bluuebunny/crossref_metadata_2025_split huggingface dataset:
Osteogenic efficacy of strontium hydroxyapatite micro-granules in osteoporotic rat model
Authors: Chandran Sunitha , Babu S Suresh , VS Hari Krishnan , Varma HK , John Annie 
Published: May 2016

Excessive demineralization in osteoporotic bones impairs its self-regeneration potential following a defect/fracture and is of great concern among the aged population. In this context, implants with inherent osteogenic ability loaded with therapeutic ions like Strontium (Sr2+) may bring forth promising outcomes. Micro-granular Strontium incorporated Hydroxyapatite scaffolds have been synthesized and in vivo osteogenic efficacy was evaluated in a long-term osteoporosis-induced aged (LOA) rat model. Micro-granules with improved surface area are anticipated to resorb faster and together with the inherent bioactive properties of Hydroxyapatite with the leaching of Strontium ions from the scaffold, osteoporotic bone healing may be promoted. Long-term osteoporosis-induced aged rat model was chosen to extrapolate the results to clinical osteoporotic condition in the aged. Micro-granular 10% Strontium incorporated Hydroxyapatite synthesized by wet precipitation method exhibited increased in vitro dissolution rate and inductively coupled plasma studies confirmed Strontium ion release of 0.01 mM, proving its therapeutic potential for osteoporotic applications. Wistar rats were induced to long-term osteoporosis-induced aged model by ovariectomy along with a prolonged induction period of 10 months. Thereafter, osteogenic efficacy of Strontium incorporated Hydroxyapatite micro-granules was evaluated in femoral bone defects in the long-term osteoporosis-induced aged model. Post eight weeks of implantation in vivo regeneration efficacy ratio was highest in the Strontium incorporated Hydroxyapatite implanted group (0.92 ± 0.04) compared to sham and Hydroxyapatite implanted group. Micro CT evaluation further substantiated the improved osteointegration of Strontium incorporated Hydroxyapatite implants from the density histograms. Thus, the therapeutical potential of micro-granular Strontium incorporated Hydroxyapatite scaffolds becomes relevant, especially as bone void fillers in osteoporotic cases of tumor resection or trauma.
Analysis of the Storage Methods for Raw Human Milk from Mothers with Infants Admitted to a Neonatal Intensive Care Unit, According to Brazilian Regulations
Authors: Grazziotin Maria Celestina Bonzanini , Grazziotin Ana Laura , Vidal Newton Medeiros , Freire Marcia Helena de Souza , da Silva Regina Paula Guimarães Vieira Cavalcante 
Published: May 2016

Background: Milk safety is an important concern in neonatal units and human milk banks. Therefore, evidence-based recommendations regarding raw milk handling and storage are needed to safely promote supplying hospitalized infants with their mother’s own milk. Objectives: To evaluate raw human milk storage methods according to Brazilian milk management regulations by investigating the effects of refrigeration (5°C) for 12 hours and freezing (–20°C) for 15 days on the acidity and energy content in a large number of raw milk samples. Methods: Expressed milk samples from 100 distinct donors were collected in glass bottles. Each sample was separated into 3 equal portions that were analyzed at room temperature and after either 12 hours of refrigeration or 15 days of freezing. Milk acidity and energy content were determined by Dornic titration and creamatocrit technique, respectively. Results: All samples showed Dornic acidity values within the established acceptable limit (≤ 8°D), as required by Brazilian regulations. In addition, energy content did not significantly differ among fresh, refrigerated and frozen milk samples (median of ~50 kcal/100 mL for each). Conclusion: Most samples tested (> 80%) were considered top quality milk (< 4°D) based on acidity values, and milk energy content was preserved after storage. We conclude that the storage methods required by Brazilian regulations are suitable to ensure milk safety and energy content of stored milk when supplied to neonates.
Establishing Edoxaban’s Role in Anticoagulation
Authors: Guirguis Erenie , Brown Dana , Grace Yasmin , Patel Dimple , Henningfield Samantha 
Published: May 2016

