bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Cyclooxygenase-2 Inhibitors on Blood Pressure
Authors: Johnson Deanna L , Hisel Tina M , Phillips Beth Bryles 
Published: June 2003

OBJECTIVE: To evaluate the effect of cyclooxygenase-2 selective inhibitors (CSIs) on blood pressure. DATA SOURCES: Clinical literature accessed through MEDLINE (1966–May 2002). Key search terms included COX-2 selective inhibitors; anti-inflammatory agents, nonsteroidal; celecoxib; rofecoxib; and hypertension. DATA SYNTHESIS: Data from prospective studies on the effects of CSIs on blood pressure are conflicting. Several studies have reported increased blood pressure as an adverse effect of CSIs. CONCLUSIONS: Additional studies are needed to evaluate the effects of CSIs on blood pressure. CSIs should be used with caution in hypertensive patients and blood pressure monitored closely if a CSI is indicated.
CANCER Resistance Surveillance Program: Initial Results from Hematology–Oncology Centers in North America
Authors: Mutnick Alan H , Kirby Jeffrey T , Jones Ronald N ,   The CANCER Study Group
Published: June 2003

OBJECTIVE The CANCER (Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance) surveillance program was initiated to collect culture data on antimicrobial and antifungal agents in hospitals treating neutropenic patients in North America, as a means to monitor the development of microbial resistance. METHODS A total of 2042 isolates from bloodstream, respiratory, urinary, and cutaneous infections in 2000–2001 were submitted by 33 oncology centers, clinics, and hospitals in North America, sent to a central laboratory, and tested by National Committee for Clinical Laboratory Standards methods against 42 different antimicrobials. RESULTS Staphylococcus aureus, Escherichia coli, coagulase-negative staphylococci, Enterococcus spp., and Klebsiella spp. represented the most frequently isolated pathogens during the initial benchmark year. The incidence of extended-spectrum β-lactamase–producing phenotypes ranged from 1.6% to 4.6% among E. coli and Klebsiella spp. Amikacin, tobramycin, polymyxin B, and piperacillin/tazobactam provided the highest susceptibility rates against Pseudomonas aeruginosa isolates. Yeast bloodstream isolates demonstrated complete susceptibility to amphotericin B, but 14% of strains were considered to have high-level fluconazole resistance. CONCLUSIONS Elevated resistance rates when compared to general hospital strains were not observed in the CANCER program during the baseline year of this novel longitudinal, resistance surveillance program. The prevalence of gram-positive pathogens, although representing more than 50% of all bacterial isolates, was slightly lower than that reported previously by other investigators. Continued evaluation for antimicrobial resistance as well as changes in the prevalence of gram-positive pathogens requires the use of longitudinal surveillance programs such as the CANCER program. Such initiatives allow the development of therapeutic strategies for coping with changes in resistance and pathogen prevalence in this dynamic at-risk patient environment.
Diagnosis and Treatment of Graves Disease
Authors: Streetman Darcie D , Khanderia Ujjaini 
Published: June 2003

