bluuebunny/crossref_metadata_2025_split huggingface dataset:
Success of Referral for Alcohol Dependent Patients from a General Hospital
Authors: Rochat Stephane , Wietlisbach Vincent , Burnand Bernard , Landry Ulrika , Yersin Bertrand 
Published: June 2004

To assess the effectiveness of a multidisciplinary evaluation and referral process in a prospective cohort of general hospital patients with alcohol dependence, alcohol-dependent patients were identified in the wards of the general hospital and its primary care center. They were evaluated and then referred to treatment by a multidisciplinary team; those patients who accepted to participate in this cohort study were consecutively included and followed for 6 months. Not included patients were lost for follow-up, whereas all included patients were assessed at time of inclusion, 2 and 6 months later by a research psychologist in order to collect standardized baseline patients’ characteristics, process salient features and patients outcomes (defined as treatment adherence and abstinence). Multidisciplinary evaluation and therapeutic referral was feasible and effective, with a success rate of 43% for treatment adherence and 28% for abstinence at 6 months. Among patients’ characteristics, predictors of success were an age over 45, not living alone, being employed and being motivated to treatment (RAATE-A score < 18), whereas successful process characteristics included detoxification of the patient at time of referral and a full multidisciplinary referral meeting. This multidisciplinary model of evaluation and referral of alcohol dependent patients of a general hospital had a satisfactory level of effectiveness. Predictors of success and failure allow the identification of subsets of patients for whom new strategies of motivation and treatment referral should be designed.
Imatinib Mesylate Treatment in Two Patients with Idiopathic Hypereosinophilic Syndrome
Authors: Payne Sonja M , Kovacs Michael J 
Published: June 2004

OBJECTIVE: To report 2 clinical cases of hypereosinophilic syndrome (HES) refractory to standard therapy and the variable responses to imatinib mesylate, and to review previously reported cases of imatinib mesylate use in the treatment of hypereosinophilia. CASE SUMMARIES: Two male patients were diagnosed with idiopathic HES complicated with organ involvement. Both were treated with imatinib mesylate after failing to respond to or being unable to tolerate standard therapy. In one patient, treatment with imatinib mesylate 100 mg/day produced resolution of symptoms and peripheral blood cell counts within 6 days. The patient has successfully maintained normal blood cell counts and has been without symptoms for more than one year after starting imatinib mesylate. The other patient failed to respond to imatinib mesylate even at the maximum dose (up to 400 mg/day). DISCUSSION: Imatinib mesylate was considered an appropriate alternative for standard therapy of HES based on the evidence that other treatments used for chronic myelogenous leukemia have also been successful in treating HES. Three small studies have supported this hypothesis. However, not all patients with HES respond to imatinib mesylate therapy. The cases presented here illustrate the marked difference. CONCLUSIONS: Imatinib mesylate has shown some promise in the treatment of HES. However, until the etiology of idiopathic hypereosinophilia and the role of imatinib mesylate in the resolution of this disease are determined, it will continue to be difficult to predict the responsiveness of a patient to imatinib mesylate therapy.
Dual Blockade of the Renin—Angiotensin System in Diabetic Nephropathy
Authors: Wade Vicki L , Gleason Brenda L 
Published: June 2004

