bluuebunny/crossref_metadata_2025 huggingface dataset:
Adolescent Characters and Alcohol Use Scenes in Brazilian Movies, 2000–2008
Authors: Castaldelli-Maia João Mauricio , de Andrade Arthur Guerra , Lotufo-Neto Francisco , Bhugra Dinesh
Published: May 2016

Quantitative structured assessment of 193 scenes depicting substance use from a convenience sample of 50 Brazilian movies was performed. Logistic regression and analysis of variance or multivariate analysis of variance models were employed to test for two different types of outcome regarding alcohol appearance: The mean length of alcohol scenes in seconds and the prevalence of alcohol use scenes. The presence of adolescent characters was associated with a higher prevalence of alcohol use scenes compared to nonalcohol use scenes. The presence of adolescents was also associated with a higher than average length of alcohol use scenes compared to the nonalcohol use scenes. Alcohol use was negatively associated with cannabis, cocaine, and other drugs use. However, when the use of cannabis, cocaine, or other drugs was present in the alcohol use scenes, a higher average length was found. This may mean that most vulnerable group may see drinking as a more attractive option leading to higher alcohol use.
Accuracy of GFR estimating equations in a large Swedish cohort: implications for radiologists in daily routine and research
Authors: Nyman Ulf , Grubb Anders , Lindström Veronica , Björk Jonas
Published: May 2016

Background

Guidelines recommend estimation of glomerular filtration rate (eGFR) prior to iodine contrast media (CM) examinations. It is also recommended that absolute eGFR in mL/min, not commonly used relative GFR (adjusted to body surface area; mL/min/1.73 m2), should be preferred when dosing and evaluating toxicity of renally excreted drugs.

Purpose

To validate the absolute Lund–Malmö equation (LM-ABS) in comparison with the absolute Cockcroft–Gault (CG) equation and the relative equations, revised Lund–Malmö (LM-REV), MDRD, and CKD-EPI, after converting relative estimates to absolute values, and to analyze change in eGFR classification when absolute instead of relative eGFR was used.

Material and Methods

A total of 3495 plasma clearance of iohexol to measure GFR (mGFR) served as reference test. Bias, precision, and accuracy (percentage of estimates ±30% of mGFR; P30) were compared overall and after stratification for various mGFR, eGFR, age, and BMI subgroups.

Results

The overall P30 results of CG/LM-ABS/LM-REV/MDRD/CKD-EPI were 62.8%/84.9%/83.7%/75.3%/75.6%, respectively. LM-ABS was the most stable equations across subgroups and the only equation that did not exhibit marked overestimation in underweight patients. For patients with relative eGFR 30–44 and 45–59 mL/min/1.73 m2, 36% and 58% of men, respectively, and 24% and 32% of women, respectively, will have absolute eGFR values outside these relative eGFR intervals.

Conclusion

Choosing one equation to estimate GFR prior to contrast medium examinations, LM-ABS may be preferable. Unless absolute instead of relative eGFR are used, systematic inaccuracies in assessment of renal function may occur in daily routine and research on CM nephrotoxicity may be flawed.
Does Witnessing Animal Cruelty and Being Abused During Childhood Predict the Initial Age and Recurrence of Committing Childhood Animal Cruelty?
Authors: Browne John A. , Hensley Christopher , McGuffee Karen M.
Published: May 2016

The goal of the current study was to examine the association between demographic characteristics and childhood experiences on the respondents’ age of committing childhood animal cruelty and its recurrency. Using data collected from 257 male inmates at a Southern medium-security state prison, the current study seeks to replicate a study by Hensley, Tallichet, and Dutkiewicz. Results revealed that those respondents who were physically abused as children reported engaging in recurrent animal cruelty. The younger the age of respondent for first witnessing animal cruelty, the sooner his initiation to hurting and killing animals occurred. In addition, those who reported witnessing a parent commit acts of animal abuse reported that they committed animal abuse themselves at an older age, while those who witnessed a brother/sister commit animal abuse reported engaging in it at an earlier age. Therefore, physical abuse and witnessing primary socializers engage in animal abuse seem to be important in understanding the respondents’ age of onset and repeated childhood animal cruelty.
Extra-ordinary aid and its shadows: The work of gratitude in Nicaraguan humanitarian healthcare
Authors: Nouvet Elysée
Published: May 2016

Nicaragua has the lowest per capita spending on health in Central America. Public clinics lack medications for chronic disease management; many citizens obtain prescriptions but cannot afford to get these filled; poorly equipped and under-staffed operating theatres function part-time while waiting lists swell. This is the context within which dozens of international healthcare missions travel to Nicaragua every year to provide surgical and primary care to the country’s poor. This article is based on research conducted in 2013 on Nicaraguan encounters with and moral framings of foreign surgical and primary care missions working in their communities. It draws on critical humanitarian studies and queer affect theory in attending to and analyzing references to gratitude within these accounts, asking what local and trans-national relations Nicaraguan narratives of gratitude toward medical aid help form, limit, and enable.
Moral sentiments in Aidland: Aid and development as moral experience
Authors: Nouvet Elysée , Jakimow Tanya
Published: May 2016

This short article introduces the special section “Morality in Aidland,” which brings together three articles exploring the work of moral sentiments in social actors’ understandings of and engagements with local, national, and international aid and development practices.
Long-term effectiveness of sphenopalatine ganglion stimulation for cluster headache
Authors: Jürgens Tim P , Barloese Mads , May Arne , Láinez Jose Miguel , Schoenen Jean , Gaul Charly , Goodman Amy M , Caparso Anthony , Jensen Rigmor Højland
Published: May 2016

Objectives

The sphenopalatine ganglion (SPG) plays a pivotal role in cluster headache (CH) pathophysiology as the major efferent parasympathetic relay. We evaluated the long-term effectiveness of SPG stimulation in medically refractory, chronic CH patients.

