bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factor Analysis and Item Reduction of the Banff Patella Instability Instrument (BPII)
Authors: Lafave Mark R. , Hiemstra Laurie , Kerslake Sarah 
Published: May 2016

Background: Clinical management of patellofemoral (PF) instability is a challenge, particularly considering the number of variables that should be taken into consideration for treatment. Quality of life is an important measure to consider with this patient population. Purpose: To factor analyze and reduce the total number of items in the Banff Patella Instability Instrument (BPII). Subsequent to the factor analysis, the new, item-reduced BPII 2.0 was tested for validity, reliability, and responsiveness. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Quality of life was measured for PF instability patients (N = 223) through use of the original BPII at their initial consultation. Data from the BPII scores were used in a principal components analysis (PCA) to factor analyze and reduce the total number of items in the original BPII, to create a revised BPII 2.0. The BPII 2.0 underwent content validation (Cronbach alpha, patient interviews, and grade-level checking), construct validation (analysis of variance comparing the initial visit and the 6-, 12-, and 24-month postoperative visits, eta-square), convergent validation (Pearson r correlation to the original BPII), responsiveness testing (eta-square, anchor-based distribution testing), and reliability testing (intraclass correlation coefficient [ICC]). Results: The BPII was successfully reduced from 32 to 23 items with excellent Cronbach alpha values in the new BPII 2.0: initial visit = 0.91; 6-month postoperative visit = 0.96; 12-month postoperative visit = 0.97; and 24-month postoperative visit = 0.76. Grade-level reading for all items was assessed as below grade 12. The BPII 2.0 was able to discriminate between all time periods with significant differences between groups ( P < .05). Eta-square was 0.40, demonstrating a medium to large effect size. The BPII significantly correlated with the BPII 2.0 (0.82, 0.90, 0.90, and 0.94 at the initial visit and 6-, 12-, and 24-month postoperative visits, respectively), providing evidence of convergent validity. A significant correlation was found between the 7-point scale and 24-month postoperative BPII 2.0 scores, a sign of anchor-based responsiveness. ICC (2,k) was 0.97, indicating strong reliability. Conclusion: The BPII 2.0 is valid, reliable, and responsive for assessment of patients with PF instability, both surgically and nonsurgically treated.
Organisational and individual support for nurses’ ethical competence: A cross-sectional survey
Authors: Poikkeus Tarja , Suhonen Riitta , Katajisto Jouko , Leino-Kilpi Helena 
Published: May 2016

Background: Nurses’ ethical competence has been identified as a significant factor governing high quality of care. However, nurses lack support in dealing with ethical problems, and therefore managerial support for nurses’ ethical competence is needed. Research questions: This study aimed to analyse, from the perspective of nurse and nurse leaders, the level of nurses’ and nurse leaders’ ethical competence, perceptions of support for nurses’ ethical competence at the organisational and individual levels and background factors associated with this support. Research design: A descriptive, cross-sectional study design was employed. The Ethical Competence and Ethical Competence Support questionnaires were used to measure the main components. Descriptive statistics and multifactor analysis of variance were used for data analysis. Participants: The participants were 298 nurses and 193 nurse leaders working in specialised (48%/52%), primary (43%/36%) or private healthcare (5%/7%) in Finland. Ethical considerations: Ethical approval was obtained from the university ethics committee. Results: Nurses estimated their own ethical competence to be at an average level, whereas nurse leaders estimated their own competence at a high level. Nurses’ and nurse leaders’ perceptions of provided support for nurses’ ethical competence was not at a high level. The positive agreement percentage related to organisational support was 44% among nurses and 51% among nurse leaders. The positive agreement percentage related to individual support was lower, that is, 38% among nurses and 61% among nurse leaders. University education had a positive association with some items of individual support. Conclusion: Despite the findings that ethical competence was estimated at a high level among nurse leaders, perceptions of support for nurses’ ethical competence were not at a satisfactory level. At the organisational level, nurse leaders need to inform of ethical procedures and practices in orientation; encourage multidisciplinary ethics discussions and collaboration; and support nurses at an individual level to participate in ethics education, multidisciplinary ethics discussions and in solving ethical problems.
Recently Approved Alternatives to Aspirin
Authors: Hovander Greg 
Published: May 2016

