bluuebunny/crossref_metadata_2025_split huggingface dataset:
Figs — The Earliest Known Ancient Drug for Cutaneous Anthrax
Authors: Ben-Noun Liubov Louba 
Published: January 2017

BACKGROUND: Anthrax is an often fatal bacterial infection, occurring in cutaneous, inhalational, gastrointestinal, and meningeal forms. Evaluation of anthrax treatment from ancient history may help healthcare providers to handle this serious disease more efficiently. OBJECTIVE: To evaluate the biblical descriptions of anthrax, focusing on its therapy in ancient times. STUDY SELECTION: All biblical texts associated with anthrax were examined and passages relating to this disease were studied closely. DATA SYNTHESIS: Biblical passages such as: “Take a cluster of figs. And they took and laid it on the boil [anthrax], and he recovered,” and “Let them take a cluster of figs, and lay it upon the boil [anthrax], and he shall recover,” convincingly indicate that figs have healing properties in cutaneous anthrax lesions. CONCLUSIONS: On the basis of this study, the National Institutes of Health together with the pharmaceutical industry may consider to work on isolation of compounds from fig plants to develop products against cutaneous and possibly other forms of anthrax once screening tests are completed.
Bumetanide: A New Loop Diuretic (Bumex, Roche Laboratories)
Authors: Halstenson Charles E. , Matzke Gary R. 
Published: January 2017

Bumetanide is a recently introduced diuretic that inhibits sodium transport in the thick ascending limb of the loop of Henle. It is structurally and pharmacologically similar to furosemide, but is approximately 40 times as potent on a milligram-for-milligram basis. After oral administration, it is rapidly absorbed, with peak serum concentrations attained at approximately 30 minutes. Its pharmacokinetic parameters are similar to those of furosemide. Bumetanide has demonstrated efficacy in the management of edema associated with congestive heart failure, hepatic cirrhosis, and renal insufficiency. Bumetanide has demonstrated an adverse-reaction profile similar to that of furosemide, although the incidence of hypochloremia and hypokalemia is greater with bumetanide. The incidence of hyperglycemia and ototoxicity is greater with furosemide. The principal indication for bumetanide may be in patients with increased risk of ototoxicity. Cost considerations should relegate bumetanide to a secondary role for the treatment of sodium and fluid retention in most clinical settings.
Toxic Psychosis following Cycloplegic Eyedrops
Authors: Kortabarría Rafael P. , Durán José A. , Chacón José R. , Domínguez Francisco J. , Pino Miguel A. 
Published: January 2017

A case of toxic psychosis due to cycloplegic eyedrops is reported. The characteristic mental symptoms of atropine intoxication include confusion with vivid visual hallucinations, restlessness, muscular incoordination, and later emotional lability. These symptoms and a short period of retrograde amnesia occurred in our patient. The adverse drug reaction was confirmed following rechallenge. The possible preventive measures against intoxication caused by atropine eyedrops are described. All healthcare professionals should be aware of the possible temporal relationship between the appearance of pathology and the administration of a drug. TOXIC PSYCHOSIS due to anticholinergic eyedrops is well documented in the medical literature, although there are few detailed cases. We report a case of toxic psychosis due to cycloplegic eyedrops in which the cause was documented by rechallenge.
Relationships among Prescription Payment Methods and Interactions between Community Pharmacists and Prescribers
Authors: Raisch Dennis W. 
Published: January 2017

