bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lactulose in the Management of Constipation: A Current Review
Authors: Kot Theresa V. , Pettit-Young Ngaire A. 
Published: January 2017

OBJECTIVE: To review the current published clinical studies evaluating the clinical efficacy and safety of lactulose compared with other laxatives or placebo. Adverse effects associated with lactulose are also reported. DATA SOURCES: Information was retrieved by searching the MEDLINE and EMBASE databases for clinical trials, abstracts, conference proceedings, and review articles dealing with lactulose. STUDY SELECTION: Emphasis was placed on clinical trials where lactulose was compared with other laxatives or placebo in patient populations where the diagnosis of constipation was reasonably established. DATA EXTRACTION: The methodology and results from clinical studies were evaluated. Assessment of the studies was made based on diagnosis of constipation, prior management of patients, follow-up of patients, dosage, and adverse effects. DATA SYNTHESIS: Clinical trials in geriatric patients, terminally ill patients, children, and normal and constipated subjects were reviewed. In most instances, lactulose was compared with a placebo, without incorporating the current education on dietary techniques for improving defecation. CONCLUSIONS: Generally, clinical trials have demonstrated a beneficial response compared with placebo, although sometimes that response has been only marginally better, from a clinical point of view.
Professional Self-Image among Israeli Pharmacists: Sectoral Differences
Authors: Lustig Ahuva , Zusman Shlomo P. 
Published: January 2017

OBJECTIVE: To examine sectoral differences in the professional activities and self-images of Israeli pharmacists. DESIGN, SETTING, AND PARTICIPANTS: Pharmacists from private, community, and hospital sectors (n=145) completed a survey that assessed the rewards accrued from their professional activities as pharmacists and evaluated their professional and sectoral self-image. RESULTS: Few intersectoral differences were found among Israeli pharmacists. Most agreed that the main rewards in the public sector are secure employment, intellectual challenge, and responsibility. In the private sector, the rewards are high income, responsibility, and opportunity to counsel. The majority of pharmacists in all sectors are satisfied with their profession, and 90.7 percent would choose it again. Nevertheless, they ranked pharmacy eighth among nine professions chosen for comparison, which shows quite a low professional image. The private and hospital pharmacists attributed a higher social status to their own sectors than to the community sector. CONCLUSIONS: The inferior professional self-image held by pharmacists, despite the rewards of the profession, should be examined in greater detail.
Lithium-Induced Parathyroid Dysfunction: A Case Report and Review of the Literature
Authors: Taylor Jerry W. , Bell Angela J. 
Published: January 2017

OBJECTIVE: Twenty-six cases of lithium-induced hyperparathyroidism have been reported in the literature. This article describes an additional case that illustrates current management recommendations. DESIGN: Case report. Clinical presentation and proposed mechanisms of the suspected drug-induced effect are discussed. CONCLUSIONS: Serum calcium concentrations should be determined before and periodically during long-term lithium carbonate therapy. Discontinuation of therapy in patients who develop lithium-induced parathyroid dysfunction generally corrects calcium and parathyroid hormone concentrations. Surgery is indicated in patients with complications of hyperparathyroidism.
Clinical Update on Pentoxifylline Therapy for Diabetes-Induced Peripheral Vascular Disease
Authors: Campbell R. Keith 
Published: January 2017

