bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Lisfranc Injuries in the National Football League
Authors: McHale Kevin J. , Rozell Joshua C. , Milby Andrew H. , Carey James L. , Sennett Brian J. 
Published: May 2016

Background: Tarsometatarsal (Lisfranc) joint injuries commonly occur in National Football League (NFL) competition; however, the career effect of these injuries is unknown. Purpose: To define the time to return to competition for NFL players who sustained Lisfranc injuries and to quantify the effect on athletic performance. Study Design: Case-control study; Level of evidence, 3. Methods: Data on NFL players who sustained a Lisfranc injury between 2000 and 2010 were collected for analysis. Outcomes data included time to return to competition, total games played after season of injury, yearly total yards and touchdowns for offensive players, and yearly total tackles, sacks, and interceptions for defensive players. Offensive power ratings ( OPR = [ total yards/10] + [ total touchdowns × 6]) and defensive power ratings ( DPR = total tackles + [ total sacks × 2] + [ total interceptions × 2]) were calculated for the injury season and for 3 seasons before and after the injury season. Offensive and defensive control groups consisted of all players without an identified Lisfranc injury who competed in the 2005 season. Results: The study group was composed of 28 NFL athletes who sustained Lisfranc injuries during the study period, including 11 offensive and 17 defensive players. While 2 of 28 (7.1%) players never returned to the NFL, 26 (92.9%) athletes returned to competition at a median of 11.1 (interquartile range [IQR], 10.3-12.5) months from time of injury and missed a median of 8.5 (IQR, 6.3-13.0) regular-season games. Analysis of pre- and postinjury athletic performance revealed no statistically significant changes after return to sport after Lisfranc injury. The magnitude of change in median OPR and DPR observed in offensive and defensive Lisfranc-injured study groups, −34.8 (IQR, −64.4 to 1.4) and −13.5 (−30.9 to 4.3), respectively, was greater than that observed in offensive and defensive control groups, −18.8 (−52.9 to 31.5) and −5.0 (−22.0 to 14.0), respectively; however, these differences did not reach statistical significance ( P = .33 and .21, respectively). Evaluation of the durability of injured players after the season of injury revealed no statistically significant difference in career length compared with controls. Conclusion: More than 90% of NFL athletes who sustained Lisfranc injuries returned to play in the NFL at a median of 11.1 months from time of injury. Offensive and defensive players experienced a decrease in performance after return from injury that did not reach statistical significance compared with their respective control groups over a similar time period.
Effective method of chitosan-coated alginate nanoparticles for target drug delivery applications
Authors: Wang Fang , Yang Siqian , Yuan Jian , Gao Qinwei , Huang Chaobo 
Published: May 2016

In the present study, alginate nanoparticles were firstly prepared for paclitaxel (PTX) delivery with an average size of 200 ± 21 nm. To improve the stability and targeting effect, the chitosan (CS) and folate-chitosan (FA-CS) were introduced to form PTX-loaded CS/ALG NPs and FA-CS/ALG NPs by a new double emulsion cross-linking electrostatic attraction method. The optimization chitosan concentration was 0.5% obtained from the experiment results. The CS/ALG-PTX NPs and FA-CS/ALG-PTX NPs had the average particle size of 306.9 ± 12.9 nm and 283.6 ± 19.2 nm with the zeta potential of 31.1 ± 1.3 mV and −2.98 ± 0.7 mV, and had higher drug loading and entrapment efficiencies than ALG-PTX NPs. The in vitro drug release profile along with release kinetics and mechanism from PTX-loaded NPs were studied under two simulated physiological conditions. Further, the in vitro anti-cancer activity of nanoparticles and the cellular uptake of nanoparticles on HepG2 cells were investigated. The results demonstrated that alginate, CS/ALG and FA-CS/ALG can be used as nanoformulation drug carriers by our new method, and FA-CS/ALG was a promising vehicle for anticancer drug targeted delivery system.
Successful Treatment of Apparent Methicillin-Resistant S. Aureus Endocarditis with Gentamicin and Cephalothin
Authors: Greenlaw Cal W. , Ott Franklin B. 
Published: May 2016

