bluuebunny/crossref_metadata_2025 huggingface dataset:
The Driver's Exposure to Risk of Accident
Authors: Bygren Lars Olov
Published: July 2017

The driving habits in three population groups in Central Sweden have been investigated by means of a mailed questionnaire containing questions about the previous calendar year and a driving journal for the subsequent week. The samples totalled 22575 individuals. The non-response was 15%, 19% and 10% respectively, but has not been found to affect the results to any great extent.

There were appreciable differences in age and sex as concerns average distances driven, distribution as to type of motor vehicle, time of day and week, driving in rural or built-up areas, on working or spare time, etc. The most interesting groups at risk were the oldest and the youngest drivers. They had in common relatively low average mileages, and to a great extent rode mopeds and drove during their spare time.

The youngest, in addition, drove relatively often during the night hours, with borrowed vehicles and in built-up areas.

Driving experience (in number of years since the first licence) and age influenced the average mileage in contrary directions, i.e. mileage decreased with passage of time since the first licence and increased with age.

The accident frequency per distance driven seemed high for lorry, moped and motorcycle. It was high among the youngest and the oldest drivers, among those with less than five years of driving experience and finally it was high during the night. On the whole a large part of the differences in accident rates was explained by the exposure to risk. Even traffic offences were a function of this exposure.

The conclusion drawn from the discussion is that motor vehicles have a central bearing on the population, that the risk differs radically between driver groups and that it should be possible to devise preventive measures out of these differences.
Short-term Psychiatric Care from a Theoretical Planning and Empirical Point of View
Authors: Lindegård Bengt , Nyström Sune
Published: July 2017

The main factors governing the consumption of mental care are the existence of illness, the subjective need for care (demand) and the objective need. Since there is no close relationship between diagnosis and need of care, the latter should be estimated separately in health planning studies. There is reason to include mental vulnerability (30% of a stratified normal population) in the health planning program, mainly as a factor requiring secondary prevention (e.g. crisis intervention) or tertiary prevention (e.g. prophylaxis against recurrences) and preferably also for primary prevention. Figures on the discrepancy between demand and need are given. This discrepancy is quantitatively small (6% in a mental out-patient material) but qualitatively important. The effect of health care availability on the later demand for care is demonstrated in a series of emergency patients, 68% of the cases being recidivists. The view is favoured that the need for hospital care should be measured stepwise: first among the outpatients in the same specialty, then if possible among the clientèle of the GP and in other specialties. There is considerable overlapping between mental and physical symptoms among psychiatric patients. The after care could in many cases be given by GPs. The number of these must, though, be increased and their training in minor psychiatry supplemented.
Computer System for Gynaecological Health Control
Authors: Danielsson Jens , Pettersson Göran , Hesselius Inge , Stenkvist Björn
Published: July 2017

Gynaecological health controls for the early diagnosis of cervical cancer are being conducted in many parts of the world at large, as also in the major part of Sweden. Even at the local level the health control programme is so extensive as to be well-suited for automatic computer processing. In Uppsala a computer system has been developed, which reduces manual routines to a minimum, while at the same time demanding high standards of discretion, flexibility and possibilities for integration of the health control system with computer systems with, for example, routine cytology, pathology and gynaecological clinical work. The construction of the system enables direct scientific statistical processing to be conducted.
Methods of Studying Prevalence and Incidence of Drug Abuse
Authors: Bejerot Nils , Maurice-Bejerot Carol
Published: July 2017

Many methods commonly used in studying morbidity, such as hospital admissions and health surveys, are unsuitable in estimating the incidence of addiction. Some methods of studying addiction rates are:

1. Mortality studies.

2. Case-finding studies; e.g. enquiries to law-enforcement, medical and social agencies.

3. Contact analysis; patients may be asked to name other cases of addiction, observation of dealer-buyer contacts, etc.

4. Registers of addicts.

5. Questionnaires and/or structured interviews with students, soldiers, etc.

6. Analyses of prescriptions.

7. Import and manufacture of drugs; drug offences; convictions in drug cases; seizures and prices of black market drugs and a miscellaneous category of other approaches.

The most ambitious estimations are based on an integration of information from several sources.

A study is presented based on an examination of arms for injection marks in a continuous flow of a high risk population (arrestees in Stockholm since 1965).
Diseases Leading to Psychotropic Drug Therapy
Authors: Hemminki Elina
Published: July 2017

The use of psychotropic drugs is on the increase. The purpose of this study was to analyse the information provided by patients themselves with regard to the nature of the diseases and the symptoms for which psychotropic drugs are prescribed. The subjects ( N=307) for the study were chosen from among people visiting a pharmacy. The cases were consecutively picked up of customers receiving psychotropic drugs by prescription; the control group comprised the next-following customers to buy some other prescribed drug. Comparison of the two groups suggested that the reasons for the increased use of drugs should be traced back to the doctor and the factors that influence him. It seems that one mechanism to which the increased utilization of psychotropic drugs is attributable arises from the broadened field of indications.
The Diagnostic Process in Outpatient Endocrine Care with Special Reference to Screening. Further Study of Diagnostic Patterns, Their Changes, Total and Diagnosis-specific Resource Consumption
Authors: Allander Erik , Rosenqvist Urban
Published: July 2017

