bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiothoracic Surgery Discharge Guideline
Authors: Dadyan Mitra , Sanborn Michael
Published: August 2010

Patient safety is a complex issue that is constantly evolving. Communication via standardized drug ordering is recognized as one of the key elements to providing a safer hospital stay, as well as a stronger patient outcome. This feature will publish bimonthly and will provide examples of standardized drug prescribing and a forum for discussion.

If you have a template that you believe other hospital pharmacies can benefit from, please submit it along with answers to the questions (seen below in the text) to Joyce Generali, Director of Drug Information at Kansas University Medical Center, 3901 Rainbow Center, Kansas City, KS 66160 or E-mail at jgeneral@kumc.edu .
Confusion between Two Forms of EDTA; Identical Name Error which Spans Three Continents; New Form and Strength
Authors: Cohen Michael R.
Published: August 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via E-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Hyperkalemia with Combined Aldosterone and Angiotensin Blockade in Patients with Heart Failure
Authors: Howard Patricia A.
Published: August 2010

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the US, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment — if they keep current with developments in drug therapy.
Extended Stability of Oxytocin in Ringer's Lactate Solution at 4° and 25°C
Authors: Boothby Lisa A. , Madabushi Rajanikanth , Kumar Vipul , Breland Burnis D. , Hatton Randy C. , Doering Paul L. , Derendorf Hartmut
Published: August 2010

Purpose

Since IV admixtures of oxytocin in the final working concentrations are not commercially available, oxytocin admixtures must be prepared immediately before use or compounded in a sterile laminar flow hood and stored until needed. Although published reports indicate short-term stability of oxytocin in Ringer's lactate solution and Ringer's lactate-dextrose 5%, longer-term stability data at various temperatures are lacking.

Methods

A stability assay was developed, validated, and executed with oxytocin at two different concentrations in Ringer's lactate solution. Stability was assessed at 4 and 25°C over 31 days.

Results

This study shows that commonly used dilutions of oxytocin in Ringer's lactate solution retain greater than 90% of initial concentrations, when stored at room temperature or refrigerated for 31 days. These data show that oxytocin admixed with Ringer's lactate solution has extended chemical stability after preparation.

Conclusions

Demonstration of extended stability of oxytocin in Ringer's lactate solution will allow hospitals to give longer dating to oxytocin IV admixtures, provided they are prepared in a sterile environment and monitored in compliance with USP <797> guidelines. This should help minimize the potentially dangerous practice of admixing this IV solution at the bedside.
AmpliChip for Cytochrome P-450 Genotyping: The Epoch of Personalized Prescriptions
Authors: Gates Brian J. , Davies Neal M.
Published: August 2010

The clinical importance of genetic polymorphisms in drug metabolism is well-known in clinical pharmacotherapy. The first widely available pharmacogenomic microarray technology approved by the Food and Drug Administration as a medical device to clinically genotype genetic polymorphisms in drug metabolism is now available with the launch of AmpliChip technology. This readily accessible clinical microarray test allows the genotyping of cytochrome (CYP) P-450 2D6 and 2C19 and marks a milestone in the epoch of evidence based personalized medicine. Many commonly used drugs are substrates for CYP2D6 and CYP 2C19 and hence may potentially demonstrate phenotypic differences as poor, intermediate, extensive, and ultrarapid metabolizers. These phenotypic variations could lead to expressed differences in pharmacotherapeutic patient outcomes. AmpliChip currently allows for testing of multiple alleles (31) in a single assay. Other technologies for pharmacogenomics are on the horizon. This article reviews the importance of polymorphic enzymes and genotyping as to how genetic polymorphisms alter pharmacotherapy and the emergence of a plethora of technologies that may become routinely available for clinical pharmacogenomic testing in the near future.
JCAHO Med Management - Managing High-Risk Medications: Implementing Medication Management Standard 7.10
Authors: Shlom Elizabeth A. , May Sondra K.
Published: August 2010