A pediatric patient with Staphylococcus aureus endocarditis was treated unsuccessfully with methicillin 74 mg/kg/day as an initial dosage and 185 mg/kg/day as a maximum dosage over a 21-day period. Treatment failure was a result of apparent methicillin resistance, which may have been induced by the initial use of suboptimum methicillin dosages. The methicillin was discontinued and the patient became afebrile within six hours of receiving a combination of cephalothin and gentamicin. Combination therapy was continued for a total of 42 days, with eventual trough serum MBC dilutions of 1:32 and gentamicin and cephalothin dosages of 2.7 and 166 mg/kg/day respectively. The patient was cured without any adverse sequelae. The rapid improvement in this patient's condition and his cure after receiving the combination therapy was probably due to the synergistic activity of gentamicin and cephalothin against S. aureus.
A Summary of Current Information, Mechanisms and Treatment
Authors: Inoue Fumio 
Published: May 2016

Adverse reactions and the possible mechanisms of the reactions caused by antipsychotics are reviewed. The mechanisms of many of these adverse reactions have not been elucidated to date, hence there have been inconsistent approaches to the problem. Complicated symptoms of the reactions, especially exacerbation of the mental state, are often considered to be a part of the psychosis under treatment. Some of the reactions are temporary, or the patient may develop tolerance to them so that an additional drug may not be necessary. It is suggested that use of the minimum dosage of antipsychotics, avoidance of polypharmacy, and close observation of the patient constitute the best approach to the prevention of unwanted reactions.
Allopurinol Hypersensitivity
Authors: Burkle Wayne S. 
Published: May 2016

Allopurinol-induced hypersensitivity reactions may involve multiple organ systems. Milder forms consist of uncomplicated dermatological lesions, while the more severe type may involve toxic epidermal necrolysis, renal impairment and hepatic disturbances. A case is presented which represents the milder form of the reaction. In addition to discussing the salient features of this case, the pertinent data from all reported cases of the more severe hypersensitivity reactions are analyzed in an attempt to identify predisposing factors and prognostic indicators.
Hypokalemic Periodic Paralysis — The Syndrome and its Treatment
Authors: Jerome Micky 
Published: May 2016

Hypokalemic periodic paralysis (hypoKPP) is a genetically determined disease characterized by episodic decreases in serum potassium levels accompanied by muscle weakness or paralysis. A case is reported and a review of the literature presented. Current evidence suggests that the primary defect associated with hypoKPP resides either in the muscle cell membranes or in the cellular metabolism and gives rise to a conduction defect which results in muscle paralysis. A variety of drugs have been employed to correct the cellular abnormality, including supplemental potassium, diuretics, propranolol and diazoxide. To date the most effective therapy is acetazolamide, which induces a mild metabolic acidosis thought to stabilize the cellular membrane against intracellular shifts of potassium ions.
Phencyclidine Psychosis
Authors: Richards Mark L. , Perry Paul J. , Liskow Barry I. 
Published: May 2016

A case of prolonged psychotic behavior is described of a 20-year-old female following the ingestion of an illicitly obtained powder probably containing phencyclidine. The various psychiatric manifestations of phencyclidine intoxications are reviewed. The benefit of treating the toxic phase with psychotropic drugs is questionable. Hospitalization, supportive measures and urine acidification appear to be the treatments of choice for patients experiencing a toxic psychosis caused by phencyclidine.
Multi-Drug-Resistant Pulmonary Tuberculosis
Authors: Guernsey Brock G. , Alexander Michael R. 
Published: May 2016

A case of multiple-drug-resistant pulmonary tuberculosis (TB) is presented. The patient's refusal to complete a course of drug therapy culminated in numerous relapses, treatment failures, and finally, death. Noncompliant drug behavior is probably the major cause of treatment failure. Supervised intermittent and short-course regimens can be utilized when patients demonstrate poor cooperation in self-medication programs. Resistance to first-line agents complicates retreatment of TB. Drug selection in these cases should be based on the results of sensitivity studies, and effective regimens frequently require the use of more toxic secondary agents. Although published guidelines for appropriate treatment of TB are available, inappropriate therapy continues to occur. Resistant organisms can be transmissible and virulent, and patients infected with them may serve as infector pools that produce new cases of primary resistance. The control of resistant TB depends on our ability to identify these individuals and to insure that they comply with effective drug regimens.
Dobutamine: A New Agent for the Management of Cardiac Decompensation
Authors: Park Glen D. , Covinsky Joel O. 
Published: May 2016

