bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cytogenetics of Childhood Acute Myeloid Leukemia: United Kingdom Medical Research Council Treatment Trials AML 10 and 12
Authors: Harrison Christine J. , Hills Robert K. , Moorman Anthony V. , Grimwade David J. , Hann Ian , Webb David K.H. , Wheatley Keith , de Graaf Siebold S.N. , van den Berg Eva , Burnett Alan K. , Gibson Brenda E.S. 
Published: May 2010

Purpose Karyotype is an independent indicator of prognosis in acute myeloid leukemia (AML) that is widely applied to risk-adapted therapy. Because AML is rare in children, the true prognostic significance of individual chromosomal abnormalities in this age group remains unclear. Patients and Methods This cytogenetic study of 729 childhood patients classified them into 22 subgroups and evaluated their incidence and risk. Results Rearrangements of 11q23 were the most frequent abnormality found in approximately 16% of patients, with 50% of these in infants. The outcome for all patients with 11q23 abnormalities was intermediate; no difference was observed for those with t(9;11)(p21-22;q23). The core binding factor leukemias with the translocations t(8;21)(q22;q22) and inv(16)(p13q22) occurred at incidences of 14% and 7%, respectively, predominantly in older children, and their prognosis was favorable. An adverse outcome was observed in patients with monosomy 7, abnormalities of 5q, and t(6;9)(p23;q34). Abnormalities of 3q and complex karyotypes, in the absence of favorable-risk features, have been associated with an adverse outcome in adults, but the results were not significant in this childhood series. However, the presence of 12p abnormalities predicted a poor outcome. Conclusion Because the spectrum of chromosomal changes and their risk association seem to differ between children and adults with AML, biologic differences are emerging, which will contribute to the redefinition of risk stratification for different age groups in the future.
Resource Utilization and Total Cost of Commercially-Available versus Manually-Compounded Solutions Used for Dialysate in Continuous Renal Replacement Therapy
Authors: Barletta Jeffrey F. , McAllen Karen J. , Hage Michael J. , Steele Brian , Bunchman Timothy E. , Barletta Gina-Marie 
Published: May 2010

Purpose The acquisition cost of commercially-available (CA) dialysis solutions is higher than manually-compounded (MC) solutions but pharmacy preparation time and medication errors are presumed to be lower. The objective of this study was to compare resource utilization and total cost between CA- and MC-dialysis solutions. Methods A model was constructed using solution acquisition cost, preparation cost, and the cost of a medication error. Solution preparation costs were obtained by prospectively recording preparation times for 1 month before and after the implementation of a CA-solution protocol. Preparation times were converted to costs using the hourly wage of a pharmacist and pharmacy technician. The presumed error rate was 0.5% for MC and 0.1% for CA solutions. A univariate sensitivity analysis was conducted by varying the incidence of a medication error. Results Preparation time for an MC solution was significantly longer than for a CA solution (8 ± 3 minutes/bag vs 4 ± 1 minutes/bag, P < .001). Total solution costs (acquisition + preparation) were $11.13 and $26.38 per bag for MC and CA, respectively. When medication errors were considered, the cost per error-free event was $48.14 per bag for MC solutions and $33.77 per bag for CA solutions. The threshold where the cost-ratio became less costly for MC solutions was when the absolute difference in error rate was no more than 0.2%. Conclusion Despite a higher acquisition cost, CA solutions could result in lower total costs compared with MC solutions. A small difference in medication error rate is required to produce these savings.
A Retrospective Medication Use Evaluation of Pioglitazone in Patients with Type 2 Diabetes Mellitus in a County Health Care System
Authors: John Ligy , Milton-Brown Jacqueline , Lal Lincy S. 
Published: May 2010

Background Pioglitazone is a thiazolidinedione oral second-line antihyperglycemic agent in the treatment of type 2 diabetes but was the highest expenditure within restricted drugs in this county health care system. Objective: A medication use evaluation of pioglitazone was conducted to determine if usage was according to guideline as well as evaluate intermediate clinical outcomes. Methods This is a retrospective analysis of a convenience sample of 199 patients who were prescribed pioglitazone therapy over a 6-month period. The following data were collected: demographics, indication, dosing, concurrent diabetes medications, pre- and post-glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), liver function tests, lipid profiles, and adverse drug events. Data were analyzed by descriptive statistics, t-test, and chi-square test. Results The final analysis included 199 patients of which 194 (97%) had documented prespecified guideline criterion for pioglitazone use. The average patient's age was 55 (standard deviation [SD] 9.5), and 72 (36.2%) of the patients were male. Ninety-nine percent of the patients were on dual therapy. After an average follow-up period of 10.5 weeks, the HbA1c decreased from a mean of 9.8% (SD 1.8%) to 8.7% (SD 1.7%) ( P < 0.05) and FBG decreased from a mean of 212 mg/dL (SD 72 mg/dL) to 174 mg/dL (SD 74 mg/dL) ( P < 0.05). In a subanalysis of 98 patients with pre- and post-lipid panels, the high-density lipoprotein (HDL) increased ( P < 0.001) and triglycerides decreased ( P < 0.02). Conclusion Pioglitazone usage in this county health care system meets preset criteria 97.5% of the time and contributes to improved glycemic control. As to whether the impact on surrogate markers led to decreases in morbidity and mortality needs to be researched in larger prospective studies in the county population.
Dexrazoxane
Authors: Cada Dennis J. , Levien Terri , Baker Danial E. 
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD-ROM forms and are also available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The January 2008 monograph topics are sevelamer carbonate, diclofenac sodium topical gel, rilonacept, bazedoxifene acetate, and clevidipine butyrate injectable emulsion. The DUE is on sevelamer carbonate.
Bariatric Surgery: Impact on Medication Management
Authors: Sardo Pam , Walker Jodi H. 
Published: May 2010