Purpose This article serves as a review of the current literature regarding the role of edoxaban for the prevention of stroke in patients with nonvalvular atrial fibrillation (AF) and the treatment of venous thromboembolism (VTE). Summary Until recent years, oral treatment options for both treatment and prevention of VTE and stroke were limited to warfarin. Dabigatran was the first new oral anticoagulant approved in over 50 years followed by rivaroxaban and apixaban. These new oral anticoagulants offer many benefits over warfarin. Edoxaban is the newest member among the oral anticoagulants and exerts its action by direct inhibition of factor Xa. It may offer some advantages in that it is the second Food and Drug Administration-approved once-daily anticoagulant available and does not interact with the cytochrome P450 (CYP450) system. However, there are concerns in patients with AF and preserved renal function (>95 mL/min), as these cohorts experienced a higher incidence of stroke in trials. Conclusion Based on the 3 clinical trials, edoxaban appears to be a safe and effective factor Xa inhibitor in patients with a creatinine clearance of <95 mL/min. It will serve as an alternative anticoagulant for those with a preference for once-daily dosing and/or taking medications that interact with the CYP450 system.
Teaching History With Digital Historical Games
Authors: McCall Jeremiah 
Published: May 2016

Background: Writing about the theory and best practices of using history-themed video games in the classroom stretches back at least to the 1980s. However, the literature on the subject is scattered, making it difficult for history educators considering the use of historical games. Purpose: This article provides an introduction for history educators to the use of computer-based historical games in history education. In this article, I provide differing definitions for types of historical games and discuss the importance of such distinctions for the history educator. I provide the strengths and biases inherent in the medium of computer-based historical games. Results: This article surveys best practices from the literature concerning the use of historical games in history class. The article concludes with a brief survey of potentially useful historical games.
Intravenous Ethchlorvynol-Induced Pulmonary Edema
Authors: Self Timothy H. , Fountain Francis F. , Dunnebacke Robert , Pipkin Michael , Patterson Herb 
Published: May 2016

A case report of intravenous ethchlorvynol-induced pulmonary edema is presented. Approximately 450 mg of ethchlorvynol was withdrawn from a Placidyl® capsule and injected by a 30-year-old man. Respiratory symptoms occurred within twenty minutes and a chest X-ray taken within two hours revealed diffuse bilateral pulmonary infiltrates. The patient's condition improved rapidly. A pertinent feature of the case is the comparatively low dose of ethchlorvynol which caused pulmonary edema. It is also of note that two colleagues of the patient did not have evidence of any adverse effects after injecting approximately 180 mg of ethchlorvynol.
Diabetic Patient Compliance as a Function of Patient Counseling
Authors: Powell M. F. , de P. Burkhart V. , Lamy P. P. 
Published: May 2016

The impact of a specially designed patient education program upon the diabetes-related knowledge and compliance of insulin dependent diabetic patients was investigated. The program consisted of an audiovisual presentation, illustrated handout material, and pharmacist-patient counseling. Based on statistical considerations, 65 eligible patients were assigned systematically to a control group (Group I) and a study group (Group II) and were evaluated for compliance following a standardized protocol. Immediately following the interview, Group II patients were instructed utilizing the patient education program. Scores for initial and final evaluations of knowledge and compliance were compared using appropriate statistical procedures. The program was successful in producing improvements in both knowledge and compliance but a need for individualization of patient education efforts was indicated. Significant improvements in compliance were not observed among patients older than the mean age for study patients and those with diabetes complicated by cardiovascular and hypertensive disease.
Self-Monitoring of Blood Pressures in Hypertensive Subjects and its Effects on Patient Compliance
Authors: Ogbuokiri Justina E. 
Published: May 2016