Dobutamine is a new inotropic agent being promoted for short-term, parenteral treatment of adults with “cardiac decompensation due to depressed contractility resulting either from organic heart disease or from cardiac surgical procedures.” Pharmacologically, it most resembles the effects of low-dose epinephrine, but with fewer beta-2 adrenergic effects. The reported advantage of dobutamine over other currently available inotropic catecholamines is that, with dobutamine, cardiac output is increased with less concurrent heart rate increase or arrhythmia potential. Dobutamine has been compared to three other drugs in congestive heart failure: isoproterenol, nitroprusside, and dopamine. Isoproterenol appears to produce a greater increase in heart rate than dobutamine; nitroprusside produces a greater decrease in capillary wedge pressure and mean arterial pressure than dobutamine, but produces the same increase in cardiac index. Except for differences in effects on pulmonary capillary wedge pressure, dobutamine and dopamine demonstrate parallel effects up to a dose of 5 μg/kg/min of dopamine. Above this dose, changes in heart rate, arrhythmias (PVCs), and peripheral resistance differentiate the two drugs. Based on available data, dobutamine appears to have hemodynamic advantages over dopamine in congestive heart failure, but these advantages are not seen in postsurgical cardiac depression. At this time, dobutamine cannot be recommended over other agents for use in the acute MI patient.
Beclomethasone Dipropionate Aerosol: Patient Consultation Recommendations
Authors: Fischer Richard G. , Kuhn John G. 
Published: May 2016

Patient administration errors in the use of beclomethasone dipropionate aerosol are frequent. Asthmatics once labeled “treatment failures” on this aerosol may only need adequate consultation to achieve therapeutic results. Pharmacists should monitor for patient noncompliance and provide instruction and follow-up on the use of beclomethasone dipropionate aerosol. Common administration errors associated with this drug are described, along with information patients should receive to obtain optimal benefits.
A Method for Post-Marketing Screening of Adverse Reactions to Drugs Initial Results
Authors: Knapp Deanne E. , Zax Brian B. , Rossi Allen C. , O'Neill Robert T. 
Published: May 2016

The FDA is pilot-testing a methodology for signaling previously unsuspected relationships between drugs and important adverse events. This method uses data it receives through the FDA spontaneous reporting program. Reviewing drugs used primarily on an outpatient basis, this screening methodology focuses on “tracer” adverse events and the organization of these reactions into body/functional systems. This review process enables a clinical evaluator to perceive more easily the clinically important drug-adverse event patterns. The method can incorporate drug use data; this enables a drug's proportional share of specific adverse events, relative to its therapeutic class, to be compared to its respective proportional share of drug use. The assumption is that the adverse event distribution of drugs in a therapeutic class should be the same as the distribution of drug use in that class, if all drugs in the class were to carry the same risk. Actual examples of drug-adverse event associations signaled by the screening method are presented. The potential uses of this methodology in other settings, and under other data situations, are discussed.
Perspectives on Medical Specialization
Authors: Schondelmeyer Stephen W. , Kirking Duane M. 
Published: May 2016

