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At least 973 records · Page 54Linked to original sources
PubMed2006

Off-label prescribing in a French hospital.

OBJECTIVE: In contrast to paediatrics patients, data concerning the extent of off-label prescribing for adult patients are limited. The aim of our study was to investigate the frequency of off-label drug use for adult patients in a French general hospital. METHOD: The study was conducted on a Wednesday in November 2004. Prescribing was prospectively assessed on the basis of conformity with the marketing authorizations. RESULTS: A total of 1341 prescriptions for 192 hospitalized patients were analysed. Twenty three per cent of the prescriptions were off-label. Among all patients, 70% received at least one off-label medicine. Most off-label prescriptions were related to an unapproved indication (75%). The main other reasons were dosage (14%) and dosing schedule (9%). Anti-thrombotic and anti-ulcer agents were found on more than 40% of the off-label prescriptions. CONCLUSION: Off-label prescriptions occur frequently in the hospital and often alternatives with the proper marketing authorizations are available. An increased involvement of hospital pharmacists should reduce the incidence of off-label prescribing and thus contribute to patient safety and possibly cost reduction.

Adult↗
PubMed2004

Establishing ethics in an organization by using principles.

Laws, codes, and rules are essential for any community, public or private, to operate in an orderly and productive fashion. Without laws and codes, anarchy and chaos abound and the purpose and role of the organization is lost. However, danger is significant, and damage serious and far-reaching when individuals or organizations become so focused on rules, laws, and specifications that basic principles are ignored. This paper discusses the purpose of laws, rules, and codes, to help understand basic principles. With such an understanding an increase in the level of ethical and moral behavior can be obtained without imposing detailed rules.

Conscience↗
PubMed1987

Translocation of protein kinase C is not required to inhibit the antigen-induced increase of cytosolic calcium in a mast cell line.

Cross-linking of receptor bound IgE antibodies by multivalent antigen (DNP8-BSA) on PB-3c cells leads to an increase of cytosolic calcium ((Ca2+)i). Active tumor promoting phorbol esters and teleocidin which specifically activate the phospholipid Ca2+-sensitive protein kinase (PKC), inhibited the antigen-mediated rise in (Ca2+)i and induced a time and dose-dependent translocation of cytosolic PKC to membranes of the PB-3c cells as determined by enzyme activity or immunoblotting using a polyclonal anti-PKC antibody. This TPA concentration did not affect the subcellular distribution of PKC, although 1 nM of 12-O-tetradecanoylphorbol-13-acetate (TPA) inhibited to 50% the antigen-mediated increase in (Ca2+)i. The concentration of TPA required to induce a half-maximal subcellular redistribution of immunodetectable PKC activity was an order of magnitude greater than the half-maximal dose required to inhibit the antigen-mediated increase in (Ca2+)i. These data demonstrate that the TPA-dependent activation of PKC is not directly coupled to its translocation to membranes.

Antigen-Antibody Complex↗
PubMed1985

An improved preservation technique for cells of hemopoietic origin.

A new technique for the cryopreservation of cell lines of hemopoietic origin is described. It uses a combination of 10% polyvinylpyrrolidone or hydroxyethylstarch with 15% glycerol, a slow stepwise addition of the cryoprotectants before freezing, cooling at 4 degrees C/min, rapid rewarming, and a slow step-wise dilution after thawing. This technique has given improved recovery rates with a number of basophil/mast cell lines, as well as a wide range of hemopoietic cells including hybridomas.

Animals↗
PubMed1982

A simple, single-step technique for selecting and cloning hybridomas for the production of monoclonal antibodies.