OBJECTIVE: This research was performed to examine community pharmacists' interactions with prescribers and to determine if these interactions are related to payment method. DESIGN: Randomly selected pharmacists (47 in chain pharmacies and 26 in independent pharmacies) collected data concerning prescriber interactions for a 40-hour period. These interactions were analyzed in terms of payment methods, prescriber acceptance, and types of information discussed. RESULTS: Information concerning 730 interactions by 72 pharmacists was obtained. Payment methods were related to the frequency of interactions per pharmacist (p<0.01). There were higher percentages of interactions for self-pay (median 2.2 percent) and Medicaid (median 1.8 percent) prescriptions than for third-party fee-for-service (mode 0 percent) or capitation prescriptions (mode 0 percent). Type of information discussed was related to payment method. The vast majority of information provided by pharmacists (91 percent) was accepted by prescribers. The rate of acceptance was 97 percent for prescriber-initiated interactions versus 88 percent for pharmacist- or patient-initiated interactions (p<0.01). CONCLUSIONS: Relationships between payment method and interactions were identified. These findings may be attributable to prescribing policies and reimbursement policies. Prescribing policies that restrict prescribers to a formulary may help make them become more adept at using those products; thus, they will make fewer prescribing errors. Reimbursement policies that require patients to consistently use a specific pharmacy (i.e., capitation) may help pharmacists become more familiar with the patient's prescription history. Therefore, interactions with prescribers are needed less frequently for these patients' prescriptions.
Nightmare Cessation following Alteration of Ophthalmic Administration of a Cholinergic and a Beta-Blocking Agent
Authors: Mort Jane R. 
Published: January 2017

OBJECTIVE: To document the termination of nightmares brought about by an alteration in the ophthalmic administration of beta-blocking and cholinergic agents. PATIENT: A 75-year-old man residing in a long-term care facility experienced nightly nightmares of approximately one-year duration. INTERVENTION: Other potential causes for the nightmares were eliminated. The administration of the ophthalmic agents was evaluated and the resident was then instructed to alter administration to include closure of his eyes for one to two minutes after administration. OUTCOME: Following the alteration in administration the nightmares were not present and have not reappeared in the ensuing year. CONCLUSIONS: Ophthalmic application of beta-blocking and cholinergic agents is used for the treatment of glaucoma and has been reported to cause a wide variety of central nervous system effects. Researchers have documented reduced systemic absorption and enhanced ocular retention time with specific modifications in the administration of the ophthalmic products. Based on this research the suggestion has been made that systemic adverse effects may be reduced by altering administration through use of lid closure and lacrimal occlusion. This case validates this hypothesis and provides strong evidence for the need to counsel all patients receiving ophthalmic agents on proper administration, including techniques to reduce absorption in order to avoid undesirable systemic effects.
Implication of Dispensing Cups in Dosing Errors and Pediatric Poisonings: A Report from the American Association of Poison Control Centers
Authors: Litovitz Toby 
Published: January 2017

OBJECTIVE: To characterize reports to poison centers involving liquid medication errors associated with the use of dispensing cups. design: Case series reported by 16 US poison centers over an eight-day period. SETTING: Calls to poison control centers, predominantly but not exclusively from homes. PATIENTS: Children and adults. RESULTS: Of 34 reported cases, most (79 percent) involved a two- to threefold dosing error, and most (94 percent) involved an error in a single dose of medication. Cough and cold preparations were implicated in 65 percent; acetaminophen elixirs in 18 percent. Three major causes of dosing errors were identified, including teaspoon/tablespoon confusion, assumption that the dispensing cup was the unit of measure, and assumption that the full dispensing cup was the actual dose. CONCLUSIONS: Dispensing cup markings should use a single unit of measure, and a uniform labeling system should be implemented. Teaspoon/tablespoon abbreviations should be avoided, and dispensing cup lettering should be more legible. Consumer education is essential to correct the misimpression that the full cup is always the recommended dose.
Ciprofloxacin-Induced Psychosis
Authors: Reeves Roy R. 
Published: January 2017

OBJECTIVE: To report a case of ciprofloxacin-induced psychosis and to discuss occurrence rates, risk factors, possible etiologies, preventive measures, and treatment courses for this adverse reaction. DATA SOURCES: Case reports and review articles identified by MEDLINE. DATA EXTRACTION: Data from pertinent published sources were reviewed and abstracted. DATA SYNTHESIS: A 49-year-old man developed symptoms of severe psychosis concomitant with ciprofloxacin (250 mg bid) treatment. Central nervous system effects secondary to ciprofloxacin treatment are uncommon and usually consist only of minor dizziness or mild headache, although rare occurrences of seizures and hallucinations have been reported. The mechanism by which ciprofloxacin causes these adverse effects is not fully understood. It has been suggested that quinolones may produce an epileptogenic effect by inhibiting the binding of gamma-aminobutyric acid to its receptor sites in the brain. There is yet no explanation for the occurrence of hallucinations or psychosis. CONCLUSIONS: Caution should be exercised when using ciprofloxacin in the treatment of patients with personality abnormalities or symptoms of psychosis.
Medication Assistance: The Development of Drug Surveillance and Drug Information in the Netherlands
Authors: van Gruting Cornelis W.D. , de Gier Johan J. 
Published: January 2017

