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991.
Donald G. Klepser Michael E. Klepser Jaclyn K. Smith Allison M. Dering-Anderson Maggie Nelson Lauren E. Pohren 《Research in social & administrative pharmacy》2018,14(4):356-359
Background
One way to reduce the complications and costs of influenza like illness and pharyngitis is to improve access to testing and treatment in early stages of infection. Pharmacy-based screening and treatment of group A streptococcus (GAS) infection and influenza has the potential to improve patient care and population health.Objective
To improve patient care and population health, the objective of this retrospective study was to assess if a previously validated service model could be implemented by pharmacy chains without mandated standardization.Methods
Researchers utilized a certificate program to provide initial training to pharmacists and shared templates from previous validated models. Pharmacy companies were responsible for navigation of all implementation within their company. Researchers analyzed the de-identified data from patients seeking point-of-care testing from the participating pharmacies.Results
Participating pharmacies reported 661 visits for adult (age 18 and over) patients tested for influenza for GAS pharyngitis. For the GAS patients, 91 (16.9%) tested positive. For the Influenza patients, 22.9% tested positive and 64 (77.1%) testing negative. Access to care was improved as patients presented to the visit outside normal clinic hours for 38% of the pharmacy visits, and 53.7% did not have a primary care provider.Conclusion
A collaborative care model for managing patients with symptoms consistent with influenza or group A streptococcus can be successfully implemented, and improve access to care outside of normal clinic hours and for those without a regular primary care provider. 相似文献992.
Mengting Xu Lesley Richardson Sally Campbell Javier Pintos Jack Siemiatycki 《Annals of epidemiology》2018,28(6):385-391
Purpose
The purpose of this study was to describe time trends in response rates in case-control studies of cancer and identify study design factors that influence response rate.Methods
We reviewed 370 case-control studies of cancer published in 12 journals during indicator years in each of the last four decades. We estimated time trends of response rates and reasons for nonresponse in each of the following types of study subjects: cases, medical source controls, and population controls. We also estimated response rates according to characteristics of study context.Results
Median response rates among cases and population controls were between 75% and 80% in the 1970s. Between 1971 and 2010, study response rates declined by 0.31% per year for cases and 0.78% for population controls. Only a minority of studies reported reasons for nonparticipation; subject refusal was the most common reported reason. Studies conducted in North America had lower median response rates than studies conducted in Europe. In-person and telephone interviews elicited higher response rates than mail questionnaires.Conclusions
Response rates from case-control studies of cancer have declined, and this could threaten the validity of results derived from these studies. 相似文献993.
Charles Donald George Keown‐Stoneman Julie Horrocks Gerarda Darlington 《Statistics in medicine》2018,37(5):776-788
Cox models are commonly used in the analysis of time to event data. One advantage of Cox models is the ability to include time‐varying covariates, often a binary covariate that codes for the occurrence of an event that affects an individual subject. A common assumption in this case is that the effect of the event on the outcome of interest is constant and permanent for each subject. In this paper, we propose a modification to the Cox model to allow the influence of an event to exponentially decay over time. Methods for generating data using the inverse cumulative density function for the proposed model are developed. Likelihood ratio tests and AIC are investigated as methods for comparing the proposed model to the commonly used permanent exposure model. A simulation study is performed, and 3 different data sets are presented as examples. 相似文献
994.
A rare clinical isolate of Streptococcus pneumoniae, highly resistant to telithromycin, contained erm(B) with a truncated leader peptide and a mutant ribosomal protein L4. By transformation of susceptible strains, this study shows that high-level telithromycin resistance is conferred by erm(B), wild type or mutant, in combination with a (69)GTG(71)-to-TPS mutation in ribosomal protein L4. 相似文献
995.
Population pharmacokinetics of micafungin in pediatric patients and implications for antifungal dosing 总被引:1,自引:0,他引:1 下载免费PDF全文
996.
