Miracle-dz/UniFAR-FTUs huggingface dataset:
Small and medium agility dogs alter their kinematics when the distance between hurdles differs

There is currently a lack of research examining the health and welfare implications for competitive agility dogs. The aim of this study was to examine if jump kinematics and apparent joint angles in medium (351-430 mm to the withers) and small (<350 mm to the withers) agility dogs altered when distances between consecutive upright hurdles differ. Dogs ran a course of nine hurdles; three set at 3.6 m apart; three at 4 m apart and three at 5 m apart. Both medium (P=0.044) and small (P=0.006) dogs landed closer to the hurdle when consecutive hurdles were set 3.6 m apart, with small dogs jumping slower at this distance (P=0.006). Results indicate that jump kinematics, but not apparent joint angles, alter when the spacing between hurdles differs. These findings may have implications for the health and welfare of agility dogs and should be used to inform future changes to rules and regulations.
Implementation of a pharmacist-supervised outpatient diabetes treatment clinic.

PURPOSE The implementation of a pharmacist-managed Veterans Affairs (VA) clinic for high-risk patients with type 2 diabetes is described, including a review of first-year performance data. SUMMARY As part of VA's ongoing initiative to improve chronic disease management by creating multidisciplinary Patient-Aligned Care Teams (PACTs) that include clinical pharmacy specialists, an outpatient diabetes treatment clinic was implemented at a VA site in Massachusetts. Operated two days weekly, the clinic provides continuity of care between physician visits by applying standard protocols and procedures for insulin therapy; oral medication and insulin doses are adjusted according to self-monitored blood glucose values and other health data transmitted by patients via telephone or secure messaging system. The clinic pharmacist monitors patients' progress toward attainment of glycosylated hemoglobin (HbA1c) goals and provides frequent followup and education to prevent hypoglycemia. During its first year of operation, the clinic enrolled 160 veterans. Among 85 patients included in a three-month review of outcomes data, the mean ± S.D. HbA1c concentration declined by more than one percentage point (from 9.12% ± 1.41% to 7.94% ± 1.18%). Further HbA1c improvements were documented in a subset of 46 patients followed for six months after clinic enrollment, with no episodes of severe hypoglycemia. CONCLUSION An outpatient clinic successfully integrated a pharmacist into a multidisciplinary PACT focused on veterans with poorly controlled type 2 diabetes. The clinic's initial experience suggests that frequent pharmacist interventions have a positive impact in promoting appropriate insulin use in this high-risk patient population.
Eosinophilic pneumonia induced by ceftaroline.

PURPOSE A case of eosinophilic pneumonia in a patient receiving ceftaroline for the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is reported. SUMMARY A 65-year-old woman was admitted to a medical intensive care unit after arriving at the emergency room with complaints of progressively worsening shortness of breath. Her medical history included chronic obstructive pulmonary disease, acute respiratory distress syndrome, recent traumatic brain injury, tobacco use, and alcohol abuse. Within the first few days of hospitalization, the patient was diagnosed with MRSA pneumonia based on microbiological data from bronchoscopy bronchial washings. Her renal function liver enzyme levels were within normal limits. Empirical antibiotic therapy included i.v. vancomycin and meropenem and was narrowed to i.v. linezolid monotherapy based on culture and sensitivity results. After 10 days of treatment with linezolid, the patient was persistently febrile, and cultures remained positive. It was decided to switch therapy to a course of i.v. ceftaroline, an anti-MRSA cephalosporin. On the fifth day of treatment with ceftaroline, the patient developed respiratory decompensation and peripheral eosinophilia of 40%. Bronchoalveolar lavage (BAL) results indicated the presence of pulmonary eosinophilia of 13%. Chest radiographs revealed pulmonary infiltrates, and the computed tomography angiography showed no evidence of pulmonary embolism. Ceftaroline was discontinued, and the patient was started on vancomycin and methylprednisolone. The patient responded to methylprednisolone therapy, with repeat BAL and peripheral blood counts showing resolved eosinophilia. CONCLUSION A patient with risk factors for respiratory disease developed eosinophilic pneumonia after receiving ceftaroline for the treatment of MRSA pneumonia. Eosinophilia resolved after ceftaroline was discontinued and i.v. methylprednisolone was initiated.
Variations in pharmacy-based transition-of-care activities in the United States: a national survey.