OBJECTIVE: To introduce readers to the use of pentoxifylline for diabetes-induced peripheral vascular disease. The article provides background on the pathophysiology of diabetic foot ulcers as well as a review of the literature on the therapeutic use of pentoxifylline for treating this disorder. DATA SOURCES: A MEDLINE search was used to identify pertinent literature, including review articles and case reports. Key index terms included pentoxifylline, diabetic foot ulcer, neuropathy, peripheral vascular disease, and intermittent claudication DATA EXTRACTION: Basic pharmacologic data regarding absorption, distribution, metabolism, and excretion were reported in normal subjects as well as in patients with renal impairment. Open and controlled clinical trials also were analyzed; subjective symptoms were reported. The economic implications also were reported. The pharmacist's role in patient education is discussed. DATA SYNTHESIS: Pentoxifylline 800 mg/d was found to be effective in improving the symptoms in patients with noninsulin-dependent diabetes mellitus, including improvement in walking distance, paresthesia, skin temperature, and subjective overall response. In nondiabetic patients, statistically significant differences in leg-ulcer healing were found between the treatment and placebo groups. Case reports illustrated healing times, which ranged from two weeks to six months. Pentoxifylline use in both insulin-dependent and noninsulin-dependent patients was assessed in clinical trials, with improvement of symptoms in both patient types. CONCLUSIONS: Studies show that pentoxifylline is an alternative to vascular surgery in the management of peripheral vascular disease in diabetic patients, particularly in those with chronic ulceration of the lower extremities that does not heal despite other optimal treatment regimens, including cessation of smoking, maintenance of normoglycemia, elimination of vasoconstrictive drugs, correctly fitted shoes, and appropriate wound care. Pentoxifylline therapy may provide an appropriate, economical treatment modality by reducing the need for hospitalization and vascular surgery.
1993 Bibliography: A 32-Year Literature Review on the Value and Acceptance of Ambulatory Care Provided by Pharmacists
Authors: Hatoum Hind T. , Akhras Kasem 
Published: January 2017

OBJECTIVE: To review the published literature on the value and acceptance of pharmaceutical services provided by pharmacists in ambulatory care settings. DATA SOURCES AND METHODS: Articles published between 1960 and 1992. A MEDLINE search of the English-language literature was conducted using the terms pharmacists, services, and ambulatory settings. Studies were selected for inclusion if they addressed services provided by pharmacists in ambulatory settings and dealt with the cost of patient care, quality of care, or attitudinal surveys. Original research reports were summarized according to objectives, sample size, duration of study, methods, and findings. Summaries were categorized according to reported positive impact, negative impact, or investigational reports with no outcome. RESULTS: One hundred seventy articles were identified; 104 of them reported research data and were summarized. The 1970s was the most prolific decade for publication of articles reporting positive, negative, or no impact, which numbered 47, 20, and 37, respectively. Positive correlation was found among studies conducted according to predetermined protocol and reporting positive impact. Moreover, academic interest in pharmacy varied for the different decades. CONCLUSIONS: Collectively, this article provides references of the published reports on pharmacy professional services in ambulatory care settings, and a summary of the articles reporting research data. Additional and more focused research on pharmaceutical services in the community is needed. Emphasis is required on practicing pharmacists' attitudes toward nondispensing, patient-oriented pharmaceutical services; the impact of educational changes on the practice of pharmacy and consumers' attitudes and willingness to pay for services; and the link between patient outcome and pharmaceutical services.
Prescription Drug Use among Ambulatory Elderly in a Swedish Municipality
Authors: Jörgensen Tove M. , Isacson Dag G.L. , Thorslund Mats 
Published: January 2017

OBJECTIVE: To analyze prescription drug use among the elderly in a Swedish municipality. METHODS: The municipality of Tierp, located in mideastern Sweden, is a well-defined geographic area that includes both rural areas and a few small, industrial towns. All people aged 65 years and older (n=4769) as of 1986 in a total population of 21000 inhabitants were included in the study. Their drug use was studied by registering all prescriptions filled by the pharmacies in the area. RESULTS: Most of the elderly (>70 percent) obtained at least one prescription during the year studied. Drug use was more common among women than men. However, the difference between men and women was much smaller among those aged 85 years or more. The drugs most commonly prescribed were cardiovascular, psychotropic, and analgesic agents. Furthermore, the study showed that simultaneous use of several drugs was quite common. One-fourth of all people aged 65 years and older used drugs from at least four different pharmacologic groups. CONCLUSIONS: Our results revealed widespread use of prescription drugs among the elderly. An important finding was extensive drug use among men aged 85 years or more. This age group is increasing and there is need for further studies of its medication use.
Penetration of Intravenous and Oral Ciprofloxacin into Sterile and Empyemic Human Pleural Fluid
Authors: Joseph Joe , Vaughan Leigh M. , Basran Gurnam S. 
Published: January 2017

