bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug Record Discrepancies in an Outpatient Electronic Medical Record: Frequency, Type, and Potential Impact on Patient Care at a Hemodialysis Center
Authors: Manley Harold J. , Drayer Debra K. , McClaran Marcy , Bender Walter , Muther Richard S. 
Published: May 2004

Background. Patients who require hemodialysis take many drugs. Electronic drug records may be discrepant with what patients are actually taking. Record discrepancies are a potential source of drug‐related problems. We sought to determine the extent to which drug record discrepancies occur in a hemodialysis population.Methods. This was a prospective observational study of patients enrolled in a pharmacist clinic at an outpatient hemodialysis center from August‐December 2001. Patients participated in monthly drug interviews conducted by a pharmacist, during which patient drug use was determined. Data collected consisted of patient demographics, drug type, and number of drugs. Drug record discrepancies were classified and assigned a potential drug‐related problem. Results were compared with the electronic drug record. Patients with documented drug record discrepancies were compared with those patients for whom no discrepancy was identified.Results. Over the 5‐month period, 215 drug interviews were conducted in 63 patients. One hundred thirteen drug record discrepancies were identified in 38 patients (60%). Discrepancies (mean ± SD 1.7 ± 1.3, range 1–7) were identified during 65 drug interviews (30.2%). Electronic drug records were discrepant by one drug record, two drug records, and more than two drug records 60.0%, 26.2%, and 13.8% of the time, respectively. Drug record discrepancies placed patients at risk for adverse drug events and dosing errors in 49.6% and 34.5%, respectively, of 113 discrepancies. Patient age negatively correlated with the number of drug record discrepancies identified (r=−0.27, p=0.04).Conclusions. Drug record discrepancies occur frequently among patients undergoing hemodialysis. Incorporation of a pharmacist into the patient care team may increase the accuracy of the electronic drug record and avert unnecessary drug‐related problems.
Impact of Hospitalization on Blood Pressure Control in Italy: Results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA)
Authors: Onder Graziano , Gambassi Giovanni , Sgadari Antonio , Williamson Jeff D. , Cesari Matteo , Landi Francesco , Bernabei Roberto , Pahor Marco 
Published: May 2004

Study Objectives. To evaluate whether hospitalization affects blood pressure control in hypertensive patients, and to identify factors associated with attainment of adequate blood pressure control and with aggressive pharmacologic treatment.Design. Retrospective study.Setting. Eighty‐one hospitals throughout Italy.Patients. A total of 3304 patients (59% women, 41% men) with a diagnosis of hypertension and uncontrolled blood pressure values at hospital admission.Measurements and Main Results. Patients' blood pressures were surveyed during study periods from 1988–1997. Controlled blood pressure was defined according to the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (systolic < 140 mm Hg, diastolic < 90 mm Hg). Aggressive pharmacologic treatment was defined as an increase in the number of antihypertensive drugs that the patient was receiving at hospital discharge compared with the number of drugs on admission. Adequate blood pressure control was achieved in only 767 (23.2%) patients, but the proportion increased in each subsequent survey. Age (odds ratio [OR] for 10‐year increase 0.82, 95% confidence interval [CI] 0.76–0.88) and male sex (OR 0.79, 95% CI 0.65–0.94) were associated with reduced likelihood of achieving adequate blood pressure control. In contrast, coronary heart disease (OR 1.38, 95% CI 1.14–1.66), year of survey (1995 vs 1988: OR 1.47, 95% CI 1.19–1.82; 1997 vs 1988: OR 1.27, 95% CI 1.02–1.42), length of hospital stay (medium vs lower tertile OR 1.20, 95% CI 0.96–1.49; higher vs lower tertile OR 1.42, 95% CI 1.13–1.77), and increase in number of antihypertensive drugs prescribed (OR 1.21, 95% CI 1.02–1.42 for one drug increase) were associated with improved blood pressure control. In 1753 (53.1%) patients, the number of antihypertensive drugs increased during their hospital stay. Younger age, fewer drugs on admission, lower comorbidity index, diagnosis of chronic heart failure, lengthy hospital stay, and increasing baseline values of systolic and diastolic blood pressure were associated with aggressive pharmacologic treatment.Conclusion. Adequate blood pressure control was achieved in only 25% of patients with hypertension despite a trend toward improvement in recent years. Advanced age was one of the main factors associated with less aggressive pharmacologic treatment and with inadequate blood pressure control.
Effects of Intravenous Magnesium Sulfate on the QT Interval in Patients Receiving Ibutilide
Authors: Caron Michael F. , Kluger Jeffrey , Tsikouris James P. , Ritvo Arnold , Kalus James S. , White C. Michael 
Published: May 2004