Antiinflammatory analgesics recently approved by the FDA for use in the United States are evaluated and compared with aspirin and other older agents. The drugs discussed are propionic acid derivatives, tolmetin, and sulindac. Indications, dosages, efficacy, side effects, cost, precautions, and interactions are discussed. The propionic acid derivatives and tolmetin are structurally different from older drugs and provide new alternatives in the treatment of inflammatory disease and pain. Of these new agents, naproxen appears to be first choice. Sulindac is the result of efforts to improve indomethacin. It possesses a longer duration of action, and it appears to cause fewer side effects.
Legal and Ethical Issues in Clinical Pharmacy Research — Informed Consent, Part I
Authors: Pathak Dev S. , Foster Thomas S. , Raehl Cynthia L. 
Published: May 2016

The continued growth of hospital and clinical pharmacy should be paralleled by the development of sound research methods justifying innovative practices. Such research will, on occasion, require experimentation involving human subjects. The principal means of assuring that the welfare of research participants is not compromised is through the procurement of effective informed consent. Pharmacists, like many other health professionals, have had relatively little exposure to methodology involved in the writing of an informed consent instrument. A comprehensive document must not only conform to the requirements of federal regulatory agencies, but must also satisfy various institutional guidelines. Past instances of unethical human experimentation are discussed, and a format for preparation of an informed consent instrument is examined. Circumstances requiring informed consent and identification of the basic elements of consent are also explained.
Comparative Bioavailability of Enteric-Coated Aspirin Preparations
Authors: Bicket William J. , Maynard Susan M. , Sawyer William T. 
Published: May 2016

A three-way crossover study was conducted in nine healthy subjects to compare the bioavailability of one uncoated and two enteric-coated aspirin products after the administration of a single 650-mg dose of each preparation. Urine was collected at various intervals for 24 hours after drug administration and assayed for total salicylic acid content as an indicator of bioavailability. There were statistically significant differences among the three products in the amount of salicylic acid appearing in the urine, both for specific collection intervals and for cumulative (24-hour) excretions. Greater (p < 0.001) amounts of urinary salicylic acid were found in the first three hours after uncoated aspirin treatment than after enteric-coated aspirin administration. After 24 hours, equivalent amounts of salicylic acid were found following treatment with uncoated aspirin and one of the enteric-coated preparations. The absorption of aspirin from enteric-coated preparations is markedly delayed when compared to that from an uncoated product.
Counseling the Hearing-Impaired Older Adult
Authors: Lamy Peter P. , Chermak Gail , Jinks Martin 
Published: May 2016

Older adults use more prescription medication than any other segment of our society. They consume about 1/4 of all prescription drugs while comprising only 1/10 of the general population.23 This widespread use of medications, while perhaps increasing longevity and improving the quality of life of older adults, also subjects these patients to a wide array of adverse drug reactions which often may be more serious than the illness for which the medication was prescribed. It has been documented that the risk of adverse reactions nearly doubles in the aged compared to younger adults.21 One report found that 60 percent of an elderly outpatient population made errors in self-medication, and more than 25 percent of these committed potentially serious errors.25 An alarming number of older adults are admitted to hospitals as a direct result of preventable drug reactions.26 As noted earlier, presbycusis afflicts nearly 14 million (60 percent) of the individuals over age 65, and these older adults are particularly vulnerable to drug-use problems. A significant number have difficulty taking their medication in the manner intended by the physician because of inadequate instruction and poor comprehension of directions resulting from hearing-impairment. An understanding of the social and medical implications of hearing impairment in the older adult and the use of the basic communication techniques described in this paper will assist the pharmacist to improve his counseling efforts in the hearing-impaired older adult. ≃
Preceptors' Views of Community Pharmacy Clerkships: A National Survey
Authors: Tannenbaum Renee P. , Sohn Catherine A. , Gerbino Philip P. , Gans John A. 
Published: May 2016

