bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship of In-Hospital Medication Modifications of Elderly Patients to Postdischarge Medications, Adherence, and Mortality
Authors: Mansur Nariman , Weiss Avraham , Beloosesky Yichayaou 
Published: April 2008

Background: Medication regimens are constantly modified and updated during a patient's hospitalization. These modifications and those made after discharge might increase the risk for nonadherence, polypharmacy, and poor outcomes among elderly patients. Objectives: To investigate the extent of in-hospital modification of medication regimens of elderly patients and its relationship to medication adherence as well as one-month postdischarge drug regimen modifications and to examine the relationship of the modifications, adherence, and polypharmacy to mortality and readmissions 3 months postdischarge. Methods: Clinical and demographic data, postdischarge medication modifications, and adherence were prospectively obtained in 212 elderly patients. Inhospital drug regimen modifications were retrospectively recorded. Results: The average ± SD in-hospital medication regimen modification rate was 49.8% ± 28.4. No modifications were found in 9.7% of the patients. Using demographic and clinical parameters, we performed regression analysis and found that patients who were admitted with polypharmacy, discharged home, and cognitively normal experienced fewer medication modifications (p conclusions: Hospitalization of elderly patients is characterized by extensive medication regimen modifications, which are directly correlated with postdischarge modifications and may indicate an increased risk of mortality.
Research Publication by Pharmacist Authors in Major Medical Journals: Changes over a 10‐Year Interval
Authors: Touchette Daniel R. , Bearden David T. , Ottum Sean A. 
Published: April 2008

Study Objective.To determine the degree to which pharmacists were involved in major clinical research publications in 1993 and 2003, and to compare the difference in publication rates by pharmacists between these 2 years.Design.Retrospective analysis.Data Source.Thirty‐seven medical journals that had high readership, had a focus on original research, were clinically oriented, and were highly regarded by the research community.Measurements and Main Results.Selection of the medical journals was first determined by those having the highest impact factors. Then journals with regular publication of original clinical research and listings of authors' degrees or licensure were included. All original research articles in these journals were reviewed for both 1993 and 2003. The primary outcome was the presence of a pharmacist as an author of one of their research articles in each of those 2 years. For those articles, the following data were collected: study subjects, study design, authors' affiliations, source of research funding, and position of author (first and/or corresponding). The primary outcome was analyzed by using multivariate logistic regression analysis. Other outcomes were compared between 1993 and 2003 by using a X2test. The number of clinical research articles identified was 8127 in 1993 and 8793 in 2003. The median (mean, interquartile range) number of authors/ article increased from 5 (5.3, 3–7) in 1993 to 6 (6.6, 4–8) in 2003 (p<0.01). There were 191 pharmacist‐authored papers (2.4%) in 1993, compared with 271 (3.1%) in 2003, for a relative increase of 29.2%. Adjusting for the increase seen in the number of authors during that period, the odds ratio that a pharmacist was an author in 2003 compared with 1993 was 1.26 (95% confidence interval 1.04‐1.53). Most (94.2%) pharmacist‐authored papers described studies involving human subjects. The proportion of clinical pharmacists (but not the number) serving as the primary author declined over time, from 36.6% (70/191) in 1993 to 27.3% (74/271) in 2003 (p=0.041). The most frequent funding sources were industry (from 38.2% in 1993 to 39.5% in 2003) and federal (from 25.1% in 1993 to 31.4% in 2003); however, the differences were not statistically significant.Conclusions.An increase was noted in the proportion of publications involving pharmacists as an author in major medical journals in 2003 compared with 1993. Pharmacists must continue to be active in clinical research, with adequate training and funding remaining significant obstacles.
Current Status of Prognostic Profiling in Breast Cancer
Authors: Pusztai Lajos 
Published: April 2008

