bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of Patients with Mental Illness’ Interactions with Medical Students: A Systematic Review
Authors: Dearman Samuel P. , Joiner Adam B. , Gordon Morris , Vince Gill 
Published: December 2017

Objectives: Mental health is a key area for learning within undergraduate medical education. Given the nature of mental illness, interactions may have the potential to uniquely affect patients. This study set out to systematically review studies reporting experiences and perceptions of patients with mental illness’ clinical interactions with medical students. This includes which factors encourage patients to interact with medical students and if patients perceive negative and positive effects from these interactions. Method: Studies reporting patient experiences of involvement in undergraduate medicine were included. A standardised search of online databases was carried out independently by 2 authors and consensus reached on the inclusion of studies. Data extraction and quality assessment were also completed independently, after which a content analysis of interventions was conducted and key themes extracted. Studies were included from peer-reviewed journals, in any language. Results: Eight studies from 5 countries were included, totaling 1088 patients. Most patients regarded interacting with medical students as a positive experience. Patients described feeling comfortable with medical students, and the majority believed it is important for students to ‘see real patients’. Patients described benefits to them as enjoyment, being involved in student education, and developing an illness narrative. Conclusions: Results suggest that most patients with mental illness want to interact with medical students, and this should be encouraged during student placements. Further research, however, is required to understand in more depth what else can be done to improve the comfort and willingness for patients to interact with students, including barriers to this.
Stability of the Nerve Gas Antidote BIS (4-Hydroxyiminomethyl-1-Pyridinomethyl) Ether Dichloride (Toxogonin®)
Authors: Christenson Inga 
Published: December 2017

The products and kinetics of hydrolysis of the nerve gas antidote bis(4-hydroxyiminomethyl - 1 - pyridinemethyl) ether dichloride (Toxogonin ®) have been investigated. A survey of these studies is given:The hydrolytic reactions were studied in the pH range 1 M hydrochloric acid to 1 M sodium hydroxide at 25, 45, 75 and 85° C.Rate constants were determined in dilute aqueous solution, generally with an initial Toxogonin concentration of 0.01 mg per ml.In addition, a report is given concerning two-year storage of 25 percent (w/v) Toxogonin solutions at pH 2.5, 3.0 and 3.5. The solutions were stored in glass or polypropylene ampuls at 5, 15, 25 and 45°C. At 5 and 15C° decomposition was negligible, at 25 and 45 °C average decomposition was 1.5 percent and 3.3 percent, respectively.
Drugs, the Patient and the Hospital
Authors: Smith William E. 
Published: December 2017

What is clinical pharmacy? How is a clinical service established? Cost of service? Benefits to the patients, pharmacists, physician, nurse? Why unit dose drug distribution? Need for pharmacy supportive personnel? Patient drug monitoring service? Drug information services? Effective com-munications with the medical staff? These questions and others will be discussed in this series of articles. Experiences gained by the author from practicing in the patient care area and managing a clinical service will be the basis for the material presented. The initial article in this issue describes current problems associated with drug therapy in hospitals. The second article will discuss the clinical pharmacy concept. Succeeding articles will present the many components required for clinical pharmaceutical services to serve patients, physicians and hospital personnel.
The Pharmacist's Dilemma—Drug Product Selection Using Bioavailability Data
Authors: Cawthorne George Kennedy , Eckel Fred M. 
Published: December 2017

One hundred fifty-six U.S. drug companies were surveyed to determine whether or not they would supply bioavailability data on 147 drugs marketed as 1894 drug products. The submitted data were analyzed for completeness, validity and potential usefulness to the pharmacist in making drug product selection decisions. Ninety (57.7 percent) companies responded to the survey. Thirty-eight (24.4 percent) sent data of which that from 29 (18.6 percent) was judged acceptable for use in drug product selection. Acceptable data were submitted on 59 drugs. Data on 46 drugs were considered blood-level bioavailability data while the data on 13 drugs were considered clinical bioavailability data. The results, though relatively limited in number of drugs, represented drugs in a number of different pharmacologic classes, so were judged to be of relatively wide applicability.
Locus of Control Dimensions among Senior Pharmacy Students Electing Post-Pharm. D. Residencies
Authors: Gourley Dick R. , Kapel David E. , Hill John W. 
Published: December 2017

