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At least 1,639 records · Page 91Linked to original sources
PubMed2005

Pain on injection of lipid-free propofol and propofol emulsion containing medium-chain triglyceride: a comparative study.

UNLABELLED: Pain on injection of propofol continues to be a problem for anesthesiologists. A lipid-free formulation of propofol and a propofol emulsion containing medium-chain triglyceride have become available in the Indian market. We performed this study to assess the pain on injection of propofol emulsion containing medium-chain triglyceride as the lipid carrier and lipid-free propofol formulation. One-hundred-thirty adult patients were randomly assigned to one of two groups: Group I received propofol emulsion containing medium-chain triglyceride and Group II received lipid-free propofol. One fourth of the total calculated induction dose was injected over 5 s in the largest vein on the dorsum of a hand. Pain was assessed using verbal response and behavioral signs. Both formulations caused pain on injection. However, the lipid-free propofol solution produced frequent (89%) and severe pain on injection compared with the emulsion containing medium-chain triglyceride (40%). IMPLICATIONS: Pain on injection of two formulations of propofol was compared. A lipid-free formulation produced more pain on injection as compared with the emulsion containing medium-chain triglyceride.

Adult↗
PubMed1992

Agricultural chemical utilization and human health.

The public is justifiably concerned about the human health effects of agricultural chemicals. The many gaps in information about the mechanisms of toxic action, human exposures, and the nature and extent of human health effects are large. Very few older pesticides, in particular, have been tested for human health effects. Workers who produce, harvest, store, transport, process, and prepare food and fibers are exposed to many chemicals that are potentially hazardous and that are used in agriculture. The occupational health of these workers has not been adequately studied, and protective efforts have sometimes been minimal. Valid and accurate risk assessment is best based on sound information about how chemicals, in this case agricultural chemicals, are involved in toxic events--their mechanisms of action. These health effects include tumor promotion, chronic and acute neurotoxicity, immunotoxicity, and reproductive and developmental toxicity. Another key part of risk assessment is exposure assessment. Fundamental studies of the toxicology of target organisms and nontarget organisms exposed to agricultural chemicals are needed to discover and develop better solutions to the problems of agricultural pest control, including better formulations, optimal application rates and public education in safety and alternative agricultural practices. The large number of pesticides that have never been adequately tested for effects on human health is particularly worrisome in light of emerging information about delayed nervous system effects.

Agrochemicals↗
PubMed1996

Social and public policy analysis: a niche for social work practice.

This article provides front line social work practitioners with a mechanism for becoming more meaningfully involved in social and public policy analysis. It suggests that a new entry point for shaping policy formulation should occur earlier on in the problem identification stage of the rational policymaking process. The article offers a series of process questions to guide this approach and contends that practitioners have the necessary knowledge and skills to effect the various role expectations required of them in this regard.

Health Policy↗
PubMed1985

Application of a computable model of human spatial vision to phase discrimination.

We have used a computable model of human spatial vision to make predictions for phase-discrimination experiments. This model is being developed to deal with a broad range of problems in vision and was not specifically formulated to deal with phase discrimination. In the model, cross correlation of the stimuli with an array of sensors produces feature vectors that are operated on by a position-uncertain ideal observer to simulate detection and discrimination experiments. In this report the stimuli are compound sinusoidal gratings composed of a fundamental and a higher-frequency component added in various phases. We compare model predictions with three key results from the literature: the effect of the contrast of the fundamental on phase discrimination, threshold phase difference as a function of the fundamental frequency, and the contrast required for phase discrimination as a function of the frequency ratio of the two grating components. In the first two cases, the predictions capture the main features of the data, although quantitative discrepancies remain. In the third case, the model fails, and this failure suggests additional restrictions on the combination of information across sensors.

Discrimination Learning↗
PubMed1988

Calcium antagonists in the treatment of hypertension. An overview.