AbstractLearning ObjectivesAfter completing this course, the reader will be able to: Assess emerging data on the use of genetic groupings of breast cancer as predictive factors, and examine the efficacy of different therapies aimed at optimizing outcomes of patients within these groups.Examine the clinical value of molecular diagnostic tests being developed to classify breast tumors, and discuss the challenges involved in validating and interpreting the results of these tests.Outline the potential uses of identifying and/or targeting breast cancer stem cells.Discuss the possible effect of genetic classification of breast tumors on the design of future clinical trials.CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.comBreast cancer is a clinically heterogeneous disease that can affect individuals with seemingly identical clinicopathologic parameters differently. This clinical heterogeneity is driven to a large extent by abnormal gene expression within tumors. Investigators now have the ability to identify the gene-expression fingerprint of an individual's tumor. This information may be used to rationally design therapeutic targets in the future, and also to predict the clinical course of an individual's disease, including response to a specific treatment. Genetic profiles of tumors are now being correlated with clinical outcome, and several prognostic and predictive indicators have emerged based on this research. There are at least four commercially available predictive or prognostic tests, and several more are looming on the horizon. The data gathered from these tests augment standard diagnostic and prognostic information obtained from traditional clinical pathological variables. The advent of gene-profiling technologies started to change the conduct of clinical trials. In the not too distant future, prospective tissue collection for molecular analysis may become routine in order to stratify patients for treatment arms and to optimize treatment strategies based on molecular features of the cancer. Coordinated efforts among oncologists, pathologists, surgeons, laboratory scientists, statisticians, and regulators will be essential in the quest to incorporate genetic profiling and molecular hypotheses into clinical trial planning and conduct.
Intraperitoneal Chemotherapy in Patients with Advanced Ovarian Cancer: The Con View
Authors: Vergote Ignace , Amant Frederic , Leunen Karin , Cadron Isabelle , Van Gorp Toon , Neven Patrick , Berteloot Patrick 
Published: April 2008

Abstract

Learning Objectives
After completing this course, the reader will be able to: Assess the rationale behind using i.p. chemotherapy for epithelial ovarian cancer patients and critically evaluate the data supporting its use.Interpret the argument that i.p. chemotherapy cannot be accepted as standard of care for first-line systemic treatment of advanced ovarian carcinoma.Determine which epithelial ovarian cancer patients may be appropriate for i.p. chemotherapy.Avoid and/or manage the toxicities observed with i.p. chemotherapy.
CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
The CME activity for this article consists of material from both “Intraperitoneal Chemotherapy in Patients with Advanced Ovarian Cancer: The Con View” (Vergote et al.) and “Intraperitoneal Chemotherapy for Women with Epithelial Ovarian Cancer” (Trimble et al.).

Objectives.
In this paper we wish to present the reasons why i.p. chemotherapy cannot be accepted as standard of care for first-line systemic treatment of advanced ovarian carcinoma.

Methods.
The recent literature on i.p. chemotherapy is critically reviewed. All possible arguments against i.p. chemotherapy are reviewed.

Conclusions.
Intraperitoneal chemotherapy is associated with a higher toxicity rate than i.v. chemotherapy. For this reason, none of the regimens investigated in the three Gynecologic Oncology Group (GOG) studies can be used as standard treatment outside clinical protocols. The trials on i.p. chemotherapy have suggested a survival difference. However, in the two most recent trials, i.p. chemotherapy or not was not the only research question because different schedules and dosages were used. In addition, the significance of the most recent GOG 172 study was only weak (p = .03), and the result was nonsignificant for progression-free survival. Intraperitoneal chemotherapy should be used only in the context of properly designed clinical trials. These trials must either assess i.p. therapy in comparison with the standard treatment or address the issue of route of administration for equivalent dosages and schedules of the same drugs, and not a mosaic of these questions. In addition, these trials should investigate i.p. regimens that are less toxic than the regimens used in the three GOG trials, and which can be combined with molecular targeted therapies.
Dexrazoxane (Totect™): FDA Review and Approval for the Treatment of Accidental Extravasation Following Intravenous Anthracycline Chemotherapy
Authors: Kane Robert C. , McGuinn W. David , Dagher Ramzi , Justice Robert , Pazdur Richard 
Published: April 2008

