reconstruction procedure. No deformations of flaps or other complications were encountered, except in one patient, who suffered a postoperative infection. Conclusions: Poly-methyl-methacrylate can be used as a suitable material to deliver good cranioplasty cosmesis. It offers an optimal dural covering and brain protection and allows fast intraoperative reconstruction with excellent cosmetic effect during the one-stage procedure. The observations of our study support the use of poly-methyl-methacrylate for the ad hoc reconstruction of cranial bone defects. Full article