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At least 127 records · Page 7Linked to original sources
PubMed1982

Rheo-optical shape analysis of human blood platelets.

Alterations in rheo-optical signals obtained from suspensions of human blood platelets treated in various ways (drugs, storage in the cold, stirring, etc.) were monitored. A self-normalizing instrument measuring scattered light and relative amplitude of rapid oscillation of light intensity (noise level) at different angles was used. The following results have been obtained: 1. The light scattered at an angle of 40 degrees was decreased with considerable selectivity by pseudopod formation, if aggregation was inhibited. 2. The noise levels at 0 degree and 40 degrees were selectively diminished by the transition from the discoid to the spheroid shape of the platelets. 3. At 40 degrees but not at 0 degree, the noise level responded without delay and was not influenced by aggregate formation. Using this method alterations in platelet form, i.e. spheroid transformation and pseudopod formation, can be specifically and continuously monitored. In addition, the noise level at 40 degrees is a definite quantitative measure of the discoid state. This allows the determination of platelet activation without manipulations such as changes in stirring rates or addition of drugs.

Adenosine Diphosphate↗
PubMedDate not supplied

[Cost-benefit analysis of a semi-automated process in the preparation of unit-doses by the Pharmacy Department].

OBJECTIVE: To determine in monetary terms the effect of implementing a semi-automated procedure for preparation of drugs for unit dose distribution. METHODS: The current net value was estimated for three different flows involved in the evaluation of semi-automated drug storage and retrieval systems used in the unit dose distribution area in a hospital: capital investment, staff costs and structural costs related to physical space occupied. RESULTS: Implantation of the new work procedure produced an annual saving of 32,390 euro in staff costs and 5,645 euro in structural costs. Global cash flow has been estimated in -96,565 euro for a five year amortization period, with a benefit/cost ratio of 2.19. CONCLUSION: Replacement of traditional unit dose cart filling systems by a semi automated procedure presents a positive benefit/cost ratio and initial investment is paid off in 44 months.

Automation↗
PubMed1998

The prevalence and risk factors of refractory partial seizure Thai patients at Prasat Neurological Institute.

The prevalence of refractory partial seizure Thai patients at Prasat Neurological Institute was retrospectively from patient charts from January 1995-December 1996 and further prospectively analysed. All epileptic patients were screened by direct questions regarding the anti-epileptic drugs (AEDs) regimen, the frequency, nature of seizure attacks and risk factors of seizure. The criteria of clinical refractory partial seizure was defined as partial seizure which cannot be controlled by a combination of at least two AEDs for four weeks. The results were 3,018 cases of total epileptic patients out of 300,008 visits. These were classified as 2,802 cases of generalized seizures (92.8%), 184 cases of partial seizures (6.1%), and 32 cases of unclassified seizures (1.1%). In the partial seizures group, the number of clinical refractory partial seizures was found to be 48 cases (26.1% of partial seizure). We found that the major risk factor of refractory partial seizures was lack of therapeutic AEDs blood level monitoring (64.5% of cases) and the other risk factors were lack of compliance, loss of follow-up but continued medication, concomitant medication, and improper drug storage. AEDs dosage was adjusted until the blood levels were in the therapeutic range, and correction of other risk factors and patient counseling was given. The number of true refractory partial seizures was reduced to 10 cases (5.4% of partial seizure). This procedure revealed that AED blood level monitoring and correction of other risk factors were essential in controlling seizure frequency. Thus, the prevalence of true refractory partial seizure in our study was 3.3 cases of refractory partial seizure per 1,000 cases of the seizure population. We recommend that AEDs blood level monitoring and exclusion of other risk factors should be added to the criteria for the definition of refractory partial seizures. This criteria should be applied when considering the use of new AEDs as an add-on therapy in refractory Thai patients.

Adolescent↗
PubMed2001

A stability-indicating HPLC assay method for budesonide.