Methods

Thirty-three patients were enrolled in an open-label follow-up study of the original Pathway CH-1 study, and participated through 24 months post-insertion of a microstimulator. Response to therapy was defined as acute effectiveness in ≥ 50% of attacks or a ≥ 50% reduction in attack frequency versus baseline.

Results

In total, 5956 attacks (180.5 ± 344.8, range 2–1581 per patient) were evaluated. At 24 months, 45% ( n = 15) of patients were acute responders. Among acute responders, a total of 4340 attacks had been treated, and in 78% of these, effective therapy was achieved using only SPG stimulation (relief from moderate or greater pain or freedom from mild pain or greater). A frequency response was observed in 33% ( n = 11) of patients with a mean reduction of attack frequency of 83% versus baseline. In total, 61% (20/33) of all patients were either acute or frequency responders or both. The majority maintained their therapeutic response through the 24-month evaluation.

Conclusions

In the population of disabled, medically refractory chronic CH patients treated in this study, SPG stimulation is an effective acute therapy in 45% of patients, offering sustained effectiveness over 24 months of observation. In addition, a maintained, clinically relevant reduction of attack frequency was observed in a third of patients. These long-term data provide support for the use of SPG stimulation for disabled patients and should be considered after medical treatments fail, are not tolerated or are inconvenient for the patients.
New insight into the preparation of flame-retardant thermoplastic polyether ester utilizing β-cyclodextrin as a charring agent
Authors: Zhang Luchong , Wu Wei , Li Jia Hui , Wang Zheng , Wang Liang , Chen Shiying
Published: May 2016

The past decade has witnessed remarkable progress of the development and amelioration of thermoplastic polyether ester elastomer (TPEE), showing its promising wide-range utility. Herein we unraveled an unprecedented research to utilize β-cyclodextrin (β-CD) with perfect charring ability in TPEE in substitution of toxic halogen flame retardants. The TPEE/phosphorous–nitrogen flame retardants (P-N FR) (aluminum diethylphosphinate and melamine polyphosphate)/β-CD system was created and the flame retardance effects were determined using the limiting oxygen index (LOI) and the vertical burning test (UL94), while the charring effects of β-CD were measured by thermogravimetric analysis (TGA), laser Raman spectroscopy (LRS), and scanning electron microscopy (SEM). Besides, the mechanical properties and the morphology were tested by the universal testing machine and SEM. Results indicate that with 10 wt% of β-CD added to the TPEE/25 wt% P-N FR systems, the UL94 can reach to V-0 grade and the tensile strength of this blend was kept above 10 MPa, which can be applied in practice. To our delight, β-CD promoted the formation of stable and compact carbonaceous char, preventing the melt dripping and enhancing the properties and the charring mechanism was better studied by real-time Fourier transform infrared spectra. Being easy to construct, sustainable, and economic, the TPEE composite modified by β-CD and P-N FR is a reliable and widely applicable novel fire retardation material.
Electrostatic monitoring of wind turbine gearbox on oil-lubricated system
Authors: Liu Ruochen , Zuo Hongfu , Sun Jianzhong , Wang Ling
Published: May 2016

The electrostatic sensing technique has been verified to be a viable method for tribo-contact monitoring under laboratory conditions in previous investigations. This paper reports on the evolution of electrostatic monitoring on a real oil-lubricated wind turbine gearbox, using a modified oil-line sensor. In a nominal test and a ramp-up test, features were extracted and the presence of debris can be detected. The permutation entropy was further introduced in an accelerated life test. It can accurately reflect the wear condition of the gearboxes and detect early faults earlier than conventional techniques, which also has a better sensitivity and performance degradation trend than time-domain features.
Equilibrium characteristics and stability analysis of helicopter slung-load system
Authors: Cao Yihua , Wang Zhaorui
Published: May 2016

Based on rigid-body slung-load hypothesis, a nonlinear dynamical model of the helicopter and slung-load system is presented. As for helicopter and slung-load system, the introduction of the rigid-body slung-load results in several extra degrees of freedom and constraints, and this makes the nonlinear equations of helicopter and slung-load motion transfer from 9 orders to 19 orders. The nonlinear equations are linearized by small perturbation hypothesis for stability analysis and they are trimmed by the continuation method. First, the simulation trimmed results are compared with the helicopter flight test data without slung-load and the calculation results of helicopter with mass-point slung-load in the literature. Then, the differences among trimmed states of the helicopter with a rigid-body slung-load, a mass-point slung-load, and without slung-load are studied. The motion modes of helicopter with rigid-body slung-load are calculated in different cases, and the effects of extra slung-load to the helicopter stability are analyzed at the same time. Results showed that the rigid-body slung-load added five new motion modes to the whole helicopter and slung-load system, two of which concerning cable swinging motion are stable, while the others concerning slung-load attitude motion are unstable. At the same time, the introduction of rigid-body slung-load makes the short-period mode and the roll mode of helicopter unstable, which has a strong impact on the flight quality of helicopter.
A generalized design method for three-dimensional guidance laws
Authors: Sun Sheng , Zhou Di , Zhou Jingyang , Teo Kok Lay
Published: May 2016

