bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulation of Ozone Depletion Using Ambient Irradiance Supplemented with UV Lamps
Authors: Díaz S. , Camilión C. , Escobar J. , Deferrari G. , Roy S. , Lacoste K. , Demers S. , Belzile C. , Ferreyra G. , Gianesella S. , Gosselin M. , Nozais C. , Pelletier E. , Schloss I. , Vernet M. 
Published: September 2006

ABSTRACTIn studies of the biological effects of UV radiation, ozone depletion can be mimicked by performing the study under ambient conditions and adding radiation with UV‐B lamps. We evaluated this methodology at three different locations along a latitudinal gradient: Rimouski (Canada), Ubatuba (Brazil) and Ushuaia (Argentina). Experiments of the effect of potential ozone depletion on marine ecosystems were carried out in large outdoor enclosures (mesocosms). In all locations we simulated irradiances corresponding to 60% ozone depletion, which may produce a 130–1900% increase in 305 nm irradiance at noon, depending on site and season. Supplementation with a fixed percentage of ambient irradiance provides a better simulation of irradiance increase due to ozone depletion than supplementation with a fixed irradiance value, particularly near sunrise and sunset or under cloudy skies. Calculations performed for Ushuaia showed that, on very cloudy days, supplementation by the square‐wave method may produce unrealistic irradiances. Differences between the spectra of the calculated supplementing irradiance and the lamp for a given site and date will be a function of the time of day and may become more or less pronounced according to the biological weighting function of the effect under study.
On the Role of Iron and one of its Chelating Agents in the Production of Protoporphyrin IX Generated by 5‐Aminolevulinic Acid and its Hexyl Ester Derivative Tested on an Epidermal Equivalent of Human Skin
Authors: Uehlinger Pascal , Ballini Jean‐Pierre , van den Bergh Hubert , Wagnières Georges 
Published: September 2006

ABSTRACTPhotodynamic therapy (PDT) with 5‐aminolevulinic acid (ALA) or its derivatives as precursors of protoporphyrin IX (PPIX) is routinely used in dermatology for the treatment of various pathologies. However, this methodology suffers to some extent from a limited efficacy. Therefore, the main goal of this study was to investigate the modulation and pharma‐cokinetics of PPIX buildup after a 5 h incubation with ALA (1.5 mM) and one of its derivatives, the hexyl ester of ALA (h‐ALA) (1.5 mM), on the human epidermal equivalent Epidex™. PPIX production was modulated with (L+) ascorbic acid iron (II) salt (LAI) or the iron (II)‐specific chelating agent deferoxamine (DFO). PPIX fluorescence from the Epidex™ layers was measured up to 150 h after the precursor administration using a microspectrofluorometer (λex: 400 ± 20 nm; λdet: 635 nm). The maximum PPIX fluorescence intensity induced by h‐ALA was about 1.7x larger than that induced by ALA. The addition of DFO resulted in a more than 50% increase in PPIX fluorescence for both precursors. The decay half life measured for PPIX fluorescence is 30 and 42.5 h, respectively, for ALA and h‐ALA. These half lives are doubled when the samples contain DFO. In the samples with the highest fluorescence intensity, a modified fluorescence spectrum was observed after 10 h, with the emergence of a peak at 590 nm, which is attributed to zinc protoporphyrin IX (Zn PPIX).
Development and Validation of the Pediatric Nausea Assessment Tool for Use in Children Receiving Antineoplastic Agents
Authors: Dupuis L. Lee , Taddio Anna , Kerr Elizabeth N. , Kelly Andrea , MacKeigan Linda 
Published: September 2006