A survey was administered to a random sample of community pharmacy practitioners who participate as preceptors in clerkship programs for colleges of pharmacy throughout the country. The purpose of this survey was to determine (1) in what ways, if any, students have affected the preceptors' practices; (2) whether the students served as a source of continuing education to the preceptors; (3) whether the preceptors identified areas of students' strengths/deficiencies; and (4) roles of colleges of pharmacy and pharmacy associations in providing continuing education programs for pharmacists. Results of this survey are discussed. Data are cross-tabulated for types of pharmacy services provided, years in practice, length of clerkship rotations, and other essential demographic information needed for evaluation. Based on responses, recommendations are made that will provide guidance to colleges of pharmacy, pharmaceutical associations, and practitioners currently involved or those who are considering involvement in clerkship programs.
The Effect of Inservice Education Provided by Consultant Pharmacists on the Behavior of Nurses in Long-Term Care Facilities
Authors: Lamy Peter P. , Westfall Lawrence K. , Speedie Stuart M. 
Published: May 2016

The objectives of the study were to assess whether an in-service education program for nurses in long-term care facilities was effective in increasing the nurses' knowledge of drugs and whether the increased knowledge affected nurses' behavior regarding drug therapy monitoring. The four-phase study was conducted in two study homes and two control homes and consisted of pre-tests, inservice, post-tests, and a three-month evaluation period. The results indicate that nurses in the study homes demonstrated a statistically significant increase in drug knowledge, and this was reflected in an objective change in behavior to more appropriate monitoring of drug therapy. It may be concluded that intensive inservice education programs are an effective method for inducing behavioral changes in nurses working in long-term care settings. These changes can improve the nurses' ability to monitor and promote safe and efficacious drug therapy in long-term care facilities.
Some Consequences of Drug Choice and Dosage Regimen for Patients with Impaired Kidney Function
Authors: Vree Tom B. , Hekster Chiel A. , van Dalen Roelof 
Published: May 2016

The object of this article is to discuss difficulties in extrapolating the performances of a drug for which the kinetic parameters are derived in healthy volunteers, to patients with severely impaired kidney function. The theoretical background of some actual or probable background is given, and a possible solution for these problems is offered, that is, choosing another drug from the same drug group. In patients without kidney function, metabolism is the only pathway of elimination. When the elimination of the metabolite formed occurs by means of renal excretion only, this metabolite accumulates in patients with impaired or absent kidney function. When a metabolic pathway of the parent drug is part of a metabolic equilibrium, the metabolic return reaction results in an “apparent parent compound,” with a half-life identical to that of the accumulated metabolite. In this way, the concentration of the “apparent” parent compound increases and the half-life of the sum of parent and “apparent” parent drug will change. Examples of this drug behavior are given for sulfamethoxazole, sulfametrole, sulfamethizole, procainamide, and N4-acetylprocainamide.
A Mild Case of Toxic Shock Syndrome
Authors: Ponte Charles D. , Traugh Cathy 
Published: May 2016

The toxic shock syndrome (TSS) most often is seen in young, healthy women who become symptomatic during menstruation. The association between TSS and the use of tampons is strong. The symptoms usually begin suddenly and are often nonspecific. Prostration and hypotensive shock can occur within 24 hours. Milder forms of the disease also may be seen. The overall mortality rate is approximately 8 percent. This report describes a mild case of TSS in a young, healthy, 16-year-old female who developed symptoms during menstruation. She had been using regular-size tampons, which were changed frequently, but she did not change tampons during the night. A positive cervical culture for Staphylococcus aureus confirmed the diagnosis. The patient responded to supportive care and intravenous oxacillin. Her generalized maculopapular rash disappeared within 24 hours of admission, and her hands began to desquamate by the time of discharge. The patient was urged to avoid the use of tampons for four months subsequent to discharge.
Treatment of Chlorpropamide Overdose with Diazoxide
Authors: Jeffery William H. , Graham E. Michael 
Published: May 2016