This continuing feature highlights the experiences of various health care organizations in implementing the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards and National Patient Safety Goals. Practical information on what worked and how organizations have been surveyed regarding the standards and goals will be provided along with updates on revisions and recommendations being established by JCAHO.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Medication Management Standards are guidelines for health care organizations to improve patient medication safety and quality of care. Medication Management Standard 7.10 states, “The hospital develops processes for managing high-risk or high-alert medications.” An institution's list of high-risk medications can be derived from published lists, retrospective review of hospital-specific incidents, and/or prospective evaluation as new drugs are added to the formulary. The hospital's policy will include the list of high-risk medications and the risk-reduction strategies that it is undertaking to reduce medication errors associated with them. One method of identifying risk-reduction strategies is to conduct a failure mode and effects analysis (FMEA). The process of conducting an FMEA is described and a list of risk-reduction strategies from two hospitals are provided.
Managed Care Pharmacist - Pharmacogenomics and Its Potential Uses in Managed Care Pharmacy
Authors: Teagarden J. Russell
Published: August 2010

Managed care pharmacists are involved formally with the interface between the delivery and financing of health care; their work thus entails an accountability for both elements. Interpreted broadly, managed care pharmacists are pharmacists working within the sphere of a health care system, health care purchaser, health insurer, managed care organization, or benefit administration agency. Patients, the pharmacy profession, and society are best served by this broad interpretation, because the interdependency of financing and delivery is inextricably linked to the achievement of good health outcomes. This continuing feature will explore contemporary issues facing managed care pharmacists.
Hospital Pharmacy Pulse - Recent Publications on Medications and Pharmacy
Authors: Generali Joyce
Published: August 2010

Hospital Pharmacy presents this new feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics.
Hepatotoxicity with Telithromycin; Sirolimus-Associated Pneumonitis; Erythema Nodosum Associated with Vaginal Ring Contraceptive; Respiratory Failure with a Single Dose of Quetiapine; Pantoprazole-Induced Thrombocytopenia in Two Patients; Pharmacist Counseling CAN Prevent Adverse Drug Events; Symposium on Anaphylaxis
Authors: Shuster Joel
Published: August 2010

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers
Gabapentin: Agitation in Dementia
Authors: Generali Joyce , Cada Dennis J.
Published: August 2010

Off-Label Drug Uses — This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Wolters Kluwer Health. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form, so the reader can easily identify the scope of information available. A summary of the data—including background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments regarding “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
Determining Nurses' Satisfaction with Pharmacy Services: A Suggested Methodology and Demonstration
Authors: Matthias Kathryn R. , Gibson Kimberly D. , Draugalis Jolaine R. , Spravzoff Steve R.
Published: August 2010

Purpose

The level of nurses' satisfaction regarding pharmacy services provided at a rural medical center was evaluated and compared to data collected in a previous study at the same institution. Information obtained was used to determine potential areas for pharmacy service improvements.

Methods

This project employed a survey research design that acquired demographic and descriptive data. The updated survey contained 43 items including 34 scaled, seven demographic, and two open-ended items. Aspects assessed by this instrument included accessibility of pharmacists, accuracy of medication delivery, quality of drug information services, and perceptions of pharmacists' value by nursing staff. All inpatient nurse practitioners, licensed practical nurses, and registered nurses who were employed at the Medical Center in the winter of 2004 were eligible to participate in this study. The a priori level of significance for all analyses was two-tailed at 0.05.

Results

A total of 199 surveys were returned for a response rate of 43.9%. The overall level of nurses' satisfaction with pharmacy services at the Medical Center had not significantly changed between the years of 2000 and 2004; however, satisfaction with several specific aspects of pharmaceutical services changed over time. Increased levels of satisfaction were related to medication accuracy and inpatient pharmacy hours; decreased levels of satisfaction were reported for medication availability in automated medication dispensing machines and pharmacy telephone services. The level of nurses' satisfaction with pharmacy services was increased in relation to the communication between pharmacists and nurses and decreased in relation to technology associated pharmacy services.

Conclusion

The data gleaned from the survey were evaluated in order to make recommendations to the Medical Center's Director of Pharmacy. An instrument was developed and validated to discern nurses' level of satisfaction with pharmacy services. This methodology may also be used at other institutions.
Insulin Human (rDNA Origin) Inhalation Powder
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: August 2010

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The June 2006 monograph topics are faropenen medoxomil, sodium phosphate monobasic monhohydrate and sodium phasphate dibasic anhydrous, methylphendate transdermal, naltrexone extended-release injectable, and sitagliptin. The DUE is on insulin human inhalation powder.
Core Competencies in Hospital Pharmacy: Essential Department Data
Authors: Weber Robert J.
Published: August 2010

The initial installments of the Director's Forum reviewed key core competencies necessary for a pharmacy department to define their value in patient care. Core competencies include medication order review, medication order dispensing, and preparing intravenous (IV) admixtures. The next article will review the final core competency: compliance with regulatory standards. Additional pharmacy department programs such as medication therapy management and patient safety are also critical in establishing a patient-centered focus, and will be discussed in future articles.
Antibiotic Order Forms
Authors: Scott Leigh Anne
Published: August 2010

Patient safety is a complex issue that is constantly evolving. Communication via standardized drug ordering is recognized as one of the key elements to providing a safer hospital stay, as well as a stronger patient outcome. This feature will publish bimonthly and will provide examples of standardized drug prescribing and a forum for discussion.