Study Objective. To develop and validate an instrument to assess nausea intensity in children aged 4–18 years.Design. Prospective, descriptive study.Setting. Tertiary‐quaternary, university‐affiliated pediatric hospital.Patients. Four pediatric inpatient groups (177 patients): group 1 (107), those receiving cancer chemotherapy; group 2 (24), those receiving cancer chemotherapy before hematopoietic stem cell transplantation; group 3 (23), those with cancer who were not receiving cancer chemotherapy; and group 4 (23), those without cancer.Intervention. We developed a scale with a standard script for administration, the Pediatric Nausea Assessment Tool (PeNAT). Revisions were made after face validity testing with clinicians and parents, and pilot testing with 15 inpatients undergoing chemotherapy.Measurements and Main Results. The PeNAT scores were obtained 4–24 hours after chemotherapy in groups 1 and 2. Dietary intake scores and number of emetic episodes were recorded for the 4 hours before PeNAT administration for all patients in group 2 and 36 patients in group 1. Parents of a subset of patients made an independent assessment of their child's nausea and pain intensities immediately before PeNAT administration. Reliability was evaluated in groups 1 and 2 by correlating the first and second (obtained 1 hr after the first) PeNAT scores. Construct validity was evaluated by comparing PeNAT scores in groups 1–4. Criterion‐related validity was evaluated by correlating PeNAT scores with emetic episodes and dietary intake. Convergent and discriminant validity were evaluated by correlating PeNAT scores with parental assessments of nausea and pain. Significant differences in PeNAT scores were noted among the study groups (p=0.035). Moderate correlation was noted between the first and second PeNAT scores (Spearman ρ = 0.649). The PeNAT scores correlated modestly with emetic episodes (Spearman ρ = 0.322) but not with dietary intake (Spearman ρ = −0.217). Children's PeNAT scores correlated moderately with their parents' assessment of nausea (Spearman ρ = 0.442), whereas little correlation was seen between children's PeNAT scores and parents' assessment of pain (Spearman ρ = 0.167).Conclusion. The PeNAT is a new instrument that can be used by children to assess nausea intensity.
Limited Sampling Strategy for Predicting Area Under the Concentration‐Time Curve of Mycophenolic Acid in Adult Lung Transplant Recipients
Authors: Ting Lillian S. L. , Partovi Nilufar , Levy Robert D. , Riggs K. Wayne , Ensom Mary H. H. 
Published: September 2006

Study Objective. To develop limited sampling strategies for estimation of mycophenolic acid exposure (by determining area under the concentration‐time curve [AUC]) in lung transplant recipients by using sampling times within 2 hours after drug administration and a maximum of three plasma samples.Design. Prospective, open‐label clinical study.Setting. Lung transplant clinic in Vancouver, British Columbia, Canada.Patients. Nineteen adult (mean age 48.3 yrs) lung transplant recipients who were receiving mycophenolate mofetil therapy along with cyclosporine (9 patients) or tacrolimus (10 patients).Intervention. Eleven blood samples were collected from each of the 19 patients over 12 hours: immediately before (0 hr) and 0.3, 0.6, 1, 1.5, 2, 4, 6, 8, 10, and 12 hours after administration of mycophenolate mofetil.Measurements and Main Results. Mycophenolic acid levels in plasma were determined by a high‐performance liquid chromatography–ultraviolet detection method. The 19 patients were randomly divided into index (10 patients) and validation (9 patients) groups. Limited sampling strategies were developed with multiple regression analysis by using data from the index group. Data from the validation group were used to test each strategy. Bias and precision of each limited sampling strategy were determined by calculating the mean prediction error and the root mean square error, respectively. The correlation between AUC and single concentrations was generally poor (r2= 0.18–0.73). Two single‐concentration strategies, eight two‐concentration strategies, and eight three‐concentration strategies matched our criteria. However, the best overall limited sampling strategies (and their predictive performance) were the following: log AUC = 0.241 log C0+ 0.406 log C2+ 1.140 (bias −5.82%, precision 5.97%, r2= 0.828) and log AUC = 0.202 log C0+ 0.411 log C1.5+ 1.09 (bias −5.71%, precision 6.94%, r2= 0.791), where Cxis mycophenolic acid concentration at time x hours.Conclusion. Two‐concentration limited sampling strategies provided minimally biased and highly precise estimation of mycophenolic acid AUC in lung transplant recipients. These optimal and most clinically feasible limited sampling strategies are based collectively on the number of blood samples required, r2value, bias, and precision.
Electrocardiographic and Blood Pressure Effects of the Ephedra‐Containing TrimSpa Thermogenic Herbal Compound in Healthy Volunteers
Authors: Caron Michael F. , Dore David D. , Min Bokyung , Kluger Jeffrey , Boguk Irena , White C. Michael 
Published: September 2006