The true proportional navigation guidance law, the augmented proportional navigation guidance law, or the adaptive sliding-mode guidance law, is designed based on the planar target-to-missile relative motion dynamics. By a proper construction of a nonlinear Lyapunov function for the line-of-sight angular rates in the three-dimensional guidance dynamics, it is shown that the three guidance laws mentioned above are able to ensure the asymptotic convergence of the angular rates as they are directly applied to the three-dimensional guidance environment. Furthermore, considering the missile autopilot dynamics as a first-order lag, we design three-dimensional nonlinear guidance laws by using the backstepping technique for three cases: (1) the target does not maneuver; (2) the information of target acceleration can be acquired; and (3) the target acceleration is not available but its bound is known a priori. In the first step of the backstepping design of the control law, there is no need to cancel the nonlinear coupling terms in the three-dimensional guidance dynamics in such way that the final expressions of the proposed guidance laws are significantly simplified. Thus, the proposed nonlinear Lyapunov function for the line-of-sight angular rates is a generalized function for designing three-dimensional guidance laws. Simulation results of a missile interception mission show that the proposed guidance laws are highly effective.
Numerical analysis of the vibration and noise induced by the unsteady flow in a centrifugal compressor
Authors: Zhou Huihui , Mao Yijun , Diao Quan , Lu Fu’an , Zhang Qunlin
Published: May 2016

Flow-induced vibration and noise widely exist in turbomachines and the connecting piping systems. The combined numerical method of computational fluid dynamics, computational structural dynamics, and computational vibroacoustics is employed to investigate the vibration and noise induced by the unsteady flow in the centrifugal compressor and pipes. Computational results indicate that the strongest pressure fluctuation is located on the clearance between the impeller and the stationary units due to the periodic rotor–stator interaction. However, the intense vibration occurs on the inlet and outlet pipes of the centrifugal compressor. Moreover, the computational result of the normal active acoustic intensity shows that the primary vibro-noise source is located on the outlet pipe. The computational result also clarifies that the thickness of the outlet pipe is one of the key parameters affecting the acoustic power output of the centrifugal compressor.
Endocrine disrupting potential and reproductive dysfunction in male mice exposed to deltamethrin
Authors: Ben Slima A , Chtourou Y , Barkallah M , Fetoui H , Boudawara T , Gdoura R
Published: May 2016

Pesticide exposure may affect semen quality and male fertility in humans. The aim of the present work was to elucidate the adverse effects of deltamethrin (Delta), a synthetic pyrethroid, on exposed male mice and their offspring. Adult male Albino/Swiss mice received deltamethrin (5 mg/kg) daily for 35 days and mated with untreated females to produce offspring. Classical measurements of ejaculate and sperm quality and testicular histopathological changes were assessed. Deltamethrin treatment affects sperm quality and quantity in the ejaculated semen of mice that had also markedly impaired libido as measured by indices of mating and fertility and number of pregnant females housed with male mice exposed to this pesticide. Exposure mice to deltamethrin significantly decreased their testosterone and inhibin B levels and affected reproductive performance. Testes of exposed mice showed marked histopathological alterations as compared to the control group. The mice exposed to 5 mg/kg body weight/day of deltamethrin showed severe alterations of the seminiferous tubules, sloughing of the germ cells, the vacuolization of germ cell cytoplasm, and the disruption of spermatogenic cells compared to the control group. Altered pregnancy outcomes were directly attributed to damage of sperm of male mice exposed to deltamethrin compared to the control group. We concluded that exposure to deltamethrin affected the reproductive system of male mice explored by altered total sperm density, motility, and morphology in mice spermatozoa.
Investigating covariate-by-centre interaction in survival data
Authors: Biard L , Labopin M , Chevret S , Resche-Rigon M
Published: May 2016

In survival analysis, assessing the existence of potential centre effects on the baseline hazard or on the effect of fixed covariates on the baseline hazard, such as treatment-by-centre interaction, is a frequent clinical concern in multicentre studies. Survival models with random effects on the baseline hazard and/or on the effect of the covariates of interest have been largely applied, for instance, to investigate potential centre effects. We aimed to develop a procedure to routinely test for multiple random effects in survival analyses. We propose a statistic and a permutation approach to test whether all or a subset of components of the variance-covariance matrix of random effects are non-zero in a mixed-effects Cox model framework. Performances of the proposed permutation tests are examined under different null hypotheses corresponding to the different components of the variance-covariance matrix, i.e ., to the different random effects considered on the baseline hazard and/or on the covariates effects. Several alternative hypotheses are evaluated using simulations. The results indicate that the permutation tests have valid type I error rates under the null and achieve satisfactory power under all alternatives. The procedure is applied to two European cohorts of haematological stem cell transplants in acute leukaemia to investigate the heterogeneity across centres in leukaemia-free survival and the potential heterogeneity in prognostic factors effects across centres.
Book Review: Ipshita Chanda and Jayeeta Bagchi (Eds), Shaping the Discourse: Women’s Writings in Bengali Periodicals 1865–1947
Authors: Bhattacharya Chandrima
Published: May 2016