This study investigated the effects, if any, that teaching hypertensive patients to take their own blood pressures, as well as education and counseling, would have on compliance. Prior to the initiation of the study, the pharmacist-investigator collected data on the hypertension clinic as it traditionally functioned. This preliminary investigation included studying the work flow of the clinic and reviewing medical records to determine who among the clinic registrants met the criteria set up for inclusion in this study. During the study phase, 12 patients were educated about their disease state, counseled, and taught to take their own blood pressures, using a home blood pressure measuring device. Upon each return visit, they were evaluated by the pharmacist using such parameters as pill counts, blood pressure readings, fluctuations in body weight, and disease symptomatology. All these data were analyzed and compared to those of the 12 patients in the control group who were educated and counseled, but not taught to take their blood pressures. An overall improvement in any or all of these monitored parameters was the criterion for determining effectiveness in promoting better compliance. At the end of the five-month study, the frequency of proscription refill had increased from 38 to 72.56 percent for the treatment group and from 31.6 to 59.26 percent for the control group. There were no significant changes in the other parameters monitored during this period.
Digoxin Toxicity with Therapeutic Levels
Authors: Powell Stephen H. 
Published: May 2016

A case of digoxin toxicity occurring in a patient with stable renal function and serum digoxin levels of 0.6–0.9 ng/ml is discussed. The patient is a 62-year-old black male admitted to the hospital with a chief complaint of shortness of breath. The patient's problem list included: (1) congestive heart failure, (2) coronary artery disease, (3) adult-onset diabetes mellitus, (4) cerebral vascular accident, (5) fever, and (6) anemia. The patient complained of a poor appetite and “sour stomach” while on digoxin. Serum electrolytes were normal, and the serum creatinine was essentially stable with a range of 1.2–1.6 mg% reported. Despite the “apparent” therapeutic serum digoxin levels, a probable diagnosis of digoxin toxicity was made, and the patient responded within two days of the dechallenge with improvement in the nausea and anorexia. The limitations and problems in assessing digoxin toxicity with serum digoxin levels are discussed.
Liver Enzyme Elevation associated with Total Parenteral Nutrition
Authors: Greenlaw Cal Wayne 
Published: May 2016

A number of complications associated with total parenteral nutrition (TPN) have been identified, and methods of prevention or treatment have been developed. However, abnormal liver function continues to occur with the use of TPN, and little is known about its incidence and etiology. Twenty-three patients, receiving TPN through the TPN program at Holy Cross Hospital from January, 1978 to May, 1978, were studied. All patients received a basic parenteral amino acid solution (Travasol®), with varying amounts of nitrogen per day, depending on nitrogen balance studies. Dextrose was supplied in quantities necessary to provide 120 percent or more of the patient's calculated basal energy expenditure (BEE). Of the 23 patients studied, elevated liver function test values were detected in two patients (8.6 percent). In both cases, the complication developed within six to eight days, and both had received calories in excess of 213 percent of their calculated BEE and had a calorie to nitrogen (kcal: N) ratio greater than 150: 1. Mean calories as a percent of calculated BEE and kcal: N ratio were significantly higher in the patients with elevated liver function test (LFT) values than in those with normal LFT values ( p < 0.05 and p < 0.005, respectively). Following identification of the elevated LFT values, both patients were immediately placed on cyclic TPN (CyTPN). In the one patient, liver enzymes reverted toward normal after seven days of CyTPN, while the second patient required only five days. Cyclic TPN was deemed effective in the reversal of abnormal liver function in these two patients. It is speculated that the abnormal liver function was a result of fatty liver infiltration. The mechanism by which this infiltration occurs and its treatment are discussed.
Trazodone (Desyrel, Mead-Johnson Pharmaceutical Division)
Authors: Rawls W. Nathan 
Published: May 2016