A simple method is described by which hybridomas can be selected and cloned in a single step immediately after fusion. This is done by plating the cells in semi-solid medium containing methylcellulose and the components of the HAT selection system. A number of variables have been examined in order to optimise the technique. The system is particularly suitable for isolating large numbers of hybridomas secreting different monoclonal antibodies. Evidence is presented to show that the colonies which grow in the system are in all probability clones. Thus, the need for routine recloning of the hybridomas is eliminated. In this way, the technique cuts down on the amount of tissue culture work associated with the production of monoclonal antibodies. Using this technique, it is easier to plate out large numbers of cells and to recover many independent hybridoma clones, than is the case when using cloning by limiting dilution.

Animals↗
PubMed1979

Chicken hematopoietic cells transformed by seven strains of defective avian leukemia viruses display three distinct phenotypes of differentiation.

Chicken hematopoietic cells transformed in vitro and in vivo by seven strains of replication-defective avian leukemia viruses were assayed for the expression of six erythroid and five myeloid differentiation parameters, including differentiation-specific surface antigens as detected by newly developed antisera. The transformed cells were found to display three distinct phenotypes of differentiation. First, cells transformed by AEV resemble erythroblasts. They express heme, globin, carbonic anhydrase and erythrocyte cell surface antigen at low levels, and histone H5 and erythroblast cell surface antigen at high levels. Second, cells transformed by MC29, CMII, OK10 and MH2 viruses have macrophage-like properties. They strongly express Fc receptors, phagocytic capacity and macrophage cell surface antigen, but only weakly express myeloblast cell surface antigen and are negative for ATPase activity. Third, cells transformed by AMV and E26 viruses resemble myeloblasts in that they weakly express Fc receptors, phagocytic capacity and macrophage cell surface antigen but strongly express myeloblast cell surface antigen and ATPase activity. No difference was found between in vitro- and in vivo-transformed cells in the parameters tested. In light of recent genetic and biochemical evidence, we believe that these phenotypes reflect the action of three new types of viral-transforming genes, designated erb (erythroblast), mac (macrophage) and myb (myeloblast).

Adenosine Triphosphatases↗
PubMed1983

Corporal punishment in schools: myths, problems and alternatives.

In many countries, corporal punishment of school children continues to be an officially or unofficially sanctioned form of institutional child abuse. Continuing support for the use of corporal punishment is related to the following factors: (1) widely held beliefs regarding the effectiveness of corporal punishment, (2) an unawareness of problems resulting from the use of physical punishment, and (3) a lack of knowledge about effective disciplinary alternatives. The purpose of this paper is threefold: One is to show that many of the beliefs are myths, e.g., corporal punishment is not needed to build character. The second purpose is to show that physical punishment can lead to more problems than it appears to solve, e.g., the punitive teacher is avoided, and thus, is not a positive factor in the child's education and development. The third purpose is to discuss two types of alternatives to punishment, the social learning approach and communication skills training. These positive methods of discipline not only enhance classroom behavior, but also facilitate learning. In an atmosphere free of abusing and demeaning acts and in a classroom characterized by positive mutual regard, teachers can maximize their effectiveness as teachers and students can maximize their effectiveness as learners.

Behavior Therapy↗
PubMed1989

Ethical issues in pain management.

Dr Albert Schweitzer is reported to have stated, "We must all die. But that I can save ... [someone] from days of torture, that is what I feel is my great and ever new privilege". If, in spite of their anecdotal texture, the reflections in this article challenge my clinical colleagues to further hard reflection, comparison, or contrast with their own professional experience, they will have been worthwhile. If our collective experiences view pain management as a clinical-ethical issue, then no patient should ever have to bear pain due to the ignorance or apathy of well-intentioned but misinformed caregivers. I conclude with the words of Judith Spross, an oncology nurse: Pain is an emergency for the person who experiences it regardless of the urgency of the underlying pathology. I believe we must apply the science and art of pain relief as though life depended upon it. Certainly the quality of life does.

Attitude of Health Personnel↗
PubMed2004

Evidence for a close relationship between conscious effort and anterior cingulate cortex activity.