Study Objective. To determine the effect of intravenous magnesium sulfate on the QT and QTc intervals in patients receiving ibutilide for immediate chemical cardioversion of atrial flutter or fibrillation.Design. Prospective, randomized, double‐blind, placebo‐controlled trial.Setting. Hospital cardiology unit.Patients. Twenty patients (mean age 72 ± 14 yrs) with atrial fibrillation (12 patients) or atrial flutter (8 patients) who were scheduled to receive ibutilide.Intervention. After determining that the patients' baseline QTc intervals were less than 440 msec and baseline serum magnesium levels were within normal limits (mean 2.1 ± 0.29 mg/dl), the patients were randomly assigned to receive either a 10‐minute infusion of magnesium sulfate 2 g in 50 ml of 0.9% sodium chloride or placebo immediately before ibutilide therapy. An additional 2 g of intravenous magnesium sulfate or placebo was given over 1 hour, 10 minutes after the first dose of ibutilide.Measurements and Main Results. QT interval duration was measured manually in all 12 leads by using a 0.5‐mm‐scale precision ruler and magnifying lens. The QT interval increased 29% from baseline at 30 minutes after ibutilide therapy in the placebo group (p=0.007), but no significant change from baseline occurred in the magnesium sulfate group. The 30‐minute QTc interval in the placebo group was 18% higher than the baseline value (p=0.01) but did not change significantly in the magnesium sulfate group. QTc changes from baseline were greater in the placebo group than in the magnesium sulfate group at 30 minutes (75 vs 19 msec, respectively, p=0.04). Magnesium sulfate reduced the risk of an ibutilide‐induced QTc interval increase of greater than 30 msec or greater than 60 msec and reduced the risk of a QTc interval value of more than 500 msec by 65%, 60%, and 68%, respectively (p=0.07, p=0.175, and p=0.160).Conclusions. Prophylactic administration of intravenous magnesium sulfate prevents increases in the QT and QTc interval 30 minutes after the last infusion of ibutilide.
Increased Frequency of Venous Thromboembolism with the Combination of Docetaxel and Thalidomide in Patients with Metastatic Androgen‐Independent Prostate Cancer
Authors: Horne McDonald K. , Figg William D. , Arlen Phil , Gulley James , Parker Catherine , Lakhani Nehal , Parnes Howard , Dahut William L. 
Published: May 2004

Study Objective. To evaluate the frequency of venous thromboembolism (VTE) in patients with advanced androgen‐independent prostate cancer who were treated with docetaxel alone or in combination with thalidomide.Design. Retrospective analysis of a randomized phase II trial.Setting. National Institutes of Health clinical research center.Patients. Seventy men, aged 50–80 years, with advanced androgen‐independent prostate cancer.Intervention. Each patient received either intravenous docetaxel 30 mg/m2/week for 3 consecutive weeks, followed by 1 week off, or the combination of continuous oral thalidomide 200 mg every evening plus the same docetaxel regimen. This 4‐week cycle was repeated until there was evidence of excessive toxicity or disease progression.Measurements and Main Results. None of 23 patients who received docetaxel alone developed VTE, whereas 9 of 47 patients (19%) who received docetaxel plus thalidomide developed VTE (p=0.025).Conclusion. The addition of thalidomide to docetaxel in the treatment of prostate cancer significantly increases the frequency of VTE. Clinicians should be aware of this potential complication when adding thalidomide to chemotherapeutic regimens.
Important Effect of Food on the Bioavailability of Oral Testosterone Undecanoate
Authors: Bagchus Wilma M. , Hust Rita , Maris Frans , Schnabel Peter G. , Houwing Natalie S. 
Published: May 2004