Trazodone is the first triazolopyridine derivative to be used clinically for the treatment of depression. It has been shown to be equal in efficacy to the tricyclic antidepressants imipramine, desipramine, and amitriptyline in the treatment of major depressive episodes. Researchers have indicated that trazodone exceeds other antidepressants in relieving anxiety, but further study is needed to confirm this effect. Trazodone has been used successfully to relieve depression in schizophrenic patients without worsening their psychotic symptoms. Trazodone blocks serotonin reuptake into presynaptic neurons with little effect on norepinephrine or dopamine. It is rapidly absorbed orally and reaches peak serum levels within two hours. Trazodone is excreted primarily as metabolites by the kidneys and possesses a biphasic elimination half-life of 4.4 hours for the first 10 hours and 7.5 hours for the next 24 hours. Trazodone 200 mg is equal to imipramine 100 mg, and the therapeutic dosage range is 200–600 mg/d. Side effects are infrequent with trazodone; its anticholinergic activity is minimal. Trazodone appears to produce less cardiovascular toxicity than tricyclic antidepressants. To date, reports of fatal overdoses are rare. Trazodone equals available antidepressant drugs in clinical efficacy, and, because it has fewer cardiovascular and anticholinergic side effects, it should prove beneficial in the treatment of depression. See Table of Contents for location in this issue of the foreign abstracts of this article.
Baker's Asthma (Grain-Dust-Induced Asthma)
Authors: Tse C.S. Ted , Raghuprasad P.K. 
Published: May 2016

A 48-year-old black male with no underlying atopy developed asthma after working nine years at a bakery. The attacks of wheezing were preceded by nasal symptoms and usually occurred after several hours of work. Skin testing revealed reactivity to dust, molds, and wheat extracts; serum level of IgE was normal, and a RAST screen to common allergens was negative. A bronchial provocation test using commercial wheat extract was negative, but the same test using the patient's own bakery flour resulted in an immediate positive reaction. The pathogenesis and management of grain-dust-induced asthma are discussed. See Table of Contents for location in this issue of the foreign abstracts of this article.
A Comparison of Various Types of Patient Instruction in the Proper Administration of Metered Inhalers
Authors: Roberts Richard J. , Robinson J. Daniel , Doering Paul L. , Dallman John J. , Steeves Roy A. 
Published: May 2016

The administration technique employed by 42 inpatients using metered inhalers was observed. Proper performance of the six steps recommended by the manufacturer provided the guidelines for correct administration. The degree of compliance with proper technique was defined as the number of steps correctly executed by the patient. The mean number of steps correctly performed was 2.9 out of the possible six (48.3 percent). Twenty-four patients were then randomized into one of three groups. Group 1 received the manufacturer's instruction sheet, Group 2 received counseling from a pharmacist, and Group 3 received both the manufacturer's instruction sheet and counseling from a pharmacist. There was a significant improvement in the postinstruction technique in Groups 2 and 3, while Group 1 failed to demonstrate any significant improvement. Comparisons were then made among the three groups. No significant difference was found between Group 2 and Group 3. However, both Groups 2 and 3 were found to be significantly different ( p < 0.05) from Group 1. This study shows that pharmacist counseling can significantly improve the degree of patient compliance in the administration of metered inhalers.
A Calculator Program for Adjusting Aminoglycoside Regimens That Accounts for Tissue Accumulation in Children and Adolescents
Authors: Loertscher M. Vance 
Published: May 2016

The author has developed a program for the Hewlett Packard HP 41C calculator that is used in the analysis of aminoglycoside serum levels for the purpose of generating a personalized dosage regimen. Although other programs have been published, until now none has made adjustments in the half-life of drug elimination due to the tissue accumulation that occurs in the initial phases of dosing. Many of these same programs fail to locate the true peak and trough serum levels, which are essential in the calculation of the volume of distribution of the aminoglycosides. This article is not meant as a method of initial dosing, but rather assumes that the physician has chosen one of the readily usable methods of dosing, such as various nomograms. Patient data taken from published studies were used in generating individual patient parameters. These parameters were compared to those calculated in the studies for means of comparison. While correlation in all parameters was not ideal, the correlation of dose and dosing interval was exact and correlation of predicted peaks and troughs with the given regimen of dosing was excellent.
Aminoglycoside Pharmacokinetics on a Microcomputer
Authors: Kaka Juzar S. , Buchanan E. Clyde 
Published: May 2016