OBJECTIVE: To describe the development of drug surveillance and drug information in The Netherlands. DATA SYNTHESIS: Historically, the professions of medicine and pharmacy have existed separately with little contact between them. Since the 1960s, this situation has changed in The Netherlands. Both professions are cooperating to an ever-increasing degree, primarily in the areas of computerized drug surveillance and individualized patient drug information, resulting in greater patient benefit. CONCLUSIONS: Exchange of knowledge between physicians and pharmacists, greater cooperation among professionals, use of computerized patient medical records, and involvement of the patient in his own healthcare will have a positive influence on the development of drug assistance in the future.
Hematologic Effects of Ethanol Consumption in Trauma Patients
Authors: Erstad Brian L. , Harlander Diana K. , Daller John A. 
Published: January 2017

OBJECTIVE: To determine the effects of ethanol (EtOH) ingestion by trauma patients on the hematologic system as evidenced by coagulation abnormalities and transfusion requirements. DESIGN: Retrospective chart review. The injury severity score (ISS) was determined for each patient. Patients were grouped according to presence of EtOH (+EtOH) and absence of EtOH (-EtOH) with further subdivision based on an ISS ≤8 or ≥9. SETTING: University medical center. PATIENTS: All adult trauma patients admitted during a one-month period. MAIN OUTCOME MEASURES: The volume of resuscitation fluids (including blood products) administered, laboratory parameters indicative of bleeding, and length of stay. RESULTS: Of 104 evaluable patients, 38 had measurable EtOH concentrations, 46 had undetectable EtOH concentrations, and the remaining 20 patients had not been tested. Although isolated, statistically significant differences were found among groups for some of the outcome measures, there were no clinically important differences. CONCLUSIONS: EtOH ingestion prior to injury did not appear to cause significant alterations in the hematologic system of trauma patients, but a larger study is needed to confirm these findings.
Leukotriene-Receptor Antagonists and 5-Lipoxygenase Inhibitors in Asthma
Authors: Larsen Julie S. , Acosta Edward P. 
Published: January 2017

OBJECTIVE: To familiarize readers with a potentially new class of compounds for treating asthma. Background information on leukotrienes is provided in addition to an indepth review of pertinent clinical trials. DATA SOURCES: Information was obtained from controlled clinical trials, abstracts, and review articles identified through a MEDLINE search of English-language articles. STUDY SELECTION: Emphasis was placed on early clinical trials that showed some benefit with these compounds as well as more recent studies using newer agents that produced more promising results. DATA EXTRACTION: Information regarding leukotriene biochemistry was extracted from basic science research and data from human studies were evaluated by the authors according to patient selection, study design, methodology, and therapeutic response. DATA SYNTHESIS: Leukotrienes have a pathophysiologic role in asthma. Two distinct but pharmacologically similar classes of leukotriene inhibitors are currently being clinically evaluated. These are leukotriene receptor antagonists and 5-lipoxygenase inhibitors. Early clinical trials with these agents yielded unfavorable results primarily because of lack of drug potency and selectivity, poor patient tolerance, and possibly the route of administration. Subsequent studies with more potent and selective agents have further implicated leukotrienes as biochemical mediators in asthma and, consequently, have shown promising clinical outcomes with respect to pulmonary function testing and patient tolerance. CONCLUSIONS: Advancements in the pathogenesis of asthma are beginning to define a role for the leukotrienes. Although more studies are needed to assess the efficacy of leukotriene inhibitors, recent clinical trials using leukotriene-receptor antagonists and 5-lipoxygenase inhibitors indicate a potential for the expansion of therapeutic regimens currently used in the treatment of asthma.
Varicella in Pediatric Patients
Authors: Drwal-Klein Laureen A. , O'Donovan Carmel A. 
Published: January 2017