If you have a template that you believe other hospital pharmacies can benefit from, please submit it along with answers to the questions (seen below in the text)
IV Potassium Given Epidurally: Getting to the “Route” of the Problem; Acetaminophen Toxicity: More Risk Exposure than We Thought?; Color Consistency
Authors: Cohen Michael R.
Published: August 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices. If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via E-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Hypothyroidism Associated with Quetiapine Therapy; Paradoxical Bronchospasm Associated with Albuterol; Alcohol Cravings with Paroxetine Therapy?; Lamotrigine-Induced Toxic Epidermal Necrolysis – Three Cases; Acute Lung Injury with Vinorelbine; Adverse Events Related to Epinephrine Use in Asthma Patients Seen in the Emergency Department; Collecting Information from Patients Having Adverse Events; New Anticonvulsants – New Adverse Effects
Authors: Shuster Joel
Published: August 2010

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Modified Bagshawe Regimen for Gestational Trophoblastic Neoplasms
Authors: Edwards Michael S. , Solimando Dominic A. , Waddell J. Aubrey
Published: August 2010

The increasing complexity of cancer chemotherapy heightens the requirement that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy. It will also serve as a review of various agents, both commercially available and investigational, used to treat malignant diseases.
Anidulafungin
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: August 2010

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The FI.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The July 2006 monograph topics are decitabine, varenicline, alglucosidase alfa, garenoxacin, and vildagliptin. The DUE is on rasagiline.
ADRs in a Community Hospital – Do These Numbers Look like Yours?; A Gaggle of “Dermatologic” Reactions – TEN, Iodide Mumps, Doxycycline Phototoxicity; Pergolide-Induced Ergotism; Acute Coronary Syndrome Due to Fluorouracil Infusion; Aripiprazole-Induced Acute Dystonic Reaction; Meta-Analysis: Cardiovascular Events and NSAIDs; More on Dopamine Agonists and Impulse Control Disorders
Authors: Shuster Joel
Published: August 2010

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the FDA's medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
The Role of Ranolazine in the Management of Chronic Stable Angina
Authors: Howard Patricia A.
Published: August 2010

This continuing feature will update readers on recent developments in cardiovascular pharmacotherapy. Cardiovascular disease remains the number one killer in the United States, and more clinical outcome trials have been conducted in cardiology than in any other field of medicine. Given this rapidly expanding knowledge base, pharmacists can have a significant impact on prevention and treatment—if they keep current with developments in drug therapy.
Doxorubicin and Docetaxel (AT/AD) for Breast Cancer
Authors: Moussavian Parvaneh A. , Solimando Dominic A. , Waddell J. Aubrey
Published: August 2010

The increasing complexity of cancer chemotherapy heightens the requirement that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy. It will also serve as a review of various agents, both commercially available and investigational, used to treat malignant diseases.
Acetylcysteine: Helicobacter Pylori Infection
Authors: Generali Joyce , Cada Dennis J.
Published: August 2010

Off-Label Drug Uses — This Hospital Pharmacy feature is extracted from Off-Label DrugFacts, a quarterly publication available from Wolters Kluwer Health. Off-Label DrugFacts is a practitioner-oriented resource for information about specific FDA-unapproved drug uses. This new guide to the literature will enable the health care professional/clinician to quickly identify published studies on off-label uses and to determine if a specific use is rational in a patient care scenario. The most relevant data are provided in tabular form, so the reader can easily identify the scope of information available. A summary of the data—including background, study design, patient population, dosage information, therapy duration, results, safety, and therapeutic considerations—precedes each table of published studies. References direct the reader to the full literature for more comprehensive information prior to patient care decisions. Direct questions or comments regarding “Off-Label Drug Uses” to hospitalpharmacy@drugfacts.com .
The Use of Combination Antimicrobials in Critically-Ill Ventilated Patients with Pseudomonal Pneumonia
Authors: Peeters Michael J. , Seifert Charles F.
Published: August 2010

Purpose

Recent 2005 American Thoracic Society and Infectious Diseases Society of America ventilator-associated pneumonia (VAP) guidelines suggest combination antimicrobial therapy for Pseudomonas aeruginosa VAP based on limited non-VAP evidence. We reviewed antimicrobial use in patients with P. aeruginosa VAP within our tertiary teaching institution to evaluate patient factors, antimicrobial selection, and outcomes.

