bluuebunny/crossref_metadata_2025 huggingface dataset:
PedHunter 2.0 and its usage to characterize the founder structure of the Old Order Amish of Lancaster County
Authors: Lee Woei-Jyh , Pollin Toni I , O'Connell Jeffrey R , Agarwala Richa , Schäffer Alejandro A
Published: May 2010

Background

Because they are a closed founder population, the Old Order Amish (OOA) of Lancaster County have been the subject of many medical genetics studies. We constructed four versions of Anabaptist Genealogy Database (AGDB) using three sources of genealogies and multiple updates. In addition, we developed PedHunter, a suite of query software that can solve pedigree-related problems automatically and systematically.

Methods

We report on how we have used new features in PedHunter to quantify the number and expected genetic contribution of founders to the OOA. The queries and utility of PedHunter programs are illustrated by examples using AGDB in this paper. For example, we calculated the number of founders expected to be contributing genetic material to the present-day living OOA and estimated the mean relative founder representation for each founder. New features in PedHunter also include pedigree trimming and pedigree renumbering, which should prove useful for studying large pedigrees.

Results

With PedHunter version 2.0 querying AGDB version 4.0, we identified 34,160 presumed living OOA individuals and connected them into a 14-generation pedigree descending from 554 founders (332 females and 222 males) after trimming. From the analysis of cumulative mean relative founder representation, 128 founders (78 females and 50 males) accounted for over 95% of the mean relative founder contribution among living OOA descendants.

Discussion/Conclusions

The OOA are a closed founder population in which a modest number of founders account for the genetic variation present in the current OOA population. Improvements to the PedHunter software will be useful in future studies of both the OOA and other populations with large and computerized genealogies.
"For someone who's rich, it's not a problem". Insights from Tanzania on diabetes health-seeking and medical pluralism among Dar es Salaam's urban poor
Authors: Kolling Marie , Winkley Kirsty , von Deden Mette
Published: May 2010

The prevalence of chronic non-communicable disease, such as type 2 diabetes mellitus (T2DM), is rising worldwide. In Africa, T2DM is primarily affecting those living in urban areas and increasingly affecting the poor. Diabetes management among urban poor is an area of research that has received little attention. Based on ethnographic fieldwork in Dar es Salam, the causes and conditions for diabetes management in Tanzania have been examined. In this paper, we focus on the structural context of diabetes services in Tanzania; the current status of biomedical and ethnomedical health care; and health-seeking among people with T2DM. We demonstrate that although Tanzania is actively developing its diabetes services, many people with diabetes and low socioeconomic status are unable to engage continuously in treatment. There are many challenges to be addressed to support people accessing diabetes health care services and improve diabetes management.
Deletions of the Derivative Chromosome 9 Do Not Influence the Response and the Outcome of Chronic Myeloid Leukemia in Early Chronic Phase Treated With Imatinib Mesylate: GIMEMA CML Working Party Analysis
Authors: Castagnetti Fausto , Testoni Nicoletta , Luatti Simona , Marzocchi Giulia , Mancini Marco , Kerim Simonetta , Giugliano Emilia , Albano Francesco , Cuneo Antonio , Abruzzese Elisabetta , Martino Bruno , Palandri Francesca , Amabile Marilina , Iacobucci Ilaria , Alimena Giuliana , Pane Fabrizio , Martinelli Giovanni , Saglio Giuseppe , Baccarani Michele , Rosti Gianantonio
Published: May 2010

Purpose

Deletions of the derivative chromosome 9 [der(9)] have been associated with a poor prognosis in chronic myeloid leukemia (CML) across different treatment modalities. In the imatinib era, the prognostic impact of der(9) deletions has been evaluated mainly in patients with late chronic-phase (CP) CML, giving partially conflicting results. Few data are available in the early CP setting. For this reason, in 2006, the European LeukemiaNet recommendations still considered der(9) deletions as a candidate adverse prognostic factor and required a careful monitoring of the patient.

Patients and Methods

To investigate the prognostic value of der(9) deletions in early CP CML, we performed an analysis of three prospective imatinib trials of the Italian Group for Hematological Malignancies of the Adult (GIMEMA) CML Working Party.

Results

A fluorescent in situ hybridization (FISH) analysis of bone marrow cells was performed at diagnosis; der(9) deletions were detected in 60 (12%) of 521 evaluable patients. At 60 months, the cumulative incidence of complete cytogenetic response and major molecular response—and the probability of event-free survival, failure-free survival, progression-free survival, and overall survival—in patients with and without deletions were not statistically different.