OBJECTIVE: To review the etiology, diagnosis, and clinical presentation of Graves disease and provide an overview of the standard and adjunctive treatments. Specifically, antithyroid drugs, β-blockers, inorganic iodide, lithium, and radioactive iodine are discussed, focusing on current controversies. DATA SOURCES: Primary articles were identified through a MEDLINE search (1966–July 2000). Key word searches included β-blockers, Graves disease, inorganic iodide, lithium, methimazole, and propylthiouracil. Additional articles from these sources and endocrinology textbooks were also identified. We agreed to include articles that would highlight the most relevant points, as well as current areas of controversy. DATA SYNTHESIS: Graves disease is the most common cause of hyperthyroidism. The 3 main treatment options for patients with Graves hyperthyroidism include antithyroid drugs, radioactive iodine, and surgery. Although the antithyroid drugs propylthiouracil (PTU) and methimazole (MMI) have similar efficacy, there are situations when 1 agent is preferred. MMI has a longer half-life than PTU, allowing once-daily dosing that can improve patient adherence to treatment. PTU has historically been the drug of choice for treating pregnant and breast-feeding women because of its limited transfer into the placenta and breast milk. Adjuvant therapies for Graves disease include β-blockers, inorganic iodide, and lithium. β-Blockers are used to decrease the symptoms of hyperthyroidism. Inorganic iodide is primarily used to prepare patients for thyroid surgery because of its ability to decrease the vascularity of the thyroid gland. Lithium, which acts in a manner similar to iodine, is not routinely used due to its transient effect and the risk of potentially serious adverse effects. In the US, radioiodine therapy has become the preferred treatment for adults with Graves disease. It is easy to administer, safe, effective, and more affordable than long-term treatment with antithyroid drugs. Hypothyroidism is an inevitable consequence of radioiodine therapy. Radioiodine is contraindicated in pregnant women because it can damage the fetal thyroid gland, resulting in fetal hypothyroidism. Bilateral subtotal thyroidectomy, which was once the only treatment available, is now performed only in special circumstances. In addition to the normal risks associated with surgery, laryngeal nerve damage, hypoparathyroidism, and hypothyroidism can occur following that procedure. CONCLUSIONS: Despite extensive experience with medical management, controversy prevails regarding choosing among the various drugs for treatment of Graves disease. None of the treatment options, including antithyroid drugs, radioiodine, and surgery, is ideal. Each has risks and benefits, and selection should be tailored to the individual patient.
Pramlintide for the Treatment of Diabetes Mellitus
Authors: Kleppinger Erika L , Vivian Eva M 
Published: June 2003

OBJECTIVE: To provide an overview of the role of amylin, as well as that of pramlintide, a synthetic analog of amylin, in maintaining glucose homeostasis; and discuss the pharmacology, pharmacokinetics, efficacy, adverse effects, and role of pramlintide in the control of postprandial hyperglycemia. DATA SOURCES: The data presented in this review were obtained from published literature, abstracts presented at scientific meetings, and information on file with the manufacturer. MEDLINE searches (1986–March 2003) using the search terms pramlintide and amylin were conducted to identify clinical trials and review articles. Additionally, the bibliographies of the identified articles were reviewed. DATA SYNTHESIS: Clinical trials have demonstrated that amylin in combination with insulin controls postprandial glucose levels by decreasing food intake, slowing gastric emptying, and suppressing glucagon secretion. Clinical trials also showed significant decreases in mean plasma glucose levels and glycosylated hemoglobin, as well as the added benefits of weight loss and reduction in insulin doses. The most commonly reported adverse effects associated with pramlintide in clinical trials were gastrointestinal complaints and hypoglycemia, which occurred most frequently during initiation of therapy. CONCLUSIONS: The administration of insulin alone often does not result in optimal metabolic control. The treatment of amylin deficiency, in addition to insulin deficiency, may be warranted in order to obtain glucose homeostasis. The role of pramlintide, an amylin analog, will become clearer as more clinical data become available.
Bosentan and Warfarin Interaction
Authors: Murphey Lisa M , Hood Elizabeth H 
Published: June 2003

OBJECTIVE: To report a case of decreased international normalized ratio (INR) in a patient receiving warfarin and bosentan. CASE SUMMARY: A 35-year-old African American woman with a history of primary pulmonary hypertension managed with warfarin, diltiazem, and hydrochlorothiazide was initiated on bosentan therapy. The patient's INR had been stable and within therapeutic range (goal 2.0–3.0) for the previous 3 months with warfarin 27.5 mg/wk, but became subtherapeutic after 10 days of bosentan therapy. Addition of over-the-counter medications, herbal products, vitamins, or dietary changes was denied. The INR remained subtherapeutic for 5 weeks despite weekly warfarin dose increases. After these 5 weeks of dosage increases, the INR became supratherapeutic for 3 weeks, resulting in a subsequent dosage decrease. The resultant warfarin dose required to maintain a therapeutic INR was 45 mg/wk, a 63.6% dosage increase after the initiation of bosentan. DISCUSSION: This case shows that a clinically significant interaction between bosentan and warfarin may exist. An objective causality assessment revealed that the interaction was probable. Although the possibility of this interaction has been noted, no previously documented occurrence of this interaction has been identified. CONCLUSIONS: Bosentan may significantly decrease the anticoagulant properties of warfarin. The INR should be monitored more frequently when bosentan is initiated, adjusted, or discontinued in patients taking warfarin.
Isotretinoin and Psychiatric Illness in Adolescents and Young Adults
Authors: Enders Shelly J , Enders Jason M 
Published: June 2003

