bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Bad-Shahs of Small Budget: The Small-budget Hindi Film of the B Circuit
Authors: Subba Vibhushan 
Published: January 2017

Since the early 1990s Kanti Shah has made over a hundred and forty films which cut across genres—from badland bandit films to raging action features, from horror to erotica. He has been called the “badshah” of B grade, the “sultan” of C grade, “a man forever associated with India’s adult film industry” but remains an interesting figure because he has slipped in and out of strict categorizations, having dabbled with films that fall under all the grades—A, B, and C—if those categories apply. However, most of Shah’s films have always been cast aside as degraded cultural artifacts hidden from public view, derided, and excluded from film histories. Using first hand interviews with filmmakers Kanti Shah and his brother Kishan Shah, ethnographic material, reading through journals and archival material, this article as a narrative tracks Kanti Shah’s filmmaking journey through the informal networks of the small-budget film industry (alternatively called B grade, C grade, exploitation films, paracinema) from the late 1980s to present times.
Assessment in basic training: what is the matrix?
Authors: Burke David 
Published: January 2017

Objectives: The aim of this paper is to foster discussion about how best to design a new assessment system for the first three years of RANZCP Fellowship training, under the new regulations for training and assessment to be implemented in 2004. Conclusions: An integrated, flexible, reliable and valid system of formative and summative assessment is required. It should include a variety of assessment tools, measuring a range of domains on a number of occasions during basic training, and it should actively involve trainees, supervisors, patients and other consumers.
Is the satisfied customer one who also Ędoes wellę? The relationship between outcome and parent satisfaction in a child and adolescent mental health service
Authors: Rey Joseph M. , O'brien Margot , Walter Garry 
Published: January 2017

Objective: Research has found little association between parent satisfaction with treatment and outcome. This report aimed to examine correlates of parental satisfaction with treatment of their child, in a child and adolescent mental health service. Method: The study was conducted in the Rivendell Unit, Sydney. Fifty-eight satisfied and 53 dissatisfied parents were identified using the Patient Satisfaction Questionnaire. Two outcome measure were used, a rating by an independent researcher and another from the patient's treating clinician. Results: After controlling for potential confounders, satisfied parents were eight times (95% CI = 2.0--34.5) more likely to have a child rated as having had a satisfactory outcome by the treating clinician. Conversely, children of satisfied parents were six times more likely to have been rated as improved (95% CI = 1.4--22.5). Conclusions: Contrary to previous reports, this study suggests that parental satisfaction is associated with outcome of treatment.
Factors contributing to difficulty with psychiatric disorder among junior medical staff
Authors: Solar Ann 
Published: January 2017

Objective: This study examines the attitudes and difficulties that junior medical staff, working in the emergency department of a teaching hospital, have in relation to psychiatric disorders. Method: Systematic textual analysis of nine in-depth interviews. Results: Three major categories identified were emotional difficulty with patient interaction, uncertainty and pessimism. Conclusion: Those doctors able to self reflect and adjust their level of emotional distance appropriately had less emotional difficulty interacting with psychiatric patients. They were also more comfortable in dealing with the issue of uncertainty associated with psychiatric disorder. There was a worrying level of pessimism regarding prognosis in psychiatric disorder.
Looking after our future colleagues: an experience from a provincial hospital in New Zealand
Authors: Kumar Shailesh , Aitken Denise 
Published: January 2017

Obective: To describe a support group developed in New Zealand for junior resident medical officers. Conclusions: Fresh medical graduates starting as junior doctors are faced with numerous stresses. Abusive relationships with supervisor, the need to balance personal and professional lives, limited ability to deal with all of the factual knowledge or with patients adequately, long, unsocial hours, financial pressures, the need to rapidly acquire the organisational skills to manage a job with multiple tasks and multiple interruptions, and being the lowest in the hierarchy are just some of the stresses junior doctors face. We, in our roles as intern supervisors, have found that running weekly support groups along with some structured sessions on how to maintain personal well being have been helpful in providing support to the junior doctors working in our hospital. Our experience is described and the implications are discussed.
Evaluation of Two Over-the-Counter Natural Thyroid Hormone Preparations in Human Volunteers
Authors: Csako Gyorgy , Corso Diane M. , Kestner Jane , Bokser Allan D. , Kennedy Paul E. , Pucino Frank 
Published: January 2017