The locus of control dimensions among senior Pharm.D. students electing post-Pharm.D. residencies (N=15) are compared with first (N = 60) and second year (N = 55) Pharm.D. students, as well as with senior Pharm.D. students not electing residencies (N=14). Volunteer clinical faculty [hospital (N=27) and community (N = 23) pharmacy preceptors] and full-time clinical faculty (N = 22) are also compared. The Reid-Ware three-factor internal-external scale was completed by the study population. The dimensions measured were: self-control, social systems control, and fatalism. This study was undertaken to:1. compare the locus of control dimensions among senior pharmacy students electing post-Pharm.D. residencies with senior pharmacy students not electing post-Pharm.D. residencies (and with other pharmacy students) and2. compare the locus of control dimensions among senior pharmacy students electing and not electing post-Pharm. D. residencies (and with other pharmacy students) with their clinical, hospital, and community faculty to identify personality congruence (i.e., similarities, differences) which might facilitate the development of patient oriented-interactive behaviors necessary for clinical practice.Self-control (SC) was the major factor that generated the significant difference in the seven groups. The clinical (full-time) faculty group is significantly different from the student groups with the exception of the P-3, residency students. Over 50 percent of the P-3 residency group responded more like the faculty groups than like other students, with more P-3 residency students responding like clinical faculty than any other student or faculty group. The implication is that a similar personality profile exists in terms of internal/external control for the P-3 residency and full-time clinical faculty groups. Professors may have influenced, stimulated, or motivated those students most like themselves to enter a residency program.Based on the data, it would appear desirable to profile pharmacy students and give those who have a strong internal self-control factor encouragement to pursue post-graduate academic or residency programs and to retain as many of those individuals as possible in the areas of pharmacy that directly influence patient care and the pharmacist's role on the health care team.
PPIs: Community Pharmacists' Compliance
Authors: Kaczmarek Elizabeth R. , Stewart Jesse E. , Hutchinson Richard A. , Boisvert Alain 
Published: December 2017

In order to determine community pharmacists' compliance with FDA PPI regulations, five trained shoppers were sent with estrogen prescriptions to 45 pharmacies in a large Midwestern city. Only 42 percent of the prescriptions dispensed were accompanied by a PPI. Fifty-six percent of the prescriptions were dispensed without safety caps. In all cases where a correct PPI was received, a follow-up phone call was made to a pharmacist at the pharmacy to determine the accuracy of the response to a question about information in the PPI. Only 39 percent of the pharmacists were able to correctly answer the phone-in question.
Determinants of Compliance in Epileptic Outpatients
Authors: Bryant Stephen G. , Ereshefsky Larry 
Published: December 2017

The authors have investigated reasons for medication compliance in a population of epileptic patients. The hypothesis that the health care belief model would be predictive of medication-taking behavior was validated. A pilot study was constructed which investigated the comparative responses of compliant and noncompliant epileptic outpatients to questions regarding demographic, clinical history, and attitudinal characteristics. Noncompliant patients were characterized as having a longer duration of epilepsy, more complicated dosage regimens, and more changes in medication. In addition, noncompliant patients both demonstrated more confusion over medication directions and less insight into the need for anticonvulsants and feared addiction to their medication. They had a lower level of satisfaction with their health care and were more frequently subject to the social complications of epilepsy. The authors suggest that a more holistic approach be taken when attempting to reverse noncompliant behavior.
Hyperglycemia associated with Propranolol and Chlorpropamide Coadministration
Authors: Holt Robert J. , Gaskins John D. 
Published: December 2017

A 59-year-old patient with acute pancreatitis is described, whose treatment was complicated by concomitant diabetes mellitus and arterial hypertension. He received propranolol and insulin without subsequent problems; however, when the insulin was changed to chlorpropamide, a significant increase in blood sugar occurred. It was postulated that this increase in blood sugar was due to an antagonistic action of propranolol at the pancreatic level which interfered with the action of chlorpropamide.
Drug Interactions & Reactions Update: Early Reports on Drug Interactions
Authors: D'arcy P.F. 
Published: December 2017