OBJECTIVE: To evaluate the relationship between isotretinoin and psychiatric illness in adolescents and young adults. DATA SOURCES: Primary literature located via MEDLINE (1966–December 2002). Key terms were isotretinoin, depression, psychosis, suicide, and adolescents. DATA SYNTHESIS: Information regarding depression was added to isotretinoin labeling in 1998 following a series of case reports and submitted to the MedWatch system. CONCLUSIONS: Although a causal relationship may exist between isotretinoin and psychiatric illness in adolescents and young adults, this has not been demonstrated in the literature. Until evidence establishes a presence or lack of causality, prescribers should exercise caution when treating adolescents and young adults with isotretinoin.
Melatonin for the Treatment of Tardive Dyskinesia
Authors: Nelson Leigh Anne , McGuire J Michael , Hausafus Sarah N 
Published: June 2003

OBJECTIVE: To review the available literature regarding the use of melatonin in the treatment of tardive dyskinesia (TD). DATA SOURCES: Literature was identified through MEDLINE (1966–September 2002), PsycINFO (1967–September 2002), and references of relevant articles. Review articles, case reports/series, and animal and human studies were reviewed. DATA SYNTHESIS: Melatonin has been investigated in TD based on its antioxidant properties. Animal studies and several human case series describe an association between melatonin and TD. Two recent, controlled studies evaluated the role of melatonin in the treatment of TD. CONCLUSIONS: There is a paucity of data evaluating the use of melatonin in TD. Both of the controlled studies evaluating its use are limited by methodologic issues. Although the most recent trial did report a statistically significant improvement in TD with melatonin, these results are not considered to be clinically significant. There are inadequate data at the present time to support the use of melatonin in patients with TD.
Simvastatin–Fluconazole Causing Rhabdomyolysis
Authors: Shaukat Aasma , Benekli Mustafa , Vladutiu Georgirene D , Slack James L , Wetzler Meir , Baer Maria R 
Published: June 2003

OBJECTIVE: To report a case of rhabdomyolysis after concomitant use of simvastatin, a commonly used hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, and fluconazole, an azole antifungal agent. CASE SUMMARY: An 83-year-old white man with a history of congestive heart failure and hyperlipidemia presented to the hospital 1 week following the addition of fluconazole to a medication regimen that included simvastatin 40 mg once daily. The patient had severe muscle weakness and a markedly elevated serum creatine kinase activity, which resolved following discontinuation of simvastatin and fluconazole. DISCUSSION: Rhabdomyolysis is a recognized adverse effect of HMG-CoA reductase inhibitors (statins), commonly caused by their interaction with other drugs, such as azole antifungals, that inhibit the cytochrome P450 isoenzyme family. An objective causality assessment revealed that the adverse drug event was probable. Although drug interactions have been described for combinations of other HMG-CoA reductase inhibitors and azole antifungals, rhabdomyolysis likely caused by the interaction between simvastatin and fluconazole has not yet been reported. This case reinforces the importance of being vigilant for drug interactions, particularly in connection with commonly prescribed medications such as statins. CONCLUSIONS: Patients receiving statins who have cancer may receive azole antifungals and other drugs that inhibit CYP3A4 during treatment, predisposing them to toxicity. These patients should therefore be monitored closely for drug interactions.
Anaphylactoid Reaction to Ciprofloxacin
Authors: Ho Dora Y , Song Jessica C , Wang Clifford C 
Published: June 2003