Study Objective. To assess the effects of food on the bioavailability of testosterone undecanoate, testosterone, and 5a‐dihydrotestosterone (DHT) after administration of a new oral testosterone undecanoate formulation, Andriol Testocaps.Design. Randomized, open‐label, crossover study with a 1‐week washout period.Setting. Clinical pharmacology unit.Subjects. Sixteen healthy postmenopausal women.Intervention. Single oral doses of testosterone undecanoate 80 mg were administered either during a fasting period or after consumption of a standardized continental breakfast.Measurements and Main Results. Serum concentrations of testosterone undecanoate were assayed by liquid chromatography with mass spectrometry detection; testosterone and DHT were assayed by gas chromatography with mass spectrometry detection. Serum concentrations of testosterone, testosterone undecanoate, and DHT were low to negligible when testosterone undecanoate was administered to subjects in a fasting state; these values were significantly higher when the test drug was coadministered with food. For testosterone, the maximum serum concentration and area under the plasma concentration‐time curve were 0.67 ng/ml and 5.37 ng·hr/ml, respectively, in the fasting state, versus 10.7 ng/ml and 56.4 ng·hr/ml, respectively, in the fed state. The same parameters were also significantly higher for testosterone undecanoate and DHT in the fed versus fasting subjects.Conclusion. Food increases the bioavailability of testosterone undecanoate, testosterone, and DHT. For proper absorption, Andriol Testocaps must be taken with meals.
Association Between Adherence to Diuretic Therapy and Health Care Utilization in Patients with Heart Failure
Authors: Chui Michelle A. , Deer Melissa , Bennett Susan J. , Tu Wanzhu , Oury Stacey , Brater D. Craig , Murray Michael D. 
Published: May 2004

Study Objective. To determine the relationship between adherence to diuretic therapy and health care utilization.Design. Prospective, observational study.Setting. University‐affiliated medical center.Patients. Forty‐two patients with heart failure.Intervention. Electronic monitoring of adherence to diuretic therapy (percentage of diuretic prescription container openings) and to scheduling (percentage of container openings within a specific time).Measurements and Main Results. All patients were prescribed a diuretic, most commonly furosemide (88%). Patients varied widely in adherence to therapy (μ = 72% ± 30%) and to scheduling (μ = 43% ± 30%). Education was a predictor of drug‐taking adherence (p=0.0062) but not of scheduling adherence. Log‐linear models revealed that poor scheduling adherence was associated with increased cardiovascular‐related hospitalizations (χ2 11.63, p=0.0006) and predicted more heart failure‐related hospitalizations (χ2 4.04, p=0.0444). In contrast, neither measure was significantly associated with cardiovascular‐ or heart failure‐related emergency department visits. We found a moderate correlation between scheduling adherence and taking adherence (r = 0.6513).Conclusion. Patients taking a greater proportion of diuretic agents on schedule may decrease the risk of cardiovascular‐ and heart failure‐related hospitalizations. If these findings are confirmed by a larger study, interventions to improve adherence and patient health outcomes should consider the timing of doses as well as the number of daily doses of a diuretic.
Variability in Polyene Content and Cellular Toxicity Among Deoxycholate Amphotericin B Formulations
Authors: Cleary John D. , Rogers P. David , Chapman Stanley W. 
Published: May 2004