Conclusion

Our data strongly support the notion that, when investigated by FISH, der(9) deletions are not a poor prognostic factor in patients with early CP CML treated with imatinib.
“Fertile with Fine Talk”: Ungoverned Tongues among Haudenosaunee Women and Their Neighbors
Authors: Noel Jan
Published: May 2010

This article casts light on the gender of fur traders by tapping into new analysis of Albany and Canadian records from the colonial period. A surprising number of active, sometimes outspoken, female participants emerge. Exploring the underlying reasons for this phenomenon, the article discusses the unusual voice Haudenosaunee women had in governance. It then observes significant freedom of speech and action among their French and Dutch colonial neighbors. The article investigates the blending of those voices as colonial women colluded with the Haudenosaunee to seal bargains in the illicit fur trade. Each group benefited from its own traditions of trade and from officials' reluctance to alienate aboriginal allies. The article thus sheds light on the authoritative female voices that receive fresh affirmation in the most recent Haudenosaunee scholarship, as well as those of certain colonial women that surfaced during dealings with indigenous neighbors. The findings are noteworthy for those interested in Iroquoia, the fur trade, and transnational approaches to gender history.
Missionization and the Persistence of Native Identity on the Colonial Frontier of Baja California
Authors: Panich Lee M.
Published: May 2010

The indigenous groups incorporated into the Spanish missions of Alta and Baja California faced a variety of challenges during the colonial period and experienced a wide range of outcomes in the persistence of native identity. The indigenous Paipai community of Santa Catarina, located in northern Baja California, is composed of the direct descendants of native peoples who lived and worked at the Dominican mission of Santa Catalina and is one of the few remaining native communities in Baja California. Through the examination of a mission census dating to 1834, this article considers the demographic parameters of life at Santa Catalina as well as the ethnolinguistic composition of the mission's indigenous population. This analysis points to two important patterns that likely had implications for the persistence of native identity at the mission. First, the mission's native population does not appear to have suffered from the demographic collapse associated with introduced diseases. Second, the native population at Santa Catalina consisted of speakers of at least three languages and was drawn from a wide geographic area. The diversity of the native population at Santa Catalina may have provided the mission neophytes the opportunity to form a larger and stronger social group that could draw on various geographical homelands for support and refuge during the mission period.
Myth, Globalization, and Mestizaje in New Age Andean Religion: TheIntic Churincuna(Children of the Sun) of Urubamba, Peru
Authors: Hill Michael D.
Published: May 2010

This paper examines the religiously syncretic and culturally hybrid phenomenon of New Age spirituality among urban mestizos in the Cusco region of Peru, primarily through ethnographic analysis of the Urubamba-based Intic Churincuna (Children of the Sun) religious group, along with its rituals and texts. Similar to many New Age Andean contexts, the group's cosmology combines an emphasis on the primordial nature of the Andes with an account of benign settlement and colonization. While arguably repressing the trauma of conquest and perpetuating racialized hegemonies, New Age Andean cosmology constructs a mythic-historical, nationalist narrative and a postcolonial subjectivity that allows urban Andean mestizos to ground their identities in indigeneity and colonization simultaneously as well as position themselves relative to contemporary contexts of globalization.
Fitting Multiculturalism into Biculturalism: Maori–pasifika Relations in New Zealand from the 1960s
Authors: Hill Richard S.
Published: May 2010

“Race relations” are an ever-present topic of public discourse and state policy formation in New Zealand. The emphasis is generally upon the relationship between the indigenous Maori, on the one hand, and the state and the majority ethno-cultural population group, the European(especially British)-derived Pakeha, on the other. In particular, the past, present, and future of the nation's foundational document, the Treaty of Waitangi, signed between the first nations and the British Crown in 1840, has dominated popular debate and official policy in recent decades. Other ethno-cultural and politico-constitutional relationships, including those between Maori and significant immigrant populations from countries within the Pacific region (Pasifika peoples), have received scant attention. This article examines Maori-Pasifika relations in the context of an emergent sociocultural and official biculturalism in New Zealand, investigating attempts to fit multicultural policies and practices within a broad bicultural framework.
A View from the Tropics: Celso Furtado and the Theory of Economic Development in the 1950s
Authors: Boianovsky Mauro
Published: May 2010