OBJECIVE: To compare the penetration of oral and intravenously administered ciprofloxacin into infected (empyemic) and noninfected(sterile) human pleural fluid. DESIGN: Eleven men and 5 women (aged 29–76) were consecutivelyselected from adult patients referred to the respiratory unit forpleural effusion. In this open-label, prospective trial, 13 patients withsterile pleural effusions were nonrandomly assigned to receive eitherciprofloxacin 200 mg (single intravenous dose), 750 mg (single oraldose), or 750 mg (two oral doses per day for 3 days); 3 patients withinfected pleural effusions received 750 mg oral doses for 10 days. Simultaneous pleural fluid and venous blood specimens were drawnover 5 hours after single dose or when steady-state was attained, andciprofloxacin concentrations were measured by HPLC. RESULTS: Pleural fluid concentrations of ciprofloxacin equaledplasma concentrations 1.5 hours after 200 mg was givenintravenously and the pleural/plasma ratio remained ∼ 0.9 for 4hours. After a single 750-mg oral dose, pleural ciprofloxacinconcentrations rose from 0 to 1.4 ug/ml, over 5 hours with thehighest pleural fluid/plasma ratio (0.7) at 5 hours. Average steadystateciprofloxacin concentrations in sterile pleural fluid after 750mg administered twice daily for 3 days, ranged between 1.1 and 1.8ug/rnl, with ratios between 0.3 and 0.9 over 4 hours. In empyemicpleural fluid at the same dosage, average steady-state ciprofloxacinconcentrations ranged between 1.9 and 3.4 ug/ml, with ratiosbetween 1.0 and 2.0 over 5 hours. CONCLUSIONS: Oral ciprofloxacin penetrates into sterile andempyemic pleural fluid with concentrations 30–90 percent and100–200 percent of plasma concentrations, respectively.
Otic Administration of Amphotericin B 0.25% in Sterile Water
Authors: Kintzel Polly E. , Trausch Diane E. , Copfer Amy L. 
Published: January 2017

OBJECTIVE: To report otic administration of parenteral amphotericin B 0.25% in sterile water. CASE SUMMARY: A 44-year-old HIV+ man was diagnosed with otitis extema. The patient's past medical history was remarkable for positive Coccidioides immitis serology for more than five months, essential hypertension, and Barrett's esophagitis. Culture results from an ear swab revealed 4+ Aspergillus fumigatus and 3+ Staphylococcus, coagulase negative. Antiinfective therapy for the otitisextema included oral and topical antibacterial and antifungal medications. AmphotericinB 0.25% in sterile water was prepared by the pharmacy for topical otic administration. The otic amphotericin B was dispensed with instructions to refrigerate and assigned a one-week expiration date. The prescription called for instillation of 1–2 drops in each ear three times a day. The patient's signs and symptoms of otitis extema resolved during several weeks of antiinfective therapy. Topical administration of amphotericin B 0.25% in sterile water was not associated with any local adverse effects in this patient. DISCUSSION: The rationale for use of the parenteral amphotericin B formulation to prepare an otic dosage form, and the rationale for the specific concentration and expiration date chosen are discussed. CONCLUSIONS: This patient tolerated topical otic administration of amphotericinB 0.25% in sterile water when administered three times daily.
Cyclosporine Monitoring Improves Graft-Versus-Host Disease Prophylaxis after Bone Marrow Transplantation
Authors: Ghalie Richard , Fitzsimmons William E. , Weinstein Alan , Manson Sharon , Kaizer Herbert 
Published: January 2017