OBJECTIVE: To determine the pharmacologic activity of over-the-counter (OTC) thyroid preparations. DESIGN: In vitro analysis and a prospective, crossover study in vivo. SETTING: Tertiary care center. PARTICIPANTS: Two healthy adult volunteers INTERVENTION: Three OTC preparations (Thytrophin PMG [bovine thyroid PMG extract], Thyro Forte [thyroid lyphogland concentrate with synergistic complex], and Thyro Complex [thyroid lyophilized gland concentrate with synergistic complex]) were analyzed in vitro. Volunteers were administered two times the manufacturer's maximum recommended daily dose of either Thytrophin PMG or Thyro Forte for one week, washed out for four to five weeks, and crossed over to receive the opposite tablet preparation for an additional week. MAIN OUTCOME MEASURES: The triiodothyronine (T3) and thyroxine (T4) contents of OTC preparations were measured by HPLC. Vital signs, serum total and free T4, total T3, thyroid stimulating hormone, thyroxine binding globulin, thyroglobulin, and general chemistry tests (including glucose and cholesterol) were monitored before, during, and between administration of the products. RESULTS: HPLC analysis of the three OTC preparations showed no T4 but did show possible T3 in two of these products. We found no definite clinical or laboratory evidence of thyroid hormone excess with either product. CONCLUSIONS: Healthcare professionals should advise against the use of these scientifically unsound and relatively expensive OTC thyroid preparations, of which the therapeutic efficacy is unknown.
Cyanide Toxicity from Sodium Nitroprusside: Risks and Management
Authors: Rindone Joseph P. , Sloane Edward P. 
Published: January 2017

OBJECTIVE: To review the risks, manifestations, and treatment of cyanide toxicity from nitroprusside therapy. DATA SOURCES: All English case reports identified in Index Medicus (MEDLINE) of cyanide intoxication related to nitroprusside from 1970 to the present were reviewed. In addition, literature regarding the incidence, risks, and treatment of cyanide toxicity from nitroprusside is presented. CONCLUSIONS: Numerous cases of cyanide toxicity associated with nitroprusside have been reported. The overall incidence appears to be infrequent; however, certain patients may be at high risk. Risk factors may include hypoalbuminemia, cardiopulmonary bypass procedures, or the administration of moderate to high doses of nitroprusside. Treatment of cyanide toxicity requires the cessation of nitroprusside and, for severe toxicity, use of the cyanide antidote kit. Cyanide toxicity from nitroprusside may be prevented by concomitant administration of sodium thiosulfate infusions.
Effectiveness of a Gentamicin Dosing Protocol Based on Postconceptional Age: Comparison to Published Neonatal Guidelines
Authors: Reed Michael D. , Lopez-Samblas Ana M. , Torres Carmen L. , Wang Helena , Feuer William J. , Goldberg Ronald N. 
Published: January 2017