Ipshita Chanda and Jayeeta Bagchi (Eds), Shaping the Discourse: Women’s Writings in Bengali Periodicals 1865–1947. Kolkata: Bhatkal & Son, 2015, 466 pages, ₹550, ISBN 978-8190676052.
Bait and Switch: The European Union’s Incoherency towards Africa
Authors: Taylor Ian
Published: May 2016

The European Union’s (EU’s) relations with Africa remain dominated by notions of partnerships via development cooperation and inconsistencies regarding economic dealings that often exert powerfully negative images of the EU as a collective unit that gives with one hand but takes back with the other. The hegemony of neoliberalism within the EU serves the broad interests of outwardly orientated fractions of the EU’s ruling elites, and navigating the tensions that this creates in any consistent set of development policies remains a key challenge to the EU–Africa relationship, particularly when these same actors practice de facto mercantilism in certain areas of policy whilst proclaiming their commitment to liberalisation. Such hypocrisy invites scorn and resentment within Africa. Handicapped by the divergent interests of its various members, the question remains whether the EU can move from individual action to a genuinely common set of policies towards the continent—beyond the rhetoric.
A layered shell containing patches of piezoelectric fibers and interdigitated electrodes: Finite element modeling and experimental validation
Authors: Nielsen Bo B , Nielsen Martin S , Santos Ilmar F
Published: May 2016

The work gives a theoretical and experimental contribution to the problem of smart materials connected to double curved flexible shells. In the theoretical part the finite element modeling of a double curved flexible shell with a piezoelectric fiber patch with interdigitated electrodes (IDEs) is presented. The developed element is based on a purely mechanical eight-node isoparametric layered element for a double curved shell, utilizing first-order shear deformation theory. The electromechanical coupling of piezoelectric material is added to all elements, but can also be excluded by setting the piezoelectric material properties to zero. The electrical field applied via the IDEs is aligned with the piezoelectric fibers, and hence the direct d33 piezoelectric constant is utilized for the electromechanical coupling. The dynamic performance of a shell with a microfiber composite (MFC) patch is investigated using frequency response functions (FRFs) obtained via external impact test as well as internal random signal excitation using the MCF patch as an actuator. The experiments are used to validate the numerical results. Good agreement between theory and experiments is obtained in a large frequency range. Discrepancies and insights into optimal modeling frequency range and non-linear behavior are discussed.
Drug Information — The Problems and Some Solutions
Authors: Conner Christopher S. , Watanabe Arthur S. , Rumack Barry H.
Published: May 2016

Several problems evident in the drug information delivery process and some solutions are presented. Major problems with current sources of drug information are accessibility of data, completeness of data, validity of information, appropriateness in the clinical setting, and currency.

Better drug information sources are needed to provide rapid answers to patient-related questions routinely occurring in the clinical setting. Currently available mechanisms described to solve existing drug information problems are clinical pharmacologists and specialists, clinical pharmacists, drug information centers, and a computer-output microfiche drug information system (DRUGDEX®).
Decision Tables for Planning Drug Therapy
Authors: Wartak Joseph , Miller T. Bryce
Published: May 2016

A new method of planning drug therapy is described. The method employs so-called decision tables, which have been used effectively in commercial and scientific data processing for over a decade. The decision tables seem to provide a simpler, clearer and more concise means of expressing the complexity and logic of the therapeutic decision making process. The use of decision tables is illustrated by an example involving therapeutic regimens in hypertensive disease.
Drug Compliance — A Study of Patient Behavior Based on Medical Records
Authors: Luckman Roger , Weisbuch Jonathan B. , Taubman Albert H. , King James , Little Forbes , French David M.
Published: May 2016

Studies concerned with medication compliance after initial prescription dispensing have been frequently cited in the literature; however, little research has been done on the initial filling of the prescription order. In order to ascertain the degree of compliance at the initial filling level, a study was carried out on a population associated with a neighborhood health center. Overall, the study indicated an initial filling compliance of 94 percent, which was affected by the site of patient encounter, the chronicity of the disease, and the specificity of the medication in relationship to the disease state. It was concluded that: Prescriptions for chronic medications are filled at a higher rate than those for acute illnesses; specific medication for a specific illness has a much higher compliance rate than nondisease specific medications; ease of access to a pharmacy is related to a higher compliance level; and frequent patient contact for a specific disease tends to increase compliance.
The Programmable Hand-Held Calculator
Authors: Buice Robert G.
Published: May 2016

The use of pharmacokinetics in the control of drug therapy requires specialized personnel and facilities which are not available in most hospitals. This limitation can be somewhat overcome by the utilization of a programmable hand-held calculator such as the Hewlett-Packard 67 or 97. This paper presents several programs for this calculator which are useful in clinical pharmacokinetics. Programming steps and instructions for program use are discussed.
The Clinical Community Pharmacist — A Proposal
Authors: Beasley John W. , Moskol Fredric E.
Published: May 2016