OBJECTIVE: To review the literature concerning dual blockade of the renin—angiotensin system (RAS) with an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II receptor blocker (ARB) in diabetic nephrophathy. DATA SOURCES: MEDLINE (1998—September 2003), EMBASE (1998–September 2003), and International Pharmaceutical Abstracts (1998–September 2003) were used to access the literature. Search terms included angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, diabetic nephropathy, dual blockade, renin—angiotensin system, and combination therapy. DATA SYNTHESIS: Monotherapy with an ACE inhibitor provides incomplete blockade of the RAS. Dual blockade of the RAS has been studied in approximately 300 patients with diabetic nephropathy. Recent randomized controlled studies suggest that dual blockade using an ACE inhibitor and an ARB in diabetic nephropathy is well tolerated and will provide an additional 11–43% reduction in albuminuria versus monotherapy. CONCLUSIONS: Dual blockade of the RAS using an ACE inhibitor and an ARB provide statistically significant reductions in albuminuria and blood pressure. Use of dual blockade is safe, but requires additional monitoring for hyperkalemia. Long-term studies are needed to determine whether the decrease in albuminuria will correlate with an actual improvement from overt proteinuria to microalbuminuria or a decreased incidence of end-stage renal disease in the overall diabetic population.
Omalizumab: A Novel Therapy for Allergic Asthma
Authors: Davis Lorrie A 
Published: June 2004

OBJECTIVE: To review the pharmacology, efficacy, and safety of omalizumab, focusing on the treatment of allergic asthma. DATA SOURCES: A MEDLINE search (1966—November 2003) was conducted using the key words omalizumab, Xolair, and Rhu-MAB25, with studies limited to those in humans and published in English. References of identified articles were reviewed for additional citations. STUDY SELECTION AND DATA EXTRACTION: Clinical trials evaluating the pharmacology, efficacy, and safety of omalizumab for treatment of allergic asthma in patients aged ≥1 2 years were selected. Clinical trials examining utility in pediatric patients were also reviewed. DATA SYNTHESIS: Omalizumab's ability to form complexes with unbound immunoglobulin E (IgE) translates into decreased unbound serum IgE levels and high-affinity IgE receptors on basophils, as well as attenuation of early and late allergic response in patients with allergic asthma. Results of clinical trials demonstrated that omalizumab administered subcutaneously is a safe and effective treatment for moderate to severe allergic asthma. Generally, omalizumab has a mild adverse effect profile. Omalizumab may be particularly useful for treatment of moderate to severe allergic asthma in patients who are poorly controlled on conventional therapy, experience adverse effects secondary to high-dose or prolonged corticosteroid treatment, or who have frequent exacerbations because of poor medication adherence. The high cost associated with omalizumab treatment may be prohibitive for some patients, thereby limiting its utility. CONCLUSIONS: Omalizumab is a safe and effective therapy for treatment of moderate to severe allergic asthma in difficult-to-treat, high-risk patients.
Leflunomide-Associated Pancytopenia With or Without Methotrexate
Authors: Chan Jonathan , Sanders Daniela C , Du Leanne , Pillans Peter I 
Published: June 2004

OBJECTIVE: To report 18 cases of pancytopenia associated with leflunomide use in Australia, 5 of which were treated at Princess Alexandra Hospital, Brisbane. CASE SUMMARIES: Leflunomide was used in the treatment of rheumatoid arthritis in 17 of 18 patients; the other patient was diagnosed with systemic lupus erythematosus. Median age was 65.5 years (range 18–79), and 15 of the patients were female. Fourteen patients were on combined treatment with methotrexate. Pancytopenia was typically severe, requiring hospital admission, withdrawal of the immunosuppressant(s), intensive supportive therapy, and treatment of neutropenic sepsis. Five patients died, 4 of whom were receiving concomitant methotrexate. Time to onset of pancytopenia ranged from 11 days to 4 years (median 4 mo). In one case in which the patient had been stable while receiving leflunomide, methotrexate, and hydroxychloroquine for 4 years, fatal pancytopenia was triggered by acute renal failure secondary to dehydration and use of nonsteroidal antiinflammatory drugs. The Naranjo probability scale suggested a probable causal association in 5 cases and possible association in the remainder. DISCUSSION: Leflunomide, indicated for treatment of active rheumatoid arthritis, inhibits pyrimidine synthesis in lymphocytes and other rapidly dividing cells and may rarely be associated with life-threatening pancytopenia. Combination therapy with methotrexate may increase the risk. Time to onset is variable, and clinicians should remain vigilant, particularly when there is a change in the patient's baseline health status. CONCLUSIONS: The risk of pancytopenia during leflunomide therapy appears to be increased when the drug is combined with methotrexate and in older patients. Onset may be delayed, and ongoing monitoring of blood counts is essential.
Lithium Intoxication as a Result of an Interaction with Rofecoxib
Authors: Bravo Alexandra E Rätz , Egger Sabin S , Crespo Sophie , Probst Willi L , Krähenbühl Stephan 
Published: June 2004