PURPOSE A national survey was conducted to assess pharmacist roles in transition-of-care (TOC) activities in the United States. METHODS An online survey was sent to 1246 pharmacy directors who were members of the American Society of Health-System Pharmacists to assess their involvement in TOC activities including medication reconciliation, admission histories, medication counseling, and postdischarge follow-up; pharmacy student and pharmacy technician involvement in TOC activities; the use of technology to facilitate TOC activities; and barriers to performing such activities. RESULTS A total of 393 respondents completed the survey (31.5% response rate). Twenty-seven percent of respondents indicated that pharmacists complete medication histories on admission, and 5% indicated that pharmacy technicians complete medication histories. Most respondents indicated that pharmacists do not routinely or consistently provide patients with tools to facilitate medication adherence before hospital discharge and that pharmacists do not routinely or consistently follow up with patients after discharge. Fifty-six percent of respondents indicated that pharmacists provide patient education for specific medications or for medications for specific diseases. Few respondents indicated that student pharmacists are involved with TOC activities. Most respondents either agreed or strongly agreed that it is important for pharmacists to be involved in TOC activities for hospitalized patients. CONCLUSION Approximately one third of survey respondents indicated that pharmacists complete medication histories. Most respondents indicated that pharmacists do not routinely or consistently provide patients with tools to facilitate medication adherence before hospital discharge or follow up with patients after discharge. Lack of pharmacy staff resources and insufficient recognition of the value of pharmacists' provision of TOC by health care executives, medical staff, nursing staff, and other health care professionals were the most frequently cited barriers to pharmacists assuming more significant roles in the TOC at the respondent's institution.
To What Extent are National Cardiovascular Disease Preventive Guidelines Accomplished in Hungary? The Goal Attainment Program (GAP)

Purpose: Improving the management of cardiovascular disease in Hungary represents an important clinical challenge. This article assesses the achievement of national consensus total cholesterol goals among Hungarian patients of physicians educated about the consensus guidelines and assisted in cardiovascular risk assessment. Methods and results: A total of 320 general practitioners provided data on 15,404 eligible patients. Among these individuals, 14,018 (91%) had documented atherosclerosis and the remaining 9% had ≥ 2 risk factors. Despite this, less than half of all patients received lipid-lowering therapy. Only 12% of high-risk patients attained the consensus total cholesterol target of < 4.5 mmol/L (< 175 mg/dL) and 31% of individuals at low-moderate risk achieved the consensus goal of < 5.0 mmol/L (< 194 mg/dL) at the first visit. Among patients in the high-risk group whose total cholesterol levels were above the consensus goal at the first visit, 54% received no lipid-lowering therapy and 46% receiv.
Independent prescribing by hospital pharmacists: Patterns and practices in a Canadian province.

PURPOSE Results of a survey to determine the frequency of prescribing by Canadian hospital pharmacists with independent prescribing authority are reported. METHODS A Web-based questionnaire was used to collect data on the prescribing activities of a designated group of hospital-affiliated pharmacists in the province of Alberta who had been granted "additional prescribing authorization" (APA) through a peer-review process and were providing clinical pharmacy services in inpatient and/or outpatient settings at the time of the survey (January-March 2014). Descriptive statistics and logistic regression analysis were used to determine the median weekly frequency of prescribing, factors associated with increased use of APA, and perceived prescribing barriers and enablers. RESULTS The survey response rate was about 50% (77 of 153 eligible pharmacists). The median self-reported number of prescriptions and medication orders written during an average week was 4.2 (interquartile range, 2.0-10.0) per 10 patients. Antibiotics and anticoagulants were the most commonly prescribed medications. Interdisciplinary care team dynamics was rated as a leading enabler of prescribing but also a leading barrier to the exercise of APA. The greatest motivators to apply for APA were the potential for increased efficiency and the potential for enhanced patient care. CONCLUSION The survey results indicated that, in an average week, hospital pharmacists with APA prescribed for almost half of the patients they cared for as part of the interdisciplinary team. Prescribing most frequently occurred after team discussion and most often involved adjusting dosages based on organ function and clinical assessment.
Iron and colorectal cancer risk in the α‐tocopherol, β‐carotene cancer prevention study