The role of specialization in pharmacy practice is an important issue confronting the profession today. The historical evolution of specialization in American medicine is presented. Medicine, while not a complete model of specialization, probably has the most mature structure of any profession. Pharmacy, in directing its own specialization process, can learn from medicine's experience. Emergence of specialties is a function of both social and technological change. An increase in the knowledge base and an expanding technology stimulated physicians to specialize. The narrowing technical interests of the medical specialist led to the formation of elite specialty societies. While these organizations initially moved to develop specialty education and training programs, later they came to have a significant impact on the entire medical profession. A major decision for medicine was the requirement that all physicians receive the same general medical education — the M.D. degree — prior to entering specialty training. Advanced specialty training through internship and residency programs predominated over programs offered by degree-granting institutions. Attempts by state agencies to license medical specialists were defeated, and a system of certification by specialty boards has flourished. The specialization process in pharmacy, however, has not developed to the same extent as in medicine. The process in pharmacy has been characterized by a lack of coordination between involved organizations and institutions. If specialization is to enhance the individual specialties, the profession of pharmacy, and the public interest, it must be developed as a planned, rather than a random, process.
Perceived Clinical Significance of Consultant Pharmacist Recommendations in the Skilled Nursing Facility
Authors: Lamy Peter P. , Miller Douglas A. , Lucarotti Richard L. , Vlasses Peter H. , Krigstein David J. , McKercher Patrick L. 
Published: May 2016

In an attempt to determine if pharmacists could make significant contributions to SNF patient care in the area of disease management, the drug therapy of the residents of two SNFs was reviewed once monthly for six months by two clinical pharmacist consultants. Pharmacist-identified problems and recommendations were communicated in writing to the medical staff by means of a communication form attached to the patient's chart. Nearly 72 percent of the recommendations made were accepted by the SNF physicians. Descriptions of the cases and corresponding recommendations were distributed to review-panel physicians. These physicians were asked to agree or disagree with the pharmacists' suggestions, and to rate the clinical significance of each recommendation using a modified Likert scale. The clinical pharmacist-consultants were perceived to have had a significant input into disease management in SNF patients.
Activity of Antibiotic Admixtures Subjected to Different Freeze-Thaw Treatments
Authors: Holmes C. J. , Ausman R. K. , Walter C. W. , Kundsin R. B. 
Published: May 2016

The freezing of antibiotic admixtures has been proposed as a potentially useful method by which the efficiency of admixture services might be improved. The time involved in thawing, however. has discouraged the implementation of this practice. This study describes a technique of thawing frozen antibiotic admixtures contained in minibags in commercially available microwave ovens. A quantitative microbiological agar gel diffusion assay was employed to determine the effect of such treatment on the antibiotic activity of the admixture. Admixtures containing cephalothin sodium, cefazolin sodium, cefamandole nafate, cefoxitin sodium, penicillin G potassium, ampicillin sodium, oxacillin sodium, carbenicillin disodium, and gentamicin sulfate in dextrose 5% solution were frozen at — 20°C for 30 days. The admixtures were assayed immediately before freezing, and again after either thawing technique: that is, upon exposure of the minibags to room temperature air or to microwave radiation. Assays were also performed 8 and 24 hours after thawing in order to assess antibiotic stability following each freeze-thaw treatment. It was discovered that, with the exception of ampicillin sodium, each of the antibiotics studied could be frozen and thawed as described without significant loss of activity, and were stable for 24 hours after thawing. The application of a freeze microwave-thaw technique to central admixture services can be seen as a cost-effective method of circumventing many of the problems associated with existing programs.
A Novel, Experiential Course in Applied Pharmacokinetics
Authors: Murphy John E. , Robinson J. Daniel , Gammill George D. 
Published: May 2016

An experiential course in applied pharmacokinetics is discussed. Objectives of the course and methods for conducting such a course are described. Results of student recommendations concerning patients' dosage regimens, along with the types of recommendations made, are outlined. Methods of instruction designed to increase clinical knowledge may best be accomplished through actual patient contact. It appears that this course is well accepted and can be adapted for use in various settings.
Clinical Pharmacist Intervention in an Extended Care Facility
Authors: Mutnick Alan H. , Swanson Larry N. 
Published: May 2016