OBJECTIVE: To report a case of anaphylactoid reaction in an HIV-negative patient associated with the administration of intravenous ciprofloxacin. CASE SUMMARY: A 79-year-old Armenian man developed an anaphylactoid reaction following a first-time exposure to intravenous ciprofloxacin. This reaction was characterized by severe hypotension, wheezing, tachypnea, tachycardia, and pruritus. The patient had complete recovery once ciprofloxacin treatment was terminated and supportive care was provided. DISCUSSION: Fluoroquinolones are important therapeutic agents in the management of infectious diseases and are generally safe and well tolerated. Anaphylactoid and anaphylactic reactions have been documented as adverse effects of ciprofloxacin, ofloxacin, norfloxacin, levofloxacin, and moxifloxacin. To date, >33 cases have been reported with ciprofloxacin, of which at least 10 occurred in HIV-positive patients. In Europe, 15 cases of anaphylactoid reactions to ofloxacin have been reported and, more recently, with moxifloxacin. Since anaphylactoid reactions are potentially life threatening, the administration of fluoroquinolones to patients who have experienced a prior reaction to any of these agents should be avoided, unless tolerance has been confirmed by oral challenge tests. CONCLUSIONS: The anaphylactoid reaction in our patient was probably induced by ciprofloxacin as validated by the Naranjo probability scale. Although anaphylactoid/anaphylactic reactions are rare adverse effects of ciprofloxacin and other fluoroquinolones, clinicians should be aware of this potentially fatal event.
Experience with an Adverse Drug Reaction Reporting Program in a Neurology Specialty Clinic
Authors: Ryan Melody , Gora-Harper Mary Lea , Caldwell Frank 
Published: June 2003

OBJECTIVE: To describe an adverse drug reaction (ADR) reporting program that was developed in a university-affiliated neurology specialty clinic. METHODS: Reportable ADRs were identified through 3 mechanisms: by clinicians through routine visits, by patients who were encouraged to follow up with the pharmacist in the clinic, and by the pharmacist who contacted high-risk patients. Patient demographics, the suspected drug(s), elements to define probability, and outcomes were documented, collated, and analyzed for trends and opportunities for continuous quality-improvement efforts. Information was shared with clinic administrators and clinicians. Serious ADRs were reported to the Food and Drug Administration. RESULTS: The experience during a 1-year period, during which 40 ADRs were reported, is described. Medications by frequency of report and types of reactions are reported. None of the ADRs required admission to the hospital. Pharmacy personnel reported the majority of ADRs (92.5%). CONCLUSIONS: This program is successfully incorporated within daily practice and is an integral part of quality-improvement efforts.
Health Survey Data on Potentially Inappropriate Geriatric Drug Use
Authors: Laurier Claudine , Moride Yola , Kennedy Wendy A 
Published: June 2003

BACKGROUND: Studies have suggested that elderly patients do not always use medications appropriately. Investigations that have relied on prescription claim databases or clinical records focus on acquisition or prescription, and hypotheses must be made to assess actual consumption. Population survey data constitute an alternative way to study inappropriate use. OBJECTIVE: To estimate the prevalence of potentially inappropriate use of medications in elderly patients in Québec based on self-reported use. METHODS: Using a cross-sectional, general population, health survey in which self-reported medication use in the 2 days prior to the survey was recorded, we estimated the prevalence of inappropriate medication use in elderly patients (≥65 y old) who responded. Two sets of published criteria were used to define inappropriate use: one to assess use of inappropriate drugs, and another to assess concomitant duplications and potential interactions. RESULTS: Of the 3400 patients surveyed, 6.5% had used ≥1 inappropriate drugs, 2.5% had ≥1 occurrences of potentially inappropriate duplication of medications, and 2.7% had ≥1 potential medication interactions. Concomitant use of at least 2 benzodiazepines was reported by 8.5% of respondents using these drugs. Use of ≥1 long-acting benzodiazepines was reported by 4.2% of the sample. CONCLUSIONS: Population health surveys are a useful tool for detecting potentially inappropriate medication use in the elderly. In particular, the high prevalence of inappropriate use of benzodiazepines signals a need for improved detection and intervention in this group. TRANSFONDO: Existen estudios que demuestran que los ciudadanos viejos no siempre usan sus medicamentos adecuadamente. Estudios basados en los bancos de datos de los reclamos de prescripción o expedientes clínicos se hacen a base de la adquisición o prescripción de medicamentos. De estos se crean hipótesis para estimar el consumo real de medicamentos. Una manera alterna de realizar estudios sobre el uso inapropiado de medicamentos lo es a través de datos obtenidos de encuestas poblacionales.
The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non‐clinical sample
Authors: Crawford John R. , Henry Julie D. 
Published: June 2003