OBJECTIVE: To evaluate the effectiveness of a gentamicin dosing protocol based on postconceptional age in producing therapeutic serum concentrations and to compare the protocol with commonly used gentamicin dosing guidelines. DESIGN: During the initial three months of this study infants were dosed according to physician discretion (group I). In the subsequent three-month period patients were dosed according to a postconceptional age dosing schedule (group II). SETTING: Infants were enrolled after being admitted to the Newborn Intensive Care Unit at the University of Miami/Jackson Memorial Medical Center. PATIENTS: Infants less than 37 weeks gestational age with normal renal function, not receiving indomethacin, and requiring gentamicin treatment were enrolled. Fifty-nine infants were enrolled into group I (median weight 1300 g [range 720–3300]), postconceptional age 29 weeks [26–37]); and 68 infants were enrolled into group II (weight 970 g [530–3000], postconceptional age 29 weeks [24–36]). INTERVENTION: Patients in group II were dosed according to the following protocol: postconceptional age <30 weeks, 3.0 mg/kg q24h, and postconceptional age 30–37 weeks, 2.5 mg/kg q18h. Peak and trough serum gentamicin concentrations were obtained in all study patients. Pharmacokinetic parameters were calculated from measured serum concentrations. Using the calculated pharmacokinetic data, peak and trough serum concentrations were simulated for five published neonatal dosing guidelines and the proposed postconceptional age protocol. MAIN OUTCOME MEASURES: The number of therapeutic serum gentamicin concentrations resulting from the dosing guidelines studied were compared. RESULTS: Measured trough concentrations differed significantly between the two groups with 35 percent of patients in group I and 90 percent of patients in group II having trough values <2 mg/L (p<0.001). There was no significant difference in measured peak concentrations between groups. Simulated trough concentrations were significantly different when postconceptional age dosing was compared with commonly used protocols (p<0.0001) with the highest percentage of concentrations <2 mg/L (89 percent) resulting from the proposed postconceptional age guidelines. CONCLUSIONS: These data suggest that the proposed postconceptional age protocol is reproducible and reliable in achieving therapeutic gentamicin serum concentrations in neonates.
Thallium-201 Myocardial Imaging in Patients with Coronary Artery Disease: Comparison of Intravenous Adenosine and Oral Dipyridamole
Authors: Mohiuddin Syed M. , Gupta Naresh C. , Esterbrooks Dennis J. , Siffring Patricia A. , Frick Mathis P. , Hilleman Daniel E. , Sketch Michael H. 
Published: January 2017

OBJECTIVE: To compare thallium-201 (201Tl) myocardial perfusion imaging following intravenous adenosine and oral dipyridamole. DESIGN: Open-label, randomized, comparison. SETTING: Outpatient, university-affiliated clinic. PATIENTS: Fifteen patients with angiographically documented coronary artery disease. INTERVENTIONS: Planar 201Tl myocardial perfusion imaging following both intravenous adenosine 140 μg/kg/min for six minutes and oral dipyridamole suspension 300 mg. MAIN OUTCOME MEASURES: A comparison between adenosine and dipyridamole was made in the following areas: concordance in interpretation of 201Tl scintigrams, cardiac and noncardiac 201Tl uptake and clearance, hemodynamic and electrocardiographic changes, and adverse effects. RESULTS: The scintigraphic studies showed perfusion defects in 13 patients (87 percent) after dipyridamole and in 15 patients (100 percent) after adenosine. 201Tl uptake and clearance were quantitated in nine myocardial segments and in four extracardiac segments in each patient. 201Tl uptake was not significantly different between adenosine and dipyridamole studies in most cardiac regions. Extracardiac 201Tl uptake was significantly less in the liver and splanchnic regions following adenosine compared with dipyridamole. 201Tl clearance was not significantly different following adenosine and dipyridamole except in the anterolateral region in the anterior view. Hemodynamic changes following administration of intravenous adenosine and oral dipyridamole were not significantly different. Adverse effects were more common with adenosine than with dipyridamole. Adverse effects with adenosine were transient; however, adverse effects with dipyridamole were prolonged and required reversal with aminophylline in 2 patients. No patients required termination of the adenosine infusion or administration of aminophylline. CONCLUSIONS: These preliminary data suggest that adenosine 201Tl imaging may be a useful alternative to dipyridamole 201Tl imaging. Although adenosine produces more frequent adverse effects, they are generally better tolerated than those associated with dipyridamole.
Nonneuroleptic Treatment of Disruptive Behavior in Organic Mental Syndromes
Authors: Smith Daniel A. , Perry Paul J. 
Published: January 2017