Study Objective. To determine the effect of an ephedra‐containing thermogenic herbal compound (TrimSpa) on rate‐corrected QT (QTc) interval duration and systolic blood pressure.Design. Randomized, double‐blind, placebo‐controlled, crossover, intent‐to‐treat study.Setting. Student laboratory at a college of pharmacy.Subjects. Thirteen healthy volunteers (eight men, five women).Intervention. Participants were given TrimSpa, which contains more than 30 ingredients including ephedra 15 mg and caffeine 60 mg, or matching placebo 3 times/day for 7 days in a crossover fashion with a 7‐day washout period between treatments.Measurements and Main Results. Each subject's QTc interval and systolic blood pressure were measured on days 1, 4, and 7. These measurements were performed immediately before study drug ingestion (baseline) and 0.5, 1, and 3 hours after ingestion. No differences in these variables were found between the TrimSpa and placebo groups. In one subject taking TrimSpa, the QTc interval increased 96 msec from baseline, more than double the largest increase in the placebo group.Conclusion. Standard doses of TrimSpa did not induce changes in subjects' QTc intervals or systolic blood pressures. However, because the QTc interval dramatically changed in one subject taking TrimSpa, a large study is needed to determine if the effect is an artifact or if the subject represents a subset of people for whom the drug may pose a risk.
Effect of Quercetin on the Plasma and Intracellular Concentrations of Saquinavir in Healthy Adults
Authors: DiCenzo Robert , Frerichs Valerie , Larppanichpoonphol Panupong , Predko Lisa , Chen Amy , Reichman Richard , Morris Marilyn 
Published: September 2006

Study Objectives. To determine if quercetin, a bioflavonoid that inhibits p‐glycoprotein, alters plasma saquinavir concentrations, and to explore the potential influence on intracellular concentrations.Design. Prospective pharmacokinetic analysis.Setting. University‐affiliated general clinical research center.Subjects. Ten healthy adults (four women, six men) with a mean ± SD age of 30.7 ± 9.4 years.Intervention. All subjects received saquinavir 1200 mg 3 times/day with food on days 1–11 and quercetin 500 mg 3 times/day with food on days 4–11.Measurements and Main Results. On days 4 and 11, nine blood samples and four peripheral blood mononuclear cell samples were drawn during a steady‐state dosing interval. Pharmacokinetic parameters were calculated by using standard noncompartmental techniques. Plasma saquinavir concentrations were similar regardless of quercetin administration. Geometric mean ratios for the area under the concentration‐time curve during an 8‐hour dosing interval (AUC0–8), maximum concentration in the dosing interval, and minimum concentration in the dosing interval were 0.99 (95% confidence interval [CI] 0.65–1.50), 0.99 (95% CI 0.64–1.54), and 1.06 (95% CI 0.68–1.67), respectively. Intracellular saquinavir concentrations displayed substantial intra‐ and intersubject variability, which limited the ability to determine the influence of quercetin coadministration (geometric mean ratio for AUC0–8= 0.51 [95% CI 0.14–1.95], six patients).Conclusion. Quercetin coadministration did not influence plasma saquinavir concentrations. Because of substantial inter‐ and intrasubject variability, more study is necessary to determine if saquinavir intracellular concentrations are altered by coadministration of quercetin.
Use of Heparin versus Lepirudin Flushes to Prevent Withdrawal Occlusion of Central Venous Access Devices
Authors: Horne McDonald K. , McCloskey Donna Jo , Calis Karim , Wesley Robert , Childs Richard , Kasten‐Sportes Claude 
Published: September 2006

Study Objective. To determine whether lepirudin flushes are more effective than heparinized saline in preventing withdrawal occlusion of central venous access devices.Design. Randomized, double‐blind clinical trial.Setting. Research institution‐tertiary referral center.Patients. Forty‐nine adults undergoing bone marrow transplantation for hematologic malignancies or metastatic solid tumors.Intervention. Twenty‐four patients received heparin and 25 received lepirudin flushes. The heparin dose was 3 ml of porcine heparin 100 U/ml (300 U) per catheter lumen at least once/day; the lepirudin dose was 3 ml of lepirudin 100 μg/ml (300 μg) per catheter lumen at least once/day After 3–4 weeks, all 49 patients received the heparin flushes.Measurements and Main Results. Efficacy was assessed by the frequency with which the patients were treated with alteplase instillations for withdrawal occlusion of their central venous access devices during the first 4 months of catheterization. Three (12.5%) patients treated with heparin alone and five (20%) treated initially with lepirudin required alteplase instillations for an estimated relative risk with lepirudin versus heparin of 1.6 (95% confidence interval [CI] 0.40–13.86, p=0.70).Conclusion. Lepirudin was not more effective than heparin, which may have been related to the conservative dose of lepirudin administered. However, higher lepirudin doses are likely to incur an unacceptable risk of systemic anticoagulation.
Analysis of the Psychoactive Terpenoid Salvinorin A Content in Five Salvia divinorum Herbal Products
Authors: Wolowich William R. , Perkins Alisha M. , Cienki John J. 
Published: September 2006