OBJECTIVE: To summarize the literature describing the epidemiology, transmission, clinical manifestations, diagnosis, treatment, and prevention of varicella in the pediatric population. DATA SOURCES: A literature search of English-language articles from 1982 to 1992 using MEDLINE and bibliographies of relevant articles. The search term used was varicella. STUDY SELECTION: All review articles and original studies addressing the epidemiology, transmission, clinical manifestations, complications, diagnosis, treatment, and prevention of varicella in pediatric patients were reviewed. Emphasis was placed on controlled studies done in the US. DATA EXTRACTION: Data from human studies were extracted by the authors and evaluated according to patient population, sample size, dosing regimen, efficacy, and safety. DATA SYNTHESIS: Varicella-zoster virus is a highly contagious virus that produces a common and costly disease in the pediatric population. The primary manifestation of varicella is the eruption of vesicular lesions. In most cases varicella is benign, but it can be associated with serious complications. Diagnosis is based primarily on clinical findings. Otherwise healthy children have traditionally received only symptomatic treatment for varicella, but recent literature suggests that antiviral therapy may be useful in these patients. Immunocompromised patients benefit from both symptomatic and antiviral therapy. Isolation and varicella-zoster immune globulin are used to prevent varicella. In the future, varicella vaccine will play an important role in preventing the disease. Varicella vaccine has been shown to be immunogenic and clinically effective in both healthy and immunocompromised children. Adverse reactions associated with the vaccine include fever, injection-site reactions, and rash. Although zoster can follow vaccination, the incidence appears to be lower in vaccinated individuals. Preliminary studies have shown that the vaccine provides protection from varicella-zoster virus for an extended period of time. CONCLUSIONS: Varicella is a common, usually benign disease of childhood. All patients may benefit from symptomatic therapy. Current literature does not support the use of antiviral therapy in all pediatric patients with varicella. When commercially available, varicella vaccine will play an important role in prevention. Long-term studies are needed to fully assess the risk of developing varicella and zoster following vaccination.
Erythromycin-Induced Hypoacusis: 11 New Cases and Literature Review
Authors: Sacristán José A. , Soto Javier A. , de Cos María A. 
Published: January 2017

OBJECTIVE: To report 11 cases of possible erythromycin-induced hearing loss and to review all cases reported in the literature. CASE SUMMARY: In the 11 cases reported, the following are reviewed: Age, gender, time to onset of and recovery from hypoacusis in relation to erythromycin administration, presence or absence of renal or hepatic disease, underlying disorders, and concurrent administration of other drugs. Hypoacusis appeared with dosages equal to or higher than 4 g/d in patients with a mean age of 52.5 ± 19 years, a high percentage of whom (45 percent) presented with renal impairment. The hearing loss was reversible in all cases, and subsided a few days (median=3) after dosage reduction or drug discontinuation. DISCUSSION: Our patients' characteristics are similar to those of patients reported in the literature. Most data indicate that erythromycin-induced hypoacusis is a dose-dependent effect; however, its occurrence in patients otherwise free from disposing factors suggests that it is idiosyncratic. CONCLUSIONS: Erythromycin administered for appropriate indications and dosage adjustments in patients with impaired renal and/or liver function may prevent or reduce the incidence of erythromycin-induced hypoacusis.
Pharmacoepidemiology of Bleeding Events after Use of R-Alteplase or Streptokinase in Acute Myocardial Infarction
Authors: McLeod Donald C. , Coln W. Gerald , Thayer Charles F. , Perfetto Eleanor M. , Hartzema Abraham G. 
Published: January 2017