The community pharmacist working in the drug store setting already has a significant role as a primary care provider. This role should be enhanced and integrated into the health care system to facilitate patient education and other patient services. We propose that clinical community pharmacists who have greater clinical and educational skills will be able to augment their role in the local health care system while remaining on-site in the community pharmacy.
Pharmacologic Aspects of Immunization
Authors: Delafuente Jeffrey C. , Panush Richard S.
Published: May 2016

Immunization has reduced the morbidity and mortality of many diseases. Immunizing agents have been available for many years, with many newer vaccines under investigation. The mechanisms of action of immunizing agents have only been clarified within the last several decades. Immunity may be attained by active immunization using a toxoid, or living or killed organisms. Passive immunity is achieved with serum immune globulins and antitoxins. Mechanisms of human immunity, routine immunization schedules and the pharmacology of immunizing agents are discussed.
Phenytoin — Chloramphenicol Interaction
Authors: Harper J. Michael , Yost Richard L. , Stewart Ronald B. , Ciezkowski Joe
Published: May 2016

A controlled retrospective study of 20 patients receiving chloramphenicol and phenytoin simultaneously, was performed to evaluate previously reported findings of phenytoin toxicity induced by its interaction with chloramphenicol. Forty-five percent of patients receiving phenytoin and chloramphenicol experienced symptoms indicative of phenytoin toxicity, compared to 0 percent and 9 percent of two control groups, one of which received phenytoin with tetracycline and the other, chloramphenicol alone.
The Effect of Drugs on Albumin Binding of Bilirubin and on Free Bilirubin Concentration as Determined by Fluorescence Quenching
Authors: Drew John H. , Wells Rhondda
Published: May 2016

Fluorescence quenching was used to determine the influence of five drugs commonly used in the newborn infant, on the binding of bilirubin to albumin, and to quantitate the resultant changes in binding parameters and the free bilirubin concentration. The five drugs studied were digoxin, furosemide, diazepam, phenytoin sodium, and theophylline. The primary influence of digoxin, furosemide, diazepam, and phenytoin sodium was on the affinity of albumin to bind bilirubin. They also affected the capacity of albumin to bind bilirubin, but to a lesser extent. Furosemide reduced the apparent binding affinity by 60 percent (p = 0.01), phenytoin sodium by 58 percent (p < 0.01), digoxin by 52 percent (p = 0.02), and diazepam by 45 percent (p = 0.03). Furosemide reduced the apparent binding capacity by 24 percent (p < 0.001), digoxin by 23 percent (p = 0.04), and diazepam by 13 percent (p = 0.10). Phenytoin sodium had a different effect on the apparent binding capacity: It increased the apparent capacity by 30 percent (p < 0.01). Theophylline had no significant effects on either binding affinity or capacity or free bilirubin concentration. Furosemide, digoxin, and diazepam significantly increased free bilirubin concentration at all total bilirubin concentrations; therefore, these drugs should be used with caution in the jaundiced newborn infant. Phenytoin sodium increased free bilirubin concentrations in the low total bilirubin ranges only; however, the increase was marginal and unlikely to be clinically significant.
Ecthyma Gangrenosum
Authors: Stewart Clinton , Mungall Dennis , Dimick Alan
Published: May 2016

A case of Pseudomonas aeruginosa septicemia complicated by ecthyma gangrenosum is presented. The usefulness of monitoring aminoglycoside concentrations in the treatment of septicemia is stressed. The pathophysiology and treatment of ecthyma gangrenosum and the pharmacokinetics of tobramycin are reviewed.
Education of Independent Elderly in the Responsible Use of Prescription Medications
Authors: Lundin Dorothy V. , Eros P. Albert , Melloh Joanne , Sands Judy E.
Published: May 2016

A pilot study to test the effectiveness of medication instruction was carried out using 61 voluntary participants age 65 and older. They were interviewed regarding their medication taking, and instruction was individualized using one of four teaching modes: oral; written; oral and written; and oral and written combined with memory aids. Postinstruction interviews revealed no significant difference in compliance among all groups. The preinstruction mean compliance score of all subjects was 98.8 percent. Although compliance, judged specifically on the basis of the prescription label instructions, was extremely high both before and after instruction, drug-taking behavior and knowledge did change. The preinstruction compliance score does not necessarily reflect safe or desirable drug-taking behavior. There was no specific information given to clients with their prescriptions and prescription medications, indicating, for drug-therapy decision makers, a much broader problem than noncompliance.
Dapsone-Induced Hemolytic Anemia in a Patient with Relapsing Polychondritis
Authors: Waller Elaine , Goehrs Homer
Published: May 2016

A 53-year-old woman presented with bilateral auricular chondritis which was responsive to high doses of prednisone. After a diagnosis of relapsing polychondritis was confirmed, she was treated with dapsone. Her disease responded well to dapsone 200 mg daily. While on this regimen, she developed a dapsone-induced hemolytic anemia which was successfully managed by a reduction in dosage. The use of dapsone for relapsing polychondritis and dapsone-induced hemolytic anemia are reviewed.
The Impact of Clinical Pharmacist Activity on Intravenous Fluid and Medication Administration
Authors: Kelly Kim L. , Covinsky Joel O. , Fendler Kermit , Bauman Jerry L.
Published: May 2016