The availability of calcium antagonists has provided yet another therapeutic option in the management of hypertension. Calcium antagonists lower the blood pressure in hypertensive individuals while preserving the blood flow at the microcirculatory level. While all the available calcium antagonists are effective in the treatment of hypertension, they differ in their hemodynamic and pharmacologic actions. Nifedipine appears to be suitable for immediate treatment of severe hypertension and for chronic treatment of uncomplicated or refractory hypertension. In some but not all patients, co-administration of a beta-blocker is necessary to blunt reflex tachycardia. This problem is less likely with the tablet/long-acting formulation of nifedipine. Verapamil and diltiazem are useful as initial therapy for chronic mild-to-moderate hypertension. They are as effective as other first-line drugs in the treatment of uncomplicated hypertension. The heart rate with verapamil or diltiazem does not change or is slightly reduced, thus contrasting with nifedipine. Experience to date suggests that calcium antagonists do not cause adverse biochemical effects and in this respect are superior to diuretics and certain beta-blockers. Currently, verapamil is available as a sustained release preparation. In the near future, nifedipine or diltiazem may also be available in the long acting formulation to permit simplicity and to enhance patient compliance in the treatment of hypertension.

Calcium Channel Blockers↗
PubMed2004

[The necessary frugality of the elderly].

The purpose of this article is to reflect on the pertinence and moral legitimacy of basing the allocation of public resources for health on the age variable, considered from the perspective of the theory of "justice as equity" as formulated by John Rawls. After characterizing the problem of public resource allocation for health -- confronted with the challenge posed by population aging -- and briefly presenting the concept of equity adopted in this study, as well as discussing the approach by Norman Daniels and Daniel Callahan to resource allocation among different age groups, we conclude that basing resource allocation on the age variable may be considered ethically adequate if we conceive the individual's life as a limited cycle of existence formed by different stages (childhood, adolescence, maturity, old age, and death), during which the needs vary, such that the distribution of resources among different age groups should be based on an ethics of protection.

Age Factors↗
PubMed1987

Glyceryl trinitrate (nitroglycerin) and the organic nitrates. Choosing the method of administration.

Nitrate usage worldwide is on the increase as the indications for therapy expand. Present indications for nitrate therapy include chronic stable angina pectoris, unstable angina pectoris, complications of acute myocardial infarction, and 'unloading' therapy for acute and chronic congestive heart failure. Nitrates are also being used in the operating suite by anaesthesiologists to control systolic blood pressure during various surgical procedures. New nitrate delivery systems have recently become available which provide considerable dosing flexibility, further increasing the interest in this group of compounds. The dominant action of nitrates is a direct effect on vascular smooth muscle, producing vasodilation of the veins and arteries. These drugs decrease myocardial work by lowering systolic blood pressure, systemic vascular resistance, and reducing intracardiac dimensions. In addition, nitrates have a potent effect on cardiac preload as a result of systemic venodilatation. There is also some evidence that nitrates exert direct effects on the coronary circulation (vasodilatation of coronary arteries and coronary collateral vessels, and direct atherosclerotic stenosis dilatation). These actions may play a role in relieving myocardial ischaemia. Adverse sequelae of nitrate therapy are well known and serious adverse reactions are uncommon. Headache and dizziness are the most frequent side effects. Nitrate tolerance is a definite problem - present evidence indicates that long acting formulations, high doses, or frequent dosing regimens are particularly likely to induce vascular tolerance to nitrates. Consequently, provision of a nitrate-free interval has taken on increasing significance as a strategy to avoid tolerance. Nitrate delivery systems are numerous. Although availability varies from country to country, in most countries there are a wide variety of formulations of glyceryl trinitrate (nitroglycerin) available, including sublingual and oral tablets, oral spray, topical ointment as well as discs or patches for transdermal administration, a transmucosal tablet and an intravenous formulation. Similar formulations of isosorbide dinitrate, except buccal tablets, are available in some countries. Isosorbide 5-mononitrate, a potent metabolite of isosorbide dinitrate, is achieving increasing popularity as an antianginal drug. Optimum nitrate therapy requires a good understanding of the properties of the various formulations, particularly onset and duration of action and propensity to induce tolerance.(ABSTRACT TRUNCATED AT 400 WORDS)

Angina Pectoris↗
PubMed1989

How to write your first book.

Many doctors have, at some time or other, the idea of writing a book. This article considers some of the practical problems involved, including dealing with publishers, the formulation of a book proposal, writing individual chapters and desirable features of computer software.

Books↗
PubMedDate not supplied

High performance for expert systems: II. A system for leukaemia diagnosis.