The official (European) pharmacopeial assay for budesonide was found to be non-specific and non-stability-indicating when used to qualify several batches of pharmaceutical grade drug substance from different sources. In contrast, the most widely cited HPLC method in the literature was found to be specific and stability-indicating with respect to drug substance stored in the dry state. However, that method failed the pharmacopeia's assay system suitability requirements because of peak tailing. Moreover, it was unable to detect or resolve two major degradation products which resulted from drug storage in non-aqueous solution. A new stability-indicating HPLC method described here overcomes these problems. This method used a Hypersil C18 column with a mobile phase consisting of ethanol-acetonitrile phosphate buffer (pH 3.4; 25.6 mM) (2:30:68, v/v/v), a flow rate of 1.5 ml/min and UV detection at 240 nm. The purity of budesonide EP and its impurity profile (related substances) were tested using the new assay method, and the results compared to those from the two other methods described above. Solid-state and solution stressed stability samples were used to evaluate all methods. Using the novel method, the epimers of budesonide. their related impurities and degradation products were separated successfully. Validation studies demonstrated that the novel method possessed a linear UV response, good system precision and accuracy, high sensitivity and specificity for budesonide. The novel method will be used for future studies of budesonide's degradation kinetics.

Anti-Inflammatory Agents↗
PubMed2005

The long road to patient safety: a status report on patient safety systems.

CONTEXT: Since the Institute of Medicine (IOM) reports on medical errors and quality, national attention has focused on improving patient safety through changes in "systems" of care. These reports resulted in a new paradigm that, rather than centering on individual errors, focuses on the "systems" necessary to facilitate and enhance quality and protect patients. OBJECTIVES: To assess the status of hospital patient safety systems since the release of the IOM reports and to identify changes over time in 2 states that collaborated on a patient safety project funded by the Agency for Healthcare Research and Quality. DESIGN, SETTING, AND PARTICIPANTS: Survey of all acute care hospitals in Missouri and Utah at 2 points in time, in 2002 and 2004, using a 91-item comprehensive questionnaire (n = 126 for survey 1 and n = 128 for survey 2). To assess changes over time, we also studied the cohort of 107 hospitals that responded to both surveys. MAIN OUTCOME MEASURES: Responses to the 91-question survey as well as changes in responses to the survey questions over an 18-month period. Seven latent variables were constructed to represent the most important patient safety constructs studied: computerized physician order entry systems, computerized test results, and assessments of adverse events; specific patient safety policies; use of data in patient safety programs; drug storage, administration, and safety procedures; manner of handling adverse event/error reporting; prevention policies; and root cause analysis. For each hospital, the 7 latent variables were summed to give an overall measure of the patient safety status of the hospital. RESULTS: Development and implementation of patient safety systems is at best modest. Self-reported regression in patient safety systems was also found. While 74% of hospitals reported full implementation of a written patient safety plan, nearly 9% reported no plan. The area of surgery appears to have the greatest level of patient safety systems. Other areas, such as medications, with a long history of efforts in patient safety and error prevention, showed improvements, but the percentage of hospitals with various safety systems was already high at baseline for many systems. Some findings are surprising, given the overall trends; for example, while a substantial percentage of hospitals have medication safety systems, only 34.1% [corrected] reported full implementation at survey 2 of computerized physician order entry systems for medications, despite the growth of computer technology in general and in hospital billing systems in particular. CONCLUSIONS: The current status of hospital patient safety systems is not close to meeting IOM recommendations. Data are consistent with recent reports that patient safety system progress is slow and is a cause for great concern. Efforts for improvement must be accelerated.

Hospital Administration↗
PubMed1984

Abnormal abdominal computerized tomography with amiodarone therapy and clinical significance.