The function of the anterior cingulate cortex (ACC) has been discussed in the last years in the context of conflict monitoring and error detection. In addition, ACC activity has been described in the context of "conscious effort". Recent neurophysiological and neuroimaging studies have described a negative correlation between ACC activity and reaction times in simple or choice reaction time experiments. One suggested explanation for this finding has been that there is a relationship between effort and ACC activity. The present ERP-LORETA study of healthy volunteers (n=35) was intended to directly investigate this relationship. In this experiment, three conditions were investigated: condition I was a choice reaction task with the instruction to stay relaxed during the task (relaxed condition), condition II was the same choice reaction task with the instruction to press the respective button as fast and correct as possible (effort condition). Condition III was just listening to the tones without button press (control condition). Subjects had to score directly after each experimental run on a visual analogue scale the amount of effort they have actually spent. The subjects showed significantly shorter reaction times during the high effort condition in comparison to the relaxed condition, as well as increased N1 amplitudes and increased ACC activity. In a subgroup analysis, this effect was present only in subjects who were (according to their self-ratings) following the instructions closely. These results provide direct evidence for a close relationship between conscious effort and ACC activity and suggest the usefulness of the applied effort-self-rating.

Adult↗
PubMed2005

A critique of Freire's perspective on critical social theory in nursing education.

Nursing has been perceived as oppressed by virtue of among other things gender, occupation and class. It has been suggested that historically, nursing education perpetuated the rituals of tradition and was oppressive in terms of what was taught and how it was taught. Developments in nurse education have resulted in nurse educators seeking alternative means of educating, with the aim of emancipating nurses. Paulo Freire (1921-1997) promoted liberation through reflection and action, directed at transforming the conditions which lead to oppression. The fundamental basis of this approach is critical social theory, which is underpinned by the philosophy that social phenomena must be understood in terms of their context and history. From a critical social theory perspective, fruitful nursing education will only be possible if the history and structure of nursing are clearly understood by those involved in the educational process. We contend that the adoption of Freire's theory in nursing education may contribute towards the development of nurses who will be competent to meet the demands of contemporary healthcare practice. However, the application of this theory to nursing education can be challenging because of constraints imposed by the system in which nurse education takes place. It is therefore important that the application of critical social theory in nurse education be evaluated.

Conscience↗
PubMed2004

Endocrine activity and developmental toxicity of cosmetic UV filters--an update.

UV filters represent a new class of endocrine active chemicals. In vitro, 8/9 chemicals showed estrogenic (MCF-7 cells), and 2/9 antiandrogenic activity (MDA-kb2 cells). Six/nine filters (benzophenone (Bp)-1, Bp-2, Bp-3, 3-benzylidene camphor (3-BC), 4-methylbenzylidene camphor (4-MBC), octyl-methoxycinnamate (OMC)) increased uterine weight in immature rats. 3-Benzylidene camphor and 4-MBC displaced 16alpha125I-estradiol from human estrogen receptor (ER)beta, not ERalpha. Developmental toxicity of 4-MBC (0.7-47 mg/kg body weight/day) and 3-BC (0.24-7 mg/kg), administered in chow was investigated in Long Evans (LE) rats. Weight gain of pregnant rats was reduced only by 3-BC, early postnatal survival rate and thymus weight by both compounds at higher doses. 4-Methylbenzylidene camphor and 3-BC delayed male puberty, and dose-dependently affected reproductive organ weights of adult male and female F1 offspring, with partly different effect patterns. Thyroid weight was increased by higher 4-MBC doses. Tissue-specific changes in mRNA levels of estrogen-regulated genes in prostate, uterus and brain regions, determined by real-time PCR, and in their response to acute estradiol challenge in adult gonadectomized offspring were observed. Lowest effective doses were 0.24 mg/kg/day for 3-BC and 7 mg/kg/day for 4-MBC. Fat tissue levels at 7 mg/kg 4-MBC (GC-MS) approached the range of UV filters in fish (Nagtegaal et al., 1997; Balmer et al., 2004).

Animals↗