Abstract

Learning Objectives
After completing this course, the reader will be able to: Evaluate anthracycline tissue injury resulting from drug extravasation.Administer dexrazoxane in its new role of reducing extravasation tissue injury.Describe the proposed mechanism of action of dexrazoxane for this use.
CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Management of anthracycline extravasation is problematic and most reports are anecdotal. On September 6, 2007, the U.S. Food and Drug Administration approved Totect™ 500 mg (dexrazoxane hydrochloride for injection) for the treatment of extravasation resulting from i.v. anthracycline chemotherapy. In two studies, a total of 57 evaluable patients experienced extravasation from peripheral vein or central venous access sites with local swelling, pain, or redness. The presence of anthracycline in skin biopsy tissue was confirmed by tissue fluorescence, and treatment with a 3-day schedule of dexrazoxane began within 6 hours of the event. The primary endpoint was a reduction in the need for surgical intervention. Only one patient required surgical repair of the injury site, and late sequelae in the remainder were absent or mild. Also, the sponsor, TopoTarget A/S, Copenhagen, Denmark, performed controlled nonclinical studies in support of dexrazoxane dose and timing for the reduction of tissue injury resulting from anthracycline extravasation. For this uncommon but serious complication of anthracycline therapy, the need for surgical intervention was 1.7% with this regimen.
Systemic Therapy for Biliary Tract Cancers
Authors: Hezel Aram F. , Zhu Andrew X. 
Published: April 2008

Abstract

Learning Objectives
After completing this course, the reader will be able to: Assess the clinical and molecular heterogeneity of BTCs.Exploit the chemotherapy responsiveness of these tumors to improve the quality of life and extend the survival of patients with BTC.Administer the most current systemic therapy in BTC patients, including the appropriate first-line treatment options.Explain the rationale for developing and discuss the current status of molecularly targeted agents in BTC.
CME Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Biliary tract cancers (BTCs) are invasive carcinomas that arise from the epithelial lining of the gallbladder and bile ducts. These include intrahepatic, perihilar, and distal biliary tree cancers as well as carcinoma arising from the gallbladder. Complete surgical resection offers the only chance for cure; however, only 10% of patients present with early-stage disease and are considered surgical candidates. Among those patients who do undergo “curative” resection, recurrence rates are high; thus, for the majority of BTC patients, systemic chemotherapy is the mainstay of their treatment plan. Patients with unresectable or metastatic BTC have a poor prognosis, with a median overall survival time of &lt;1 year. Despite a paucity of randomized phase III data, a consensus on first-line systemic therapy is emerging. In this review, we discuss the clinical experience with systemic treatment of BTC, focusing on the rationale for a first-line regimen as well as future directions in the field.
Commentary: Can Circulating HER-2 Extracellular Domain Predict Response to Trastuzumab in HER-2–Negative Breast Cancer?
Authors: Esteva Francisco J. 
Published: April 2008

Abstract
This commentary evaluates the study of Ardavanis et al. in this issue and makes recommendations for further studies of HER-2 extracellular domain circulating levels as a prognostic indicator in metastatic breast cancer.
Dimensions of Sexual Orientation and HIV-Related Risk Among Adolescent Females: Evidence From a Statewide Survey
Authors: Goodenow Carol , Szalacha Laura A. , Robin Leah E. , Westheimer Kim 
Published: April 2008

Objectives. We examined the relationship of 2 dimensions of sexual orientation—sexual identity and sex of partners—with self-reported behaviors and experiences to identify factors that may place adolescent females at risk of HIV/AIDS. Methods. We gathered data on sexually experienced female high school students from 4 waves of a population-based survey. We used logistic regression analyses to investigate the association between their sexual identity (3666 heterosexual; 184 lesbian, gay, or bisexual; 113 not sure) and sex of partners (3714 male only, 79 female only, and 180 both males and females) with HIV-related risk behaviors. Results. Self-defined sexual identity was often inconsistent with sex of sexual partners. Sexual identities other than heterosexual and having same-sex partners (either exclusively or in addition to male partners) were associated with high rates of several HIV-related risk behaviors. Coerced sexual contact was significantly associated with every risk outcome. AIDS education in school predicted lower HIV risk on 4 of 6 indicators. Conclusions. Programs to prevent HIV infection among adolescent females should take into account the complexity of sexual orientation and should address the needs and behaviors of sexual-minority youths.
Risk for Reassault in Abusive Female Same-Sex Relationships
Authors: Glass Nancy , Perrin Nancy , Hanson Ginger , Bloom Tina , Gardner Emily , Campbell Jacquelyn C. 
Published: April 2008