OBJECTIVE: To summarize the literature describing nonneuroleptic treatments of unacceptably disruptive behavior in chronically institutionalized psychiatric patients with mental retardation, autism, organic brain syndrome, and dementia. DATA SOURCES: Relevant articles were identified from a MEDLINE search of the above diagnoses linked with “aggression” and “psychomotor agitation.” Additional references were found in the bibliographies of these articles. STUDY SELECTION/DATA EXTRACTION: The studies reviewed were limited to prospective evaluations of nonneuroleptic drug therapy of these behavior disturbances. Case reports, case series, and retrospective studies were excluded. Studies of patients with schizophrenia, affective disorders, and personality disorders were also excluded. DATA SYNTHESIS: Studies of lithium, beta-blockers, carbamazepine, benzodiazepines, and buspirone were adequate for review. As a rule, these studies are hampered by poor design. The lithium studies suggest that mentally retarded patients with behavior disturbances may respond to lithium treatment. The beta-blocker studies suggest improvement in patients with mental retardation, autism, organic brain syndrome, and dementia. Neuroleptic discontinuation or a decrease in dose was possible in some patients. The carbamazepine studies were inconclusive. Carbamazepine should be reserved for patients with concomitant seizure disorders. Benzodiazepines were helpful in treating elderly demented patients. Thus far, buspirone has been evaluated in only a few, poorly designed studies and is not yet recommended for treatment of behavior disturbances. CONCLUSIONS: Legislation has restricted the use of neuroleptics in many patients receiving long-term healthcare. Despite the questionable validity of the studies reviewed, lithium, beta-blockers, carbamazepine, and benzodiazepines may be considered as alternatives to neuroleptics in selected cases.
Contribution of the Human Kidney to the Metabolic Clearance of Drugs
Authors: Vree Tom B. , Hekster Yechiel A. , Anderson Patricia G. 
Published: January 2017

OBJECTIVE: To demonstrate that the human kidney is capable not only of filtering and secreting drugs and their metabolites, but also of carrying out conjugation reactions such as acyl glucuronidation, N-glucuronidation, and glycination. DATA SOURCES: Plasma concentrations and renal excretion rates of drugs are measured and renal clearance is calculated in a series of selected pharmacokinetic studies in healthy human volunteers (some studies were conducted in the authors' laboratory and others were reported in the literature). BACKGROUND THEORY: It is generally agreed that the liver plays the dominant role in drug metabolism, and that the function of the kidneys is limited to excretion of parent drug and metabolites. This can be easily understood when a metabolite is present in both plasma and urine. When the metabolite is present in urine but is not measurable in plasma, then the possibility exists that the metabolite is formed by the kidneys. RESULTS: “Simple” excretion by the kidneys is demonstrated for sulfatroxazole/sulfamethoxazole. Ether glucuronides of codeine are formed in the liver, and the resulting glucuronide is excreted by the kidneys. Possible formation of N1- and N2-glucuronides by the kidneys is demonstrated for sulfadimethoxine, sulfametomidine, and sulfaphenazole. Acyl glucuronidation of probenecid and nalidixic acid is carried out by the kidneys. The acyl glucuronidation of probenecid shows a capacity-limited formation/excretion rate of 46 mg/h, which is subject dependent. During this process, the acyl glucuronidation of co-administered nalidixic acid is reduced from 53 to 16 percent compared with that of nalidixic acid alone. Probenecid and its acyl glucuronidation do not inhibit the ether glucuronidation of codeine in the liver, but only interfere with the active tubular secretion process. The acyl glucuronidation of the nonsteroidal antiinflammatory drug naproxen and its metabolite, O-desmethylnaproxen, may be carried out by the liver and kidneys. Glycination of benzoic acid and salicylic acid is carried out in both the liver and kidneys. CONCLUSIONS: It is difficult to recognize renal drug metabolism in the intact human body (in vivo); the glucuronides or conjugates must be measured via direct HPLC analysis. In cases where the metabolite is present in high concentrations in urine but not in blood, there may be an indication that the kidneys are responsible for the formation of the metabolite. Impaired kidney function not only affects renal excretion but may also affect renal metabolism.
Evaluation of the Reliability and Validity of a Measure of Anxiolytic Drug-Use Intensity for Pharmacoepidemiologic Studies
Authors: Ried L. Douglas , Johnson Richard E. 
Published: January 2017

OBJECTIVE: To assess the reliability and validity of a proposed new standard of drug-use intensity, the minimum marketed dose (MMD), using anxiolytic drugs as models. DESIGN: Retrospective, cohort design. SETTING: Staff model, nonprofit health maintenance organization. PATIENTS/PARTICIPANTS: Eighty-five patients who obtained one or more prescriptions for an anxiolytic, antidepressant, or sedative-hypnotic drug during three consecutive one-year time periods. Fifty-nine patients had a prescription filled during the year before the study. RESULTS: For anxiolytic drugs, the magnitude of the average correlation for the MMD measure of drug-use intensity was greater than the total number of prescriptions and the total number of dosage units. Discriminant validity was demonstrated because the MMD was not correlated with measures in unrelated therapeutic categories. Summed MMD units were shown to significantly predict physical impairment (criterion validity). CONCLUSIONS: The MMD measure of drug-use intensity was reliable and valid for anxiolytic drugs. These findings suggest that information gathered from automated prescription records may be a useful indicator of drug-use intensity in pharmacoepidemiologic studies.
Abnormal Platelet Aggregation Associated with Fluoxetine Therapy
Authors: Alderman Christopher P. , Moritz Claire K. , Ben-Tovim David I. 
Published: January 2017