Study Objective. To determine the content of the hallucinogen salvinorin A in a variety of Salvia divinorum herbal products and to compare the content with the label claims of potency and purity.Design. Laboratory analysis.Setting. University‐affiliated laboratory.Samples. Five herbal products containing Salvia divinorum.Measurements and Main Results. The samples were purchased from the Internet and local drug paraphernalia shops (“head shops”). High‐performance liquid chromatography and thin‐layer chromatography–gas chromatography–mass spectroscopy were used for the analysis. All five samples contained salvinorin A, a psychoactive compound found in Salvia divinorum; however, the salvinorin A concentrations we measured were much lower than those claimed on the product label. Vitamin E was also found in two samples and caffeine in one sample.Conclusion. The five salvinorin A herbal products were found to be subpotent, and three products contained adulterants. Any discrepancy between the advertised salvinorin A concentration and their actual concentration may pose a potential risk of both misuse and overdose. These concerns, and the recently reported teenage suicide that could have been related to salvia consumption, underscore the need for practitioners to become familiar with the signs and symptoms of salvia use.
Interaction Between Selective Serotonin Reuptake Inhibitors and Nonsteroidal Antiinflammatory Drugs: Review of the Literature
Authors: Mort Jane R. , Aparasu Rajender R. , Baer Rebecca K. 
Published: September 2006

Objective. To evaluate the evidence of an interaction between selective serotonin reuptake inhibitors (SSRIs) and nonsteroidal antiinflammatory drugs (NSAIDs) producing an increased risk for gastrointestinal adverse outcomes such as bleeding.Methods. We searched MEDLINE for English‐language literature published between 1966 and August 2005. All studies examining gastrointestinal adverse effects from an SSRI‐NSAID combination were included.Data Synthesis. Four retrospective studies examined gastrointestinal adverse outcomes from the combination of SSRIs and NSAIDs. The risk ratio for an upper gastrointestinal bleed from this drug combination (compared with not receiving either agent) ranged from 3.3–15.6, and the risk ratio for gastrointestinal adverse effects was 12.4. Two studies found that the risk for an upper gastrointestinal bleed from the drug combination exceeded the additive risk of the agents alone. The risk ratio for an upper gastrointestinal bleed from an SSRI‐aspirin interaction was 1.9–7.2. In addition, the number needed to harm in terms of an upper gastrointestinal bleed from an SSRI‐NSAID combination ranged from 62–75 patient‐years, and the number needed to harm for gastrointestinal adverse effects was 2 patient‐years.Conclusion. Concurrent use of an SSRI and NSAID increases the risk of gastrointestinal adverse outcomes such as bleeding. Clinicians must take care to avoid these negative outcomes by altering NSAID or SSRI therapy, or by providing ulcer‐protective drugs.
Coronary Artery Disease and Hypertension: Outcomes of a Pharmacist‐Managed Blood Pressure Program
Authors: McConnell Karen J. , Zadvorny Emily B. , Hardy Angela M. , Delate Thomas , Rasmussen Jon R. , Merenich John A. ,   Clinical Pharmacy Cardiac Risk Service Study
Published: September 2006