Objectives. We revised the Danger Assessment to predict reassault in abusive female same-sex relationships. Methods. We used focus groups and interviews to evaluate the assessment tool and identify new risk factors and telephone interviews at baseline and at 1-month follow-up to evaluate the revised assessment. Results. The new assessment tool comprised 8 original and 10 new items. Predictors included increase in physical violence (relative risk ratio [RRR]=1.95; 95% confidence interval [CI]=0.84, 4.54), constant jealousy or possessiveness of abuser (RRR = 4.07; 95% CI = 0.61, 27.00), cohabitation (RRR = 1.96; 95% CI = 0.54, 7.12), threats or use of gun by abuser (RRR=1.93; 95% CI=0.79, 4.75), alcoholism or problem drinking of abuser (RRR=1.47; 95% CI=0.79, 2.71), illegal drug use or abuse of prescription medications by abuser (RRR = 1.33; 95% CI = 0.72, 2.46), stalking by abuser (RRR=1.39; 95% CI=0.70, 2.76), failure of individuals to take victim seriously when she sought help (RRR=1.66; 95% CI=0.90, 3.05), victim’s fear of reinforcing negative stereotypes (RRR=1.42; 95% CI=0.73, 2.77), and secrecy of abuse (RRR=1.72; 95% CI=0.74, 3.99). Both unweighted (P < .005) and weighted (P < .004) versions of the revised assessment were significant predictors of reassault. Conclusions. The revised Danger Assessment accurately assesses risk of re-assault in abusive female relationships.
Incidence of and Risk Factors for Sexual Orientation–Related Physical Assault Among Young Men Who Have Sex With Men
Authors: Lampinen Thomas M. , Chan Keith , Anema Aranka , Miller Mary Lou , Schilder Arn J. , Schechter Martin T. , Hogg Robert Stephen , Strathdee Steffanie A. 
Published: April 2008

Objectives. We sought to determine incidence of, prevalence of, and risk factors for sexual orientation–related physical assault in young men who have sex with men (MSM). Methods. We completed a prospective open cohort study of young MSM in Vancouver, British Columbia, surveyed annually between 1995 and 2004. Correlates of sexual orientation–related physical assault before enrollment were identified with logistic regression. Risk factors for incident assaults were determined with Cox regression. Results. At enrollment, 84 (16%) of 521 MSM reported ever experiencing assault related to actual or perceived sexual orientation. Incidence was 2.3 per 100 person-years; cumulative incidence at 6-year follow-up was 10.8 per 100 person-years. Increased risk of incident sexual orientation–related physical assault was observed among MSM 23 years or younger (relative hazard=3.1; 95% confidence interval [CI] = 1.6, 5.8), Canadian Aboriginal people (relative hazard = 3.0; 95% CI=1.4, 6.2), and those who previously experienced such assault (relative hazard=2.5; 95% CI=1.3, 4.8). Conclusions. These data underscore the need for increased public awareness, surveillance, and support to reduce assault against young MSM. Such efforts should be coordinated at the community level to ensure that social norms dictate that such acts are unacceptable.
Turning Loss Into Legislation
Authors: Labella Angelena , Singh Devika 
Published: April 2008

Same-sex partnerships encounter tremendous challenges in the context of healthcare, including empowerment to act on behalf of loved ones. We share challenges faced by two women who confronted this issue head-on when their same-sex partners were critically, and, in one case, fatally, injured. In both cases, hospitals initially refused to recognize these women as next of kin; one woman endured years of legal battles in her struggle to win the right to care for her partner. The other testified about her heartrending experience before the Washington State Judiciary Committee, helping to inspire legislation regarding rights for visitation and end-of-life decisions on behalf of same-sex partners. We seek to remind health care providers of the limitations of current laws and to inspire them to support change.
Expandable Liner Hanger System Enhances Liner Installations by Providing Viable Solutions that Overcome Deployment and Installation Issues in Low-Pressure Reservoirs
Authors: Wardak Ajmal , Williford James , Al-Madlouh Mohammed 
Published: April 2008