A screening procedure based on physical examination alone was used in the outpatient unit of a department of endocrinology and metabolism. The volume effectiveness and efficiency of this diagnostic process was evaluated by studying the case-records and by mail questionnaire. The case-records of 296 patients admitted to the clinic during 1968 were analyzed. It was found that 103 of these patients were immediately referred back after a brief physical examination only. The pattern of diagnosis, its changes during the screening procedure, and the outpatient-investigation were also studied. 50% of the patients subjected to outpatient-investigation ended up with a new diagnosis. It was also possible to construct a diagnosis-specific cost estimate for outpatient-investigation, starting from a non-confident and arriving at a confident diagnosis. The distribution of these costs was very skew. The cost for the physician performing the screening was estimated to represent only 2.6% of the costs saved by the introduction of the screening.
The Tromsø Heart Study: A Multiple Regression Analysis of the Relationship between Coronary Risk Factors and Some Physical and Social Variables
Authors: Førde Olav H. , Thelle Dag S.
Published: July 2017

Univariate analysis of the cross-sectional data of the Tromsø Heart Study revealed group differences in the levels of blood pressure and serum lipids. In order to isolate the contribution from each of the physical and social variables which characterized these groups, a multiple variate analysis was carried out with serum triglycerides, serum cholesterol, systolic and diastolic blood pressure as dependent variables. Besides age, height and weight, seasonal variation contributed substantially to the explanation of the variance of the dependent variables. The influence of the social variables was somewhat reduced compared to the univariate analysis, though most of them did remain significant also in the multivariate analysis. The explained percentage of the total variance ranged from 13% for systolic blood pressure to 26% for serum cholesterol.
Previous Job and Health at the Age of 70
Authors: Roupe Sture , Svanborg Alvar
Published: July 2017

The influence of previous job on health at the age of 70 has been investigated in two representative contrast groups belonging to the population study “70-year-olds in Gothenburg”. Anamnestic information, clinical and laboratory data were compared in probands with sedentary work and with arduous manual work. An increased incidence of traumatic injury and an inability to hear whispering at a distance of 5 meters were observed among the heavy workers. In this group, there was also a statistically significantly increased frequency of cyanosis, dyspnea, and post-inflammatory sequelae found on X-ray examination, even if an association between facial cyanosis and exposure to wide ranging atmospheric temperatures and ultraviolet irradiation must be considered. Although the blood pressure levels were almost identical the comparison between the two contrast groups showed an increased incidence of hypertension configuration of the heart and an elongation of the aorta among the manual workers. Thus, the main differences indicated that arduous work was associated with increased risk of traumatic injury, impaired hearing and a certain pulmonary dysfunction, whereas no difference was found in the prevalence of circulatory diseases and diseases of the back and peripheral joints, for example. A very generalized conclusion might be that in the group of elderly people having survived to the age of 70 previous job had not markedly influenced their state of health.
Social Class and Changes in Health-Related Habits in Finland in 1973–1983
Authors: Aro Seppo , Räsänen Leena , Telama Risto
Published: July 2017

The aim of this project was to study social class differences with respect to various health-related habits and especially to note the changes in these habits after a 10-year follow-up period. From this study conclusions can be drawn as to whether health education efforts and increased interest in personal health has been more widely adopted by the more educated groups than the less educated groups, whose morbidity and mortality rates are higher. The sample consisted of 902 white-collar and blue-collar workers. Smoking was found to be more common among blue-collar workers in both years. Smoking rates had declined in all groups except female blue-collar workers. Occasions of drinking were more frequent among white-collar than blue-collar workers. However, heavier forms of drinking were more common in male blue-collar than white-collar groups, while the opposite was true among women. Dietary habits in white-collar groups were closer to the “official” recommendations than in the respective blue-collar groups in both years. White-collar men were physically more active at the time of the first investigation, and even more so ten years later. Among women, social class differences were in the same direction, but less marked.

In conclusion, in the early 1970s the health-related habits examined were, in most instances, less favourable among blue-collar than white-collar workers. No consistent pattern of change in these habits was observed in the 10-year follow-up. At the end of the follow-up, many of the “inequalities” still persisted.
The Relation of Social Class to Risk Factors, Rehabilitation, Compliance and Mortality in Survivors of Acute Coronary Heart Disease
Authors: Conroy Ronan M. , Cahill Suzanne , Mulcahy Risteard , Johnson Howard , Graham Ian M. , Hickey Noel
Published: July 2017