Methods

Intubated patients with a P. aeruginosa sputum culture, infiltrate on chest x-ray, and increased white blood cell count were retrospectively enrolled. Collected data identified illness acuity using the Simplified Acute Physiology Score II (SAPS), culture sensitivities, antimicrobial use, and patient survival at hospital discharge.

Results

Fifty-nine patients were analyzed between January 2003 and November 2004. Average age was 57 ± 15.7, body mass index (BMI) of 28.5 ± 6.1, and SAPS of 45.1 ± 13.7. Survival was significantly higher among patients on two culture-sensitive antimicrobials (23/28, 82%) vs less than two agents (12/31, 39%; P = 0.0018). Almost all patients who received the beta-lactam and aminoglycoside (BL/Ag) combination survived (15/16; P = 0.0015). While fewer severely ill patients lived (SAPS greater than 54; 4/16; P = 0.0029), none were placed on the BL/Ag combination, and few on appropriate antimicrobials (6/37; P = 0.0324). Lower survival was seen among obese patients (BMI higher than 30; 9/25; P = 0.0043); although, 5/6 obese patients on BL/Ag survived ( P = 0.0237). Patients more than 64-years-old were more often on two appropriate antimicrobials ( P = 0.0143) and had a higher survival ( P = 0.0241). Unfortunately, we observed a lack of culture follow-up, as only 60% (30/50) of inappropriate antimicrobials were switched to sensitive agents.

Conclusions

Our results emphasize the need to use combination BL/Ag antimicrobials for P aeruginosa VAP as the current guidelines suggest, and to ensure that antimicrobials are optimized based on culture results.
A Primer: Basic PubMed Searching for Pharmacists
Authors: Schrimsher Robert H. , Kendrach Michael G.
Published: August 2010

Electronic database searching has become more prevalent, especially with the proliferation of Internet full-text databases. PubMed provides free access to MEDLINE, which is the largest biomedical database, which provides over 14 million citations since the mid-1960s. This resource is accessible free through the Internet and indexes over 4,800 medical journals. PubMed certainly has implications for drug usage and research, thus it is important for pharmacists to be able to proficiently search this database. Regardless of the types of pharmacists' daily responsibilities, (eg, compounding, sterile products, clinical, management) PubMed is a very useful database to locate information. This article provides a primer for pharmacists (and pharmacy students) regarding PubMed searching and discusses its most practical aspects. Not every function of PubMed can be discussed or illustrated. Major topics discussed are sidebar functions, searching MeSH terms, basic searching, limitations, and some helpful hints specifically for pharmacists. The importance and usefulness of PubMed functions and use resulting in a competent search are strictly the authors' assessment. Because PubMed is constantly evolving, functions and/or formats may have been added or changed since this writing.
Ibandronate Intravenous
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: August 2010

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The FI.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The September 2006 monograph topics are dasatinib, darunavir, ranibizumab injection, oxymorphone HCl extended-release tablets/oxymorphone HCl tablets, and 17a-hydroxyprogesterone caproate. The DUE is on oxymorphone
Strategies for Developing Clinical Services – Implementing a Decentralized Pharmacy Program
Authors: Sanborn Michael
Published: August 2010

The focus of this Director's Forum is on the justification and implementation of a decentralized pharmacy practice model. This article is the first of three articles that will address the challenges that the pharmacy director must face when expanding pharmacist clinical practice opportunities. Two future articles will review advanced practice programs and the evaluation of clinical services. The goal of the Director's Forum throughout 2006 is to provide readers with information on all of the necessary core competencies of hospital pharmacy practice, comprising a “toolkit” in establishing a patient-centered pharmacy department.
Effects of an Automated Drug Dispensing System on Medication Adverse Event Occurrences and Cost Containment at SAMSO
Authors: Dib Jean G. , Abdulmohsin Saud A. , Farooki Masood U. , Mohammed Khurram , Iqbal Mohammed , Khan Jamal Ahmed
Published: August 2010

Purpose

To evaluate the impact of an automated drug dispensing system (ADDS) on cost containment and medication adverse event (MAE) occurrences at Saudi Aramco Medical Services Organization (SAMSO).