AbstractLow-pressure reservoir characteristics are not often considered as a contributor to installation failure during deployment of conventional hydraulic-set liner hanger systems. Often, this situation occurs in cases where there is a sudden change in the well properties. If this phenomenon occurs, the outcome of a job can be changed from success to a failure. These low-pressurized reservoirs are considered as being capable of being maintained with fluid weight (balanced) rather than as candidate for one that is controllable by lighter-weight fluids (less than 8.3ppg) (underbalance). In the balanced wells, liner installation issues can range from sudden high-rate fluid loss causing differential pressure sticking of the liner, inability to get to depth, or inability to place cement around the liner forming the primary liner top seal.In the underbalanced wells, issues such as difficulty in running the liner to bottom, and premature setting of the liner hanger during deployment of the liner can be seen, and during the critical stage of cementing the liner, problems such as inability to circulate at rates and pressures, inability to move the liner during the cement job, and inability to provide a liner-top seal prior to releasing the running tool can result. Such are the issues faced by operators in different areas of the globe.A solution to these issues has been identified. An expandable liner hanger (ELH) system, which allows the annulus fluid to be isolated from the work string fluid during deployment and throughout the cement job because of its pressure-balanced configuration can resolve these problems. In addition, the ELH system can be set up for liner drilling, enabling the liner to be drilled through the low pressure reservoir, the shoe to be cemented, and the liner top to be isolated upon setting. Multiple jobs have been performed successfully in this manner, saving the operator several days of rig time through one or more benefits provided by the system; i.e., getting the liner to bottom, providing a premium cement bond, and eliminating remedial cementing jobs. Selected cases concerning low-pressured well types will be the focus of this paper.
Field Trials of Fiber Assisted Stimulation in Saudi Arabia: An Innovative Non-Damaging Technique for Achieving Effective Zonal Coverage During Acid Fracturing
Authors: Al-Ismail Maytham I. , Al-Harbi Moataz M. , Al-Harbi Abdulaziz K. , Ramanathan Venkateshwaran 
Published: April 2008

Abstract
Acid fracturing has been part of Saudi Aramco's gas development strategy to maximize productivity from for vertical wells in the Khuff carbonates over the last several years. During acid fracturing, the wormholes created by the reaction with the formation results in excessive fluid loss. Controlling fluid loss is one of the key objectives in acid fracturing treatments to be able to create longer and wider fractures, and hence maximize well productivity. Alternating stages of polymer pad with diesel emulsified acid for deeper penetration and in-situ gelled acid, a polymer-based system, have been extensively used in most fracture treatements in an attempt to control excessive leak-off during the treatment.
The vertical well treatments target several reservoir sub-layers with varying degrees of porosity and permeability contrast. These layers are often divided by lithological streaks that make vertical communication challenging.Hence in many instances acid fracturing ends up over-stimulating the highest reservoir quality zones and by-passing or under-stimulating the other zones.Consequently, the zonal contribution from these wells is not optimal.
A pilot involving use of a new degradable fiber technology designed to achieve effective acid diversion during acid fracturing was recently implemented in several gas producers.The pilot comprised field trials in wells with similar reservoir characteristics and multiple porosity lobes.The treatments were designed and pumped with alternating stages of acid and fiber-laden polymer based pad fluid. The viscosity increase achieved in the pad by the addition of fibers and its bridging mechanism plugged off the just stimulated zones effectively, thus diverting the new stage of acid into the unstimulated porous zones. The fibers degrade and hydrolyze with temperature and time so no reservoir damage occurs.
This paper discusses the planning and design processes leading to the successful implementation of the technology, and the excellent post-stimulation results achieved. Bottomhole pressure gauge data were collected, and production logs were run to ascertain the effectiveness of the new technology.Results from the conducted pilot, along with production history comparisons with offset producers will be discussed.