In vitro and in vivo studies have associated iron with both the initiation and promotional stages of carcinogenesis. We investigated whether iron was associated with colorectal cancer in a nested case‐control study within the α‐tocopherol, β‐carotene cancer prevention study cohort. Exposure was assessed at baseline, using a 276‐item food frequency questionnaire and a fasting serum sample. The study included 130 colorectal cancer cases (73 colon cancers and 57 rectal cancers) and 260 controls. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Supplemental iron intake was only reported for 4 cases and 18 controls; therefore, we were unable to obtain meaningful results for this variable. Comparing the highest to the lowest quartiles, there was an inverse association between serum ferritin and colorectal cancer risk (OR = 0.4, 95% CI = 0.2–0.9) and a suggestion of an inverse association between dietary iron and colorectal cancer risk (OR = 0.4, 95% CI = 0.1–1.1). In addition, serum ferritin, serum iron and transferrin saturation were all inversely associated with colon cancer risk specifically (OR = 0.2, 95% CI = 0.1–0.7, p trend = 0.02; OR = 0.2, 95% CI = 0.1–0.9, p trend = 0.05; OR = 0.1, 95% CI = 0.02–0.5, p trend = 0.003, respectively), whereas serum unsaturated iron binding capacity was positively associated with colon cancer risk (OR = 4.7, 95% CI = 1.4–15.1, p trend = 0.009). In summary, we found a significant inverse association between several serum iron indices and colon cancer risk. © 2006 Wiley‐Liss, Inc.
Outcomes of annual wellness visits provided by pharmacists in an accountable care organization associated with a federally qualified health center.

BACKGROUND The clinical and financial outcomes of annual wellness visits (AWVs) conducted by clinical pharmacists working as part of an accountable care organization (ACO) in a federally qualified health center were evaluated. METHODS In this retrospective, single-center, chart review study, patients seen for AWVs at El Rio Health Center between October and December 2013 were eligible for study inclusion. Data collected from patient charts included patient demographics, preventive screenings ordered by clinical pharmacists during the AWV and completed within one month after the visit, other screenings completed by clinical pharmacists during the visit, medication changes by clinical pharmacists, and revenues collected from the AWV and preventive screenings. Descriptive statistics were calculated and variables compared; p values were calculated using single-sample Student's t tests. RESULTS Three hundred patient records were reviewed. Clinical pharmacists completed 1608 interventions, with a mean of 5.4 interventions per patient. A total of 272 referrals were made, 120 (45%) of which were completed within one month of the visit. Of the 183 laboratory tests ordered for diabetes and lipid screening, 152 (83%) were completed within one month of the AWV (p < 0.001). Of the 370 vaccinations offered during the visits, 182 (49%) were administered (p < 0.001). Twenty-four medication and dosage changes were made by clinical pharmacists during AWVs, and the total revenue for the AWVs conducted by pharmacists and services completed during the visits exceeded $22,000. CONCLUSION Recommendations made by pharmacists during AWVs in an ACO associated with a federally qualified health center had a high acceptance rate and generated substantial revenue.
Hospital delirium treatment: Continuation of antipsychotic therapy from the intensive care unit to discharge.