The article shows how Celso Furtado's interpretation of development and underdevelopment as interdependent phenomena was part of the emergence of development economics as a research field in the 1950s. The main features of underdeveloped economic structures, according to Furtado, were their technological heterogeneity—in the sense of significant differences in the capital-labor ratio between two or more sectors—and underemployment caused by maladjustment between the availability of factors and irreversible production methods. Both characteristics were explained by the historical pattern of integration of those economies into international trade.
Sumatriptan and Myocardial Infarction in a Woman with Normal Arteries; Heparin-Induced Thrombocytopenia Presenting as Otalgia; Methotrexate-Induced Aseptic Meningitis – First Report Associated with Intramuscular Use; Contrast-Induced Encephalopathy; Anosmia Caused by Amiodarone; Review of Thyroid Problems Associated with Amiodarone; Adverse Effects of Inhaled Corticosteroids – Different Numbers Associated with Funded versus Non-Funded Clinical Studies; Safety Review of Fluoroquinolones
Authors: Shuster Joel
Published: May 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 Food and Drug Administration's (FDA) medWatch program (800-FDA-1088). If you have reported an interesting preventable ADR to medWatch, please consider sharing the account with our readers.
Cyclophosphamide, Vincristine, Doxorubicin and Dacarbazine (CYVADIC) for Soft Tissue Sarcomas
Authors: Tran Quan , Solimando Dominic A. , Waddell J. Aubrey
Published: May 2010

The increasing complexity of cancer chemotherapy now requires that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy, and review various agents, both commercially available and investigational, used to treat malignant diseases.
New Drugs Approved by the FDA; Agents Pending FDA Approval; Supplemental Applications Filed by Manufacturer; Significant Labeling Changes
Authors: Baker Danial E.
Published: May 2010

This monthly feature will help readers keep current on new drugs, indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@drugfacts.com .
Errors with Injectable Medications: Unlabeled Syringes are Surprisingly Common; Unintended Consequences of High-Alert Stickers; Easily Misread Abbreviations
Authors: Cohen Michael R. , Smetzer Judy L.
Published: May 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 (ISMP). If you have encountered medication errors and would like to report them, you may call USP tollfree, 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 United States Pharmacopeia (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.
High-Dose Insulin in the Treatment of Antihypertensive Overdose
Authors: Clark Emily G. , Nykamp Diane L. , Nguyen Vy V.
Published: May 2010

Objective

To describe a case of calcium channel blocker overdose along with an angiotensin-converting enzyme inhibitor and angiotensin receptor blocker, which was successfully treated with high-dose insulin with dextrose and potassium supplementation (HDIDK).

Case Summary

A 52-year-old woman was transferred to an admitting hospital after ingesting 14 tablets of trandolapril/verapamil SR ( Tarka)4 mg/240 mg, 15 to 16 tablets of olmesartan ( Benicar) 20 mg, and an unknown amount of (escitalopram) Lexapro combined with unknown quantities of alcohol and benzodiazepines. This combination caused hypotension and electrocardiogram changes. The patient was treated for hypotension-induced shock with epinephrine, glucagon, HDIDK, magnesium, and fluids. An insulin infusion ran for 24 hours. The patient was discharged to a psychiatric facility 3 days after admission.

Discussion

The non-dihydropyridine, verapamil, causes dilation of the coronary and peripheral vasculature by inhibiting the influx of calcium ions through L-type calcium channels. HDIDK is thought to be a useful treatment in the state of hypoinsulinemia, which prevents the uptake of glucose by myocytes and can lead to decreased inotropy and eventually shock. High-dose insulin allows glucose to be properly used for energy by the myocytes.

Conclusions

Currently HDIDK therapy is recommended as an adjunct to conventional therapy in calcium channel blocker poisoning only after fluids, high-dose calcium salts, and vasopressors. In this case, early implementation of HDIDK treatment was shown to shorten the length of therapy.
Stability of Levalbuterol in a Mixture of Levalbuterol and Ipratropium Nebulizer Solution
Authors: Yamreudeewong Weeranuj , Teixeira M. Glaucia , Mayer Gabriele E.
Published: May 2010

Levalbuterol hydrochloride ( Xopenex) inhalation solution is a short-acting bronchodilator, which was approved by the United States Food and Drug Administration for the treatment or prevention of bron-chospasm in adults and children 6 years of age and older. Levalbuterol is also a (R)-enantiomer of racemic albuterol. Because of the lesser dose required for bronchodilatory effect, levalbuterol may cause less cardiovascular adverse effects, such as tachycardia, than racemic albuterol.