A four-month study was conducted at an extended care facility to determine if Jelliffe's method of digoxin dosing yielded a lower incidence of digoxin toxicity without loss of therapeutic efficacy, as compared with an established way of dosing. The study was divided into two phases. During both phases, all patients at an extended care facility taking oral digoxin were monitored for signs and symptoms of both digoxin intoxication and digoxin underdosage. The same patients were studied in both phases, and the number and frequency of observations made on these patients was also identical. Serum digoxin, potassium, and creatinine levels, and electrocardiograms were obtained monthly to aid in the documentation of digoxin underdosage or toxicity. In Phase I (control), the patients' digoxin regimens were determined by physician order without any pharmacist intervention. In Phase II (study), all patients were dosed based upon the calculations made by the clinical pharmacist using Jelliffe's method. Clinical pharmacist intervention with the use of Jelliffe's method for digoxin dosing yielded a statistically significant decrease in toxicity and a decreased incidence of digoxin underdosage in Phase II as compared with Phase I, without any compromise in therapy.
A Comparative Evaluation of Oral Anticoagulant-Phenytoin Interactions
Authors: Taylor Jerry W. , Alexander Bruce , Lyon Lynn W. 
Published: May 2016

This article reviews the literature concerning oral anticoagulant-phenytoin interactions. Two cases involving concurrent warfarin-phenytoin administration are discussed. The medical literature supports a major interaction between dicumarol and phenytoin. Dicumarol significantly increases phenytoin levels, while the effect of phenytoin on dicumarol lessens anticoagulant activity. The available evidence indicates oral anticoagulants differ in their interactions with phenytoin. The mechanisms involved in oral anticoagulant-phenytoin interactions are also discussed.
Clinical Pharmacokinetics of Antiepileptic Drugs
Authors: van der Kleijn E. , Schobben F. , Vree T.B. 
Published: May 2016

Methods for the calculation of dosage regimen, based on studies about rates of absorption, distribution, and elimination of antiepileptic drugs in patients with different medical conditions, are described. These methods are meant to provide more accurate guidelines for treating patients. When the therapeutic concentration of a drug chosen for the established diagnosis is known, and the clearance of the drug in the given circumstances is also known, then the dose rate (dose per time interval) can be calculated. By determining the plasma concentration at appropriate time periods, it is possible to monitor therapy. Simultaneous clinical observation is necessary to judge and audit the quality and adequacy of the medication.
Alprazolam (Xanax®, the Upjohn Company)
Authors: Evans R. Lee , Cardoni Alex A. 
Published: May 2016

Alprazolam is a triazolobenzodiazepine, a derivative of the benzodiazepines. Comparison studies of alprazolam and diazepam or chlordiazepoxide in patients suffering from clinical anxiety secondary to anxiety neurosis or chronic alcohol withdrawal suggest an equal efficacy of those agents. Studies examining the use of alprazolam for the treatment of “primary depression” suggest that it is as effective as imipramine in the treatment of exogenous (reactive) depression. Although alprazolam may be effective in patients with exogenous depression, no extrapolation can be made to the treatment of endogenous depression. Mechanisms of action have not been fully elucidated, but probably are similar to those of other benzodiazepines. Peak blood levels are reached in 0.7–1.6 hours and the elimination half-life after steady state is approximately 19 hours. Daily dosages established from clinical studies ranged from 1 to 6 mg. Clinically, alprazolam appears to be ten times more potent than diazepam. Drowsiness, headaches, lightheadedness, dry mouth, and depression appear to be the most common side effects of the drug. It is concluded that alprazolam offers no striking therapeutic advantage over currently marketed benzodiazepines.
Teratogenesis: A Review of the Basic Principles with a Discussion of Selected Agents: Part III
Authors: Hays Dennis P. 
Published: May 2016

Before a woman realizes she is pregnant, a large amount of development has occurred in the embryo. If she consumes a drug during her pregnancy, the possibility exists that the drug could harm the fetus. The most important variable is timing, with the fetus showing the highest degree of susceptibility during the first trimester of gestation. This article presents data on the relative time a pregnancy test becomes positive as compared to fetal development; passage of drugs across the placenta; placental and fetal drug metabolism; and the availability of teratogenic information to health professionals. Teratogenic effects of specific substances or classes of substances are discussed, including alcohol, analgesics, antibiotics, anticoagulants, anticonvulsants, antithyroid/thyroid drugs, various environmental agents, and paternal drug exposure.