The authors describe the use of a microcomputer to evaluate an existing dosage regimen and to determine a new regimen and steady-state peak and trough levels for four aminoglycoside antibiotics — Amikacin, gentamicin, kanamycin, and tobramycin. The microcomputer program is based on a one-compartment open pharmacokinetic model for the aminoglycosides. It accounts for patients' sex, age, height, obesity, and ascitic compartment. The program is divided into seven subprograms for each of the four aminoglycosides: (1) steady-state peak and trough levels are predicted, based on serum creatinine for a given dosage regimen; (2) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained, based on serum creatinine; (3) a dosage regimen is determined, on the basis of serum creatinine, for desired steady-state peak and trough levels; (4) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained for given aminoglycoside serum levels; (5) a dosage regimen for desired peak and trough levels is ascertained for given aminoglycoside serum levels; (6) a dosage regimen that conforms to 6, 8, 12, 16, or 24 hours is ascertained from data collected using Sawchuk's and Zaske's method; and (7) a dosage regimen, estimated for desired peak and trough levels, is estimated from data collected using Sawchuk's and Zaske's method.
Decreased Absorption of Cefaclor in Short Bowel Syndrome
Authors: Nahata Milap C. , Freimer Nelson , Hilty Milo D. 
Published: May 2016

Oral cefaclor is rapidly absorbed in patients with a shortened gastrointestinal tract (23 cm). A case is reported of a 27-month-old female child who had received oral cefaclor for five days in treatment of otitis media. The child had had a bowel resection at birth. She did not respond to oral therapy with cefaclor and was admitted to the hospital, where she received cefamandole intramuscularly. The patient recovered in five days. Further investigation using cefaclor with this patient demonstrated serum concentrations below the minimum inhibitory concentration of Hemophilus influenzae, pneumococcus, and many other organisms. When oral antibiotics are prescribed, it is necessary to monitor serum concentrations to ensure absorption.
Interaction of Penicillins with the Components of Plasma Expanders
Authors: Koshiro Akira , Fujita Toshio 
Published: May 2016

The interaction of penicillin with high molecular components of plasma expander such as dextran, 6-hydroxyethylstarch, and polygeline were studied. The formation of penicilloyl polysaccharides and smaller amounts of penicilloyl polygeline during incubation were confirmed by ultrafiltration and gelfiltration. The ultrafiltration through Collodion-Bags SM 13200 was found to be a rapid and convenient method for the determination of macromolecular penicilloates. The accelerated degradation by the formation of penicilloyl esters with glucose and lactic acid was also suggested.
Reactions and Interactions in Handling Anticancer Drugs
Authors: D'Arcy P.F. 
Published: May 2016

The clinical toxicity of anticancer drugs has been well documented with regard to the adverse effects of treatment in patients. However, many of these drugs have a direct irritant effect on the skin, eyes, mucous membranes, and other tissues. Handled without due care, especially when being prepared for injection, most cytotoxic drugs can cause local toxic or allergic reactions; they also present hazards of carcinogenicity and mutagenicity. This spectrum of potential risk should be kept in mind by personnel administering or handling these drugs, especially in oncology units where just a few individuals may routinely and frequently reconstitute many doses of cytotoxic agents. This is work in which the hospital pharmacist should and must be involved; indeed, many of the techniques and skills required are identical with those used in standard aseptic procedures for preparing pharmaceutical products. Pharmacy departments should take the initiative in making hospital staff aware of the potential risks of handling neoplastic agents, and they should spearhead a multidisciplinary assessment for producing local guidelines for working with these drugs. This article warns practitioners about the inherent dangers of these practitioner-drug interactions and suggests ways in which they may be reduced. Information is given in tabular form regarding recommended procedures for reconstituting 24 anticancer drugs and precautions to protect the personnel handling them, especially when there is spillage of powdered or liquid drugs. Also, guidelines are given about incompatibilities with admixtures of such drugs, and the literature is reviewed relative to recent developments in hospital pharmacy departments where reconstitution of anticancer drugs has been incorporated into existing intravenous fluid preparation/admixture units. Not only has this been shown to be safer and more effective in terms of time and labor, but also it has cut the cost of injectable cytotoxic drugs by an appreciable percentage.