The stability of levalbuterol in the mixture of levalbuterol and ipratropium nebulizer solution was studied. At 0, 1, 2, 6, 24, 48 hours and 5, 7, 14, and 28 days, 150 mcL of this mixture was combined with 1.5 mcL of internal standard solution (mepivacaine 5 mg in 1 mL of distilled water) and injected into the high-performance liquid chromatography (HPLC) system. Injections were done in triplicate and the concentrations for levalbuterol and ipratropium calculated using a calibration curve. The concentration of each drug was found to be within the acceptable limit (± 10% of the initial concentration) in all test samples. The levalbuterol and ipratropium mixture was stored at room temperature during the study period. Over the time period of 28 days at room temperature, no significant decrease in concentrations could be detected for levalbuterol or ipratropium.
Is Combined Angiotensin Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Therapy Safe in Heart Failure Patients?
Authors: Howard Patricia A.
Published: May 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 stay current with developments in drug therapy.
Hydroxyethyl Starch 130/0.4
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also 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 May 2008 monograph topics are sugammadex, desvenlafaxine succinate extended-release, rilonacept, progesterone vaginal insert, and fospropofol disodium. The DUE is on ciclesonide inhalation aerosol.
New Drugs Approved by the FDA Agents Pending FDA Approval Supplemental Applications Filed by Manufacturer Significant Labeling Changes
Authors: Baker Danial E.
Published: May 2010

This monthly feature will help readers keep current on new drugs, indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@drugfacts.com .
Recent Publications on Medications and Pharmacy
Authors: Sterling Jacyntha
Published: May 2010

Hospital Pharmacy presents this 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. Suggestions or comments may be addressed to: Jacyntha Sterling, Drug Information Specialist at Saint Francis Hospital, 6161 S Yale Ave., Tulsa, OK 74136 or e-mail: jasterling@saintfrancis.com .
Highlights from the 2008 Surviving Sepsis Campaign, Part 1
Authors: Kimborowicz Katarzyna , Thomas Zachariah
Published: May 2010

In 2004, the Society of Critical Care Medicine and 10 other health care organizations sponsored the Surviving Sepsis Campaign (SSC) guidelines. 1 The SSC represents the first major international effort to reduce sepsis-related mortality. The campaign has proven to be highly controversial and has been greeted with both high praise and sharp criticism. In 2008, these guidelines were revised. 2 This article is part 1 of a 2-part series, summarizing and providing analysis of key aspects of the 2008 SSC. Part 1 will discuss controversial issues surrounding the campaign and examine the recommendations for initial resuscitation, antibiotic, as well as vasopressor therapy.
Evaluation of Pharmacist-Managed Education of Medical Residents
Authors: Liles Anne Marie , Kelley Kristi
Published: May 2010

Purpose

The purpose of this study was to determine the effectiveness of presentations provided by pharmacists/pharmacy students in increasing medical residents' knowledge of treatment options and guidelines of various disease states. A secondary objective was to evaluate medical residents' satisfaction and perception of increased knowledge.

Methods

A series of presentations were conducted by pharmacist/pharmacy students in an internal medicine resident clinic. Topics covered included dyslipidemia, hypertension (HTN), and asthma. Prior to each presentation, medical residents completed a pretest. One to 3 weeks after the presentations, residents were asked to complete a post-test identical to the pretests. At the conclusion of the series, medical residents responded to a follow-up survey that assessed the residents' perception of the usefulness of the presentations and interest in future presentations.

Results

Twenty medical residents attended the dyslipidemia presentations and completed a pretest with 18 of these residents completing a post-test. The overall increase in median score was 7%. Twelve residents attended the HTN presentations and completed a pretest with 11 of these residents completing a post-test. The overall increase in median score was 17%. Thirteen residents attended the asthma presentations with 10 of these residents completing a post-test. The overall increase in median score was 3%. Seventeen residents completed the follow-up survey with “agree” being the most common response to all items indicating satisfaction and perception of increased knowledge.