Study Objective. To evaluate the toxicity of amphotericin B deoxycholate formulations.Design. In vitro experiment.Setting. University research center.Material. Human mononuclear THP‐1 cells.Intervention. The human mononuclear cells were exposed in vitro for 2 hours to the following deoxycholate formulations of amphotericin B, in 2.5‐ and 5‐μ/ml concentrations: Apothecon, Pharmacia, Sigma, Gensia, Pharma‐Tek, and VHA.Measurements and Main Results. Toxicity of the amphotericin B formulations were assessed by measuring interleukin (IL)‐1β expression in an in vitro model. Amphotericin B content was measured by enzyme‐linked immunosorbent assay (ELISA), and amphotericin A and B contents were assessed by spectrophotometry. Endotoxin contamination was evaluated in all reagents. Expression of IL‐1β from Sigma, Pharmacia, and Pharma‐Tek formulations was increased approximately 250%, 50%, and 25%, respectively, compared with amphotericin A. Amphotericin B content of Sigma, Pharmacia, Pharma‐Tek, and Gensia formulations, as measured by ELISA, was increased approximately 450%, 200%, 200%, and 100%, respectively, compared with Apothecon. This variation could not be explained by differences in amphotericin A or B content as measured by spectrophotometry.Conclusion. Amphotericin B is obtained from a fermentation plant and manufactured as a pharmaceutical at different facilities. Both previous clinical observations and the current in vitro evaluation revealed significant differences among the formulations. Likely, other polyenes or pyrogenic toxins in differing amounts are in these formulations, thus explaining the variability in toxicity observed among the formulations.
Metabolism of Tenofovir and Didanosine in Quiescent or Stimulated Human Peripheral Blood Mononuclear Cells
Authors: Robbins Brian L. , Wilcox Carrie K. , Fridland Arnold , Rodman John H. 
Published: May 2004

Objective. As tenofovir disoproxil fumarate substantially increases plasma concentrations of didanosine in patients with human immunodeficiency virus‐1 infection, we sought to determine whether tenofovir and didanosine showed a similar intracellular interaction in human peripheral blood mononuclear cells (PBMCs).Design. Comparative in vitro incubation of two antiretrovirals in lymphocytes.Setting. Clinical research laboratory.Material. Radiolabeled tenofovir and didanosine in human PBMCs.Measurements and Main Results. Phosphorylation of 2 and 20 μ didanosine to dideoxyadenosine triphosphate (ddATP) was determined in quiescent and stimulated PBMCs in the presence or absence of 5 μ tenofovir. Similarly, phosphorylation of 5 μ tenofovir to tenofovir diphosphate (TFVpp) was examined in the presence or absence of 2 and 20 μ didanosine. Intracellular amounts of ddATP and TFVpp were determined by incubating PBMCs with radiolabeled tenofovir or didanosine alone and together for up to 16 hours and then separating the anabolites by high‐performance liquid chromatography for quantitation. The presence of tenofovir did not affect the amount of ddATP in quiescent or stimulated PBMCs with 2 or 20 μ didanosine. In addition, didanosine did not alter the amount of TFVpp that formed. The amount of ddATP was modestly (1.5–3‐fold) but consistently higher in stimulated than in quiescent PBMCs, but the amount of TFVpp did not differ.Conclusion. There is no significant interaction between tenofovir and didanosine in human PBMCs as determined by the extent of formation of the phosphorylated anabolites. This suggests that adjusting didanosine dosage, when given with tenofovir, to achieve similar didanosine plasma concentrations, may be sufficient to accommodate the systemic drug interaction.
The Role of Lipid‐Lowering Drugs in Cognitive Function: A Meta‐Analysis of Observational Studies
Authors: Etminan Mahyar , Gill Sudeep , Samii Ali 
Published: May 2004

Study Objective. To quantify the risk of cognitive impairment with use of lipid‐lowering drugs.Design and Data Sources. Literature search through MEDLINE and EMBASE databases; data from seven observational studies were analyzed.Measurements and Main Results. We quantified the risk of cognitive impairment first with the use of any lipid‐lowering drug, and then specifically with the statins, using the random effects model. We tested for heterogeneity using the Q statistic as well as quantitatively using the Ristatistic. All seven studies provided data for statin users, and five provided data only on use of lipid‐lowering drugs. Compared with patients not receiving lipid‐lowering drugs, the relative risk of cognitive impairment with any lipid‐lowering drug was 0.62 but was not statistically significant (95% confidence interval [CI] 0.28–1.38), and the relative risk with statins was 0.43 and was statistically significant (95% CI 0.31–0.62).Conclusion. Lipid‐lowering drugs—in particular, the statins—seem to lower the odds of developing cognitive impairment. Randomized, controlled trials are needed to address the efficacy of these agents specifically in different types of dementia.
Mechanical Properties and Testing of Metallic Materials
Authors: Fatemi Ali 
Published: May 2004

Abstract
The article contains sections titled:

1.