OBJECTIVE: The principal objective of this study was to determine whether a relationship exists between trough cyclosporine concentrations measured by HPLC and the development of acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation. DESIGN: A retrospective analysis of 59 consecutive human leukocyte antigen-matched bone marrow transplants. Patients received uniform GVHD prophylaxis with cyclosporine and methotrexate. Whole blood trough cyclosporine concentrations were measured at least twice weekly during hospitalization and weekly after discharge. SETTING: A dedicated bone marrow transplant unit in an academic center. MAIN OUTCOME MEASURES: The means of cyclosporine concentrations were assessed for each patient on a weekly basis during the first 50 days after transplant. These means were compared between patients developing grade 2–4 acute GVHD and patients without significant GVHD. RESULTS: Eighteen patients developed acute GVHD at a median of 25 days after bone marrow transplant (range 10–50). There was no correlation between the development of GVHD and patient age, diagnosis, donor age, donor gender, donor-recipient gender mismatch, and time to neutrophil engraftment (> 1000 × 106cells/L). Although mean weekly cyclosporine concentrations were consistently lower in patients developing acute GVHD, the difference in values compared with those of patients with GVHD was not statistically significant. Mean weekly cyclosporine concentrations at the time of neutrophil engrafiment were statistically associated with the development of GVHD. Patients with GVHD had mean ? SD concentrations of 174 ± 69 ng/mL, significantly lower than 254 ± 114 ng/mL in patients without GVHD. Furthermore, the rate of GVHD was 82 percent in patients with mean concentrations <200 ng/mL at the time of neutrophil engrafiment as compared with a rate of 34 percent in patients with concentrations ≥200 ng/mL (relative risk = 2.4). Also, mean cyclosporine concentrations measured during the week of onset of GVHD were significantly lower compared with mean cyclosporine concentrations of all other patients at risk of GVHD during that week. CONCLUSIONS: Cyclosporine concentrations are associated with the development of acute GVHD. Patients with HPLC whole blood concentrations <200 ngl/mL are at significantly higher risk of developing GVHD, particularly if these concentrations are observed during the week of neutrophil engrafirnent. More effective GVHD prophylaxis could be achieved by careful monitoring of cyclosporine concentrations after transplant.
Theophylline Disposition in Korean Patients with Congestive Heart Failure
Authors: Jeong Chan Su , Hwang Soon Chul , Jones Daniel W. , Ryu Hwan Sun , Sohn Kieho , Sands Charles D. 
Published: January 2017

OBJECTIVE: This study proposed to determine the systemic disposition on of theophyllinein Korean adult patients during decompensated congestive heart failure compared with disposition after recovery. DESIGN: An experimental, prospective, self-controlled, non randomized design was used. SETTING: The study was performed in a general communityhospital located in Pusan, Korea. PATIENTS: Eight nonsmoking elderly Korean patients with decompensated congestive heart failure presenting to the emergency department were included in the study. Consecutive patients who met entrance criteria were selected. All patients completed the study. INTERVENTIONS: A single dose of aminophylline 6 mg/kg was administered by intravenous infusion over 30 minutes. Standard methods of congestive heart failure therapy were used in each patient, including bed rest, restriction of sodium, and drug therapy including digoxin. After compensation of congestive heart failure was achieved the theophylline infusion was repeated. OUTCOME MEASURES: Serum theophylline concentrations were measured at 2, 6, 12, and 18 hours after completion of the dose at base line and following treatment. RESULTS: A clinically and statistically significant improvement in mean theophylline total body clearance was demonstrated following treatment (from 21.7 ± 2.8 to 43.4 ± 4.7 mL/kg/h [mean ± SEM]; p<0.01). Comparison of these results with a computer model based on literature averages of peoples of all nationalities showed significant underprediction of theophylline clearance both before (p<0.05)and after (p<0.01) treatment. The theophylline elimination half-life prior to treatment was 18.2 ± 2.2 hours and decreased to 9.1 ± 0.8 hours following treatment(p<0.O1). There was no statistical difference between the computer-model predicted initial theophylline half-life and the measured value, but the model significantly underpredicted the improvement following treatment. CONCLUSIONS: The improvement in theophylline clearance demonstrated in this study appears to be greater than that reported for Western patients. This has practical application to the calculation of appropriate theophylline maintenance dosage regimens in Korean patients with cardiac failure. These data support the need for consideration of racial differences in individualizing dosage regimens. We suggest that all kinetic models, whether software supported or not, should consider incorporating ethnic origin as a demographic factor that helps select the proper model for individual patients.
Stability and Activity of Intravenous Immunoglobulin with Neonatal Dextrose and Total Parenteral Nutrient Solutions
Authors: Lindsay Christine A. , Dang Ken , Adams James M. , Ou Ching Nan , Baker Carol J. 
Published: January 2017