Conclusion

There was an overall improvement in pharmacotherapy knowledge of medical residents as anticipated. Residents were satisfied with the presentations and perceived an increase in their pharmacotherapy knowledge.
Improving Heparin Safety: A Multidisciplinary Invited Conference
Authors: Peterson Carl , Ham Charles W. , Vanderveen Tim
Published: May 2010

Heparin is widely used in a variety of settings for prevention and treatment of thromboembolic events. Data from a number of sources indicate that it is also one of the drugs most frequently associated with adverse events and medication errors, many of which are serious. National media attention has focused on recent events involving heparin and The Joint Commission has included heparin in its 2009 National Patient Safety Goal to reduce patient harm from anticoagulants. Heparin safety is on the national agenda and health care organizations are struggling to improve it. Health care providers in clinical, management, and executive roles must work together to improve heparin safety.

Over 40 anticoagulation experts and practitioners came together in San Diego on March 13 through 14, 2008 to share information, offer perspectives, and address issues on the topic improving heparin safety. These individuals represented The Joint Commission, United States Pharmacopoeia, the Institute for Safe Medical Practices, academic institutions, large health care systems, and small hospitals who participated in a day and a half of presentations and round-table discussions. This article summarizes 21 presentations with a primary focus on types and frequency of heparin errors as well as identified opportunities to improve heparin safety. The conference was sponsored by Cardinal Health's Center for Safety and Clinical Excellence.
Recent Publications on Medications and Pharmacy
Authors: Sterling Jacyntha
Published: May 2010

Hospital Pharmacy presents this 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.
Thrombin, Topical (Recombinant)
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also 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 July 2008 monograph topics are on subcutaneous methylnaltrexone bromide, certolizumab pegol, regadenoson injection, olopatadine hydrochloride nasal spray, and triamcinolone acetonide injectable suspension. The DUE is on subcutaneous methylnaltrexone bromide.
Avoid Confusion with Torisel Dose Preparation; Remove Vials from Cartons; Sumatriptan Confused with Sitagliptin; Misdispensing of Purinethol Instead of Propylthiouracil: A Preventable Disaster
Authors: Cohen Michael R.
Published: May 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 United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). 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.
Using Your Smartphone or PDA as a Thin Client
Authors: Felkey Bill G. , Fox Brent I.
Published: May 2010

Our ability to connect to each other and to information systems continues to increase. Some may feel that they are already “too connected.” For others, even more connectivity may be the goal. We have continually focused on the topic of connectivity, directly and indirectly, in this column. This month's installment discusses the functional capability that allows us to use our portable devices to remotely access another computer.
Tactics to Reduce Pharmacy Staff Turnover and Increase Job Satisfaction
Authors: Sanborn Michael
Published: May 2010

The Director's Forum series is written and edited by Michael Sanborn and Robert Weber and is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. Another specific goal of this column is to address many of the key challenges that pharmacy directors currently face while providing information that will foster growth in pharmacy leadership and patient safety. Pharmacist turnover is a significant challenge for pharmacy directors today, and this Director's Forum article will focus on specific elements and tactics that can reduce staff turnover and improve pharmacist and technician job satisfaction.
ABCs of ABGs: A Guide to Interpreting Acid-Base Disorders
Authors: Wargo Kurt A. , Centor Robert M.
Published: May 2010

Purpose

This objective of this article is to provide a useful resource on the assessment of arterial blood gasses (ABGs) for clinical pharmacists, pharmacy residents, and students.

Acid-base pathophysiology can be separated into metabolic or respiratory acidosis and alkalosis, as well as those disturbances that are compensated. This article provides readers with a stepwise approach for assessing ABGs, as well as offering actual case examples to familiarize the reader with the concepts of acid-base disorders. By the completion, the reader will have the tools necessary to assess any ABG that may be encountered in clinical practice.

Conclusion

Comprehension of acid-base pathophysiology is a complicated and overwhelming task for novice and experienced clinicians alike. Utilization of the stepwise approach proposed in this article will help clinicians at all levels of training assess and develop treatment options for any acid-base disturbance encountered in practice.
Intraventricular Colistin for the Treatment of Multidrug-Resistant Pseudomonas Aeruginosa Shunt Infection
Authors: Dixon Kelly S. , Hassoun Ali
Published: May 2010

Purpose

To report a case of ventriculoperitoneal shunt (VPS) infection with multidrug-resistant (MDR) Pseudomonas aeruginosa infection treated successfully with intraventricular colistin.