Study Objective. To assess the effectiveness of a pharmacist‐managed service in improving hypertension control among patients with coronary artery disease.Design. Prospective cohort studySetting. Health maintenance organization.Patients. Three hundred seventy‐six patients with uncontrolled hypertension and coronary artery disease.Intervention. Pharmacist‐managed, physician‐supervised population‐management approach to optimize evidence‐based drug management.Measurements and Main Results. Blood pressure reduction and control were evaluated, as well as the use of angiotensin‐converting enzyme inhibitors and generic antihypertensive drugs during 7‐month follow‐up. At baseline, mean ± SD age was 70.4 ± 8.8 years, 247 (65.7%) were men, 201 (53.5%) had a history of myocardial infarction, and 237 (63.0%) had diabetes mellitus. Baseline mean systolic blood pressure was 151 mm Hg, and none had achieved their blood pressure goal. During follow‐up, mean systolic blood pressure decreased 16.1 mm Hg overall (p<0.001), and 179 (47.6%) patients achieved their goal blood pressure (p<0.001). Blood pressure reductions were 14.7 and 18.4 mm Hg in patients with and patients without diabetes, respectively (p<0.001). The target dose for angiotensin‐converting enzyme inhibitors was achieved in 252 (67.0%) patients compared with 102 (27.1%) at baseline (p<0.001). Generic fill rates for antihypertensive drugs continued to be higher than 95% during follow‐up (p=0.723).Conclusion. A pharmacist‐managed, physician‐supervised population‐management approach in patients with coronary artery disease significantly improved blood pressure control. Clinically meaningful reductions in blood pressure were achieved by using evidence‐based, cost‐effective drug regimens.
Effectiveness of a Two‐Part Educational Intervention to Improve Hypertension Control: A Cluster‐Randomized Trial
Authors: Hennessy Sean , Leonard Charles E. , Yang Wei , Kimmel Stephen E. , Townsend Raymond R. , Wasserstein Alan G. , Ten Have Thomas R. , Bilker Warren B. 
Published: September 2006

Study Objective. To measure the effectiveness of a multifaceted educational intervention to improve ambulatory hypertension control.Design. Cluster‐randomized trial.Setting. Academic health system using an ambulatory electronic medical record.Subjects. A total of 10,696 patients with a diagnosis of hypertension cared for by 93 primary care providers.Intervention. Academic detailing, provision of provider‐specific data about hypertension control, provision of educational materials to the provider, and provision of educational and motivational materials to patients.Measurements and Main Results. The primary outcome was blood pressure control, defined as a blood pressure measurement below 140/90 mm Hg, and was ascertained from electronic medical records over 6 months of follow‐up. We determined the adjusted odds ratio for the association between the intervention and the achievement of controlled blood pressure. When we accounted for clustering by provider, this adjusted odds ratio was 1.13 (95% confidence interval 0.87–1.47). Adjusted odds ratios were 1.03 (95% confidence interval 0.78–1.36) in patients whose blood pressure was controlled at baseline and 1.25 (95% confidence interval 0.94–1.65) in those whose blood pressure was not. These odds ratios were not significantly different (p=0.11).Conclusions. These results were consistent with no effect or, at best, a relatively modest effect of the intervention among patients with hypertension. Had we not included a concurrent control group, the data would have provided an unduly optimistic view of the effectiveness of the program. The effectiveness of future interventions may be improved by focusing on patients whose blood pressure is uncontrolled at baseline.
Quantitative Ultrasound Imaging of Healthy and Reconstructed Cleft Lip: A Feasibility Study
Authors: van Hees Nancy J. M. , Thijssen Johan M. , Huyskens Rinske W. , Weijers Gert , Nillesen Maartje M. , de Korte Chris L. , Katsaros Christos 
Published: September 2006

Objective: To investigate the feasibility of echographic imaging of healthy and reconstructed cleft lip and to estimate tissue dimensions and normalized echo level. Methods: Echographic images of the upper lip were made on three healthy subjects and two patients using a linear array transducer (7 to 11 MHz bandwidth) and a noncontact gel coupling. Tissue dimensions were measured using calipers. Echo levels were calibrated and were corrected for beam characteristics, gel path, and tissue attenuation using a tissue-mimicking phantom. Results: At the central position of the philtrum, mean thickness (SD) of lip loose connective tissue layer, orbicularis oris muscle, and dense connective layer was 4.0 (0.1) mm, 2.3 (0.7) mm, and 2.2 (0.7) mm, respectively, in healthy lip at rest; and 4.1 (0.9) mm, 3.8 (1.7) mm, and 2.6 (0.6) mm, respectively, in contracted lip. Mean (SD) echo level of muscle and dense connective tissue layer with respect to echo level of lip loose connective tissue layer was −19.3 (0.6) dB and −10.7 (4.0) dB, respectively, in relaxed condition and −20.7 (1.5) dB and −7.7 (2.3) dB, respectively, in contracted state. Color mode echo images were calculated, showing lip tissues in separate colors and highlighting details like discontinuity of the orbicularis oris muscle and presence of scar tissue. Conclusions: Quantitative assessment of thickness and echo level of various lip tissues is feasible after proper echographic equipment calibration. Diagnostic potentials of this method for noninvasive evaluation of cleft lip reconstruction outcome are promising.