PURPOSE The rate of continuation of antipsychotics for the management of delirium during hospital transitions of care in a tertiary care medical center was investigated. METHODS A retrospective chart review was conducted for adult patients admitted to the medical intensive care unit (MICU) between June 1, 2011, and May 31, 2012, who were initiated on antipsychotic therapy at least 24 hours before transfer out of the MICU. The primary outcome evaluated was the percentage of patients initiated on an antipsychotic in the MICU who were continued on therapy after transfer to a medical ward. Secondary outcomes included the appropriateness of continuing antipsychotic therapy during transitions of care and the percentage of patients continued on an antipsychotic after hospital discharge. RESULTS Of the 87 patients who met the study inclusion criteria, 23 (26%) were continued on antipsychotic therapy after their transfer from the MICU to the medical ward. Of the 23 patients continued on antipsychotic therapy, 9 (39%) were discharged from the hospital with an antipsychotic. Fourteen of the 23 patients were eligible for assessment of inappropriate antipsychotic continuation upon transfer from the MICU. Of these 14 patients, 9 (64%) were inappropriately continued on an antipsychotic. Patients continued on antipsychotic therapy at hospital discharge were more likely to be discharged to a facility (rehabilitation, skilled nursing facility, or healthcare institution) (p = 0.049). Future areas for study should include (1) prospective analysis to understand the clinical decision-making of providers when treating delirium, (2) evaluation of the long-term impact of continuing antipsychotic therapy for delirium, and (3) ways to improve communication of medication regimens during transitions of care. Plans to reduce antipsychotic continuation could involve reassessing patients on the medical wards, improving documentation of the indication for use in the medical record, or developing protocols to taper off antipsychotics before patients are discharged from the hospital. CONCLUSION The continuation of antipsychotics for the management of delirium during transitions of care was a common practice at a tertiary care medical center. Patients receiving antipsychotics for treatment of delirium in the MICU were inappropriately continued on these agents when transferred from the MICU to the medical floor or discharged from the hospital.
PARVOVIRUS B19 FREQUENCY IN EXANTHEMATIC CASES INITIALY SUSPECTED AS MEASLES OR RUBELLA INFECTIONS IN SÃO PAULO, BRAZIL

Parvovirus B19 infection may be misdiagnosed as measles, rubella, or other exanthematic diseases which are common in childhood. The clinical differential diagnosis for these infections can be misleading due to their similarity in most mild cases and the occurrence of atypical cases. In order to establish the occurrence of parvovirus B19 infection among children with exanthema, paired serum samples from 881 patients with presumptive diagnoses of measles or rubella were tested for IgM and IgG antibodies against parvovirus B19 through the ELISA capture method from 1993 to 1996, after being proved to be not measles or rubella infections. Parvovirus B 19 infection was confirmed in 80 individuals (9%) with IgM positive antibodies, and 240 (27%) with IgG positive antibodies. Sera positive for B19 corresponded to 1% of measles and 96% of rubella suspected cases. Therefore, parvovirus B19 should be considered for serological analysis when a child presents exanthema. DOI: http://dx.doi. org/10.17525/vrr.v14i1. 24
Improving performance of an accountable care organization on a quality measure assessing β-blocker use in systolic heart failure.

PURPOSE The implementation and outcomes are described for a clinical pharmacist-generated initiative to improve the performance of a Medicare Pioneer accountable care organization (ACO) quality measure evaluating the percentage of patients at least 18 years of age with heart failure and a left ventricular ejection fraction (LVEF) of less than 40% who are prescribed with an evidence-based β-blocker (carvedilol, metoprolol succinate, or bisoprolol). SUMMARY Atrius Health clinical pharmacists developed several educational documents to facilitate appropriate prescribing of evidence-based therapies in patients with heart failure. After educating clinicians, clinical pharmacists reviewed patient charts to determine eligibility for initiating or switching to evidence-based β-blocker therapy. Medicare Pioneer ACO patients 18-85 years of age with heart failure and a current or prior LVEF of less than 40% were reviewed. Patients had a current prescription for metoprolol tartrate, atenolol, or no β-blocker. Patients were considered ineligible if they had a documented contraindication or intolerance to β-blocker therapy or were clinically unstable. Recommendations to initiate or switch to an appropriate β-blocker were sent electronically by a clinical pharmacist to an eligible patient's treating physician before a scheduled office visit. In approximately three months, 48 patients underwent chart review by a clinical pharmacist. Performance improved by 8% after the implementation, with 82% of eligible patients achieving the quality measure in 2014-an increase from 74% in 2013. CONCLUSION The performance on a Medicare Pioneer ACO quality measure evaluating β-blocker use in systolic heart failure improved in a one-year period after a clinical pharmacist-generated initiative was implemented at Atrius Health practice sites.
Complete and partial hydatidiform mole in Hawaii: cytogenetics, morphology and epidemiology