A 56-year-old black woman with a known history of sub-arachnoid hemorrhage and hydrocephalus necessitating VPS placement experienced fever, headache, and neck pain several weeks after she underwent emergent colectomy with ileostomy for Clostridium difficile colitis. Fever and neck stiffness were significant on examination. The patient's laboratory data demonstrated elevated cerebrospinal fluid (CSF) white blood cell count and protein level. A culture of the CSF grew P. aeruginosa and Enterococcus faecalis. Despite multiple antibiotic regimens and removal of the shunt, the CSF cultures continued growing P. aeruginosa. Intraventricular colistin was initiated as monotherapy, and colistin successfully sterilized the CSF within 24 hours. The patient developed severe headache and confusion, which her physicians thought was colistin-induced arachnoiditis; this condition resolved rapidly on discontinuation of therapy.

Discussion

The emergence of MDR, gram-negative microorganisms is a major concern for health care professionals worldwide. The rapid appearance of these organisms has led to a concurrent increase in central nervous system (CNS) infections caused by such bacteria. Furthermore, the clinical value of antibiotics that remain active against MDR, gram-negative bacteria in the CNS is limited by their decreased penetration of the blood-brain barrier. There is a revived interest in the use of intrathecal or intraventricular colistin to ensure adequate drug concentrations at the site of infection.

Conclusion

Intrathecal or intraventricular administration of colistin appears to be an appealing therapeutic option for CNS infections, especially in life-threatening emergencies. Further studies are needed to clarify the role of intrathecal colistin for treating MDR, gram-negative CNS infections.
New Drugs Approved by the FDA; New Dosage Forms and Indications Approved by the FDA; Agents Pending FDA Approval; New Drug Applications Filed by Manufacturer; Supplemental Applications Filed by Manufacturer; Significant Labeling Changes or “Dear Health Care Professional” Letters Related to Safety
Authors: Baker Danial E.
Published: May 2010

This monthly feature will help readers keep current on new drugs, new indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of this information; however, if there are any questions, please let us know at hospitalpharmacy@drugfacts.com .
Adopt Health Information Technology Systems Now! But in what Sequence?
Authors: Felkey Bill G. , Fox Brent I.
Published: May 2010

The question is familiar to many of us. Numerous systems designed to improve the medication-use process are presented to pharmacists, but what is the best sequence for implementing these technologies? This month we look at opinions from chief information officers of health systems on the question of the sequence of information technology system adoption. We also provide our perspectives on this question.
Impact of Pharmacy-Generated Recommendations on Antibiotic Therapy in a Community Hospital
Authors: Steinberg Jennifer G. , Machado Caridad , Clarke Heidi , Marsh Wallace A. , Kelly Gloria
Published: May 2010

Purpose

To examine the impact of a pharmacy-initiated antibiotic review service on the appropriateness of antibiotic therapy at a community hospital.

Methods

A retrospective review was conducted that assessed antibiotic prescribing before implementation of an antibiotic review service, followed by an interventional phase that assessed the impact of pharmacy-generated recommendations. Medical records were evaluated for appropriateness of antibiotic therapy. For records reviewed retrospectively, potential recommendations for improvement of antibiotic appropriateness were documented. Potential recommendations were based on evidence-based practice guidelines and pertained to organism susceptibilities, renal dosage adjustments, intravenous-to-oral conversion, duplication, duration, and indication for therapy. During the interventional phase, recommendations were directed to the prescribing physician via telephone or written communication. Patient charts were revisited regularly to assess for potential new recommendations and to determine acceptance of previous recommendations.

Results

At initial review, 95 (59%) orders reviewed retrospectively were considered appropriate. A total of 73 potential recommendations for improving appropriateness of retrospective orders were recorded. At completion of follow-up, overall appropriateness of retrospective orders decreased to 57%. Prospectively, 115 (57%) orders were considered appropriate at initial review. Physicians accepted 39 (71%) of the 55 recommendations generated for improving appropriateness of these orders. Pharmacy-generated recommendations were successful in improving the number of appropriate prospective orders by 13% ( P = 0.004) and identified a cost savings of approximately $12,000.