A system for diagnosing leukaemia subtypes from monoclonal antibody test results has been programmed directly from the expertise of one immunologist. It gives an acceptable conclusion for 400 past cases, with summaries of its reasoning and suggestions for further tests. Its development included three major components: elicitation of the basic items of knowledge, formulation of a coordinated overall scheme, and representation in a computer language. All three were interdependent and required many cycles of trial and error, involving further discussions with the expert at all stages. By far the most difficult component was the formulation of a comprehensive specification for the problems of the domain, and this was only achieved when the knowledge engineer had gained a fair understanding of the application. The system is a tree-structured logic program written in PROLOG. This format facilitated experimentation with different knowledge representations, control of the interrelationships between rules and the elimination of errors. The problems of quality control and maintenance are of paramount importance for high-performance systems.

Diagnosis, Computer-Assisted↗
PubMed1994

Oral solid dosage forms that should not be crushed: 1994 revision.

This revision and update of an article published previously in Hospital Pharmacy (1992; 27:690-699) alerts healthcare practitioners about medications that should not be crushed. This list serves those who dispense and administer medications so that potential problems associated with disruption of special pharmaceutical formulations may be prevented. Products are identified that should not be crushed and for which a similar liquid form is available.

Administration, Oral↗
PubMedDate not supplied

The smart-talk trap.

In today's business world, there's no shortage of know-how. When companies get into trouble, their executives have vast resources at their disposal: their own experiences, colleagues' ideas, reams of computer-generated data, thousands of publications, and consultants armed with the latest managerial concepts and tools. But all too often, even with all that knowledge floating around, companies are plagued with an inertia that comes from knowing too much and doing too little--a phenomenon the authors call the knowing-doing gap. The gap often can be traced to a basic human propensity: the willingness to let talk substitute for action. When confronted with a problem, people act as though discussing it, formulating decisions, and hashing out plans for action are the same as actually fixing it. And after researching organizations of all shapes and sizes, the authors concluded that a particular kind of talk is an especially insidious inhibitor of action: "smart talk." People who can engage in such talk generally sound confident and articulate; they can spout facts and may even have interesting ideas. But such people often exhibit the less benign aspects of smart talk as well: They focus on the negative, and they favor unnecessarily complex or abstract language. The former lapses into criticism for criticism's sake; the latter confuses people. Both tendencies can stop action in its tracks. How can you shut the smart-talk trap and close the knowing-doing gap? The authors lay out five methods that successful companies employ in order to translate the right kind of talk into intelligent action.

Administrative Personnel↗
PubMed1999

Holistic approach to health education on AIDS.

OBJECTIVE: To identify a method for health education using the example of an educational seminar on AIDS prevention and control at Hebei Medical University in China, 1994. METHODS: Our goal is the theoretical formulation of a unified community approach for problem solving through the combination of the self regulative approach and the case analytical approach. "Quality improvement", "essential quality" and "human ecosystems" provide the basic ideas for better understanding the integration of culture, science and technology within the "cultural norm". RESULTS: The present seminar was successfully organized for Chinese medical students based on the theme of "living with AIDS". Through this program, we identified that self regulative and case analytical approach were major issues for holistic approach to health education. We also identified that a community approach provides the scientific basis for health education in the community. CONCLUSIONS: The present paper generates a healthcare paradigm for surveillance in health/medical education. Through a better understanding of community approach, we related "community care" (emphasizing self, mutual, professional and institutional care) to the "practical norm"; and "preventive epidemiology" (emphasizing the unification of quality and quantity, as well as systems and population) to the "research norm".

Acquired Immunodeficiency Syndrome↗
PubMed2004

In vitro evaluation of fixed dose combination tablets of anti-tuberculosis drugs after real time storage at ambient conditions.

Rifampicin exhibits variable bioavailability from solid oral dosage forms and this problem is more apparent when it is formulated as fixed dose combination (FDC) in presence of other first-line anti-tuberculosis drugs. To determine the cause of variable bioavailability, the aging effect on physical and chemical performance of rifampicin from FDC formulations after real time storage at the ambient conditions was investigated. For this purpose, six FDC formulations from different manufacturers were stored at ambient conditions (20-35 degrees C, with no control of humidity) in the final packing for a period of 16-38 months and its in vitro quality control tests for rifampicin were compared with the initial performance of these tablets. None of the formulations have shown significant weight gain/loss and the assay values were within the pharmacopeial limits when evaluated by a stability indicating method. Further storage had no effect on physical performance of FDC tablets as indicated by unaltered dissolution profiles. Formulation reevaluation after real time storage at the ambient conditions for 16-38 months indicated that rifampicin containing FDC formulations are stable throughout its shelf life and instability is not a cause of variable bioavailability.