Letters in correspondence columns or brief reports in medical journals are an essential part of an early warning system, and they are invaluable in alerting clinicians and clinical pharmacists to associations between drugs and their reactions. A survey of the literature during the first half of 1982 has identified a number of these early reports; some are purely anecdotal, others may be coincidental, but all serve to warn the practitioner of potential hazard. Brief information on the following reports of drug-drug interactions is given in this article with the intention of giving these reports wider publicity and, possibly, encouraging further observation and research to establish or disprove their validity in a larger and wider range of patients or volunteer subjects. The following interactions are reviewed: amiodarone-quinidine, lidocaine-prenylamine, erythromycin-carbamazepine, azapropazone-phenytoin, chlordiazepoxide-levodopa, gentamicin-furosemide, ethanol-aspirin, acetaminophen-coumarin anticoagulant, and cimetidine-lidocaine.
Review of Cimetidine Drug Interactions
Authors: Sorkin Eugene M. , Darvey Diane L. 
Published: December 2017

The literature on cimetidine drug interactions has been thoroughly reviewed. Several different mechanisms have been proposed for cimetidine-related drug interactions. These mechanisms include: (1) impaired hepatic drug metabolism due to inhibition of hepatic microsomal enzymes, (2) reduced hepatic blood flow, resulting in decreased clearance of drugs that are highly extracted by the liver, (3) increased potential for myelosuppression when administered concurrently with other drugs capable of causing myelosuppression, and (4) altered bioavailability of acid-labile drugs. Cimetidine binds reversibly to the hepatic cytochrome P-450 and P-448 systems, resulting in decreased metabolism of drugs that undergo Phase I reactions (e.g., dealkylation and hydroxylation). In contrast, glucuronidation pathways are unaffected. The rapid onset and reversal of cimetidine's inhibition of hepatic metabolism indicates an effect on hepatic enzyme systems. Cimetidine also has been reported to decrease hepatic blood flow. Drugs that are highly extracted by the liver, such as propranolol, lidocaine, and morphine, may be postulated to have a decreased hepatic clearance. Cimetidine, through its effect on gastric pH, may increase the absorption of acid-labile drugs or may decrease the absorption of drugs. There have been reports of increased potential for myelosuppression when cimetidine is administered concurrently with drugs capable of causing bone marrow suppression. An understanding of the mechanisms involved in cimetidine drug interactions allows the clinician to prevent and predict these interactions.
Computer-Assisted Drug Therapy for Epilepsy
Authors: Peterson Gregory M. 
Published: December 2017

Monitoring serum concentrations of anticonvulsant drugs has improved substantially the treatment of epilepsy. However, a sound knowledge of the pharmacokinetics of anticonvulsant drugs is necessary when interpreting serum concentration results and considering dosage adjustments of these drugs. A computer program developed to assist physicians and pharmacists in designing individualized medication regimens for patients with epilepsy is described. The program also can be used as an interactive educational device for medical and clinical pharmacy students.
Cost-Containment of Antimicrobial Therapy
Authors: Barriere Steven L. 
Published: December 2017

In 1983, health care services for Medicare and Medicaid patients become tied to a diagnosis-related group (DRG) classification and reimbursed based on predetermined rates, regardless of the amounts expended. U.S. hospitals that formerly encouraged resource consumption to generate revenue now urge judicious use of drugs, laboratory tests, and radiology in an effort to contain costs while maintaining quality patient care. Antimicrobials account for the largest proportion of all drugs used in hospitals, but their inappropriate use, unfortunately, is widespread, resulting in poor therapy, emergence of resistance, increased adverse effects, and wasted health care dollars. Newer β-lactam agents offer enhanced in vitro potency and spectra of activity, improved pharmacokinetic characteristics, and a relative lack of adverse effects. However, these drugs are expensive, and excessive use defeats cost-containment programs necessary under DRG reimbursement. To ensure their appropriate use, a variety of methods and some control system is probably necessary in most hospitals. In certain situations early discharge of hospital patients and home antimicrobial therapy may be the most desirable method to conserve hospital resources and provide quality health care.
Serum Bactericidal Activity of Ceftazidime Increased by Netilmicin
Authors: LeBel Marc , Pellerin Michel , Bergeron Michel G. , Rivera Giselle , Huot Marthe 
Published: December 2017