Summary. The results of a 5 year prospective cytogenetic and epidemiologic investigation of complete and partial hydatidiform mole are described. A total of 40 complete and 88 partial moles were identified by pathologic criteria in a population of 1602 spontaneous abortions. Cytogenetic observations confirmed the close correlation between chromosome constitution and histopathologic type, virtually all the complete moles were paternal parthenogenones and virtually all the partial moles were triploid. The distributions of maternal age, race, place of birth and socioeconomic status were the same in women with partial moles and in the control population of spontaneous abortions. However, the incidence of complete moles was significantly increased in women aged <20 years and also in Filipino women, these two effects being independent of one another.
Pattern of Ocular Manifestation of HIV/ AIDS among Patients on HAART in ART Clinic of Gondar University Hospital, Northwest Ethiopia

Background: The ocular manifestations of HIV may lead to visual impairment or blindness. In Ethiopia, patients typically initiate antiretroviral treatment (ART) with low CD4 cell counts when the risk of ocular complications may be high. Objective: To determine the prevalence and types of HIV associated ocular conditions in patients referred for on HAART in Ethiopia. Methods: This cross-sectional study was undertaken between March 2010 and August 2010 at the ART clinic of Gondar University Hospital, Northwest Ethiopia. Ophthalmic examinations were performed on all consecutive patients satisfying the criteria for enrolment into the ART clinic irrespective of the presence or absence of ophthalmic/visual symptoms. Results: Enrolled patients (n = 126), of these 70 (57.6%) were females with male to female ratio of 1:1.25 and had a median CD4 cell count of 183 cell/μL (inter-quartile range [IQR], 105-253 cells/μL). About 76.2% of the patients had either Stage I or II. Ninety one (72.3%) of the patients had a CD4 count more than 200 cells/μL at the time of examination. The prevalence of HIV-associated ocular disease was 21.4%. Retinal Microvasculopathy was the commonest finding seen in 9 (7%). The other ocular manifestations noted included: uveitis 4 (3.2%), ophthalmic Herpes Zoster 3 (2.4%), Seborrheic blepharitis 3 (2.4%) and Molluscum contagiosum 3 (2.4%). One patient was found to have disseminated Kaposi sarcoma that had involved the eyelids. Conclusion: The study demonstrates that HIV/AIDS affects the eyes patients on HAART. It is, hence, recommended that eye care should be a part of the package of medical care in the management of patients on HAART.
Level of interleukin-1beta and clinical signs after endotoxin injection in stallions

The study was performed on 10 stallions of Polish Primitive Horses divided into two groups: CONTROL (n=3), and ENDO (n=7) – subjected to Escherichia coli LPS injection in the dose of 0.3 μg/kg b.w. The study was meant to determine the concentration of interleukine-1β (IL-1β) in blood serum. Rectal temperature (Tr), scrotal skin temperature (Tss), and heart (HR) and respiratory (RR) rates were also measured. A statistically significant increase in IL-1 β concentration was noticed in 3-4 h (maximum in 3 h, ΔIL-1β- 24.1 pg/ml) after LPS administration. In endotoxin-tre ated stallions alterations in clinical signs of the disease were significant and characteristic of endotoxaemia (increased Tr, HR, RR). An increase in Tss was observed within 2-6 h (maximum in 3 h, ΔTSS-1.7 o C ) after infusion of the endotoxin.