We studied 299 consecutive male 28-day survivors of unstable angina or myocardial infarction aged under 60 years to examine the relationship between social class and initial risk factors, change in risk-factors at one year follow-up, return to work, and 3-year mortality. There was a significant correlation between smoking on admission and social class, with 80% of lower and 31% of upper classes being current smokers. Daily cigarette consumption among smokers was significantly higher in lower-class patients. Lower-class patients also had a significantly higher weekly alcohol intake. Although the proportion of hypertensives did not vary with social class, mean in-hospital blood pressure was higher in lower-class patients. Social class bore no relationship to amount of leisure exercise, serum cholesterol or degree of overweight. There was a 90% 1-year return to work overall, and while there was no relationship between social class and eventual re-employment, lower-class patients took significantly longer to return to work. There were highly significant associations between social class and successful smoking cessation, increase in leisure exercise and weight reduction over the first year after discharge. There was no significant association between social class and 3-year mortality.
The Incidence and Prevalence of Familial Polyposis Coli in Denmark
Authors: Bülow Steffen , Holm Niels Vilstrup , Hauge Mogens
Published: July 2017

Based on the Danish Polyposis Register, the frequency of familial polyposis coli was estimated at the end of 1982. The mean annual incidence rate of polyposis coli has remained rather constant at approximately I×10−6×yr−1 since the forties. The life-time risk of developing polyposis coli is about 1×10−4. The point prevalence rate was 26×10−6 at the end of 1982. The number of cases found in sibs and children of probands made it probable that a nation-wide prophylactic examination of first degree relatives resulted in a complete identification of affected family members. The completeness of the Danish Polyposis Register in the period 1976–82 was estimated to be 90% and the validity of the diagnosis is considered to be 100%.
Work Pattern of Child Health Centre Nurses in Stockholm
Authors: Widlund Gunnel , Höjer Bengt
Published: July 2017

The aim of the study was to describe the working patterns of nurses at Child Health Centres in Stockholm and the changes in those patterns over a 5-year period. Time-motion studies and interviews were used. According to the results about 50% of working time was spent in a direct contact with families. The distribution of the working time on different tasks was roughly the same in two surveys carried out in 1977 and 1982. Additional duties assigned to the nurses were managed thanks to a decrease in the number of children in the districts. The time-motion method gave reliable information on the nursing work pattern and how this was influenced by new procedures that were implemented.
Assessment of ADL in Home-care for the Elderly: Change in ADL and Use of Short-term Hospital Care
Authors: Åsberg Kerstin Hulter
Published: July 2017

In order to study the value of Katz' Index of ADL (Activities of Daily Living) for monitoring ADL-status among elderly persons receiving home-care, and to study their use of short-term hospital care, 40 consecutive recipients of a home-care subsidy in a health service district were followed during a period of six months. A licenced practical nurse visited them monthly, assessed their ADL-performance, and recorded their use of short-term hospital care. Twenty-seven persons changed in ADL-grade: 8 improved, 13 deteriorated, and 6 changed temporarily between the first and the final observation. Twenty-one persons were admitted to short-term hospital care; 19 of these changed in ADL-grade. The medical conditions that motivated hospital admission were serious and required hospital resources. The Index of ADL was found to monitor changes in ADL-status and is used today as a common language of disability between caretakers in the home and in hospital care.
Quality of Hospital Data and DRGs
Authors: Aas I. H. Monrad
Published: July 2017

Research on and application of DRG is frequently performed with the aid of computerized data. This study has been made to assess the importance of errors in hospital data bases for DRG research, and the financial consequences if DRG is used as a reimbursement system. For the same hospital stays information on the DRG grouping variables has been collected from medical records and a data base. Frequencies of errors in the data base for the DRG grouping variables (principal diagnosis, secondary diagnosis, complications, procedures, age and discharge status of death) and length of stay are given. DRG grouping is performed on the basis of both medical record and data base information. The analysis shows the DRG system to be robust towards errors in the data bases. The procedure used in many countries for testing the US DRG definitions with national data found in data bases is also considered to be robust towards errors. Data quality in the studied data base is sufficient for DRG research purposes. The factors giving the robustness are of a general nature and may also apply to other data bases. Quality of computerized data is a less critical factor for DRG than for other applications of such data. If the present data base had been used in financial connection the errors would have had almost no deteriorating effect on hospital incomes.
Diabetes Mellitus and Disability Pension
Authors: Morén-Hybbinette Ingalill , Moritz Ulrich , Scherstén Bengt
Published: July 2017

Disability documents of all diabetic persons ( n = 1,707) granted a disability pension in Sweden during 1980 were studied. The following factors were analysed: age, sex, civil status, profession, unemployment, being a housewife, immigration status, form for disability pension application, duration of diabetes, type of treatment, presence of classical late complications and age at onset of diabetes, obesity and alcohol problems.