Utilization patterns and cost data were collected for intravenous therapy in two populations. Patients in two units were considered to be study, and the clinical pharmacist on these units emphasized appropriate use of and acceptable alternatives to various modes of intravenous therapy. In two other comparable units, the clinical pharmacist did not pay special attention to intravenous therapy. The study was conducted for approximately six weeks to assure a minimum of 50 patients on each of the four units. The results of this study indicate that utilization patterns for intravenous therapy can be significantly altered by clinical pharmacist activity. Substantial savings in costs to the patient were demonstrated.
The Pharmacy Service of Memorial Hospital Medical Center
Authors: Smith William E. , Brodie Donald C.
Published: May 2016

This article identifies the scope of activities, needs and subjects of a clinical pharmacy service program in a progressive community hospital. Even after ten years of constant effort, a comprehensive hospital clinical pharmacy program still rquires continual review, changes, and improvements.
Investigation of the Crystallization of Phenytoin in Normal Saline
Authors: Salem Ronald B. , Yost Richard L. , Torosian George , Davis Frank T. , Wilder B. J.
Published: May 2016

A study was designed to determine if the admixture of phenytoin in normal saline would remain physically stable for a suitable period of time to allow for intravenous infusion. Five phenytoin concentrations (1.0 mg/ml, 2.5 mg/ml, 5.0 mg/ml, 7.5 mg/ml, and 10.0 mg/ml) were prepared in triplicate by adding a sufficient volume of normal saline to the appropriate volume of phenytoin sodium injection to produce a total volume of 100 ml. Aliquots of all solutions were withdrawn at zero, 1, 8, 16, and 24 hours. Solutions were filtered through a 0.22 micron millipore filter and the concentration of phenytoin and pH of each solution was determined. A significant concentration difference was not seen between zero time and 24 hours. The pH of the samples ranged from 9.75 to 11.00. While phenytoin sodium appears to be stable in the concentrations tested when sodium chloride 0.9% is the vehicle, several important factors must be considered and caution must be used if the admixture is administered intravenously.
Ataxia as the Primary Symptom of Lithium Toxicity
Authors: Salem Ronald B. , Director Kenneth , Muniz Carlos E.
Published: May 2016

Two cases of ataxia as the primary symptom of lithium toxicity are presented. The authors discuss these cases in regard to previous literature. Usually, lithium toxicity is suspected only after a combination of several symptoms appear. This report points out the possibility of lithium toxicity presenting with only one symptom. The possibility of a synergistic effect between Phenytoin and lithium is suggested in one of the cases.
Indomethacin-Induced Acute Renal Failure: Report of a Case and Review of the Literature
Authors: Koren James F. , Brown James R. , Alissandratos Jane K. , Hudgins Larry B.
Published: May 2016

An 84-year-old black male with hypertensive cardiovascular disease and arthritis suffered deterioration in renal function when placed on indomethacin for an acute monoarticular arthritis. Renal function improved after discontinuing the indomethacin. The patient received indomethacin again, and there was a rapid increase in both the serum creatinine and blood urea nitrogen, which declined a second time when the drug was stopped. The plasma renin activity after indomethacin treatment was found to be markedly elevated. The counterbalancing effect of prostaglandins and plasma renin activity in preserving renal function in patients with underlying disease states is stressed. A review of the literature is provided and some rationalizations made as to what type of patient would be most susceptible to renal failure with indomethacin therapy.
Antibiotic Sensitivity of Penicillin - Resistant Staphylococcus aureus in three midwestern family practice populations
Authors: Helling Dennis K. , Jones Mark E. , Majhanovich John J. , Massad Susan
Published: May 2016

Penicillin-resistant Staphylococcus aureus is commonly seen in hospital settings. Recent evidence suggests similar trends in community settings. This study was conducted to determine the incidence of nasal carriage and antibiotic sensitivity patterns of S. aureus in non-hospitalized patients from three midwestern family practice offices. The effect of geographic location of the clinics on nasal carriage and antimicrobial sensitivities was investigated.

The following participant variables were analyzed to determine their correlation with nasal carriage and penicillin sensitivity patterns: age, sex, last hospitalization, previous antimicrobial usage, patient or family member employment in a health care facility, and the number of household members.