Cephalosporins are often used in combination with aminoglycoside antibiotics in the treatment of gram-negative infections. Although ceftazidime possesses activity against gram-negative bacteria, especially against Pseudomonas, combined use with aminoglycosides is useful. In this study, 12 healthy volunteers (6 men, 6 women; mean age 21.5 yr) received a single dose of ceftazidime 1 g iv and one week later ceftazidime 1 g iv with netilmicin 100 mg iv. Both antibiotics were infused over five minutes. Concentrations of ceftazidime were determined by high performance liquid chromatography. Serum bactericidal activity (SBA) was evaluated against seven microorganisms isolated from clinical specimens. The mean peak serum level of ceftazidime was 113.4 μg/ml. At eight hours, we observed a concentration of 2.6 μg/ml. The total clearance was 126 ml/min, while the renal clearance was 100 ml/min. Ceftazidime exhibited a half-life of 1.9 hours. Up to ten hours, the SBA of ceftazidime against Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, and Salmonella typhi was > 1:8 in more than 90 percent of samples. At one hour, ceftazidime exhibited a SBA of 1:4 for Staphylococcus aureus, and 1:16 for Pseudomonas aeruginosa. With the addition of netilmicin, median SBA against Staph. aureus and P. aeruginosa were 1:32 and 1:64, respectively, at one hour. Netilmicin enhanced the SBA of ceftazidime. The combination was not effective against Streptococcus faecalis.
Voluntary cough intensity and its influencing factors differ by sex in community-dwelling adults
Authors: Yawata Akiko , Tsubaki Atsuhiro , Yawata Haruka , Takai Haruna , Matsumoto Kayomi , Takehara Nana , Kobayashi Ryosaku 
Published: December 2017

Background: Cough peak flow (CPF) is widely used for measuring voluntary cough intensity. However, the respective factors that affect CPF are not known. The aim of this study was to determine the factors affecting CPF by sex in community-dwelling adults. Method: We recruited participants using posters exhibited at a public gymnasium. Participation was voluntary, and all participants provided informed consent. Nonsmoking community residents (102 males, 49.6 ± 20.2 years of age; 101 females, 51.4 ± 18.4 years of age) participated in this study. The main outcome measures were sex differences in CPF, respiratory function, respiratory muscle strength, thorax extension, and grip strength. Factors affecting CPF by sex were analyzed using multiple regression analysis. Results: All parameters were higher in men than in women. CPF was affected by thorax expansion at the tenth rib, inspiratory muscle strength and forced expiration in 1 s in men, and thorax expansion at the tenth rib, inspiratory reserve volume, and expiratory muscle power in women. A weak negative correlation was observed between CPF and age ( p = −0.24, p < 0.05) in women. Conclusions: The factors affecting CPF differed by sex in community-dwelling adults. Clinical Trial Number: UMIN000023912
Radiosurgery and stereotactic radiotherapy with cyberknife system for meningioma treatment
Authors: Di Franco Rossella , Borzillo Valentina , Ravo Vincenzo , Falivene Sara , Romano Francesco Jacopo , Muto Matteo , Cammarota Fabrizio , Totaro Giuseppe , Ametrano Gianluca , Rossetti Sabrina , Cavaliere Carla , D’ Aniello Carmine , Iovane Gelsomina , Porricelli Maria Assunta , Berretta Massimiliano , Botti Gerardo , Starace Luigi , Salvia Enrico La , Facchini Gaetano , Muto Paolo 
Published: December 2017