Functional handicaps and symptoms related to a clinically advanced diabetes mellitus could be regarded as the basis for the decision to grant a disability pension to 20–25% of the pensioners. For the remaining 75–80% neither the diabetic state nor its late complications could be held responsible for reduced work capacity. Rather, symptoms like angina pectoris and rheumatic symptoms and many other factors such as obesity, alcohol problems, being an immigrant, or being unemployed influenced the decision to grant a disability pension.
Causes of death in a cohort of 50 465 young men – Validity of recorded suicide as underlying cause of death
Authors: Allebeck Peter , Allgulander Christer , Henningsohn Lars , Jakobsson Sten W.
Published: July 2017

We studied causes of death in a cohort of all young males (n = 50 465) conscripted for military service in 1969–70. Six hundred eighty three deaths occurred in the cohort during the follow-up through 1983. Injury-related deaths accounted for 75% of all deaths. Of these, 38% were definite suicides, 10% undetermined suicides and 30% motor vehicle accidents. The validity of officially recorded causes of death was studied by scrutinizing all death certificates (n = 683) and forensic reports, including police reports, toxicological and histological data, from a sample (n = 322) of deaths with unclear circumstances.

Of 161 officially recorded suicides (E950–959), only one case was reevaluated into poisoning, “undetermined” (E980). Of 47 cases officially recorded “undetermined” (E980–989), 9 were reevaluated into definite suicide (E950–959) although we believe that this is still an underestimation of “true” suicide cases. An alcohol concentration of more than 0.1 g% was found in 45% of all violent deaths (E800–999), 34% of all suicides and 60% of all “undetermined” deaths.

We conclude that the causes of death in most cases of injury related death in young age are recorded with high accuracy. Reevaluation of recorded deaths from “undetermined” causes revealed a number of definite suicides, although the “true” number of suicides is difficult to assess even after close scrutiny of the information available.
Methods for the Evaluation of Social Effects on Birth Weight – Experiences with Swedish Population Registries
Authors: Ericson Anders , Eriksson Margareta , Källén Bengt , Zetterström Rolf
Published: July 2017

All births in Sweden in 1986, registered in the Medical Birth Registry, were analyzed with linked data from the November 1985 census in order to identify variables which could be used as proxy variables for the socio-economic situation of the women, using birth weight as outcome variable. Two phenomena appear to be strong socio-economic indices of significance for birth weight: whether the woman co-habited or not at the census and whether she had a long education (> 14 years) and an “academic” work. The two variables interacted, however: when the woman had a long education, cohabitation status played no significant role. Maternal education as judged from occupation seemed to play a more important role than paternal education or job. To some extent, the effects of the socioeconomic variables could be explained by different smoking habits but a residual effect existed which may have different explanations. Cohabitation status and education may be used as estimates of socio-economic level of significance for birth weight and perhaps other pregnancy outcome in the analysis of, for instance, the effect of various occupational exposures on pregnancy outcome.
Multiple membership multiple classification (MMMC) models
Authors: Browne William J , Goldstein Harvey , Rasbash Jon
Published: July 2017

In the social and other sciences many data are collected with a known but complex underlying structure. Over the past two decades there has been an increase in the use of multilevel modelling techniques that account for nested data structures. Often however the underlying data structures are more complex and cannot be fitted into a nested structure. First, there are cross-classified models where the classifications in the data are not nested. Secondly, we consider multiple membership models where an observation does not belong simply to one member of a classification. These two extensions when combined allow us to fit models to a large array of underlying structures. Existing frequentist modelling approaches to fitting such data have some important computational limitations. In this paper we consider ways of overcoming such limitations using Bayesian methods, since Bayesian model fitting is easily accomplished using Monte Carlo Markov chain (MCMC) techniques. In examples where we have been able to make direct comparisons, Bayesian methods in conjunction with suitable ‘diffuse’ prior distributions lead to similar inferences to existing frequentist techniques. In this paper we illustrate our techniques with examples in the fields of education, veterinary epidemiology, demography, and public health illustrating the diversity of models that fit into our framework.
Risk factors for vasovagal reaction associated with cerebral angiography via femoral catheterisation
Authors: Yang Yunna , Zhang Zhenhai , Li Tong , Gu Zheng , Sun Yongquan
Published: July 2017

Objective

To analyse the related risk factors for vasovagal reaction associated with cerebral angiography via femoral catheterisation and discuss treatment measures and prevention and control methods.

Methods

The data of 3107 patients on whom cerebral angiography was performed in two high-volume interventional neuroradiology centres within 8 years were retrospectively analysed. Patients were divided into the vasovagal reaction and non-vasovagal reaction groups according to whether vasovagal reaction developed. The two groups’ clinical data were analysed using univariate and multivariate logistic regression analysis to examine vasovagal reaction-related factors.

Results

Of the 3107 patients included, 127 developed vasovagal reaction (4.09%). Of the 127 patients who developed vasovagal reaction, 123, three and one had vasovagal reaction after sheath removal, during cerebral angiography and upon femoral artery compression device removal, respectively. Differences in age, body mass index, sex ratios, proportions of patients with hypertension, diabetes and hyperlipemia, and adoption rate of femoral artery compression device were not statistically significant between the two groups ( P > 0.05). Compared with the control group, the vasovagal reaction group had a significantly longer preoperative fasting time ( P < 0.05). Multivariate logistic regression analysis revealed preoperative fasting time as the only risk factor for vasovagal reaction that was associated with cerebral angiography ( P < 0.001).