OBJECTIVE: To report the occurrence of lithium intoxication in a patient with bipolar disorder after adding rofecoxib to the medication regimen. CASE SUMMARY: A 68-year-old woman with bipolar disorder under long-term treatment with lithium, carbamazepine, pipamperon, and mirtazapine was prescribed rofecoxib 25 mg twice daily for the treatment of leg pain. Within one week, she showed progressive hypokinesia and tremor, which was treated with propranolol. Subsequently, she developed bradycardia, necessitating treatment with isoproterenol. Her lithium serum concentration had doubled compared with those before rofecoxib, and her renal function had deteriorated. After stopping lithium and rofecoxib, her laboratory values and neurologic signs improved or normalized within 2 days. An objective causality assessment revealed a probable relationship between concomitant use of the drugs and the resulting symptoms. DISCUSSION: As of May 24, 2004, only 3 cases of reversible lithium intoxication as a result of a possible interaction with rofecoxib or celecoxib have been previously reported. The mechanism of the interaction between lithium and cyclooxygenase (COX) 2 selective inhibitors is most probably related to inhibition of renal synthesis of prostaglandins, which are important for the maintenance of renal perfusion and tubular function. Impairment of renal blood flow, leading to a decrease in the glomerular filtration rate, and increased proximal tubular absorption are the most likely mechanisms by which COX-2 selective inhibitors reduce lithium clearance. CONCLUSIONS: Coadministration of rofecoxib and lithium may result in life-threatening lithium intoxication, especially in patients with a preexisting decrease in renal function and/or decreased intravascular volume.
Prospective Analysis of Discordant Results between Biochemical Markers and Biopsy in Patients with Chronic Hepatitis C
Authors: Poynard Thierry , Munteanu Mona , Imbert-Bismut Françoise , Charlotte Frederic , Thabut Dominique , Le Calvez Sophie , Messous Djamila , Thibault Vincent , Benhamou Yves , Moussalli Joseph , Ratziu Vlad 
Published: June 2004

AbstractBackground: The FibroTest and ActiTest are noninvasive biochemical markers of liver injury that are intended for use as alternatives to liver biopsy in patients with chronic hepatitis C. The aims of this study were to assess the quality of biopsy and the prevalence of discordances between biopsy and markers, to identify factors associated with discordances, and to attribute these discordances to either markers or biopsy failure.Methods: Fibrosis stage and activity grade were prospectively assessed on the same day by a liver biopsy and by markers. On the basis of risk factors for failure and independent endpoints, discordance was classified as being attributable to biopsy or to markers.Results: Only 74 of 537 patients (14%) had a biopsy size ≥25 mm. Discordance was observed in 154 of 537 patients (29%), including 16% for fibrosis staging and 17% for activity grading. Steatosis, an inflammatory profile, and biopsy size were associated with discordance. Discordance was attributable to failure of markers in 13 patients (2.4%) and to biopsy failure in 97 (18%; P &lt;0.001 vs Fibrotest and Actitest), and was nonattributable in 44 patients (8.2%). The most frequent failures attributable to markers were false negatives (1.3%) attributable to inflammation. The most frequent failures attributable to biopsy were false negatives of activity grading (10.1%) and of fibrosis staging (4.5%), both associated with smaller biopsy size and steatosis. False positives of fibrosis staging (3.5%) were associated with fragmented biopsies.Conclusion: In this series, the size of liver biopsy is adequate in only a minor proportion (∼14%) of patients with chronic hepatitis C. When biopsy and marker results are discordant, a reason can be identified in more than two-thirds of cases and, in those cases, biopsy failure is &gt;7 times more common than diagnostic failure of markers.
Lithium Monitoring by Reverse Iontophoresis in Vivo
Authors: Leboulanger Benoı̂t , Aubry Jean-Michel , Bondolfi Guido , Guy Richard H , Delgado-Charro M Begoña 
Published: June 2004