Objective The aim of this work was to evaluate the impact of stereotactic radiosurgery/fractionated stereotactic radiotherapy with the Cyberknife system on local disease control, clinical outcome and toxicity in patients with meningioma, according to the site and histological grade of lesion. From January 2013 to April 2017, 52 patients with intracranial meningiomas were treated with the Cyberknife system. Twenty-four patients had undergone previous surgery: 38% gross total resection, 10% subtotal resection; 27 patients underwent no surgery; 22 patients had a recurrence of meningioma. Methods Radiosurgery was used for lesions smaller than 2 cm, stereotactic radiotherapy for lesions larger than 2 cm, or smaller but close to a critical site such as the optical chiasm, optic pathway or brainstem. Results Local control and clinical outcomes were analysed. Median follow-up was 20 months: six patients died, one after re-surgery died from post-surgical sepsis, three from heart disease. Progression-free survival had a mean value of 38.3 months and overall survival of 41.6 months. We evaluated at 12 months 28 patients (100% local control); at 24 months 19 patients (89% local control); at 36 months nine patients (89% local control). At baseline, 44/52 patients (85%) were symptomatic: 19 visual disorders, 17 motor disorders, six hearing disorders, 10 headache and six epilepsy. Visual symptoms remained unchanged in 52%, improved in 32%, resolved in 16%. Headache was improved in 40%, resolved in 10%, unchanged in 50%. Epilepsy was resolved in 17%, unchanged in 33%, worsened in 33%. Conclusions Stereotactic radiosurgery/fractionated stereotactic radiotherapy with Cyberknife provides a good local disease control, improving visual, hearing and motor symptoms.
Glycemic control among primary care patients with type 2 diabetes mellitus in the Gaza Strip, Palestine
Authors: Radwan Mahmoud , Elsous Aymen , Al-Sharif Hasnaa , Abu Mustafa Ayman 
Published: December 2017

Aim: In this study, we aimed to assess the level of good glycemic control, to determine association between adherence to antidiabetic medications and glycosylated hemoglobin (HbA1c) and to examine factors influencing good glycemic control. Materials and methods: A cross-sectional design was employed among 369 patients with type 2 diabetes mellitus (T2DM) from four Ministry of Health health centers in 2016. A sample of 3 ml blood was taken to measure the HbA1c, and patients were asked to fill out a pretested questionnaire. Univariate and multivariate logistic regressions, to identify independent factors associated with good glycemic control, were conducted using SPSS software version 22 (IBM Corp, Armonk, NY, USA). Results: Mean [±standard deviation (SD)] of HbA1c was 8.97 (2.02) and one fifth of patients had good glycemic control (HbA1c ⩽ 7%). Factors associated with good glycemic control were: older age [odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.933–0.988), high medication adherence (OR: 2.757, 95% CI: 1.308–4.693), and better health literacy (OR= 2.124, 95% CI: 1.917–4.921). Duration of diabetes mellitus (DM > 7 years) was inversely related to good glycemic control (OR = 2.255, 95% CI: 1.189–4.276). Conclusion: Our study showed that glycemic control was suboptimal, and factors associated with that were: older age, high medication adherence, and better health literacy. Knowledge of these factors could be an entry toward helping patients and targeting interventions to improve glycemic control and prevent diabetes-related complications.
Non-traumatic isolated medial cuneiform fracture: A unique mechanism of a rare injury
Authors: Paisan Gabriella , Magister Steven , Bridgforth Andrew , Yarboro Seth 
Published: December 2017

We report a case of a 23-year-old woman who sustained a stress fracture to the medial cuneiform. Isolated medial cuneiform fractures are extremely rare with less than 10 cases reported in the literature. The patient initially presented to an urgent care facility complaining of right midfoot pain that occurred while running. Radiographs obtained at the time showed no acute abnormality and the patient was told to resume normal activities. Several weeks later, she presented to urgent care again after exercising, this time unable to bear weight and with swelling and ecchymoses of the right foot. Plain radiographs were again normal, but a high suspicion for injury remained, so a magnetic resonance imaging of the foot was obtained. The advanced imaging showed an acute, non-displaced fracture of the medial cuneiform. Because the fracture was discovered soon after the injury and was non-displaced, she was treated conservatively and at 6-month follow up had returned to all pre-injury activities with no complaints. These rare fractures are often missed at initial presentation because they are usually not evident on plain radiographs. Unless more advanced imaging is obtained to rule out a fracture, a delay of diagnosis can occur resulting in additional morbidity for the patient. Level of clinical evidence: Level 5
Osteomacs interact with megakaryocytes and osteoblasts to regulate murine hematopoietic stem cell function
Authors: Mohamad Safa F. , Xu Linlin , Ghosh Joydeep , Childress Paul J. , Abeysekera Irushi , Himes Evan R. , Wu Hao , Alvarez Marta B. , Davis Korbin M. , Aguilar-Perez Alexandra , Hong Jung Min , Bruzzaniti Angela , Kacena Melissa A. , Srour Edward F. 
Published: December 2017

Key Points
OM, osteoblast, and megakaryocyte interactions regulate HSC function in the niche. OMs differ functionally and phenotypically from BM-derived macrophages.