Antitubercular Agents↗
PubMed2006

Sanitary and phytosanitary measures and food safety: challenges and opportunities for developing countries.

Because of fast-growing demand, export markets can absorb high value added products and offer high returns; for many developing countries export market development is thus a key requirement for rural income generation and rural growth. Although developing countries face increasingly strict sanitary and phytosanitary standards in their export markets, they can maintain and improve market access--and improve domestic food safety and agricultural productivity--by adopting a strategic approach to food safety, agricultural health and trade. High-income countries should increase development flows to help developing countries build the capacity to plan and execute the necessary strategies. The first proposal in this paper is to make two existing sets of guidelines widely available to interested parties, in particular through the World Bank and the World Organisation for Animal Health (OIE). The first covers the broad process of problem assessment, strategy development and action plan formulation; the second set deals with institutional analysis and training of staff of the official sanitary control services. The second proposal is that interested countries and donors should speed up the ongoing development of guidelines, computer software tools and training material to help countries quantify the importance and impact of food safety issues. The focus here is on a 'multipurpose agricultural data analysis and modelization system'. The third proposal is to carry out a case study to help demonstrate that a number of animal health issues related to food safety should be treated as relating to 'global public goods' and thus require intervention on a global scale. Possible candidates are foot and mouth disease and highly pathogenic avian influenza.

Agriculture↗
PubMed1991

Training primary health care workers to foster community participation.

A low level of community participation was identified as one of the weaknesses of the health sector in the United Republic of Tanzania. In order to remedy this situation, a systematic process of training trainers and students was established with full involvement of village people. Twenty-five themes were put forward as starting points for discussions between students and villagers. The students were encouraged to learn from the villagers by listening to them and asking them questions. They also participated in community activities and lived with villagers so as to obtain a good understanding of rural living conditions. In this way, problems were identified and solutions were jointly formulated. A workbook was developed during a series of workshops with students, trainers, village communities, and planners. At least two teachers were trained from each health training school; all schools were supplied with workbooks. The approach has been adopted by most health training schools in Tanzania, and the Ministry of Health is now committed to it. Both students and trainers find this to be a valuable learning experience.

Community Health Services↗
PubMed1991

Is there an optimal prophylactic nitrate therapy?

Nitrates have a place in the prophylactic treatment of patients with angina pectoris. Their efficacy is not in doubt. However, there may be some practical problems associated with their use, such as unreliable absorption, short duration of action, treatment-induced headache, development of nitrate tolerance and a suggested rebound phenomenon observed during intermittent dosing. This article discusses how many of these problems may be solved by selection of formulation as well as nitrate compound. Thus, the development of a controlled-release formulation producing sufficiently high nitrate plasma concentrations during part of the day, followed by a low nitrate level rather than a nitrate-free interval, seems to have the potential to prevent both nitrate tolerance and rebound phenomenon. This system would also offer a sufficiently long duration of action with a convenient once-daily dose regimen.

Angina Pectoris↗
PubMed1989

Evolving concepts of borderline personality disorders.

The author examines major trends in the definition of borderline conditions in this century. Particular note is taken of the conflicts among psychodynamic, empirical-descriptive, and biological approaches to the problem leading up to DSM-III formulations; current controversies; and the implications of these historical trends for the future of borderline concepts.

Borderline Personality Disorder↗
PubMed1989

A theory development role for nurse administrators.

Nurse administrators can formulate useful theories while solving the complex problems of practice. An awareness of the mental perspective that frames one's thoughts about experiences can aid in theory development. Examples are developed to illustrate how different mental perspectives lead to different theories, decisions, and outcomes. It is argued that a system perspective, when used as an aid for conceptualizing experiences, will assist nursing administrators in developing theories that address their comprehensive sphere of activity and influence.

Administrative Personnel↗