Abstract
Background: We investigated reverse transdermal iontophoresis as an alternative, noninvasive method for lithium monitoring in vivo. The objectives of such an approach would be to facilitate compliance with treatment and to improve the quality of life for bipolar patients.
Methods: We studied 23 bipolar or schizo-affective patients. Over a 2-h period, we extracted lithium and other cations across intact skin by application of an electric current (0.8 mA) and quantified the concentrations by ion chromatography. A blood sample provided comparative reference values for the drug and other electrolytes.
Results: Lithium, sodium, potassium, and calcium were efficiently extracted by iontophoresis. Lithium extraction fluxes were proportional to the corresponding serum concentrations, whereas sodium, potassium, and calcium extraction fluxes were relatively constant, consistent with their stable concentrations in blood. Normalization of the lithium extraction flux with that of sodium, which acted as an “internal standard”, permitted calibration of the monitoring procedure without the need for a blood measurement. This conclusion was tested retrospectively by dividing the patients into two groups. The reverse iontophoretic extraction data from the first subset (a) established the proportionality between lithium iontophoresis (or the relative electrotransport of lithium and sodium) and (b) predicted lithium blood concentrations in the second subset of patients. The predictive ability was very good, with the internal standard concept providing substantial benefit.
Conclusions: Reverse iontophoresis appears to offer a novel and accurate method for lithium monitoring.
Petrinetze – Ein anschaulicher Formalismus der Nebenläufigkeit (Teil 1) (Petri Nets – An Intuitive Formalism for Concurrency (Part 1))
Authors: Niebert Peter 
Published: June 2004

Abstract
Der Beitrag gibt eine kurze Einführung in Petrinetze zur Modellierung nebenläufiger Systeme. Im ersten Teil werden Stellen-Transitionsnetze als klassische Repräsentanten der Petrinetze eingeführt und grundlegende Modellierungskonzepte erläutert. Im zweiten Teil werden verschiedene Erweiterungen der Petrinetze diskutiert, welche die Ausdrucksstärke und Handhabbarkeit erheblich steigern und für größere Projekte unumgänglich sind.
Petrinetze – Ein anschaulicher Formalismus der Nebenläufigkeit (Teil 2) (Petri Nets – An Intuitive Formalism for Concurrency (Part 2))
Authors: Niebert Peter 
Published: June 2004

Abstract
Der Beitrag gibt eine kurze Einführung in Petrinetze zur Modellierung nebenläufiger Systeme. Im ersten Teil wurden Stellen-Transitionsnetze als klassische Repräsentanten der Petrinetze eingeführt, sowie grundlegende Modellierungskonzepte erläutert. In diesem zweiten Teil werden verschiedene Erweiterungen der Petrinetze diskutiert, welche die Ausdrucksstärke und Handhabbarkeit erheblich steigern und für größere Projekte unumgänglich sind.
Prozessalgebra, Teil 1 (Process Algebra, Part 1)
Authors: Brinksma Ed , Mader Angelika 
Published: June 2004