Conclusion

The pharmacy-initiated antibiotic review service has been well accepted by physicians and appears to have a positive impact on the number of appropriately prescribed antibiotic orders. Complete implementation of this review service may demonstrate greater impact.
Certolizumab Pegol
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E.
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent in print and are also available online. Monographs can be customized to meet the needs of a 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. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The December 2008 monograph topics are on granisetron transdermal system, lidocaine HCl ophthalmic gel 3.5%, casopitant, pegloticase, and mepolizumab. The DUE is on granisetron transdermal system.
Aerobic oxidation with bifunctional molecular catalysts
Authors: Ikariya Takao , Kuwata Shigeki , Kayaki Yoshihito
Published: May 2010

A new series of half-sandwich group 8 and 9 metal complexes bearing a metal/NH bifunctional moiety were synthesized from benzylic amines. The isolable Ir amide complexes serve as effective catalysts for aerobic oxidative transformation of secondary and primary alcohols into the corresponding ketones and esters under mild conditions. The aerobic oxidative kinetic resolution of racemic secondary alcohols with chiral bifunctional Ir catalysts was found to proceed smoothly under mild conditions with high selectivity. A novel imido-bridged dirhodium complex, which may be regarded as a dinuclear variant of the bifunctional mononuclear amide complexes, also proved to promote aerobic oxidation of a secondary alcohol and H2.
Questions of source in African cinema: the heritage of the griot in Dani Kouyat's films
Authors: Smith Kate Bolgar
Published: May 2010

This article offers a review of the long-accepted genre of return to the source within African cinema through an analysis of the work of the celebrated Burkinab director and griot, Dani Kouyat. Drawing on sociological and anthropological knowledge of the Mande region, and particularly
the musical traditions of the griot, the author suggests that the source material of such films needs to be reassessed. While return to the source films are often thought to present Africa's pre-colonial past, the author argues that a focus on pre-colonial Africa does not preclude a focus
on contemporary cultures. A re-view of the return to the source films from a local perspective reveals a binding factor between the past and the present: the heritage of the griot. An analysis of two of Kouyat's films demonstrates the ability of return to the source films to be culturally
syncretic and inspired by contemporary events as the director interlaces the past and the present, the local and the global. Questioning the tendencies to ghettoize films from Africa, the author proposes an outlook for African screen media scholarship that recognizes a film's specific cultural
heritage and integrates it into the global film tradition.
Animation as socio-political commentary: an analysis of the animated films of Congolese director Jean Michel Kibushi
Authors: Callus Paula
Published: May 2010

This article broadly explores the relationship between non-indexical audio-visual formats and socio-political commentary by focusing on the animated films of Congolese film-maker Jean Michel Kibushi. It uses a multidisciplinary approach, drawing on biographical information, the history of animation in Africa and the Democratic Republic of Congo, animation and African film theory, writing on Congolese popular culture and collective memory, and personal interviews with Kibushi. The article argues that Kibushi's films both mobilize local cultural forms and offer socio-political critique.
Collaboration and control in the development of Janet Green's screenplay Victim
Authors: Nelmes Jill
Published: May 2010

This article discusses the draft screenplays and correspondence held in the Janet Green collection concerned with the writing of Victim (1961), one of three social issue films that Green wrote for producer Michael Relph and director Basil Dearden. Victim was the first
film to openly depict homosexuality in Britain and went through a long and difficult development process. From the letters we find out about the complex relationship between those developing the film and the tensions during the writing of the different drafts. The collection is especially
interesting because the correspondence not only allows a study of the writer and the producer/director/writer relationship but also, in the case of Victim, the role of the British Board of Film Censors as well as the participation of Green's husband, John McCormick and lead actor Dirk
Bogarde. The complex mix of argument, negotiation and collaboration suggests a struggle for control of ideas in the development process between the players involved. How decisions are made as to the content of each draft is recorded in the letters, allowing a fascinating picture to build up
about the creation of the screenplay, which, as Janet Green explains, was written with the shadow of the censor's axe (JG 10/6: 25/10/60).
The constructive use of film genre for the screenwriter: mental space of film genre first exploration
Authors: Selbo Jule
Published: May 2010

This article aims to examine components of film genre that may be of practical use to the screenwriter in the creative ideation process as well as in the construction of a screenplay. The varying uses of the term genre has led to a misunderstanding of its efficacious place in the screenwriter's
toolbox and it is my intent to forge beyond genre studies of historical, marketing, iconographic and thematic perspectives and focus on the implications of film genre in the development of a screenplay. To achieve this objective, film genre will be explored in relation to the philosophical
constructs proposed by Gilles Fauconnier and George Lakoff, specifically the idea of mental space as it relates to the building of a film narrative into an idealized cognitive model that appeals to and attracts a specific audience.
Drivers of Brand Commitment: A Cross-National Investigation
Authors: Eisingerich Andreas B. , Rubera Gaia
Published: May 2010

