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In this study, we investigated the possible use of novel lipidated sorbitol-based transporters as functional devices for the improvement of non-viral gene delivery. These transporters are composed of a sorbitol scaffold bearing 8 guanidine moieties that mimic the arginine residues of well-known cell-penetrating peptides. In addition, the transporters carry different lipid groups to aid DNA condensation and facilitate lipid vesicle-binding. We found that the transporters described in this study have the potential to function as plasmid DNA/siRNA-condensers and surface ligands for the enhancement of cellular uptake of lipid vesicles. Shorter lipid chains were found to be better for condensation, whereas longer chains were superior surface ligands. The differential activity of different cores might be explained by facilitated decondensation of cores prepared with transporters comprised of shorter lipid chains. However, we suggest that there is an optimum value of decondensation to achieve higher transfection activities. The proper use of the transporters presented in this study enabled us to prepare a highly efficient non-viral gene delivery system based on a core-shell structure, in which a condensed DNA core is encapsulated by a lipid envelope. A multifunctional envelope-type nano-device prepared with an optimal surface ligand favorably competes with commonly used transfection systems.

Vitiligo is a chronic disorder of depigmentation that has different treatment modalities, butpatients’ nonadherence is common. This study aimed to assess the influence of patients’ medication beliefs on patients’ adherence to topical, oral medications, and phototherapy in vitiligo. Between September 2015 and February 2016, 260 patients with vitiligo were asked to fill in theBeliefs about Medicines Questionnaire (BMQ) to assess their beliefs about therapy for vitiligo.Their adherence to the therapy was examined using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: The MMAS-8 scale and BMQ had good internal consistency (Cronbach’s a 50.78 and 0.66, respectively). Using Morisky’s recommended cutoff point, 71% of patients were categorized as low or nonadherent to the scheduled therapy. Patients who perceived specific necessity of dermatological medicines significantly adhered to their therapy (OR 1.23; 95% CI 1.09, 1.38; p = 0.001) whereas patients who had specific concerns about the adverse effects exhibited significant low adherence (OR 0.65; 95% CI 0.56, 0.76; p0.001). Conclusion: Positive beliefs about the necessity of medications in vitiligo do not necessarily reflect high adherence. Patients’ adherence behavior is a multidimensional and dynamic process. The prolonged course of treatment, its cost, and unsatisfactory outcomes influenced the patients’ adherence.

Vitiligo is a chronic disorder of depigmentation that has different treatment modalities, butpatients’ nonadherence is common. This study aimed to assess the influence of patients’ medication beliefs on patients’ adherence to topical, oral medications, and phototherapy in vitiligo. Between September 2015 and February 2016, 260 patients with vitiligo were asked to fill in theBeliefs about Medicines Questionnaire (BMQ) to assess their beliefs about therapy for vitiligo.Their adherence to the therapy was examined using the 8-item Morisky Medication Adherence Scale (MMAS-8). Results: The MMAS-8 scale and BMQ had good internal consistency (Cronbach’s a 50.78 and 0.66, respectively). Using Morisky’s recommended cutoff point, 71% of patients were categorized as low or nonadherent to the scheduled therapy. Patients who perceived specific necessity of dermatological medicines significantly adhered to their therapy (OR 1.23; 95% CI 1.09, 1.38; p = 0.001) whereas patients who had specific concerns about the adverse effects exhibited significant low adherence (OR 0.65; 95% CI 0.56, 0.76; p0.001). Conclusion: Positive beliefs about the necessity of medications in vitiligo do not necessarily reflect high adherence. Patients’ adherence behavior is a multidimensional and dynamic process. The prolonged course of treatment, its cost, and unsatisfactory outcomes influenced the patients’ adherence.

Background: Cardiovascular medications have been commonly associated with medication errors. Objective: The objective of this study was to investigate the incidence and predictors of medication errors in patients with acute coronary syndrome. Setting: the coronary care unit of a university teaching hospital. Methods: This was a prospective observational study on 150 patients admitted to the coronary care unit between August 2014 and July 2015. Main outcome measure: The principal outcome was the number (frequency) of encountered medication errors. Results: Of total 5790 prescription items reviewed, 547 (9.4%) potential medication errors were identified of which 523 (9.0%) were prescribing errors and 24 were monitoring errors. The most frequent prescribing errors were dosing errors (231, 42.2%) followed by loading dose omission error (91, 16.6%), omission of essential drugs on 1st day(43, 7.9%), and timing error (40, 7.3%). Errors frequently encountered with drugs such as aspirin, enoxaparin, beta-blockers followed by angiotensin-converting enzyme inhibitors and clopidogrel. Multivariate logistic regression analysis revealed that renal impairment (OR 6.02; 95% CI1.4–35.4; p = 0.02) and longer duration of hospital stay (OR 4.01; 95% CI 1.5–10.7; p = 0.005) were predictors of the higher incidence of medication errors. Conclusion: Prescribing and monitoring errors in coronary care unit are frequent and avoidable, with the majority of errors were ranked to be of mild to moderate severity. Dosing errors, omission of essential drugs and monitoring errors were most common error types encountered. Dosage adjustment based on estimation of the glomerular filtration rate immediately after admission help avoiding dosage-related errors.