Swabs of the anterior nares were collected from 462 ambulatory patients seen at the three family practice offices. Of these patients, 155 (33.5 percent) were shown to be carriers of S. aureus; 89 percent of the S. aureus isolates were resistant to penicillin. Significant numbers of organisms were also found resistant to tetracycline (22 percent) and sulfadiazine (78 percent). No significant correlations were found between the participant variables and the sensitivity of S. aureus to penicillin or carriage of the organism, nor were there any significant differences between clinics. Penicillinase-resistant penicillins and erythromycin are recommended for use in suspected staphylococcal skin infections.
A Study of Intravenous Emulsion Compatibility: Effects of Dextrose, Amino Acids, and Selected Electrolytes
Authors: Black Curtis D. , Popovich Nicholas G. , Roy Myrella
Published: May 2016

Microscopic and electronic counting procedures as well as visual observations for creaming and flocculation were employed to quantitatively and qualitatively measure the effects of dextrose, amino acids, and various mono- and di-valent cations on the globule size distribution of the soybean oil emulsion 10%, Intralipid®. A linear regression analysis was demonstrated to successfully profile much of the stability data. Results indicated that divalent cations caused flocculation in the emulsion's internal phase immediately upon or shortly after the addition of their salts. The rate and extent of flocculation intensified with increasing ionic concentration. Amino acids, apparently acting at the oil/water interface, delayed divalent cation-induced flocculation; however, they did not prevent emulsion stability loss. The addition of dextrose 5% or 12.5% brought about a reduction of emulsion pH and significant globule coalescence 72 hours after admixture. Monovalent cations (i.e., Na+, K+) induced a progressive loss of emulsion stability over the 72-hour course of the experiments, the effect a function of ionic concentration. From the data, a model has been generated to predict significant changes ( p < 0.05) in Intralipid's® globule size distribution upon addition of solute and exposure to room temperature. Further recommendations of solute admixture with the intravenous emulsion are also included.
Cephalosporin-Aminoglycoside Synergistic Nephrotoxicity: Fact or Fiction?
Authors: Mannion James C. , Bloch Richard , Popovich Nicholas G.
Published: May 2016

A review of synergistic nephrotoxicity associated with the concomitant administration of aminoglycoside and cephalosporin antibiotics is presented. A combination of these antibiotics is frequently administered in clinical practice as initial therapy in the treatment of gram-negative bacillary infection. The nephrotoxicity associated with cephalosporin/aminoglycoside administration in humans has been characterized as an acute tubular necrosis. Attempts to investigate this type of toxicity in animals using the rat as the model have revealed that the rat kidney is not affected by the aminoglycoside/cephalosporin combination in the same manner as the human kidney. The results from studies using the rat were not predictive of the nephrotoxicity encountered in humans, and cephalosporins actually appear to protect the rat from aminoglycoside-induced renal damage. The mechanism of the protective effect in rats and the toxic effects in man remain unknown. A species differentiation clearly exists between man and rats with respect to the nephrotoxic effects of aminoglycoside/cephalosporin combinations. The weight of present evidence indicates that, in man, an aminoglycoside/cephalosporin combination is synergistically nephrotoxic.
Drug Information Services Activity, 1961–1979: A Citation Analysis
Authors: Pearson Robert E.
Published: May 2016

In an attempt to determine the interrelationships of articles published regarding drug information services activity, a citation analysis was performed. The period chosen for study was 1961–1979. During this period, some 258 publications were identified as meeting the operational definition of drug information services activity. A subset of publications was selected for further study and showed that (1) less than 1/3 of the articles in the subset cited one another, (2) the “classic” article (s) are seldom cited, and (3) authors tend to cite themselves more frequently than others. A historiograph is presented which shows all of the citation interrelationships of the subset of publications.
Amikacin Penetration into Synovial Fluid during Treatment of Septic Arthritis
Authors: Honda Dennis H. , Adams Harry G. , Barriere Steven L.
Published: May 2016

The concentration of amikacin from simultaneous synovial fluid and serum samples was measured on four separate occasions in a patient treated for Serratia marcescens septic arthritis. Synovial fluid levels were between 12.5 and 24.4 μg/ml, with concurrent serum levels of 12.1–21.0 μg/ml. Parenterally administered amikacin readily distributed into synovial fluid. Failure to eradicate the patient's Serratia septic arthritis with amikacin and daily arthrocentesis may have been a result of inactivation of the antibiotic arising from acidosis occurring in the synovial fluid.
Prediction of the Stability of Meclofenoxate Injection in Parenteral Admixtures
Authors: Koshiro Akira , Fujita Toshio
Published: May 2016

A new method for predicting pharmaceutical stability in parenteral admixtures was studied using meclofenoxate hydrochloride injection as a model preparation. The pH and temperature of clinical parenteral admixtures are not constant, unlike experimental buffer solutions, and it is impossible to predict the accurate degradation ratio by the preceding method described by many authors. This study provides a solution to this problem, making possible the accurate prediction of degradation ratios of pharmaceuticals even in such complicated systems.
Clinical Trial of Topical Erythromycin in Inflammatory Acne
Authors: Prince Randall A. , Busch Douglas A. , Hepler Charles D. , Feldick Harley G.
Published: May 2016

Sixty-nine informed subjects participated in a split-face, double-blind trial of topical erythromycin base 2% in Vehicle/N® versus Vehicle/N® alone. All subjects had grades II or III acne as described by Pillsbury. Study solutions were assigned to a randomly selected side of the subject's face. Solutions were applied twice daily. Inflammatory lesion counts were performed by the same investigator during the eight weeks of study at biweekly intervals. The difference in inflammatory lesion counts from beginning to end of study for each side of the face was compared utilizing Student's paired t-test There was not a statistically significant difference in mean inflammatory lesions at the end of eight weeks (D̅ = 1.46, t = 1.36, df 68). There was, however, a significant difference at two and six weeks (D̅ = 2.59, t = 3.72, df 68; D̅ = 1.41, t = 2.03, df 68). Observed differences in lesion counts were not considered to be clinically significant.
Structure-Side Effect Sorting of Drugs: V. Glaucoma and Cataracts Associated with Drugs and Chemicals
Authors: Lien E.J. , Koda R.T.
Published: May 2016