Conclusion

Excessive fasting time before cerebral angiography is the most important risk factor for vasovagal reaction associated with cerebral angiography.
From socially motivated lay historians to lay censors: Epistemic conformity and defensive group identification
Authors: Klar Yechiel , Bilewicz Michał
Published: July 2017

This article examines why people cooperate with the silencing and censorship efforts of authorities that deprive them of historical knowledge. We analyze two motivational factors that account for people’s adherence to the “official” historical narrative and their willingness to serve as lay censors silencing and suppressing alternative historical narratives of the group. The first factor is epistemic conformity which is the motivation to believe in the veridicality of the consensual ingroup’s historical narrative. The second factor is a defensive form of identification with the group in glorifying and narcissistic ways. Polish and Israeli examples are discussed to illustrate societal backlash to historical discoveries that present the national ingroup in a negative manner.
Changing Needs for Information and Support in an Online System for Parents of Children With Kidney Disease
Authors: Pinsk Maury , Nicholas David
Published: July 2017

Background:

Pediatric chronic kidney disease is psychologically, financially, and physically demanding on parents providing care. Parents often feel isolated because of the rarity of the condition, and geographic isolation often compounds this perception in Canada. Many parents seek assistance online for both information and social support.

Objective:

This study examines an online portal, titled “Ability Online,” which was designed to provide support and information to a diverse group of parents using chat facilities, bulletin boards, and e-mail. Specifically, we sought to identify how the technologies offered in this system related to the support and information seeking needs for parents. Secondary aims of determining possible reasons for attrition over time were explored as well.

Design:

Mixed methodology sequential exploratory design using the qualitative methodology of descriptive interpretation.

Setting:

Telephone interviews.

Patients:

Twenty parents of pediatric patients with chronic kidney disease from four Canadian centers who engaged in an online social support system “Ability Online.”

Measurements:

Interview transcripts generated from 20 taped phone conversations were reviewed from parents who engaged in the online system, and the themes derived from these transcripts served to generate semistructured interview questions that focused on their use of, and perceived benefit from, this technology for social support. Follow-up telephone interviews were then conducted with a 6-person subset of the original group in an effort to further define the impact of technology on their experience. This same smaller cohort provided data on social supports, caregiver satisfaction, and caregiver stress.

Results:

Many parents experience a progression through which their needs for knowledge and support change over time. Specifically, parents describe a transition from pure information seeking, to seeking parental interaction, mutual support and collaboration, and ultimately to advocacy. Parents described how technology could be used to address those needs.

Limitations:

Our cohort was slightly more educated and representative of more urban populations than published data reflecting the population of North American pediatric patients living with kidney disease.

Conclusions:

Our data suggest themes of technology use influencing the goals of online support seeking. While our findings are preliminary, further study may inform Web designers to identify the changing needs of participants in designing such online support networks, and minimize the reasons that participants fail to adopt, or terminate their online experiences.
Inverted ILM Flap Technique in a Pediatric Traumatic Macular Hole—A Case Report
Authors: Nuzzo Tommaso , Patelli Fabio , Esposito Giovanni , Colombo Leonardo , Rossetti Luca
Published: July 2017

Purpose:

To report and describe the clinical course of a pediatric traumatic macular hole (TMH) case and its management.

Case Report:

A pediatric patient presented a macular hole following blunt ocular trauma. The patient was followed every 2 weeks for 4 months. After the worsening of the macular hole reported by optical coherence tomography (OCT), pars plana vitrectomy with inverted flap technique plus SF6 gas tamponade was performed. Traumatic macular hole appeared closed at the OCT during follow-up. Initial visual acuity was counting finger at 30 cm. After surgery, the patient achieved a visual acuity of 20/100 at 3-month follow-up.

Conclusion:

This case shows a good anatomic and functional success performing a pars plana vitrectomy with inverted flap technique in a large TMH in a pediatric patient. We underline the importance of the surgical timing in the management of similar cases.
Community Pharmacy Practice and an Aging Population
Authors: Sumner Edward D. , Durand Ronald P. , Lancaster Carol J. , Dickinson George E.
Published: July 2017

Objective:

To determine pharmacists' perceptions of the influence of older patients on community pharmacy practice.

Data Sources:

A mailing list obtained from the South Carolina Board of Pharmacy provided names of community pharmacists by practice setting and gender.

Design:

A questionnaire was mailed in July 1990 to a random sample of community pharmacists in South Carolina. The questionnaire contained 41 Likert-type opinion statements. Demographic questions relating to practice type and location, pharmacists' educational experiences, and position were included.

Data Synthesis:

The opinion statements were examined by grouping respondents on the basis of demographic information. Analysis of variance or Student's t-test was used to look for differences among survey responses among various groups of pharmacists. Scheffe's test was used to compare means when the groups were significantly different. The a priori level of significance was 0.05. Critical values were adjusted by the number of statements considered to preserve the error rate at five percent (Bonferroni procedure).