Method

An ADDS replaced the traditional unit-dose cassette-exchange and open floor-stock medication systems at SAMSO in early 2005 on five nursing units. Data collection for MAE occurrences and pharmacy medication supply to these units were performed pre- and postimplementation of the ADDS.

Results

Reported MAEs decreased by approximately 27%. The overall medication issuance decreased by an average of 43%, corresponding to overall medication cost reduction by an average of 42%.

Conclusion

Implementation of an ADDS improved the efficiency of drug distribution, assisted in cost containment, and decreased the total number of MAEs.
Human Resources Management for the Pharmacy Director
Authors: Weber Robert J.
Published: August 2010

This article of the Director's Forum provides hospital pharmacy directors with an introduction to the essential human resources skills of behavioral interviewing and performance management. While patients are a pharmacy department's most valued asset, the staff that care for those patients are critical to a patient-centered pharmacy service. Hospital pharmacy directors must practice effective human resource management to effectively recruit and retain a highly qualified and professionally satisfied staff.
Ultrafine Clay Minerals of the Pleistocene Olorgesailie Formation, Southern Kenya Rift: Diagenesis and Paleoenvironments of Early Hominins
Authors: Deocampo Daniel M. , Behrensmeyer Anna K. , Potts Richard
Published: August 2010

The Pleistocene Olorgesailie Formation in the southern Kenya Rift has yielded a remarkable assemblage of Acheulean artifacts and vertebrate fossils, including hominin specimen KNM-OG 45500. Members 1 and 7 both contain clay-rich deposits that have been pedogenically modified into paleosols (UM1p and UM7p, respectively). This study provides the first detailed mineralogical and geochemical analyses of the clays of this important Pleistocene basin. The smectitic clays, which show abundant evidence for pedogenesis, were apparently originally deposited under lacustrine conditions. They have an average structural formula of (Ca0.01Na0.32K0.26)(Si3.76Al0.24)(Al0.86Ti0.04Fe0.68Mg0.42)O10(OH)2. The high layer charge clays indicate diagenetic alteration of detrital clay derived from the volcanic drainage basin, probably involving alkaline waters of variable salinity. Despite overall lower salinity compared to other Plio–Pleistocene basins of the region (e.g.Olduvai Gorge), the basin still shows evidence for authigenic clay mineral precipitation. Clay chemistry and bulk geochemical indicators of pedogenesis imply that UM1p clays more closely reflect depositional paleo-waters, whereas UM7p clays have been more pedogenically altered due to subaerial exposure. UM1p smectites show some Mg enrichment near the western Lava Hump locality, consistent with discharge of Mg-bearing paleo-waters from a volcanic aquifer into a siliceous and alkaline (though not highly saline) paleo-lake. UM7p smectites were deposited in a more saline paleo-lake, but have lost substantial amounts of Mg due to post-depositional weathering. Locally abundant artifacts and vertebrate fossils found in these deposits accumulated at times following deposition of the lacustrine clay, probably concurrent with pedogenesis. The limnological conditions associated with initial clay deposition, therefore, preceded hominin occupation of the exposed surfaces.
Porosity Evolution of Free and Confined Bentonites during Interlayer Hydration
Authors: Likos William J. , Wayllace Alexandra
Published: August 2010

Methods for predicting the volume change and swelling-pressure behavior of expansive clays require detailed understanding of coupled interactions between clay microstructure and macrostructure under hydraulic, thermal, and mechanical loads. In this study a suite of water-vapor sorption experiments was conducted using compacted bentonites hydrated in controlled relative humidity (RH) environments maintained under free and constrained volume-change boundary conditions. Emphasis was placed on examining the influences of compaction and predominant exchange cation on the water uptake, volume change, and swelling pressure response. Densely compacted specimens exhibited greater volume changes under free swelling conditions and greater swelling pressures under fully confined conditions. Water uptake, volume change, and swelling pressure were all more significant for Colorado (Ca2+/Mg2+) bentonite than forWyoming (Na+) bentonite. Plastic yielding, evident as a peak in the relationship between swelling pressure and RH, was more evident and occurred at lower RH for the Colorado bentonite. This observation was interpreted to reflect the limited capacity for interlayer swelling in Ca2+/Mg2+ bentonites and corresponding structural collapse induced by the onset of water uptake in larger intra-aggregate and inter-aggregate pores. A semi-quantitative model for the evolution of clay microstructure resulting from interlayer hydration was considered to attribute the experimental observations to differences in the efficiency with which transitions in basal spacing translate to bulk volume changes and swelling pressure. Results provide additional insight and experimental evidence to more effectively model the mechanical behavior of compacted bentonites used as buffer or barrier materials in waste repository applications.
Application of Box—Behnken Design to Modeling the Effect of Smectite Content on Swelling to Hydrocyclone Processing of Bentonites with Various Geologic Properties
Authors: Özgen Selçuk , Yildiz Ahmet
Published: August 2010