Abstract
Dieser Beitrag beinhaltet eine Einführung in die Prozessalgebra. Im ersten Teil wird eine Basis-Prozessalgebra vorgestellt und informell die Bedeutung ihrer Operatoren erläutert. Im zweiten Teil des Artikels beschreiben wir, wie prozessalgebraische Ausdrücke als Transitionssysteme interpretiert werden können. Anhand des Roboter-Beispiels der Artikelserie werden die elementaren Konzepte illustriert. Ein Kernstück der Prozessalgebra, beobachtbares Verhalten verschiedener Prozesse zu vergleichen, wird erläutert. Der Beitrag schließt mit einem kleinen Überblick über verschiedene Richtungen in der Prozessalgebra.
Prozessalgebra, Teil 2 (Process Algebra, Part 2)
Authors: Brinksma Ed , Mader Angelika 
Published: June 2004

Abstract
Dieser Beitrag ist der zweite Teil einer Einführung in die Prozessalgebra. Im ersten Teil wurde eine Basis-Prozessalgebra vorgestellt und informell die Bedeutung ihrer Operatoren erläutert. Im zweiten Teil des Artikels beschreiben wir, wie prozessalgebraische Ausdrücke als Transitionssysteme interpretiert werden können. Anhand des Roboter-Beispiels der Artikelserie werden die elementaren Konzepte illustriert. Ein Kernstück der Prozessalgebra, beobachtbares Verhalten verschiedener Prozesse zu vergleichen, wird erläutert. Der Beitrag schließt mit einem kleinen Überblick über verschiedene Richtungen in der Prozessalgebra.
Temporale Spezifikationslogiken (Temporal Logics for Specifications)
Authors: Dierks H. , Olderog E.-R. 
Published: June 2004

Abstract
Logiken sind in der Informatik ein weitverbreitetes Mittel zur Spezifikation. Dazu werden Logiken verschiedener Ausprägung benutzt, z.B. temporale Logiken für reaktive Systeme, zu denen die Systeme der Automatisierungstechnik zählen. Dieser Beitrag enthält eine Einführung in die wichtigsten temporalen Logiken und Literaturverweise.
Überwacht lernende Klassifikationsverfahren im Überblick, Teil 1 (Overview of Supervised learning Classification Methods, Part 1)
Authors: Hengen Heiko , Feid Michael , Pandit Madhukar 
Published: June 2004

Abstract
Der vorliegende Aufsatz beschäftigt sich mit Klassifikationsverfahren wie sie z.B. im Rahmen der technischen Diagnose oder für die digitale Bildverarbeitung eingesetzt werden können. Aus der Vielzahl der verfügbaren Methoden werden die charakteristischen Vertreter behandelt. Ein besonderes Augenmerk wurde dabei der praktischen Anwendbarkeit der Verfahren gewidmet – deren Vorzüge und Nachteile werden ausführlich erörtert und ihre Leistungsfähigkeit anhand unterschiedlicher charakteristischer Merkmalsverteilungen getestet. Ferner wird auf die Auswahl von Merkmalen sowie die dazu notwendigen Gütekriterien eingegangen. Abschließend werden die Verfahren an zwei Modellfällen aus der digitalen Bildverarbeitung und der technischen Diagnose erprobt und die erhaltenen Ergebnisse aus praktischer Sicht diskutiert.
Adequacy of Anticoagulation in Patients with Atrial Fibrillation Coming to a Hospital
Authors: Bungard Tammy J. , Ackman Margaret L. , Ho Geotham , Tsuyuki Ross T. 
Published: June 2004

Study Objective. To evaluate the adequacy of anticoagulation in patients with atrial fibrillation (AF) coming to a hospital.Design. Retrospective medical record review.Setting. Tertiary care hospital.Patients. Consecutive patients with a history of AF who had been prescribed warfarin and who had the international normalized ratio (INR) measured when they arrived at the hospital. Those who developed AF as a complication during hospitalization were excluded.Measurements and Main Results. Of 1085 patients, 375 (mean age 73 yrs, 56.3% men) were eligible for further evaluation. Most had nonvalvular AF; in 44.5% the INR was subtherapeutic, in 36.5% it was therapeutic, and in 18.9% it was supratherapeutic. Patients admitted for any thromboembolic event and for ischemic stroke were significantly more likely to have subtherapeutic INRs.Conclusion. It is well documented in the literature that warfarin is underprescribed, but our results suggest that even in treated patients, about half are inadequately protected from thromboembolism.
Comparative In Vitro Activity and Pharmacodynamics of Five Fluoroquinolones Against Clinical Isolates of Streptococcus pneumoniae
Authors: Kays Michael B. , Conklin Michelle 
Published: June 2004