Conclusions:

The strongest indicator of the impact of the elderly population on community pharmacy is pharmacists' perceived need for more continuing education in geriatrics and gerontology. Economic problems, physician overprescribing, and patient compliance were ranked as the three most difficult aspects of geriatric pharmacy. This study reinforces the need to incorporate geriatric/gerontology education into every pharmacy curriculum.
Absorption of Herbinol—A Polyherbal Topical Cream
Authors: Mody Vandana D. , Mangalan Sivadasan , Pandya Kalpesh K. , Patel Ramanbhai B. , Chakravarthy Balakrishna K.
Published: July 2017

Objective:

To determine serum absorption concentrations of two bioactive chemical markers (munjistin and rottlerin) of Herbinol, a topical polyherbal antiseptic cream.

Design:

Topical application of Herbinol cream on the back of albino rats on hair-free skin.

Study:

Serum concentrations of munjistin and rottlerin were estimated after application of Herbinol on the backs of the rats at 0,1, 2,3,4, and 24 hours and concentrations were quantified by high-performance-thin-layer chromatography. The validity of the procedure was verified by recovery studies by adding a known concentration of standards to drug-free serum.

Results:

Peak serum concentrations of both munjistin and rottlerin were observed two hours after topical application of Herbinol and the concentrations measured were 122 ± 5.8 ng/mL of rottlerin and 38 ± 3.2 ng/mL of munjistin. At these concentrations both compounds showed antimicrobial effects.

Conclusions:

The absorption studies performed with the topical antiseptic polyherbal cream Herbinol showed quantifiable serum concentrations of rottlerin and munjistin two hours after application. Both the markers showed antimicrobial efficacy at the measured concentrations and thus have clinical significance. This is a preliminary report on absorption studies of a polyherbal drug.
Rifabutin: A New Rifamycin for the Prevention of Atypical Mycobacterial Infection
Authors: Martin David E. , Raasch Ralph H.
Published: July 2017

Objective:

To discuss the chemistry, mechanism of action, in vitro activity, pharmacology, clinical efficacy, and toxicity of rifabutin, a new rifamycin, in the prevention and treatment of disseminated mycobacterial infection in patients with AIDS.

Data Sources:

The English-language literature was searched from 1980 through October 1993 using MEDLINE, International Pharmaceutical Abstracts (IPA), Index Medicus, and bibliographic reviews of relevant textbooks and review articles.

Study Selection:

One published report of two identical randomized, prospective, double-blind trials of rifabutin to prevent disseminated mycobacteremia is available. Other literature reviewed included a clinical case series of patients treated with rifabutin for documented or presumed mycobacterial infection.

Data Extraction:

Clinical trial and case series were evaluated for study design, efficacy, and toxicity.

Data Synthesis:

In two trials, rifabutin has been shown to prolong the onset of mycobacteremia (caused by Mycobacterium avium-intracellulare or M. avium complex) in adult AIDS patients with CD4-lymphocyte counts <200 cells/mm3. The prolongation of time to bacteremia is significant compared with placebo as the CD4 count declines. However, overall survival is not prolonged by rifabutin prophylaxis in these patients. No blind, randomized studies are available evaluating the efficacy of rifabutin in treating documented mycobacteremia in AIDS patients, or in treating pulmonary infections caused by Mycobacterium tuberculosis.

Conclusions:

Rifabutin should be added to the prophylactic regimens of HIV-positive patients with CD4 counts <100 cells/mm3. Prophylactic treatment prolongs the period of time before dissemination of mycobacterial infection occurs (bacteremia), with associated delays in onset of fever and fatigue, decline in performance score, and hospitalization. Rifabutin is usually well tolerated in patients given 300 mg/d. Rifabutin is a weaker enzyme inducer than rifampin, but drug interactions with rifabutin should be monitored under circumstances of concomitant therapy with anticoagulants or anticonvulsants.
Use of Prostaglandin F2 Alpha for Cyclophosphamide-Induced Hemorrhagic Cystitis
Authors: Cocnata Christina L.
Published: July 2017

Objective:

To examine the use of prostaglandin F2 alpha in treating cyclophosphamide-induced hemorrhagic cystitis.

Data Sources:

An English language literature search using MEDLINE 1982–1993 and bibliographic reviews of related textbooks and review articles.

Study Selection:

Articles containing pertinent information regarding the therapeutic use and effects of prostaglandin F2 alpha as a treatment for cyclophosphamide-induced hemorrhagic cystitis in humans.

Data Extraction:

Resources were evaluated and information was extracted independently.

Data Synthesis:

A review of human cases suggests that intravesical administration of prostaglandin F2 alpha may be an effective bedside therapy for cyclophosphamide-induced hemorrhagic cystitis. Adverse reactions are limited primarily to local effects. The optimal dosage regimen of intravesical prostaglandin F2 alpha is not clearly established.