Objectives: To provide UK normative data for the Depression Anxiety and Stress Scale (DASS) and test its convergent, discriminant and construct validity.Design: Cross‐sectional, correlational and confirmatory factor analysis (CFA).Methods: The DASS was administered to a non‐clinical sample, broadly representative of the general adult UK population (N = 1,771) in terms of demographic variables. Competing models of the latent structure of the DASS were derived from theoretical and empirical sources and evaluated using confirmatory factor analysis. Correlational analysis was used to determine the influence of demographic variables on DASS scores. The convergent and discriminant validity of the measure was examined through correlating the measure with two other measures of depression and anxiety (the HADS and the sAD), and a measure of positive and negative affectivity (the PANAS).Results: The best fitting model (CFI = .93) of the latent structure of the DASS consisted of three correlated factors corresponding to the depression, anxiety and stress scales with correlated error permitted between items comprising the DASS subscales. Demographic variables had only very modest influences on DASS scores. The reliability of the DASS was excellent, and the measure possessed adequate convergent and discriminant validity.Conclusions: The DASS is a reliable and valid measure of the constructs it was intended to assess. The utility of this measure for UK clinicians is enhanced by the provision of large sample normative data.
Outcomes of patients completing and not completing cognitive therapy for depression
Authors: Cahill Jane , Barkham Michael , Hardy Gillian , Rees Anne , Shapiro David A. , Stiles William B. , Macaskill Norman 
Published: June 2003

Objectives: The aims of this study were to use symptom intensity measures collected at each session (1) to describe the outcomes of clients who received cognitive therapy (CT) for depression in a clinically representative sample, and (2) to compare the outcomes of clients who completed the agreed number of sessions with those who did not.Design and method: Clients (N = 58) contracted to attend between 12 and 20 sessions of CT completed the Beck Depression Inventory (BDI) immediately prior to each therapy session. The BDI and other measures were collected at intake and, for those who completed therapy, at a post‐therapy assessment.Results: Completers' BDI scores improved significantly from intake to post‐treatment and significantly more from intake to their final session than did those of non‐completers. However, when non‐completers' final session scores were matched with scores of randomly selected completers at the corresponding session, the difference in improvemen was not significant. A significantly higher proportion of clients who completed the agreed number of sessions achieved reliable and clinically significant change (71.4%, 25/35), compared with just 13% (3/23) of clients who did not.Conclusions: (1) CT for depression can be effective in a clinically representative population. (2) Attrition from clinical trials may bias estimates of treatment effectiveness.
Individual differences in post‐traumatic stress following post‐intimate stalking: Stalking severity and psychosocial variables
Authors: Kamphuis Jan H. , Emmelkamp Paul M. G. , Bartak Anna 
Published: June 2003

Objective: Stalking can have a major psychosocial impact on its victims. Accumulating evidence suggests frequent post‐traumatic stress (PTS) reactions. The present study aimed to detail the affective and cognitive responses following post‐intimate stalking, and to assess the associations between stalking severity, person‐related psychosocial variables and symptoms of PTS.Design: Female members (N = 131) of a Dutch nation‐wide support group were contacted by mail and completed questionnaires pertaining to their stalking history, Big Five personality traits, coping, social support, as well as PTS reactions and symptoms.Method: The Traumatic Constellation Identification Scale was used to elucidate emotional and cognitive responses to post‐intimate stalking. To assess the associations between stalking severity indices, person‐related psychosocial variables and PTS, a regression analysis was conducted using the Impact of Events Scale as a dependent variable.Results: Affective reactions included affective liability, fear, shame and loss. Associated maladaptive beliefs included decreased trust, increased alienation and isolation, and attributions of self‐blame. Indices of stalking severity accounted for 22% of the PTS variance, with stalking violence being the most potent predictor. Another 8% of PTS variance was associated with a passive coping reaction and (lower) openness to experience.Conclusion: PTS following stalking was associated with both stressor‐related and person‐related variables. Risk factors for PTS included severe stalking including violence and passive coping. Prolonged post‐intimate stalking may lead to personality adaptation (i.e. becoming more closed, cautious and reserved).