Although the antiarrhythmic agent, amiodarone, is known to cause elevation of liver function tests, the effect of this drug on abdominal computerized tomography (CT) scans in patients on amiodarone therapy is unknown. Since iodine is in its molecular structure, the presence of amiodarone or its metabolites might be expected to produce higher CT numbers similar to the effect of contrast agents. To test this hypothesis, CT scans were performed in a series of 25 patients receiving amiodarone, 14 receiving short-term (mean 2.5 +/- 1.3 days) and 19 receiving long-term therapy (mean 130 +/- 75 days), as well as in a control group not receiving amiodarone. Gastrointestinal symptoms (if any) and liver function tests (LFT) prior to instituting amiodarone therapy and at the time of CT scan were also documented. CT scans showed a modestly increased density in multiple organs in the short-term group, but a markedly increased hepatic density in all but one patient in the long-term group. Presence of gastrointestinal symptoms or abnormal LFT did not appear to correlate with the CT number. Such findings would suggest that increased hepatic density on CT scan is to be expected in patients receiving long-term amiodarone therapy, and although the exact biologic pathways of amiodarone metabolism are uncertain, the liver appears to be a major site of drug storage and/or metabolism.

Adult↗
PubMed2005

Microcalorimetric studies of the effects on the interactions of human recombinant interferon-alpha2a.

The applicability of the physical stability of protein solution monitored by isothermal titration calorimetry (ITC) was evaluated. The second virial coefficient, b2, derived from the dilution enthalpies of protein solution measured by ITC under various experimental conditions was studied. The protein applied in this work is human recombinant interferon-alpha2a (hrIFN-alpha2a), which is a commercial drug applied for the treatment of virus-infected diseases. The results obtained were used to predict the possibility of hrIFN-alpha2a aggregation, and the prediction can be further confirmed by size-exclusion chromatography (SEC). Various factors affecting the stability of protein solution were investigated, for example, temperature, salts, surfactants, and mechanical stress. Specifically, the results show that the dilution enthalpy of hrIFN-alpha2a increased with increasing temperature and NaCl concentration, while b2 decreased, indicating that the attraction between hrIFN-alpha2a molecules was enhanced under these conditions. On studying the effect of mechanical stress, the data obtained reveals that the introduction of centrifugal or vortex force strengthened the attractive forces between hrIFN-alpha2a molecules. These implications were supported by SEC data, demonstrating that the amount of aggregated hrIFN-alpha2a was increased. As a consequence, the methodologies presented in this investigation offer a possibility of monitoring the physical stability of protein solution at various stages of recovery, purification as well as the development of appropriate drug storage formulations.

Calorimetry↗
PubMed1980

Provision of medicines in Ecuador.

Part of the drug budget in Ecuador goes on expensive, non-essential, or unsafe proprietary medicines, while many drugs considered necessary in developed countries are unavailable. The promotional activities of pharmaceutical companies are unchecked and objective drug information in scarce.

Drug Industry↗
PubMed1980

Technical considerations in the gas chromatographic analysis of desipramine.

Procedures are presented for minimizing variability in and interferences with the gas chromatographic determination of desipramine in plasms. Careful consideration of procedures for sample collection and storage, drug separation from matrix components, and chromatography appears to be a prerequisite for avoiding inaccurate and imprecise determinations of this antidepressant, especially at levels below 20 micrograms/l. Numerous pitfalls are examined and optimal conditions for obviating them are presented.

Blood Specimen Collection↗
PubMed2003

Rational design and engineering of therapeutic proteins.

An increasing number of engineered protein therapeutics are currently being developed, tested in clinical trials and marketed for use. Many of these proteins arose out of hit-and-miss efforts to discover specific mutations, fusion partners or chemical modifications that confer desired properties. Through these efforts, several useful strategies have emerged for rational optimization of therapeutic candidates. The controlled manipulation of the physical, chemical and biological properties of proteins enabled by structure-based simulation is now being used to refine established rational engineering approaches and to advance new strategies. These methods provide clear, hypothesis-driven routes to solve problems that plague many proteins and to create novel mechanisms of action. We anticipate that rational protein engineering will shape the field of protein therapeutics dramatically by improving existing products and enabling the development of novel therapeutic agents.

Animals↗
PubMed2004

Myoclonus: current concepts and recent advances.

