<p>The decarboxylation of
Δ9-tetrahydrocannabinolic acid (THCA) plays pivotal role in the potency of
medical cannabis and its extracts. However, the literature data point out
substantial variations in the process reaction rate and conversion efficacy due
to variability of the temperature, heat transfer efficacy, raw material
attributes, consequently resulting in incomplete decarboxylation, cannabinoid
content decrease due to decomposition, evaporation, and possible side
reactions. Our present work aims to draw attention to mid-infrared (MIR)
spectroscopy for in-situ monitoring and decipher the THCA decarboxylation
reaction in the solid state. The initial TG/DTG curves of THCA, for a first
time outlined the solid-solid decarboxylation dynamics, defined the endpoint of
the process and the temperature of the maximal conversion rate, which aided in
the design of the further IR experiments. Temperature controlled IR
spectroscopy experiments were performed on both THCA standard and cannabis
flower by providing detailed band assignment and conducting spectra-structure
correlations, based on the concept of functional groups vibrations. Moreover, a
multivariate statistical analysis was employed to depict the spectral regions
of utmost importance for the THCA→THC interconversion process. The principal
component analysis model was reduced to two PCs, where PC1 explained 94.76% and
98.21% of the total spectral variations in the THCA standard and in the plant
sample, respectively. The PC1 plot score of the THCA standard, as a function of
the temperature, neatly complemented to the TG/DTG curve and enabled
determination of rate constants for the decarboxylation reaction undertaken on
several temperatures. Consequently, a progress in elucidation of kinetic models
of THCA decarboxylation, fitting experimental data for both, solid state
standard substance and a plant flower, was achieved. The results open the horizon
to promote an appropriate process analytical technology (PAT) in the outgrowing
medical cannabis industry.</p>
The aim of the study was to get detailed insight into the antibiotic consumption trends in the three year period (2016-2018) in Kocani Hospital, to identify the most often prescribed antibiotics and to determine whether the treatment of given diagnosis was in accordance with the official guidelines. The survey covered all pediatric and infant patients admitted to the pediatric ward. Patients’ data included gender, age, diagnosis, antibiotic used and doses. The majority of admitted patients were in the age group of 0-1 (27.48%, 25.94% and 30.77% for 2016, 2017 and 2018, accordingly) followed by age group of 1-2 years (20.86%, 22,0% and 23.83% for 2016, 2017 and 2018, consequently) and 2-3 years (16.06%, 16.1% and 14.63% for 2016, 2017 and 2018, consequently) .The most frequent diagnosis was acute tonsillitis which was determined in ~21% of patients, pneumonia without complications in ~18% and acute bronchitis in ~16% of patients in the period 2016-2018. Results from conducted survey identified high prescription rate and use of antibiotics predominantly ceftriaxone (82.58%, 81.05% and 50.85% in 2016, 2017 and 2018, respectively) contrary to official recommendations and evidences based on clinical data for treatment of the diagnoses in question. So, it is foreseeable to conclude that there is urgent need for restrictive and educational measures i.e. to strength the surveillance and monitoring of antibiotic prescription and usage and hence to promote awareness for rational use of antibiotics on all health-care levels.
Key words: antibiotic prescription, antibiotic consumption, pediatric wards, annual report
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.