Introduction

1.1.

Concepts of Stress and Strain

1.1.1.

Stress

1.1.2.

Strain

1.2.

Elastic Deformation and Properties

1.2.1.

Young's Modulus

1.2.2.

Shear Modulus

1.2.3.

Poisson's Ratio

1.2.4.

Relation Between Elastic Constants

1.3.

Plasticity and Flow

2.

Mechanical Testing

2.1.

Tensile Test

2.1.1.

Significance and Use

2.1.2.

Apparatus and Specimen

2.1.3.

Stress ‐ Strain Diagram

2.1.4.

Strength Properties

2.1.5.

Ductility

2.1.6.

Toughness and Resilience

2.1.7.

True Stress ‐ True Strain Diagram

2.1.8.

Strain‐Rate Sensitivity

2.1.9.

Temperature Effects

2.2.

Compression Test

2.3.

Bend and Flexure

2.3.1.

Elastic Bending Stress and Deflection

2.3.2.

Bend and Flexure Test

2.4.

Shear and Torsion

2.4.1.

Direct Shear Stress and Test

2.4.2.

Torsional Shear Stress and Test

2.5.

Hardness Tests

2.5.1.

Rockwell Hardness Test

2.5.2.

Brinell Hardness Test

2.5.3.

Vickers Hardness Test

2.5.4.

Knoop Hardness Test

2.5.5.

Correlation of Hardness with Strength

2.6.

Impact Testing

2.6.1.

Notched Bar Impact Test

2.6.2.

Dynamic Tear Test

2.7.

Creep Test

2.8.

Stress Relaxation Tests

3.

Fatigue Loading

3.1.

Principles and Terminology

3.1.1.

Fatigue Phenomena

3.1.2.

Fatigue Fracture Surfaces

3.1.3.

Fatigue Behavior

3.2.

Cyclic Stress‐Controlled Fatigue

3.2.1.

Stress ‐ Life Curves

3.2.2.

Fatigue Tests

3.2.3.

Mean Stress Effects

4.

Fracture Mechanics

4.1.

Principles and Terminology

4.2.

Fracture Toughness
Crystallization and Precipitation
Authors: Mullin John W. 
Published: May 2004

AbstractThe article contains sections titled:1.Introduction2.System Properties2.1.Solutions and Solubility2.2.Saturation and Supersaturation2.3.Crystal Size and Solubility2.4.Effect of Impurities3.Phase Equilibria3.1.One‐Component Systems3.2.Two‐Component Systems3.2.1.Eutectics3.2.2.Solid Solutions3.2.3.Compound Formation3.3.Three‐Component Systems3.4.Multicomponent Systems3.5.Phase Transformations4.Kinetics and Mechanisms of Crystallization4.1.Crystal Nucleation4.1.1.Primary Nucleation4.1.2.Secondary Nucleation4.1.3.Nucleation Measurements4.1.4.Induction Periods4.2.Crystal Growth4.2.1.Measurement of Growth Rate4.2.2.Expression of Growth Rate4.2.3.Dependence of Growth Rate on Crystal Size4.3.Growth ‐ Nucleation Interactions4.4.Crystal Habit Modification4.5.Inclusions in Crystals4.6.Caking of Crystals5.Crystallization from Solutions5.1.Cooling Crystallizers5.1.1.Nonagitated Vessels5.1.2.Agitated Vessels5.1.3.Direct‐Contact Cooling5.2.Evaporating Crystallizers5.3.Vacuum (Adiabatic Cooling) Crystallizers5.4.Continuous Crystallizers5.5.Crystal Yield5.6.Controlled Crystallization5.7.Comparison of Batch and Continuous Crystallization5.8.Crystallizer Modeling and Design5.8.1.Population Balance5.8.2.Design and Scaleup Problems6.Crystallization from Melts6.1.Single Stage Processes6.2.Multistage Processes6.3.Column Crystallizers6.4.High‐Pressure Crystallization6.5.Prilling and Granulation7.Crystallization from Vapors8.Precipitation8.1.Solubility Products8.2.Ostwald's Rule of Stages8.3.Development of Precipitates8.3.1.Ripening8.3.2.Agglomeration8.3.3.Precipitate Morphology8.3.4.Coprecipitation8.4.Precipitation Techniques8.4.1.Reaction Precipitation8.4.2.Salting Out8.5.Precipitation Methods and Equipment9.Fractional Crystallization9.1.Recrystallization from Solutions9.2.Recrystallization from Melts9.3.Recrystallization Schemes9.4.Recrystallization from Supercritical Fluids9.5.Separation of Enantiomers and Racemates10.Miscellaneous Crystallization Techniques10.1.Salting‐Out Crystallization10.2.Reaction Crystallization10.3.Adductive and Extractive Crystallization10.4.Spray Crystallization10.5.Spherical Crystallization10.6.Freeze Crystallization
Size Reduction
Authors: Bernotat Siegfried , Schönert Klaus 
Published: May 2004