A patient who took a chlorpropamide overdose was treated for several hours with concentrated glucose solutions, with little success in maintaining adequate serum glucose concentrations. Intravenous diazoxide administration was begun with the hope of decreasing pancreatic insulin release. After diazoxide was begun, glucose requirements decreased dramatically, and serum glucose was supranormal for most of the period of diazoxide administration. The case was complicated by the fact that the patient had taken three agents that can cause hypoglycemia—chlorpropamide, alcohol, and aspirin. Drug interactions potentiating the hypoglycemic effect of the chlorpropamide were also possible. Glucose infusion is the mainstay of therapy for a sulfonylurea overdose. However, glucose acts as a further stimulus of insulin release from a sulfonylurea-primed pancreas. Administration of concentrated glucose solutions is technically difficult because of damage to veins. Metabolic consequences of high rates of glucose infusion to hyperinsulinemic patients include hypokalemia and hypophosphatemia. Diazoxide appeared to decrease the glucose requirement in this patient, as it did in three other reported cases. Diazoxide is approved for certain hypoglycemic, hyperinsulinemic conditions. Sulfonylurea overdose represents a hypoglycemic, hyperinsulinemic condition; diazoxide appears to be an effective treatment.
Drug-Induced Infertility
Authors: Buchanan James F. , Davis Larry Jay 
Published: May 2016

Primary infertility may result from the use of various drugs. This phenomenon may be the result of an effect on the hypothalamic-pituitary-gonadal axis or a direct toxic effect on the gonads. Some of the drugs considered in this article demonstrate sex-related differences in their ability to cause infertility; there also may be age-related differences. The drugs described in this review, in regard to their association with the development of infertility, include various individual antineoplastic agents (cyclophosphamide, chlorambucil, busulphan, and methotrexate) and combinations of these chemotherapeutic drugs, glucocorticosteroids, hormonal steroids (diethylstilbestrol, medroxyprogesterone acetate, estrogen, and the constituents of oral contraceptives), antibiotics (sulfasalazine and co-trimoxazole), thyroid supplements, spironolactone, cimetidine, colchicine, marihuana, opiates, and neuroleptic agents.
Thrombocytopenia Associated with Moxalactam Administration
Authors: Au Janet P. , Geiger Gail S. 
Published: May 2016

Thrombocytopenia associated with moxalactam disodium administration occurred in an elderly, debilitated, 84-year-old male. The patient presented with a decreased platelet count and prolongation of prothrombin time and partial thromboplastin time. Occult blood was found in the urine and stool, and generalized petechiae with ecchymoses were found over the entire body. The moxalactam was discontinued because of suspected drug-induced thrombocytopenia, and daily vitamin K therapy was instituted. By day 2 of vitamin K therapy, the platelet count had risen slightly, but the patient's condition did not improve. On day 3 of vitamin K therapy, the platelet count had decreased. There was a generalized worsening of the patient's medical condition, and he expired two days later. The use of moxalactam has been associated with thrombocytopenia. The possibility of hemorrhage consequent to the use of this antibiotic is clinically important.
An in Vivo Single- and Multiple-Dose Study of Several Marketed Brands of Conventional and Controlled-Release Theophylline
Authors: Kotzan Jeffrey A. , Vallner Joseph V. , Stewart James T. , Honigberg Irwin L. , Brown W.J. 
Published: May 2016