OBJECTIVE: To document the development of abnormal hemostasis in a patient treated with fluoxetine. CASE SUMMARY: A 49-year-old man developed a release-type defect in platelet aggregation during treatment with fluoxetine. Abnormal platelet aggregation was observed during platelet viability testing, in which adenosine diphosphate, epinephrine, ristocetin, arachidonic acid, and collagen were used as agonists. Two days after the withdrawal of fluoxetine, platelet function returned to normal. DISCUSSION: Fluoxetine is an antidepressant that is thought to act through inhibition of serotonin reuptake in the central nervous system. Fluoxetine also inhibits the reuptake of serotonin in platelets, significantly decreasing granular storage and potentially influencing platelet aggregation characteristics. Clinical manifestations of abnormal platelet function have been reported in association with fluoxetine therapy. CONCLUSIONS: The rapid normalization of platelet aggregation after the withdrawal of fluoxetine in this patient does not conform to the known clinical pharmacokinetics of norfluoxetine. The half-life of fluoxetine is shorter, suggesting that the parent drug (rather than norfluoxetine) was the causative agent. Serum fluoxetine and norfluoxetine concentrations were not measured in this patient.
Dobutamine-Induced Fever
Authors: Robison-Strane Susan R. , Bubik Jane Simson 
Published: January 2017

OBJECTIVE: To report a case of dobutamine-induced fever. PATIENT: A 71-year-old woman with congestive heart failure who developed a fever after receiving dobutamine during two separate hospital admissions. RESULTS: Other possible causes of the fever during the first admission included relapse of staphylococcal sepsis and drug fever from vancomycin or metoclopramide. However, rechallenge with dobutamine on a subsequent admission demonstrated a highly probable relationship between dobutamine and fever. CONCLUSIONS: A strong temporal relationship between dobutamine and fever was noted during the patient's second admission and the case was not complicated by other new medications. No underlying infectious or noninfectious cause of the fever was found. Therefore, when patients receiving dobutamine become febrile, dobutamine should be considered as a possible cause.
Transient Hepatic Dysfunction in an Infant of an Epileptic Mother Treated with Carbamazepine during Pregnancy and Breastfeeding
Authors: Merlob Paul , Mor Naomi , Litwin Aviva 
Published: January 2017

OBJECTIVE: A case is reported of a carbamazepine (CBZ)-treated epileptic mother whose newborn presented with transient hepatic dysfunction characterized by direct hyperbilirubinemia and high concentrations of gamma-glutamyltransferase (GGT). DATA SOURCES: Information was obtained from case reports, clinical trials, and relevant bibliographic laboratory studies. DATA EXTRACTION: Data from case reports were evaluated and compared with those from our patient. The hepatotoxic reactions together with the microsomal enzymatic induction of CBZ were reviewed. DATA SYNTHESIS: A female infant bom to an epileptic mother treated with CBZ throughout pregnancy and breastfeeding presented with transient direct hyperbilirubinemia and high concentrations of GGT. The characteristics of her transient hepatic dysfunction were: early appearance (during the first day of life); discrepancy between the normal liver enzymes and high GGT concentrations; slow decrease of GGT, which nevertheless remained at above-normal concentrations even after the complete disappearance of direct hyperbilirubinemia; and spontaneous resolution in spite of only occasional breastfeeding. The possible explanations of this transient hepatic dysfunction (like enzymatic induction) are discussed. CONCLUSIONS: CBZ-induced hepatic dysfunction in neonates appears to have different clinical expressions. Infants of epileptic mothers treated with CBZ throughout pregnancy and breastfeeding should be carefully monitored for possible adverse effects.