As advances in technology have led to increased use of bentonites, more high-quality bentonite has been sought. The volume of high-quality bentonites available is shrinking and use of bentonite reserves containing impurities is inevitable. The aim of this study was to apply Box–Behnken experimental design and response surface methodology to model and optimize some operational parameters of a hydrocyclone to produce three groups of bentonite concentrates. The four significant operational parameters of hydrocyclones are feed solid ratio, inlet pressure, vortex diameter, and apex diameter, and these parameters were varied and the results evaluated using the Box–Behnken factorial design. In order to produce bentonite concentrates using a hydrocyclone, mathematical model equations were derived by computer simulation programming applying a least-squares method, using Minitab 15. Second-order response functions were produced for the swelling and to establish the quantity of smectite in the bentonite concentrates. Predicted values were found to be in good agreement with the experimental values (R2 values of between 0.829 and 0.999 for smectite and three different swelling groups for the bentonites). Although in natural states these bentonites are not suitable for industrial use, enhancements were obtained giving up to 81.45% smectite and by increasing swelling by 194% for the three bentonite groups. The swelling properties of the bentonites are improved by increasing the proportion of smectite content. The graphics were designed to relate swelling and smectite content according to the two-dimensional hydrocyclone factors, and each factor was evaluated in itself. The present study revealed that the Box–Behnken and response surface methodology can be applied efficiently to model the hydrocyclone for bentonite; the method is economical and provides the maximum amount of information in a short period of time and with the smallest numberof experiments.
A Child With an FGFR3 Mutation, a Laterality Disorder and an Hepatoblastoma: Novel Associations and Possible Gene–Environment Interactions
Authors: Baynam Gareth S. , Goldblatt Jack
Published: August 2010

We report on a 3-year-old girl, from a 3-generation family with an FGFR3 Pro250Arg mutation, who in addition to craniosynostosis, had a laterality disorder and hepatoblastoma, following a pregnancy complicated by maternal insulin-dependent diabetes. The clinical features possibly result from the combined effects of the maternal diabetes and the familial FGFR3 mutation, thus representing a unique gene–environment interaction that may have implications for the understanding of the phenotypes described in this child.
Are Attitudes Towards Economic Risk Heritable? Analyses Using the Australian Twin Study of Gambling
Authors: Le Anh T. , Miller Paul W. , Slutske Wendy S. , Martin Nicholas G.
Published: August 2010

This study employs multiple regression models based on DeFries and Fulker (1985), and a large sample of twins, to assess heritability in attitudes towards economic risk, and the extent to which this heritability differs between males and females. Consistent with Cesarini et al. (2009), it is found that attitudes towards risk are moderately heritable, with about 20 percent of the variation in these attitudes across individuals being linked to genetic differences. This value is less than one-half the estimates reported by Zyphur et al. (2009) and Zhong et al. (2009). While females are more risk averse than males, there is no evidence that heritability in attitudes towards risk differs between males and females. Even though heritability is shown to be important to economic risk-taking, the analyses suggest that multivariate studies of the determinants of attitudes towards risk which to not take heritability into consideration still provide reliable estimates of the partial effects of other key variables, such as gender and educational attainment.
Heritability of Head Size in Dutch and Australian Twin Families at Ages 0–50 Years
Authors: Smit Dirk J. A. , Luciano Michelle , Bartels Meike , van Beijsterveldt Catharine E. M. , Wright Margaret J. , Hansell Narelle K. , Brunner Han G. , Estourgie-van Burk G. Frederiek , de Geus Eco J. C. , Martin Nicholas G. , Boomsma Dorret I.
Published: August 2010