Conclusions:

Patients with intractable vesical hemorrhage secondary to cyclophosphamide administration may benefit from bedside intravesical instillation of prostaglandin F2 alpha. Information in the literature regarding prostaglandin bladder irrigation is scarce, and confined to case reports. Clinical studies are needed to endorse and/or refute the efficacy of intravesical instillation of prostaglandin F2 alpha as a treatment modality for hemorrhagic cystitis.
Interaction between Potassium-Depleting Diuretics and Lovastatin in Hypercholesterolemic Ambulatory Care Patients
Authors: Aruna Augustine S , Akula Shiva K , Sarpong Daniel F
Published: July 2017

Objective:

To evaluate the potential impact of potassium-depleting diuretics on the efficacy of lovastatin.

Design:

A retrospective study of ambulatory patients taking lovastatin and thiazide or loop diuretics was conducted.

Setting:

Ambulatory care patients with coexisting hypercholesterolemia and hypertension from a Veterans Affairs Medical Center.

Participants:

A total of 32 patients were studied, 13 of whom had been taking lovastatin before diuretics were added. Another 19 patients had been receiving diuretics before lovastatin was initiated. The changes in their total cholesterol from baseline were recorded and analyzed.

Main Outcome Measures:

In all the patients taking lovastatin and diuretics concurrently, total cholesterol concentrations dropped initially, followed by a rise despite continuation of therapy with lovastatin. The reason for this initial drop in total cholesterol following 1 month of concurrent therapy is the subject of further investigation in a prospective study.

Results:

Regardless of the order of administration of the lipid-lowering and antihypertensive drugs, serum cholesterol rose 20% from its nadir.

Conclusions:

Patients taking potassium-depleting diuretics and a hepatic hydroxymethylglutaryl-coenzyme A reductase enzyme inhibitor (lovastatin) concurrently do not seem to benefit substantially from the lipid-lowering effect of lovastatin, probably because of a functional antagonism of the lipid-lowering effect of lovastatin by potassium-depleting diuretics.
Use of Intravenous Omeprazole in a University Hospital
Authors: Vargas Emilio , Puerro Miguel , Portoles Antonio , García-Arenillas Mar , Ambit Maria I , Moreno Alfonso
Published: July 2017

Objective:

To evaluate the characteristics of using intravenous omeprazole in a university hospital.

Method:

A prospective follow-up of all patients (n = 108) treated with intravenous omeprazole in our hospital was done from October 1994 through May 1995. Based on requests sent to the pharmacy service, patients receiving this drug were located and their charts were reviewed. The patients were visited daily throughout the duration of their treatment to evaluate any change in dosage, addition of new drugs to the regimen, and the final date of treatment.

Results:

Only 52% of the patients received omeprazole for indications in which its usefulness is clearly demonstrated. The dosages used frequently exceeded those recommended by the pharmaceutical manufacturer and in the literature. In fact, more than 50% of the patients were treated with dosages over 40 mg/d. It would have been possible to administer omeprazole orally instead of intravenously in 17% of the patients. Twenty-three percent of the patients were treated simultaneously with omeprazole and histamine2-antagonists.

Conclusions:

The use of intravenous omeprazole in our hospital is not optimal; thus, it seems that a strategy to improve this situation should be designed.
Gender Differences among Patients Reporting Medication Allergies
Authors: Trinkle Randy
Published: July 2017

Objective:

To determine whether there are gender differences in the frequency of reporting and accuracy of medication allergy information given by adult patients on admission to the hospital.

Setting:

This study was conducted in the acute medical ward of a rural hospital.

Methods:

This was a prospective study of all patients admitted to the ward over a three-month period. Patients who claimed to have an allergy to a target drug (opiates, antibiotics, nonsteroidal antiinflammatory drugs) were interviewed to learn the nature of any reactions.

Results:

Forty-three patients (of 183 evaluable patients) claimed to have one or more medication allergies. Women were more likely than men to claim a medication allergy (p = 0.023) and to have had a probable allergic reaction (p = 0.011). The allergy status of men was more likely to be unevaluable (p < 0.001).

Conclusions:

This study found that women both claim and experience more medication allergies than do men. Given the paucity of research in this area, gender differences in medication allergy claims deserve further study. The reasons for these differences also have not been well studied and require further investigation. Because a layperson may misidentify an adverse drug reaction as being due to an allergy, pharmacists should verify allergy status to ensure the accuracy of the medical record and the appropriateness of drug therapy.
Physical Aging of Thin Films of Nylon and PET
Authors: Spinu I. , McKenna G. B.
Published: July 2017

The physical aging of nylon 66 and PET [poly(ethylene terephthalate)] films as a function of aging temperature, magnitude of applied stress, and aging time was investigated. One hundred micron thick nylon films and 5μm and 190 μm films of PET were investigated in temperature ranges that extended from below the glass transition temperature to well above it. Creep experiments were performed to probe the evolution of the material response after quenching from a "stabilization" temperature to the aging temperature and it was found that the classical time-aging time superposition could be applied to both the nylon and PET materials in the temperature range from 25 to 60°C. The behaviors at higher temperature could not be superposed using time-aging time shifting. The rate of aging of the nylon films was found to be significantly different from that found for a similar nylon that had been injection molded.
Surface Modification of Polymer Webs by Oxyfluorination
Authors: Hruska Zdenek , Lepot Xavier
Published: July 2017