The literature on glaucoma and/or cataracts associated with various types of clinically used drugs and certain chemicals has been surveyed. The physicochemical and pharmacological bases of these ocular toxicities have been critically analyzed wherever possible. Various means of avoiding or preventing these processes have also been reviewed. It is hoped that awareness and better understanding of drug-induced ocular toxicities may prevent or minimize damage to this very intricate and sensitive organ of the body.
Methyldopa-Induced Hemolytic Anemia and Parkinsonism
Authors: Olusanya Olu A.
Published: May 2016

Alpha-methyldopa has been known to cause Coombs positive hemolytic anemia and extrapyramidal signs in hypertensive patients. The occurrence of these side effects has been described separately in patients. This report documents the occurrence of both reactions in a single patient.
The Pharmacist as Prescriber of Drug Therapy: The USC Pilot Project
Authors: Stimmel Glen L. , McGhan William F.
Published: May 2016

Recent legislation in California allows pilot projects to investigate prescribing by pharmacists. The University of Southern California School of Pharmacy project was approved in October, 1978. To be certified as prescribers, pharmacists must successfully complete a physical assessment course and a certifying examination. From an original group of 30 interested pharmacists, 25 were certified; five different pharmacists were added later. Prescribing pharmacists must meet with their supervising physician once every two weeks, and are restricted to the project formulary. A variety of health care settings are represented in the project, with pharmacists prescribing for ambulatory patients with chronic diseases, geriatric patients in extended care facilities, psychiatric patients, and selected inpatients. Project evaluation will continue through 1982 and will focus on safety and quality of care, patient acceptance, and cost of care.
Hypertensive Crisis Resulting from Avocados and a MAO Inhibitor
Authors: Generali Joyce A. , Hogan Linda C. , McFarlane Michael , Schwab Steven , Hartman Charles R.
Published: May 2016

A hypertensive episode precipitated by avocados in a patient on tranylcypromine is described. The patient complained of severe throbbing headache, chest pain, and diaphoresis upon visiting the emergency room. Intravenous phentolamine was administered repeatedly to treat elevated blood pressure. Approximately 4 1/2 hours later, the patient's blood pressure stabilized, and he was released after a short period of observation. This is the first documented case of avocado-induced hypertensive crisis.
Continuous Infusion of Naloxone in the Treatment of Narcotic Overdose
Authors: Bradberry J. Chris , Raebel Marsha A.
Published: May 2016

This paper describes case reports and pharmacokinetic information regarding the continuous intravenous administration of naloxone in treatment of narcotic overdose. Continuous naloxone infusion has been used successfully in acutely narcotized patients, and a review of the pharmacodynamic and pharmacokinetic properties of naloxone indicate the reasons for this mode of administration. Summaries of clinical studies in support of the infusion method are given. A naloxone protocol is outlined.
Postgraduate Pharmacy Fellowships
Authors: Kaul Alan F. , Powell Stephen H. , Cyr Dale A.
Published: May 2016

During May 1981, the Pharmacy Services Department of the Brigham and Women's Hospital conducted a national survey by mail questionnaire regarding postgraduate pharmacy fellowships. There was a total response rate of 74 percent to the questionnaire. Fifty-eight fellowships are offered at 26 fellowship sites. Information regarding type of specialty fellowship, fellowship characteristics, fellowship location and contact person, and qualifications of applicants is reported.
Chloramphenicol: New Perspectives on an Old Drug
Authors: Powell Dwight A. , Nahata Milap C.
Published: May 2016

Chloramphenicol is an old antibiotic being used with increasing frequency in serious childhood infections largely due to the emergence of ampicillin-resistant Hemophilus influenzae type b. Because of this renewed popularity and the recent availability of accurate analytical techniques for measurement of chloramphenicol, there have been many recent articles examining the pharmacokinetics of chloramphenicol and its two major prodrug esters, chloramphenicol succinate and chloramphenicol palmitate. New data from these studies include the incomplete bioavailability of chloramphenicol succinate, the possible superior bioavailability of chloramphenicol palmitate vs. chloramphenicol succinate, and the wide interpatient variability in chloramphenicol clearance. These observations, coupled with the known serious hematologic toxicity (reversible bone marrow suppression or irreversible aplastic anemia) and metabolic toxicity (gray baby syndrome) associated with chloramphenicol use, require that initial antibiotic doses be selected by age and be carefully individualized by measurement of peak serum chloramphenicol concentrations.
Evaluating Drug Use Behavior
Authors: Freeman Howard E. , Solomon Marian A.
Published: May 2016

Evaluations of drug use behavior can be described as an emerging activity. There are a variety of stakeholders, a number of different activities, and a multitude of purposes for which evaluations have utility. A tentative codification of drug use evaluations is offered that takes into account stakeholders, activities, and purposes. Summaries of completed and on-going studies are provided to illustrate the value of undertaking drug use evaluations.