OBJECTIVE: To determine in nonresearch, general medical practice conditions the comparative incidence and types of bleeding complications after the use of streptokinase (SK) and r-alteplase (recombinant tissue plasminogen activator, rt-PA) to treat acute myocardial infarction (AMI). DESIGN: Retrospective medical record review of concurrently treated patients (96-hour observation posttreatment) in 32 participating hospitals in the US. MAIN OUTCOME MEASURES: The medical record description of all bleeding events regarding the body site affected, changes in hemoglobin concentrations, blood products administered, and clinical outcome (permanent sequelae or death). Bleeding severity was determined by defined criteria. CONTROL DATA: Comorbidity and concomitant medications (e.g., aspirin, heparin, warfarin) likely to predispose or contribute to bleeding events were analyzed. DATA ANALYSIS: Logistic regression analysis. RESULTS: Data from 419 patients who received rt-PA and 207 who received SK were evaluated. In the 96-hour period after initiation of thrombolytic therapy, 30.5 and 31.9 percent of rt-PA and SK patients, respectively, experienced one or more bleeding events (crude risk ratio [CRR] = 1.04; 95 percent confidence interval [CI] 0.91–1.14; p=0.73). In the first 24-hour period, 21.5 percent of rt-PA and 15.9 percent of SK patients experienced bleeding events (CRR = 0.74; 95 percent CI 0.42–1.15; p=0.08). The leading types of bleeding and percents of all patients affected were: Perivascular access site (18.4 percent), gastrointestinal (6.4 percent), skin/soft tissue/muscle (5.0 percent), urinary (3.4 percent), pulmonary (2.2 percent), systemic (1.9 percent), and oral (1.4 percent). Intracranial bleeding occurred in 4 rt-PA and 2 SK patients; 4 of these patients died. Events deemed clinically significant occurred in 15 rt-PA and 9 SK patients (3.8 percent of all patients). Ten patients likely died from these events, 6 within the first 24 hours. Three rt-PA patients and 1 who received SK (0.6 percent) died of cerebrovascular events within the first 24 hours. After controlling for demographic factors and therapeutic variables, using logistic regression analyses, no thrombolytic-related differences were found in the incidence or severity of bleeding following use of the two thrombolytics. CONCLUSIONS: These clinical data do not support a theoretical advantage of rt-PA to cause less bleeding propensity than SK.
Whole-Cell and Acellular Pertussis Vaccines
Authors: Wintermeyer Susan M. , Nahata Milap C. , Kyllonen Kay S. 
Published: January 2017

OBJECTIVE: To provide a review of pertussis vaccines, including information on efficacy, adverse reactions, and antibody production following administration of both whole-cell and acellular pertussis vaccines. DATA SOURCES: A MEDLINE search and extensive review of journals was conducted to identify the information for this review. DATA EXTRACTION: Pertinent studies reporting experience with pertussis vaccinations were reviewed. DATA SYNTHESIS: The differences in efficacy, adverse reactions, and antibody responses between whole-cell and acellular pertussis vaccines are emphasized. The status of acellular pertussis vaccination in the US is defined. CONCLUSIONS: Acellular (chemically detoxified or recombinant) pertussis vaccine formulation appears to cause fewer adverse reactions than whole-cell vaccine in most studies. Clinical efficacy and safety in the very young has not been well established. Thus, acellular pertussis vaccine is reserved for the 4th and 5th doses in the US. Oral or intranasal formulations of the pertussis vaccine are being evaluated.
Aminoglycoside Pharmacokinetics: Volume of Distribution in Specific Adult Patient Subgroups
Authors: Dager William E. 
Published: January 2017

OBJECTIVE: To review the published clinical studies reporting volume of distribution for aminoglycosides in patient population subgroups. Controversies in methods used are discussed. DATA SOURCES: National Library of Medicine Medlars, searched using MEDLINE. STUDY SELECTION: Published articles primarily relating to pharmacokinetic properties of aminoglycosides in specific adult patient subgroups published within the past 20 years were included. Pediatric studies were excluded. DATA EXTRACTION: The methodology, assay technique, and results from clinical studies reporting aminoglycoside volume of distribution were evaluated. DATA SYNTHESIS: Clinical studies reporting aminoglycoside volume of distribution subgroups, including the methods by which their results were derived, are tabulated. CONCLUSIONS: The expected aminoglycoside volume of distribution can vary, depending on a patient's clinical presentation. Data presented will allow a more refined initial estimation of volumes of distribution, which may facilitate the achievement of desired aminoglycoside serum concentrations.