The objectives of this study were to investigate the relationship between personality trait variables and theophylline disposition in asthmatic patients. Twenty-five patients admitted to a hospital who required intravenous theophylline for bronchodilation were studied. Data on theophylline half-life, and the patients' histories on congestive heart failure, liver disease, and smoking behaviour were abstracted. Eysenck's personality inventory was administered to obtain a score on the two personality traits: neuroticism and extraversion. High neurotic patients showed a significantly (p less than 0.005) lower theophylline half-life. Neuroticism appeared to be, in this patient population, a more important determinant of theophylline half-life than variables such as congestive heart failure, liver disease, or smoking behaviour.

Adolescent↗

PubMedDate not supplied

Use of proportional reporting ratios (PRRs) for signal generation from spontaneous adverse drug reaction reports.

BACKGROUND: The process of generating 'signals' of possible unrecognized hazards from spontaneous adverse drug reaction reporting data has been likened to looking for a needle in a haystack. However, statistical approaches to the data have been under-utilised. METHODS: Using the UK Yellow Card database, we have developed and evaluated a statistical aid to signal generation called a Proportional Reporting Ratio (PRR). The proportion of all reactions to a drug which are for a particular medical condition of interest is compared to the same proportion for all drugs in the database, in a 2 x 2 table. We investigated a group of newly-marketed drugs using as minimum criteria for a signal, 3 or more cases, PRR at least 2, chi-squared of at least 4. FINDINGS: The database was used to examine retrospectively 15 drugs newly-marketed in the UK, with the highest levels of ADR reporting. The method identified 481 signals meeting the minimum criteria during the period 1996-8. Further evaluation of these showed that 70% were known adverse reactions, 13% were events which were likely to be related to the underlying disease and 17% were signals requiring further evaluation. IMPLICATIONS: Proportional reporting ratios are a valuable aid to signal generation from spontaneous reporting data which are easy to calculate and interpret, and various refinements are possible.

Adverse Drug Reaction Reporting Systems↗

PubMedDate not supplied

The cancer information service research consortium: an emerging laboratory for cancer control research.

The Cancer Information Service (CIS) was established in 1975 by the National Cancer Institute (NCI) to provide accurate, up-to-date information about cancer to the nation. Although the CIS has in the past served as a venue for cancer communications research, up until very recently the research capacity of the CIS was underutilized. In 1993, this situation changed dramatically with funding from the NCI to form the Cancer Information Service Research Consortium (CISRC). In this article the CISRC is described for the first time, including its research agenda and administrative structure. Early indications from the CISRC suggest that the CIS can serve as one of the premiere laboratories in the country for cancer communications and cancer control research. Several factors are suggested for the early success of the CISRC in sustaining this collaborative effort with the CIS. The progress that has been made by the CISRC could provide a useful model for other large health information programs to maximize their contributions to behavioral science and health promotion research, as well as to establish their own program of policy-relevant research.

Community-Institutional Relations↗

PubMedDate not supplied

Balancing research and service: the experience of the cancer information service.

BACKGROUND: The National Cancer Institute's Cancer Information Service (CIS), the nation's foremost resource for cancer information, has supported cancer control research throughout its 22-year history. The Cancer Information Service Research Consortium (CISRC) is a consortium established to fully involve the CIS in theory-based cancer control research. METHODS: This paper focuses on the experiences of the CIS Project Directors in the development and implementation of three research projects within the CIS program. Conclusions are drawn from discussions that have taken place over time in such venues as conference calls, CISRC Members Council meetings, and project advisory meetings. RESULTS: Overall, the CISRC/CIS collaboration has been successful. A number of factors have contributed to this success, including the perceived value of the research within the CIS and the mechanisms and structures established to foster collaboration. The lessons learned, based on the challenges and opportunities of implementing these intervention research projects within the operations of the regional CIS offices, are discussed. CONCLUSIONS: Integration of research within a service program requires careful planning and preparation. Mutual benefit, shared ownership, consistency with current practice, staff training, and the value of research to each partner were essential ingredients to the success of this collaboration.

Communication↗

PubMedDate not supplied

Empiric antimicrobial therapy in febrile granulocytopenic patients. Randomized prospective comparison of amikacin plus piperacillin with or without parenteral trimethoprim/sulphamethoxazole.

In a prospective randomized trial parenteral trimethoprim/sulphamethoxazole was added to amikacin plus piperacillin in order to compare triple-drug antibiotic combination with a standard regimen as empiric therapy of fever in patients with granulocytopenia. One hundred and sixty-one episodes were evaluated; 74 episodes with amikacin plus piperacillin and 87 episodes with amikacin plus piperacillin plus trimethoprim/sulphamethoxazole. The overall response to therapy (63% vs. 84%) as well as the response of microbiologically documented infections (60% vs. 82%) was significantly better in patients treated with the triple-drug combination (p less than 0.05). However, no statistically significant differences in response to antibiotics at different infection sites or with regard to any single pathogen was found between the two groups. Trimethoprim/sulphamethoxazole seemed to be responsible for additional toxicity (nausea and vomiting) when added to amikacin plus piperacillin, but these side-effects were clearly related to the rate of infusion of trimethoprim/sulphamethoxazole. The findings of this study support the use of a three-drug versus a two-drug combination as empiric antibiotic regimen in febrile granulocytopenic patients.

Adolescent↗

PubMedDate not supplied

Contrast injection around mandril wire of an Accustick system using an extension tubing: technical note.

We describe a technique for injecting contrast material around a mandril wire of an Accustick access system through the outer 6 French sheath of this system, thus identifying the position of the wire. This is accomplished by using an extension tubing.

Catheters, Indwelling↗

PubMedDate not supplied

Acetyl-L-carnitine: behavioral, electrophysiological, and neurochemical effects.

Aged rats were chronically administered acetyl-L-carnitine (AC) for 10 months. During this period they were tested on learning and sensorimotor tasks and were then subsequently tested electrophysiologically to assess induction and decay rates of long-term synaptic enhancement (LTE) in the hippocampus. Four groups were tested: young controls (4 mo-con), middle-aged controls (16 mo-con), old controls (24 mo-con), and old AC-treated rats (24 mo-AC). After completion of electrophysiological testing, each rat was sacrificed and investigated for age- or drug-related changes in three neurotransmitter markers; including, NMDA-sensitive glutamate receptors, high affinity choline uptake, and adenosine receptor number in the neocortex, hippocampus or caudate nucleus. Aging impaired spatial learning and there was a robust positive correlation between NMDA receptors in the hippocampus and acquisition of the spatial learning task. Induction of hippocampal LTE was reduced in 24 mo-AC rats and NMDA receptor number and high-affinity choline uptake in the frontal cortex was increased. Several suggestions are offered to explain the action of AC on these neurobiological parameters in old rats.

Acetylcarnitine↗

PubMedDate not supplied

A molecular biological approach to synaptic plasticity and learning.

Until the more recent advances made in molecular biology, attempts to link synaptic plasticity and learning have focused on using LTP as a marker of learning-induced synaptic plasticity, where one has expected to observe the same magnitude of change in synaptic strength as that observed with artificial stimulation. To a large extent this approach has been frustrated by the fact that it is generally assumed that the representation of the memory traces is distributed throughout widespread networks of cells. By implication it is more likely that one would observe small distributed changes within a network; a formidable task to measure. In this review we describe how the advances in molecular biology give us both the tools to investigate the mechanisms of synaptic plasticity and to apply these to investigations of the underlying mechanisms in learning and the formation of memories that have until now remained out of our grasp.

Animals↗