Background: Cardiovascular medications have been commonly associated with medication errors. Objective: The objective of this study was to investigate the incidence and predictors of medication errors in patients with acute coronary syndrome. Setting: the coronary care unit of a university teaching hospital. Methods: This was a prospective observational study on 150 patients admitted to the coronary care unit between August 2014 and July 2015. Main outcome measure: The principal outcome was the number (frequency) of encountered medication errors. Results: Of total 5790 prescription items reviewed, 547 (9.4%) potential medication errors were identified of which 523 (9.0%) were prescribing errors and 24 were monitoring errors. The most frequent prescribing errors were dosing errors (231, 42.2%) followed by loading dose omission error (91, 16.6%), omission of essential drugs on 1st day(43, 7.9%), and timing error (40, 7.3%). Errors frequently encountered with drugs such as aspirin, enoxaparin, beta-blockers followed by angiotensin-converting enzyme inhibitors and clopidogrel. Multivariate logistic regression analysis revealed that renal impairment (OR 6.02; 95% CI1.4–35.4; p = 0.02) and longer duration of hospital stay (OR 4.01; 95% CI 1.5–10.7; p = 0.005) were predictors of the higher incidence of medication errors. Conclusion: Prescribing and monitoring errors in coronary care unit are frequent and avoidable, with the majority of errors were ranked to be of mild to moderate severity. Dosing errors, omission of essential drugs and monitoring errors were most common error types encountered. Dosage adjustment based on estimation of the glomerular filtration rate immediately after admission help avoiding dosage-related errors.

Background: Cardiovascular medications have been commonly associated with medication errors. Objective: The objective of this study was to investigate the incidence and predictors of medication errors in patients with acute coronary syndrome. Setting: the coronary care unit of a university teaching hospital. Methods: This was a prospective observational study on 150 patients admitted to the coronary care unit between August 2014 and July 2015. Main outcome measure: The principal outcome was the number (frequency) of encountered medication errors. Results: Of total 5790 prescription items reviewed, 547 (9.4%) potential medication errors were identified of which 523 (9.0%) were prescribing errors and 24 were monitoring errors. The most frequent prescribing errors were dosing errors (231, 42.2%) followed by loading dose omission error (91, 16.6%), omission of essential drugs on 1st day(43, 7.9%), and timing error (40, 7.3%). Errors frequently encountered with drugs such as aspirin, enoxaparin, beta-blockers followed by angiotensin-converting enzyme inhibitors and clopidogrel. Multivariate logistic regression analysis revealed that renal impairment (OR 6.02; 95% CI1.4–35.4; p = 0.02) and longer duration of hospital stay (OR 4.01; 95% CI 1.5–10.7; p = 0.005) were predictors of the higher incidence of medication errors. Conclusion: Prescribing and monitoring errors in coronary care unit are frequent and avoidable, with the majority of errors were ranked to be of mild to moderate severity. Dosing errors, omission of essential drugs and monitoring errors were most common error types encountered. Dosage adjustment based on estimation of the glomerular filtration rate immediately after admission help avoiding dosage-related errors.

Background: Cardiovascular medications have been commonly associated with medication errors. Objective: The objective of this study was to investigate the incidence and predictors of medication errors in patients with acute coronary syndrome. Setting: the coronary care unit of a university teaching hospital. Methods: This was a prospective observational study on 150 patients admitted to the coronary care unit between August 2014 and July 2015. Main outcome measure: The principal outcome was the number (frequency) of encountered medication errors. Results: Of total 5790 prescription items reviewed, 547 (9.4%) potential medication errors were identified of which 523 (9.0%) were prescribing errors and 24 were monitoring errors. The most frequent prescribing errors were dosing errors (231, 42.2%) followed by loading dose omission error (91, 16.6%), omission of essential drugs on 1st day(43, 7.9%), and timing error (40, 7.3%). Errors frequently encountered with drugs such as aspirin, enoxaparin, beta-blockers followed by angiotensin-converting enzyme inhibitors and clopidogrel. Multivariate logistic regression analysis revealed that renal impairment (OR 6.02; 95% CI1.4–35.4; p = 0.02) and longer duration of hospital stay (OR 4.01; 95% CI 1.5–10.7; p = 0.005) were predictors of the higher incidence of medication errors. Conclusion: Prescribing and monitoring errors in coronary care unit are frequent and avoidable, with the majority of errors were ranked to be of mild to moderate severity. Dosing errors, omission of essential drugs and monitoring errors were most common error types encountered. Dosage adjustment based on estimation of the glomerular filtration rate immediately after admission help avoiding dosage-related errors.