The aim of this publication is to describe an industrial application of the oxyfluorination process to polymer webs. Controlled oxyfluorination of polymer surfaces is a solventless, highly efficient and cost-effective technique of surface modification. The adhesive properties of oxyfluorinated polypropylene films are largely improved so that a variety of solventand water-based printing inks used in contact printing technology can be used. We have confirmed that, in many cases, the necessity to employ an expensive top-coating process that uses acrylic primers to optimise the film printability, can be avoided. The oxyfluorination process with its long lasting effect is a competitive alternative to the simple corona discharge treatment. The oxyfluorination ALKOR' SURFOX process can be described as an environmentally responsible technology that delivers a broad range of products possessing many exceptional surface properties.
Analysis of the Velocity Profile of the Popliteal Artery and Its Relevance During Blood Flow Studies
Authors: Olowoyeye Omodele Abosede , Gar-Wai Chiu Stephanie Elaine , Leung General , Wright Graham A. , Moody Alan R.
Published: July 2017

The mean blood velocity is required to calculate blood flow and to determine the associated shear rate. The maximal blood flow velocity is assumed to have a parabolic velocity profile; therefore, the mean velocity is half of the maximal value. Previous studies have been carried out on vessels such as the brachial and femoral artery, but none have been reported for the popliteal artery. To assess the velocity profile of the popliteal artery, a spectral Doppler analysis was performed on ten healthy patients during varied flow states (resting, distal occlusion, hyperemia). The results were then averaged over the entire cardiac cycle. The flow described in these patients’ popliteal artery had a blunted parabolic flow profile with a TAVmean:TAVmax ratio of 0.68 ± 0.07 at baseline. The baseline measures were compared to a TAVmean:TAV max ratio of 0.68 ± 0.12 during distal occlusion and 0.67 ± 0.16 during reactive hyperemia. These descriptive results may suggest that adjustments may be needed for a blunted parabolic profile, especially when calculating the mean velocity of the popliteal artery.
Reporting Margin Status in Synoptic Reports
Authors: Renshaw Andrew A. , Mena-Allauca Mercy , Gould Edwin W.
Published: July 2017

Purpose

The format of a synoptic report can significantly affect the accuracy, speed, and preference with which a reader can retrieve information. The purpose of this study was to compare different formats for reporting margin status in synoptic reports of colonic carcinoma.

Methods

The performance of 17 nonpathologists (cancer registrars and medical and nonmedical personnel) at identifying specific information in various formatted synoptic reports was evaluated using four computerized quizzes that measured both accuracy and speed.

Results

Compared with the standard format (“Involved by invasive carcinoma” and “Uninvolved by invasive carcinoma”), reporting margins as “Free” or “Positive” was significantly faster (17%, P < .001) and significantly more accurate (99% v 98%, P = .001). Significantly more errors for the standard format were found in quiz 4 (eight of 272; 2.9%) than the prior three tests combined (nine of 816; 1.1%; P = .05). Using “Free” or “Positive” with either a list format or including bolding of all positive margins was also faster than the standard format but not any faster than simply changing the wording. All users preferred “Free” and “Positive”; no user preferred “Involved by invasive carcinoma” and “Uninvolved by invasive carcinoma.”

Conclusion

Using “Free” and “Positive” for reporting margin status in synoptic reports is preferred by all users and results in more accurate, faster information retrieval. Errors may be related to fatigue.
First Case Report of a Dramatic Radiographic Response to a Checkpoint Inhibitor in a Patient With Proficient Mismatch Repair Gene Expressing Metastatic Colorectal Cancer
Authors: Sorscher Steven , Resnick Jamie , Goodman Michael
Published: July 2017

Metastatic colorectal cancer (mCRC) remains the second most common cause of cancer death in the United States, and therapeutic options are limited. Recently, the checkpoint inhibitor pembrolizumab was given the Food and Drug Administration breakthrough therapy designation for the treatment of patients with mCRC whose tumors demonstrate deficient mismatch repair gene (dMMR) expression (as evidenced by microsatellite instability–high [MSI-H]). The designation was based on a phase II study showing that in patients with dMMR, an objective response rate of 40% was seen, whereas in patients with proficient mismatch repair gene mCRCs, the response rate was 0%. To our knowledge, this is the first case of a patient with a proficient mismatch repair gene mCRC whose tumor demonstrated a dramatic response to a checkpoint inhibitor. Because this patient’s tumor harbored amplification of both the PD-L1 and PD-L2 genes, the observed response was consistent with the presumed mechanism of action of checkpoint inhibitors. Checkpoint inhibitors are thought to activate a cytotoxic immune response that has been inhibited through tumor expression of PD-L1 and PD-L2. Given this result, dMMR in mCRC may not be the only predictor of responsiveness to checkpoint inhibition. As in non–small-cell lung cancer, PD-L1 or PD-L2 expression (or perhaps gene amplification) may also be predictors of checkpoint inhibitor efficacy.