We assessed the heritability of head circumference, an approximation of brain size, in twin-sib families of different ages. Data from the youngest participants were collected a few weeks after birth and from the oldest participants around age 50 years. In nearly all age groups the largest part of the variation in head circumference was explained by genetic differences. Heritability estimates were 90% in young infants (4 to 5 months), 85–88% in early childhood, 83–87% in adolescence, 75% in young and mid adulthood. In infants younger than 3 months, heritability was very low or absent. Quantitative sex differences in heritability were observed in 15- and 18-year-olds, but there was no evidence for qualitative sex differences, that is, the same genes were expressed in both males and females. Longitudinal analysis of the data between 5, 7, and 18 years of age showed high genetic stability (.78 > RG> .98). These results indicate that head circumference is a highly heritable biometric trait and a valid target for future GWA studies.
Influence of Gestational Diabetes Mellitus on Weight Discrepancy in Twin Pregnancies
Authors: Klein Katharina , Mailath-Pokorny Mariella , Leipold Heinz , Krampl-Bettelheim Elisabeth , Worda Christof
Published: August 2010

Objective:To evaluate the influence of gestational diabetes mellitus on weight discrepancy in twin pregnancies.Methods:200 twin pregnancies were included in the study. 157 nondiabetic pregnant women with twin gestations and 43 twin pregnancies with gestational diabetes mellitus (GDM) with viable fetuses born after 24 weeks of gestation were enrolled. Influence of maternal age, body-mass-index at the time of the oral glucose tolerance test, parity, smoking, chorionicity, gestational age at delivery and diagnosis of GDM on weight discrepancy of the twins was evaluated.Results:Mean weight discrepancy of all analyzed twin pregnancies was 285 grams (± 231), relative weight discrepancy was 11.3% (± 8.6). Univariate regression analyses showed that GDM, chorionicity and gestational age at delivery were significantly associated with weight discrepancy. In the multivariate model only diagnosis of GDM was significantly associated with weight discrepancy.Conclusion:Twin pregnancies with insulin requiring gestational diabetes seem to have less birth weight discrepancy than twin pregnancies with normal glucose tolerance.
Treatment of acromegaly
Authors: Dénes Judit , Korbonits Márta , Hubina Erika , Góth Miklós
Published: August 2010

Az acromegalia a növekedési hormon (GH) túltermelése következtében kialakuló betegség, amely számos szövődménnyel jár, és megfelelő kezelés nélkül a mortalitás növekedéséhez vezet. Jellegzetes tünetei ellenére, valamint a korszerű biokémiai és képalkotó diagnosztikai módszerek mellett is általában több év telik el a betegség kialakulásának kezdete és a diagnózis felállítása között. Terápiás lehetőségként sebészi beavatkozás, gyógyszeres (dopaminagonista, szomatosztatinanalóg és GH-receptor-antagonista) kezelés és radioterápia áll rendelkezésre. A kezelés célja a biztonságos GH- és inzulinszerű növekedési faktor-I- (IGF-I) szintek elérése, a tumor eltávolítása vagy méretének csökkentése, valamint a betegség szövődményeinek kezelése, végső fokon a mortalitás csökkentése. Az eredményes kezelés több különböző diszciplína képviselőjének megfelelő együttműködésén alapszik.
Genetic background of cholesterol absorption efficacy. The role of Niemann–Pick C1-like 1 receptor and its genetic variation in lipid metabolism
Authors: Harangi Mariann , Balogh István , Harangi János , Paragh György
Published: August 2010

A Niemann–Pick C1-like-1 egy szterolfelismerő domént tartalmazó membránfehérje, amelyet nagy számban expresszálnak csúcsi felszínükön a bélhámsejtek. Az utóbbi évek vizsgálatai azt igazolták, hogy ez a fehérje szükséges a szabad koleszterin bejutásához a bélhámsejtekbe a bél lumenéből. Biokémiai vizsgálatok azt igazolták, hogy a Niemann–Pick C1-like-1-hez kötődik az ezetimib, amely egy hatékony koleszterinfelszívódást gátló szer. A bélből történő koleszterinfelszívódás ütemében és az ezetimibkezelés hatékonyságában tapasztalt egyéni eltérések hátterében felmerült néhány Niemann–Pick C1-like-1 génvariáció oki szerepe.
Risk assessment model for venous thromboembolism in hospitalized surgical and non-surgical patients in the 4th Hungarian Antithrombotic Guidelines entitled “Diminution and Treatment of Venous Thromboembolism”
Authors: Dávid Marianna , Losonczy Hajna , Udvardy Miklós , Boda Zoltán , Blaskó György , Tar Attila , Pfliegler György
Published: August 2010