Firms increasingly employ global brand management strategies for the effective coordination of their global activities. Effective coordination requires adapting global brand management strategies to cultural nuances. This study examines the influence of culture on the impact of four key brand management elements (i.e., brand innovativeness, brand customer orientation, brand self-relevance, and social responsibility) on customer commitment to a brand. Using responses from 167 U.K. and 230 Chinese consumers, the authors empirically demonstrate that brand innovativeness and brand self-relevance have a greater effect on brand commitment in cultures that are individualist, short-term oriented, and low on power distance (i.e., the United Kingdom), while brand customer orientation and social responsibility have a greater impact on brand commitment in cultures that are collectivist, long-term oriented, and high on power distance (i.e., China). Furthermore, the findings reveal that in collectivist, long-term-oriented, and high-power-distance cultures, the four brand management activities equally contribute to brand commitment. The research informs global brand managers wanting to optimize brand positioning and strengthen customers’ brand commitment across cultures.
Evaluation of cell counting and leukocyte differentiation in cerebrospinal fluid controls using hematology analyzers by the German Society for Clinical Chemistry and Laboratory Medicine
Authors: Kleine Tilmann O. , Nebe C. Thomas , Löwer Christa , Lehmitz Reinhard , Geilenkeuser Wolf-Jochen , Kruse Rolf , Dorn-Beineke Alexandra
Published: May 2010

Background: Manual cell counting in cerebrospinal fluid (CSF) is technique-dependent, time-consuming, and thus costly and prone to inter-operator variability and low precision. Flow cytometry (FCM) with fast hematology analyzers (HAs) appears to improve accuracy and precision of CSF cell analysis; rapid CSF cell analysis is especially needed in emergency laboratories. Ten external trials of the German Society for Clinical Chemistry and Laboratory Medicine evaluated FCM with Coulter (LH750, 755), Abbott CD3200™, CD3500™, CD3700™, CD4000™, Sapphire™, ADVIA120® CSF assay, and Sysmex® XE-2100 single platform analyzers.

Methods: CSF controls were produced using native blood leukocytes and erythrocytes, resembling CSF and thus rendering the trials feasible and allowing comparison with native manual counting in a Fuchs-Rosenthal chamber and FACScan-CD45-CD14 dual platform analysis, which was used as the reference method. Statistical evaluation was performed using Passing/Bablok regression analysis.

Results: Our evaluation revealed significant differences with respect to target values in leukocyte and erythrocyte counts, as well as leukocyte differentiation. These differences were attributed to inaccuracies produced by the HAs, due to blank correction in connection with impedance analysis, leukocyte loss, especially through monocyte injury due to the erythrocyte lysing agent, incomplete erythrocyte lysis, ADVIA cell sphering, cell differentiation using algorithms and peroxidase activity. Erythrocyte counting in the CSF controls was inaccurate with the Coulter and ADVIA analyzers.

Conclusions: Evaluation of HAs by means of the CSF controls revealed inaccuracies in cell counting and leukocyte differentiation. Analyzer techniques, used for CSF cell assays, therefore need to be improved.

Clin Chem Lab Med 2010;48:839–48.
Cord blood and maternal serum neopterin concentrations in patients with pre-eclampsia
Authors: Cayci Tuncer , Akgul E. Ozgur , Kurt Yasemin Gulcan , Aydin Ibrahim , Alacam Hasan , Ozkan Esin , Yaman Halil , Cakir Erdinc , Deren Ozgur , Dogan Pakize , Bilgi Cumhur , Erbil M. Kemal
Published: May 2010

Background: Pre-eclampsia is a syndrome characterized by hypertension and proteinuria. The aim of this study was to investigate neopterin concentrations in cord blood and maternal serum in patients with pre-eclampsia and a control group.

Methods: Cord blood and maternal serum neopterin were measured in 21 patients with pre-eclampsia and in 27 control subjects. Neopterin concentrations were measured by high performance liquid chromatography.

Results: Cord blood neopterin concentrations were significantly increased in patients with pre-eclampsia compared to controls (54.3±16.8 vs. 43.4±8.5 nmol/L, p=0.011, respectively). Maternal serum neopterin (257.3±36.8 vs. 150.9±33.8 nmol/L, p<0.001) was also higher in patients with pre-eclampsia.

Conclusions: Cord blood and maternal serum neopterin concentrations are higher in patients with pre-eclampsia. Maternal serum neopterin concentrations used may be used as a marker for the early diagnosis of pre-eclampsia.

Clin Chem Lab Med 2010;48:1127–31.