In a single-dose study, 18 healthy adult males consumed each of six dosage forms of theophylline. A conventional-release tablet, a syrup, and four competing brands of controlled-release theophylline were studied. Serial serum samples were obtained and analyzed via high pressure liquid chromatography (HPLC). After achieving steady state, 15 healthy adult males consumed each of five dosage forms of theophylline in a multiple-dose study. Serial blood samples were obtained between 0 and 72 hours and subjected to analysis with HPLC. The results indicated that the controlled-release products were not bioequivalent, although they achieved longer time-to-peak values than did the immediate-release syrup and the conventional-release tablet. A single sustained-release product was uniquely different on most pharmacokinetic parameters when compared with the remaining three controlled-release products. In general, the dosage form variation exceeded the individual subject variation on the single-dose study, but the opposite was true for the multiple-dose study.
Bupropion Hydrochloride
Authors: Dufresne Robert L. , Weber Stanley S. , Becker Robert E. 
Published: May 2016

Bupropion is a trimethylated monocyclic phenylaminoketone that is an effective antidepressant in humans. It neither is sedating, anticholinergic, nor cardiotoxic. Its mechanism of action may be related to dopamine, but remains uncertain at this time. Clinical trials comparing bupropion 300–750 mg/d with placebo show it to be superior to placebo in efficacy and as well tolerated. Bupropion, in controlled clinical trials, is as effective as amitriptyline or imipramine, with fewer side effects. The only clinically significant adverse reaction to bupropion in more than 1000 patients studied has been seizure induction at a frequency comparable with that of imipramine. Bupropion appears to be safe and effective in both adult and geriatric depressed patients. Although it appears to be safer and equally efficacious when compared with currently used antidepressants, it has not been tested by routine clinical use.
Chlorpropamide-Induced Hemolytic Anemia
Authors: Or Reuven , Merin Edna , Stupp Yehudith , Matzner Yaacov 
Published: May 2016

Acute intravascular hemolysis developed when a diabetic patient, previously treated with glyburide, was started on another oral sulfonylurea drug, chlorpropamide. Immunoglobulins were not found in the patient's serum and the red cells were coated with C3 only, suggesting an “innocent bystander” reaction. This case demonstrates that there is no cross reactivity between glyburide and chlorpropamide in producing hemolytic anemia.
Clinical Pharmaceutical Services in Retail Practice II. Factors Influencing the Provision of Services
Authors: Nelson Arthur R. , Zelnio Robert N. , Beno Carolyn E. 
Published: May 2016

The second phase of a two-part investigation of factors influencing the development of clinical pharmaceutical services in retail practice is presented. This report focuses on why pharmacists who reported a willingness and competency to perform services in Phase I had not developed such a practice. Transcripts from 11 focus group interviews conducted with pharmacists throughout South Carolina were analyzed by two panels. The first panel summarized subjects' comments regarding the major dimensions: (1) awareness, (2) demand, (3) motivation, (4) requisites, and (5) barriers for delivery of services. The second panel judged the validity of the first panel's analysis. Pharmacists were aware of common clinical services, but had given little thought to unique services oriented to patients' needs. Monetary factors were deemed to be more important than was concluded from the first phase. Pharmacists saw a minimal demand for services, but a great need. Pharmacists also felt the need for more clinical skills, but better systems of delivery also were emphasized. The report concludes with a strategy for promoting clinical services in retail practice.
Hepatitis Associated with Allopurinol
Authors: Ohsawa Tomoji , Ohtsubo Masatoshi 
Published: May 2016

When adverse reactions occur, it is important to identify the etiologic drug. We describe a case of hepatitis associated with allopurinol. A 66-year-old female was admitted for rehabilitation of a cerebral hemorrhage on September 11, 1981. Allopurinol, clofibrate, and baclofen were administered. Severe hepatitis developed on November 13. The clinical laboratory data returned to normal on November 30. Challenge tests were conducted on clofibrate, allopurinol, and baclofen. The challenge test was positive after the administration of allopurinol. Allopurinol hepatitis is most likely a hypersensitivity reaction, as is suggested by the symptoms of eosinophilia and rash. Renal dysfunction may predispose one to develop hepatitis associated with allopurinol.