Abstract
The article contains sections titled:

1.

Introduction

2.

Fundamentals

2.1.

Particle Breakdown

2.2.

Material Properties

2.3.

Process Description

3.

Size‐Reduction Equipment

3.1.

Crushers

3.1.1.

Jaw Crushers

3.1.2.

Gyratory (Cone) Crushers

3.1.3.

RollCrushers

3.1.4.

Impact and Hammer Crushers

3.2.

Grinding Media Mills

3.2.1.

Tumbling mills

3.2.2.

VibrationMills

3.2.3.

PlanetaryMills

3.3.

Roller and Ring‐Roller Mills

3.3.1.

Operation Characteristics

3.3.2.

Roller Mills

3.3.3.

Ring‐RollerMills

3.4.

Impact and Jet Mills

3.4.1.

Impact Mills

3.4.2.

Jet Mills

3.5.

Cutting Mills

3.6.

Wet Grinding
Size Enlargement
Authors: Sommer Karl 
Published: May 2004

AbstractThe article contains sections titled:1.Introduction2.Binding Mechanisms of Agglomerates2.1.Tensile Strength of Agglomerates Derived from Attractive Forces2.2.Attractive Forces in Size Enlargement in Air2.2.1.Electrostatic Forces2.2.2.Van der Waals Forces2.2.3.Capillary Forces2.2.4.Solid Bridges2.2.5.Influence of Particle Surface Roughness on Binding2.2.6.Strengthening of Binding Forces2.3.Attractive Forces of Particles in a Liquid Medium2.3.1.DLVO theory2.3.2.Flocculation by Polymeric Flocculants3.Characterization of Agglomerates3.1.Particle Size, Particle Size Distribution3.2.Agglomerate Density and Porosity3.2.1.Definition3.2.2.Densities3.2.3.Porosities3.3.Agglomerate Strength3.4.Redispersion4.Size Enlargement Processes4.1.Growth Agglomeration (Pelletization)4.1.1.Agglomeration Kinetics4.1.2.Pan and Drum Agglomeration4.1.3.Mixer and Fluidized Bed Agglomeration4.1.3.1.Pan and Drum Mixers4.1.3.2.Horizontal Mixers4.1.3.3.High‐Speed Mixers4.1.3.4.Fluidized‐Bed Agglomeration4.2.Agglomerate Formation from Moist Material4.2.1.Introduction4.2.2.Agglomeration Equipment for Plastic Materials4.3.Drying Processes4.3.1.Atomization Drying4.3.1.1.Fundamentals of Atomization Drying4.3.1.2.Fluidized‐Bed Spray Drying4.3.1.3.Combination Processes4.3.2.Contact Drying4.3.3.Vacuum Drying4.4.Spherical Agglomeration4.5.Pressure Agglomeration4.5.1.Compression Equations4.5.2.Stamp Presses4.5.3.Roller Presses4.5.4.Tableting4.5.4.1.Tableting Equipment4.5.4.2.Tablet Pressing4.5.4.3.Tableting Problems4.5.4.4.Effect of Compression Rate and Humidity