Study Objective. To compare in vitro activity and pharmacodynamics of five fluoroquinolones against clinical isolates of Streptococcus pneumoniae.Design. In vitro analysis.Setting. University research laboratory.Intervention. Minimum inhibitory concentrations (MICs) were determined for penicillin and five fluoroquinolones by E test for 201 S. pneumoniae isolates. Serum concentration‐time profiles were simulated for the following regimens: ciprofloxacin 750 mg orally every 12 hours and 400 mg intravenously every 8 hours; levofloxacin 500 mg orally and intravenously every 24 hours; trovafloxacin 200 mg orally and intravenously every 24 hours; gatifloxacin 400 mg orally and intravenously every 24 hours; and clinafloxacin 200 mg orally and intravenously every 12 hours.Measurements and Main Results. Free 24‐hour areas under the serum concentration‐time curves (AUC0–24) were calculated using the trapezoidal rule, and the average AUC0–24:MIC ratio was calculated for each regimen. Differences in ratios among agents were determined by analysis of variance (Scheffe post hoc test, p<0.05). For intravenous dosing, the average AUC0–24:MIC for gatifloxacin, clinafloxacin, trovafloxacin, ciprofloxacin, and levofloxacin was 146, 142, 122, 71, and 61, respectively. For both oral and intravenous regimens, gatifloxacin and clinafloxacin ratios were significantly greater than those for trovafloxacin, levofloxacin, and ciprofloxacin (p≤0.007). Ratios for trovafloxacin were significantly greater than those for levofloxacin and ciprofloxacin (p<0.0001), and levofloxacin and ciprofloxacin ratios were not significantly different from each other.Conclusion. Gatifloxacin and clinafloxacin achieve significantly higher AUC0–24:MIC ratios for S. pneumoniae than trovafloxacin, levofloxacin, and ciprofloxacin. Large comparative studies are necessary to determine the clinical significance of these findings.
Randomized, Multicenter Comparison of Oral Granisetron and Oral Ondansetron for Emetogenic Chemotherapy
Authors: Herrington Jon D. , Kwan Peter , Young Robyn R. , Lagow Elaine , Lagrone Lore , Riggs Mark W. 
Published: June 2004

Study Objectives. To compare the antiemetic effectiveness and safety of oral granisetron plus dexamethasone with those of oral ondansetron plus dexamethasone administered before emetogenic chemotherapy.Design. Randomized, prospective, multicenter, open‐label study.Settings. University‐teaching hospital and veterans health care system.Patients. Sixty‐one chemotherapy‐naïve patients scheduled to receive emetogenic antineoplastic agents.Intervention. A single‐dose oral granisetron 1 mg and dexamethasone 12 mg or single‐dose oral ondansetron 16 mg and dexamethasone 12 mg was administered before chemotherapy.Measurements and Results. Twenty‐four hours after administration patients were contacted to assess nausea, emesis, and adverse events. There were no statistical differences in frequency of nausea or emesis between groups. Seventy‐six percent and 82% of patients receiving ondansetron and granisetron, respectively, experienced no emesis 24 hours after chemotherapy. Complete protection from nausea occurred in 58% and 46% of patients receiving the drugs, respectively. Adverse events were similar between groups.Conclusion. Oral granisetron 1 mg and ondansetron 16 mg plus dexamethasone are safe and effective in preventing nausea and vomiting related to emetogenic chemotherapy.