A kórházban kezelt sebészeti és belgyógyászati betegekben jelentős a vénásthromboembolia-rizikó. Profilaxis nélkül, a műtét típusától függően, a sebészeti beavatkozások kapcsán a betegek 15–60%-ában alakul ki mélyvénás trombózis vagy tüdőembólia, és az utóbbi ma is vezető kórházi halálok. Bár a vénás thromboemboliát leggyakrabban a közelmúltban végzett műtéttel vagy traumával hozzák kapcsolatba, a szimptómás thromboemboliás események 50–70%-a és a fatális tüdőembóliák 70–80%-a nem a sebészeti betegekben alakul ki. Nemzetközi és hazai felmérések alapján a nagy kockázattal rendelkező sebészeti betegek többsége megkapja a szükséges trombózisprofilaxist. Azonban profilaxis nélkül marad a rizikóval rendelkező belgyógyászati betegek jelentős része, a konszenzuson alapuló nemzetközi és hazai irányelvi ajánlások ellenére. A belgyógyászati betegek körében növelni kell a profilaxisban részesülők arányát és el kell érni, hogy trombózisrizikó esetén a betegek megkapják a hatásos megelőzést. A beteg trombóziskockázatának felmérése fontos eszköze a vénás thromboembolia által veszélyeztetett betegek felderítésének, megkönnyíti a döntést a profilaxis elrendeléséről és javítja az irányelvi ajánlások betartását. A trombózisveszély megállapításakor, ha nem ellenjavallt, profilaxist kell alkalmazni. „A thromboemboliák kockázatának csökkentése és kezelése” című, 4. magyar antithromboticus irányelv felhívja a figyelmet a vénástrombózis-rizikó felmérésének szükségességére, és elsőként tartalmazza a kórházban fekvő belgyógyászati és sebészeti betegek kockázati kérdőívét. Ismertetjük a kockázatbecslő kérdőíveket és áttekintjük a kérdőívekben szereplő rizikófaktorokra vonatkozó bizonyítékokon alapuló adatokat.
Uma perspectiva analítica para a reforma do Estado
Authors: Diniz Eli
Published: August 2010

Os problemas e as dificuldades ligadas à reforma do Estado no Brasil são examinados por um ângulo pouco explorado na bibliografia: o do legado político-institucional da antiga ordem. O principal alvo das críticas são as visões reducionistas, incapazes de dar conta da complexidade do seu objeto e de atribuir o crédito devido à sua dimensão propriamente política.
O discurso da nova administração pública
Authors: Andrews Christina W. , Kouzmin Alexander
Published: August 2010

O artigo faz uma análise crítica da estratégia de reforma do Estado defendida, no artigo publicado nesta edição de Lua Nova, por Luiz Carlos Bresser Pereira.
Reorganizando a modernidade
Authors: Domingues José Maurício
Published: August 2010

Discute-se idéias (tais como a "política gerativa" proposta por Anthony Giddens) para uma reorganização da modernidade, alternativas tanto ao privatismo individualista quanto a uma concepção de solidariedade excessivamente estatizada que é própria do Welfare State.
Tendência histórica de preços pagos ao produtor de hortifrutigranjeiros do Rio Grande do Sul, Brasil
Authors: Viana João Garibaldi Almeida , Barchet Isabela , Zen Bárbara , Souza Renato Santos de
Published: August 2010

O presente trabalho tem como objetivo analisar a evolução histórica dos preços pagos ao produtor de hortifrutigranjeiros do Rio Grande do Sul no período de 1973 a 2006, dando especial atenção ao período anterior e posterior à estabilização monetária alcançada com o Plano Real de 1994. As séries históricas de preços nominais mensais dos produtos hortifrutigranjeiros analisados (aipim, batata, cebola, tomate, laranja, bergamota, maçã, pêssego e uva) foram disponibilizadas pela EMATER-RS. O trabalho permitiu concluir que todos os produtos analisados apresentaram desvalorização significativa em seus preços de 1973 a 2006. Constatou-se que a década de 1980 foi o período de maior desvalorização para a horticultura, e o período pós-Plano Real foi o de maior desvalorização para a fruticultura.