Multicompartment compliance aids (MCAs) are devices with each discrete section denoting a single dosing occasion. The purpose of an MCA is to maximize patient adherence and thereby optimize the treatment benefits. These devices are widely employed throughout western Europe and UK and use appears to be rapidly increasing (2) although the RPS as moved away from these devices as a means to improve adherence. We analysed MCAs from various pharmacies over a wide geographic area in England and North Wales. We concluded that most MCA users are elderly patients. Also, most of the patients suffer of combined cardiovascular disease. However, a significant proportion of patients falls in the mental/ neurological disease category. Additionally, most of the externals added to MCAs are inhalers and painkillers. Moreover, SDIs are more frequent in female patients and these SDI are mainly related with mental health medication, cardiovascular disease medication and neurological medication. In conclusion, a directive for dispensing of MCAs in pharmacies by pharmacists through an enhanced service should be elaborated having in consideration PIMs, SDIs, drug stability and use of externals and MCA design and brand.

Tomato (Solanum lycopersicum L.) has almost 190 million tonnes produced in 2023. Tomato fruit suffer losses of up to 50% during harvest and transport, which causes financial hardship, reduces the amount of food available and causes environmental harm. Calcium plays an important role in cell wall strength. This work assessed the use of a calcium transport stimulants (MCAS) to increase the firmness of tomato fruit in the laboratory and the foliar application to tomato plants. Then handling damage was simulated. In the laboratory, the calcium with MCAS significantly increased the fruit firmness compared to the untreated and calcium without MCAS, which were not significantly different. When calcium with MCAS was applied to tomato plants foliarly before harvest, the calcium with MCAS treated fruit were significantly firmer than the untreated or calcium without MCAS treated fruit for up to 10 weeks after harvest, and this was achieved by applying only 0.91 kg ha-1 calcium. Finally, when fruit were exposed to a simulated drop, the calcium with MCAS treated fruit remained firmer than the undamaged fruit or dropped fruit with calcium without MCAS. Calcium with MCAS could significantly increase the fruit firmness and increase the shelf-life of tomatoes while applying less calcium.

Our knowledge of biology and mast cell (MC) function, as well as disorders associated with the pathologic activation of MCs has been evolving over the last few decades. Anaphylaxis, mast cell activation syndrome (MCAS) and mastocytosis are interrelated yet distinct conditions within the spectrum of mast cell activation disorders. Nevertheless, all three conditions can co-exist in one and same patient, as pathologic MC activation is the key finding in all three. When mediator release is excessive and involves multiple systems, anaphylaxis and MCAS may occur. Furthermore, mastocytosis is a clonal disorder of MCs and often presents with anaphylaxis and MCAS. Nevertheless, in some cases even proliferative and accumulative features of MCs in mastocytosis can account for symptoms and disease progression. In each case, diagnosis can be only made when diagnostic consensus criteria are fulfilled. The current article aims to provide a concise clinical update and pinpoint main difficulties in diagnosing these puzzling disorders of MCs in medical practice.