OBJECTIVE: To determine in vitro the compatibility of reconstituted intravenous immunoglobulin (IVIG) (Gammagard, Baxter-Hyland) with five different neonatal and pediatric intravenous solutions in Viaflex polyvinyl chloride bags. DESIGN: In vitro compatibility study. INTERVENTIONS: Samples were taken at time=0, 10, 30, 60, 90, and 120 minutes and at 4, 8, 12, and 24 hours and assayed for total immunoglobulin G content and antibodies to hepatitis B surface antigen. Type III group B Streptococcus (GBS) and opsonic activity for type III GBS were analyzed at time=0, 60, and 120 minutes and 12 and 24 hours. All results were compared with those from pure IVIG. RESULTS: Our results demonstrate that mixing IVIG with intravenous solutions commonly used in the care of premature infants (dextrose 5% in water [D5W], D15W, D5W/NaCl 0.225%, and total parenteral nutrition [TPN]) does not significantly alter total immunoglobulin G concentrations or concentration of antibodies to hepatitis B surface antigen or type III GBS. As well, the in vitro functional activity for type III GBS of the IVIG, when mixed with these solutions for up to 24 hours, remained intact. An apparent decrease in bactericidal killing was seen with the IVIG/central TPN mixture. This apparent decrease was found to be an artifact of the high concentration of glucose (20 percent) in the solution. CONCLUSIONS: We propose that Gammagard may be mixed with these solutions through Y-site connections without loss of antibody content or functional activity of the IVIG.
Stability of Diluted Dexamethasone Sodium Phosphate Injection at Two Temperatures
Authors: Lugo Ralph A. , Nahata Milap C. 
Published: January 2017

OBJECTIVE: Premature neonates with bronchopulmonary dysplasia frequently are treated with intravenous dexamethasone for their chronic lung disease. The injection volumes of the commercially available products often are too small to measure accurately. The objective of this study was to evaluate the stability over 28 days of dexamethasone sodium phosphate injection 4 mg/mL diluted with bacteriostatic NaCl 0.9% to 1 mg/mL. DESIGN: Ten vials of dexamethasone 1 mg/mL were prepared from dexamethasone sodium phosphate injection, USP 4 mg/mL and bacteriostatic NaCl 0.9% injection. Five vials were stored at 4 °C and five at 22 °C. Dexamethasone was measured on days 0, 1, 3, 7, 14, 21, and 28 by an accurate, reproducible, and stability-indicating HPLC method. Samples were also inspected visually for precipitation or discoloration on each study day. RESULTS: The samples retained at least 97.7 percent of the original concentration of dexamethasone sodium phosphate when stored at either 4 or 22 °C for 28 days. No discoloration or precipitation was observed. CONCLUSIONS: Dexamethasone sodium phosphate injection 1 mg/mL in bacteriostatic NaCl 0.9% was stable for 28 days at 4 and 22 °C.
Busulfan
Authors: Buggia Isabella , Locatelli Franco , Regazzi Mario B. , Zecca Marco 
Published: January 2017

OBJECTIVE: To review the current published studies evaluating the pharmacokinetics, clinical efficacy, safety, and toxicity of busulfan in pediatric and adult patients. DATA SOURCES: English-language literature published between 1953 and 1993 was analyzed; pertinent literature was reviewed. STUDY SELECTION: Emphasis was placed on pharmacologic studies and clinical trials involving busulfan therapy both in myeloproliferative disorders and in conditioning regimens for autologous or allogeneic bone marrow transplantation. DATA EXTRACTION: Data from both pediatric and adult studies were evaluated; emphasis was placed on the relationship between plasma concentrations of busulfan and its efficacy and toxicity. DATA SYNTHESIS: Busulfan has been used widely at conventional dosages (1–12 mg/d) for the treatment of patients with chronic myelogenous leukemia (CML). Busulfan at high doses (usually 16 mg/kg) given with other cytotoxic drugs (especially cyclophosphamide) is a common preparative regimen in patients undergoing allogeneic or autologous bone marrow transplantation (BMT) for acute or chronic leukemia and other nonmalignant disorders (e.g., hemoglobinopathies, inborn error of immune system, congenital metabolic disorders). Pharmacokinetics of high-dose busulfan are age-dependent. Busulfan systemic exposure and, thus, tissue and tumor exposure are lower in children than with adults. Relationships between toxicity (principally neutropenia, hepatic veno-occlusive disease, incidence of seizures) and drug exposure were found for busulfan. CONCLUSIONS: Busulfan is a useful, sufficiently safe drug in the treatment of patients with CML. At higher dosages, busulfan is a fundamental part of myeloablative therapies for patients undergoing BMT. As the pharmacokinetics and metabolism of busulfan is further understood, there is great potential for improving treatment outcome. An assessment of maximal tolerated exposure determined by therapeutic drug monitoring may decrease the incidence and lethality of regimen-related toxicities.