Myoclonus presents as a sudden brief jerk caused by involuntary muscle activity. An organisational framework is crucial for determining the medical significance of the myoclonus as well as for its treatment. Clinical presentations of myoclonus are divided into physiological, essential, epileptic, and symptomatic. Most causes of myoclonus are symptomatic and include posthypoxia, toxic-metabolic disorders, reactions to drugs, storage disease, and neurodegenerative disorders. The assessment of myoclonus includes an initial screening for those causes that are common or easily corrected. If needed, further testing may include clinical neurophysiological techniques, enzyme activities, tissue biopsy, and genetic testing. The motor cortex is the most commonly shown myoclonus source, but origins from subcortical areas, brainstem, spinal, and peripheral nervous system also occur. If treatment of the underlying disorder is not possible, treatment of symptoms is worthwhile, although limited by side-effects and a lack of controlled evidence.

Animals↗
PubMed2002

Simulation studies and the alignment of interests.

Chemotherapy patients are treated with cytostatic drugs. Cytostatic drugs can be produced if ordered or they can be produced to keep in stock. The time that cytostatic drugs can be kept in stock before being spoiled is limited. It is always possible that the patient cannot receive chemotherapy because he/she is not in the right condition. A simulation model is presented which allows to calculate for each combination of patient type and cytostatic drug type the effects on waiting times and costs. In practice actors will behave not as recommended by the simulation model. The cause of the latter is analyzed and solutions are proposed.

Antineoplastic Agents↗
PubMed2006

[Application aids in pharmacotherapy].

The actual administration of pharmacotherapy is in most cases entirely up to the patient. Correct application can often be only achieved with application aids. They are already part of many preparations: printed blister packages, measures for dosing liquids, applicators for topical use, dosage sprays, and supports for eye drop containers. Special needs can be covered by additional application aids like dosage syringes for child medication, spacers for asthma sprays, devices for splitting or crunching tablets. Filling the medicines in containers better manageable by the patient, in week dispensers or week blisters, may also be crucial to guarantee correct dosing and regimen. Application aids often play a significant part in the success of a therapy. Needed are evidence based criteria for the selection of devices and instructions. Such criteria need to be developed because they are still largely lacking.

Drug Administration Schedule↗
PubMed1998

Predictors of medication use, compliance and symptoms of hypotension in a community-based sample of elderly men and women.

OBJECTIVE: To investigate use of prescription and non-prescription drugs, predictors of drug use and symptoms of postprandial and postural hypotension were examined in 765 men and 846 women. METHOD: A questionnaire mailed to 6324 subjects randomly chosen from the electoral roll. RESULTS: Drug use, both prescription and non-prescription, was greater (P < 0.0001) in women (mean 4.1 total drugs, CI 3.9, 4.3) than in men (3.5 drugs, CI 3.3, 3.7); 41% of women and 36% of men used at least four drugs. Total drugs used were significantly greater in women (standardized regression coefficient (b) = 0.101, P < 0.0001), and increased with the number of diagnoses (b = 0.461, P < 0.0001) and taking antidepressants (b = 0.160, P < 0.0001). Use of non-prescription drugs was also greater in women (b = 0.094, P < 0.0001) and in association with arthritis (b = 0.053, P = 0.036) but decreased with age (b = -0.013, P < 0.0001). Potentially important drug interactions occurred in 10% of subjects and included hypoglycaemic agents with b-blockers and asthma with b-blockers. Symptoms of postprandial hypotension, reported in 2.6% of subjects, increased with the number of drugs used (OR 1.17, CI 1.05, 1.31) and with diabetes (OR 2.27, CI 1.05, 4.89). Symptomatic postural hypotension, recorded by 13% of subjects, related significantly to age (OR 1.04, CI 1.02, 1.06), tranquillisers (OR 1.98, CI 1.11, 3.54), antidepressants (OR 2.23, CI 1.30, 3.84) and ACE inhibitors (OR 2.14, CI 1.42, 3.22). CONCLUSION: Reduction in the number and frequency of drug doses and better knowledge about drugs may improve compliance. Observed associations with polypharmacy or hypotension suggest possible approaches to decreasing drug-related illness and limiting the adverse effects of hypotension in the elderly.

Aged↗