Purpose Bariatric surgery requires permanent changes in the approach to administration of pharmaceuticals, lifestyle, and medical care. Summary Bariatric surgery is currently recommended only for adolescents and adults who are severely overweight and have comorbid conditions. Often, obesity-related health problems improve or disappear after the weight is lost. As a life changing event, bariatric surgery requires permanent changes in the approach to health care. Postsurgical selection of medication will be quite different from therapeutic regimen options prior to surgery. In addition, bariatric surgery has resulted in reduction of medication intake associated with obesity-related comorbid disease. Patients will require detailed education to ensure awareness regarding medication-related precautions. Conclusion Options described in this article will assist the health care team to individually tailor medications to meet the needs of the unique post-bariatric surgery patient population.
Raltegravir Potassium
Authors: Cada Dennis J. , Levien Terri , Baker Danial E. 
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The February 2008 monograph topics are nilotinib, sapropterin dihydrochloride, asenapine, bendamustine hydrochloride, and lacosamide. The DUE is on oral therapy for pulmonary hypertension.
One Tablet or One Bottle? Avoiding Mix-Ups between Sterile Water and Sodium Chloride Bags a Chain is Only as Strong as its Weakest Link
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: May 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or United States Pharmacopeia (USP) ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Doripenem for Injection
Authors: Cada Dennis J. , Levien Terri , Mistry Bhavin , Baker Danial E. 
Published: May 2010

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy & Therapeutics Committee. Subscribers also receive monthly 1-page summary monographs on the agents that are useful for agendas and pharmacy/nursing inservices. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and are also available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The March 2008 monograph topics are nebivolol, 6% hydroxyethyl starch 130/0.4 in 0.9% normal saline, romiplostim, tocilizumab, and prasugrel. The DUE is on nebivolol.
Persistence Saves Patient's Life; Do Not Use Epidural Tubing for an Intravenous Solution; Topical Antiseptic Given Orally; Refrigerator Monitoring
Authors: Cohen Michael R. 
Published: May 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800-233-7767 (800-23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or United States Pharmacopeia (USP) ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Autoimmune-Hemolytic Anemia Associated with Montelukast and Zafirlukast Therapy in a Patient with Hepatitis C
Authors: Wargo Kurt A. , Roark Kimberly , Ibrahim Farrah 
Published: May 2010

Objective To report a case of autoimmune-hemolytic anemia (AIHA) associated with montelukast and, subsequently, zafirlukast in a patient with hepatitis C. Case Summary A 57-year-old white man with known hepatitis C presented with jaundice, bilateral lower-extremity edema, fatigue, and exertion for 3 weeks. He started using montelukast a week prior to experiencing these symptoms. After consultation with his primary care provider, montelukast was replaced with zafirlukast, which improved edema but other symptoms persisted. The patient was admitted to the hospital with symptoms, physical findings, and laboratory tests suggestive of AIHA. Leukotriene receptor antagonist therapy was discontinued and the patient received treatment with red blood cell transfusions and corticosteroids. The patient's hemoglobin stabilized within 9 days. Discussion AIHA may occur idiopathically or secondarily in association with drug or chemical exposures, lymphoproliferative disorders, collagen vascular diseases, or malignancies. Several mechanisms for drug-induced AIHA have been elucidated; however, direct laboratory testing is difficult. Therefore, diagnosis of drug-induced AIHA should be made when other causes have been ruled out, when temporal relation can be made, and when improvement of symptoms occurs upon discontinuation of the suspected agent. Conclusion Over 100 drugs have been implicated in the formation of warm antibody hemolytic anemia; however, there are currently no reports of leukotriene receptor antagonists associated with AIHA. Even though, in this case report, the patient had coexisting hepatitis C, which can cause AIHA alone, an objective causality assessment revealed that the AIHA was possibly due to montelukast and zafirlukast.
Paricalcitol versus Calcitriol in the Treatment of Secondary Hyperparathyroidism in Hemodialysis Patients
Authors: Rabinovich Marina , Walton Ted 
Published: May 2010

Purpose A mainstay treatment of secondary hyperparathyroidism has been the administration of vitamin D analogs. Paricalcitol is a vitamin D analog thought to reduce parathyroid hormone (PTH) levels with fewer effects on calcium (Ca) and phosphorous (P) levels than intravenous calcitriol. However, there are limited data directly comparing the 2 agents. The primary objective was to compare the efficacy of paricalcitol to calcitriol in hemodialysis patients. Secondary objectives evaluated the safety and direct costs associated with these agents. Methods This was a retrospective study of hemodialysis patients who received at least 8 weeks of both therapies from 2002 to 2004. Primary outcomes included the percentage of patients achieving greater than or equal to 50% reduction in baseline PTH levels; the change in PTH levels from baseline to the end of therapy; and time to achieve greater than or equal to 50% reduction in baseline PTH concentrations. Secondary outcomes included the percentage of patients experiencing hypercalcemia, hyperphosphatemia, or elevated Ca and P product; and the percentage of patients hospitalized secondary to these side effects. Results Calcitriol-treated patients showed a median reduction in PTH concentrations from baseline to the end of treatment phase of 8.3% versus paricalcitol reduction of 1.5%. This result was not statistically significant ( P = 0.08); however, it should be examined in a study powered to detect this difference. A similar number of patients in both treatment groups were able to achieve a greater than or equal to 50% reduction in baseline PTH concentrations but calcitriol-treated patients were more likely to achieve this primary end point faster than the paricalcitol-treated group (166 days vs 207 days, respectively, P = 0.18). The incidence of side effects between the agents was similar. There was a substantial difference in the annual drug cost between paricalcitol and calcitriol. Conclusion Paricalcitol did not seem to result in clear efficacy and safety benefit over calcitriol in this study. However, due to the study's retrospective design and potential for a type 2 error, as well as limited published data comparing this agent to calcitriol, additional research is required before paricalcitol becomes the standard of care in patients with chronic kidney disease and secondary hyperparathyroidism.
The Impact of a Long-Acting Erythropoiesis Stimulating Protein on Patient Throughput in a Hospital-Based Ambulatory Oncology Clinic
Authors: Griffith Niesha , Allen Colleen , Pultz Andrew , Penza Sam 
Published: May 2010

Objectives To quantify labor and time expended, resources used, and the net impact on patient throughput and staff time (from the institution's perspective) associated with short-acting (epoetin alfa) and long-acting (darbepoetin alfa) erythropoietin stimulating proteins (ESPs). Design Prospective time/motion assessment and retrospective chart review of patient visits and resources used. Setting Single hospital-based ambulatory oncology clinic. Methods Time and motion measurements related to patient treatment and drug preparation were collected for (1) patient check-in; (2) phlebotomy; (3) laboratory processing; (4) pharmacist assessment/counseling; and (5) ESP preparation, administration, and documentation. ESP use for 266 chemotherapy cycles administered between August 1, 2003 and March 31, 2004 was grouped as epoetin alfa only and darbepoetin alfa only. Results For 313 observed events, the mean total time calculated for the 5 prespecified activities associated with a visit for ESP administration was 55.4 minutes, of which pharmacy assessment/counseling was responsible for the majority of time expended (22.6 min). A significant (23%) reduction in the number of mean visits per cycle was recorded for the darbepoetin alfa group ( P < 0.001, resulting in 1 less visit per average chemotherapy cycle). This difference remained statistically different (42% reduction; P < 0.001) when the mean number of visits specifically for ESP administration was compared between the darbepoetin alfa and epoetin alfa groups. Darbepoetin alfa recipients also received significantly fewer doses of ESP per cycle compared with those given epoetin alfa (P < 0.001). The use of darbepoetin alfa saved the clinic 125 hours of staff/patient time per cycle with a potential of 120 hours/cycle additional savings if the epoetin alfa patients had received this long-acting ESP. During calendar year 2004, 610 patients received a red-cell growth factor following chemotherapy for a solid tumor. These patients represent an average of 3,660 cycles of chemotherapy per year. The reduction in visits (1/cycle) with long-acting ESP, at 55.4 minutes of staff time per visit, will potentially result in avoidance of 3,379.4 hours of staff time or 1.62 full-time equivalents per year. Conclusions Patient office visits for ESP administration are associated with significant time for clinic staff. A long-acting ESP, such as darbepoetin alfa, may enable significant time savings for clinic staff and providers by reducing the number of necessary visits for ESP administration. The time saved also provides an opportunity to reallocate staff to perform additional supportive care activities.
Cross Contamination with Insulin Pens; Look-Alike Vials; Kids and Medication Patches; New Look-Alike Name Pair; Preventing Dosing Errors with Methotrexate Injection
Authors: Cohen Michael R. 
Published: May 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them in your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP tollfree, 24 hours a day, at 800-233-7767 (800-23-ERROR). Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or United States Pharmacopeia (USP) ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.