OBJECTIVE: To determine whether the presence or absence of a fully functioning cytochrome P450 2D6 allele was associated with the dosage of the antidepressant drug venlafaxine in patients who had either adverse effects or absence of a therapeutic response to treatment with the immediate release or extended release form of venlafaxine. PATIENTS AND METHODS: We reviewed the electronic medical records of 199 patients enrolled in a previous pharmacogenomic study (June 1, 2002 through April 30, 2004) who had either adverse effects or the absence of a therapeutic response to treatment with psychotropic medications. This review identified 38 patients previously treated with venlafaxine immediate release or extended release and subsequently genotyped for the 2D6 gene with a commercial genotyping assay. Their dosage was examined along with their 2D6 genotype to determine whether the presence or absence of a fully functioning 2D6 allele was associated with their venlafaxine dosage. RESULTS: Of the 38 patients, 5 had a 2D6 genotype that consisted of 1 inactive allele and 1 allele associated with decreased activity. None of these 5 patients were able to tolerate treatment with more than 75 mg/d of venlafaxine. The remaining 33 patients had at least 1 fully active 2D6 allele, 26 of whom had been able to tolerate treatment with 150 mg/d or more of venlafaxine (P less than .002). CONCLUSION: Genetic variations of the P450 2D6 gene may contribute to patient-specific variation in response to treatment with venlafaxine. Physicians should be alert to the possibility that an adverse reaction may indicate a slow metabolizer and consider genotyping such patients. 相似文献
997.
998.
Rautemaa R Richardson M Pfaller M Koukila-Kähkölä P Perheentupa J Saxén H 《The Journal of antimicrobial chemotherapy》2007,60(4):889-892
BACKGROUND: Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED, APS1) is an autosomal recessive disease exceptionally common in Finland. Most patients have chronic oral candidiasis from early childhood and this infection has been shown to be carcinogenic. Hence, patients receive repeated treatment and prophylactic courses of antifungals throughout life. In Finland, 92 patients have been diagnosed with APECED and 66 of them are currently alive. Our aim was to study the effect of long-term azole treatment on the candidal colonization of APECED patients and the influence on antifungal susceptibilities. METHODS: We evaluated the culture reports from 1994 to 2004 of 56 APECED patients followed in Helsinki University Central Hospital. Candida albicans strains of all 11 patients initially reported resistant (n = 27) and 12 patients reported susceptible (n = 16) to fluconazole were re-analysed for their susceptibility to fluconazole. Antifungal usage was analysed up to 30 years back. RESULTS: A total of 162 fungal cultures had been performed. Of these, 75% had been reported positive for Candida and 63% for C. albicans. Eleven patients (31.4%) had been reported to harbour at least once a C. albicans strain resistant to fluconazole. Re-analysis of the stored C. albicans strains originally reported to be resistant to fluconazole revealed a mean MIC of 19.5 mg/L. CONCLUSIONS: Multiple courses (>6) of fluconazole annually and low dose prophylaxis are major risk factors for persistent colonization with C. albicans with decreased susceptibility in APECED patients. 相似文献
999.
Coluzzi DJ 《Dentistry today》2007,26(4):124, 126-9; quiz 129
1000.
White DJ 《The Journal of clinical dentistry》2007,18(1):21-24
OBJECTIVE: A repeated measures digital imaging technique (Digital Plaque Image Analysis-DPIA) was used to assess the antiplaque effectiveness of a 0.454% stannous fluoride dentifrice. METHODOLOGY: Subjects were qualified to enter the study based upon a previous assessment of dental plaque accumulation while brushing with a standard (non-antimicrobial) fluoridated dentifrice. Fourteen qualifying subjects were entered into a cross-over study design, including the use of a standard 0.243% sodium fluoride (NaF) dentifrice, or a 0.454% stannous fluoride (SnF,) dentifrice. Cross-over periods were separated by a one-week washout. During the assigned treatments, subjects visited the imaging laboratory on six separate days over two weeks, reporting each day for three separate assessments of plaque accumulation, as assessed by DPIA. On each "grading day," subjects entered for plaque assessments prior to morning tooth brushing, and without consuming any food or beverages. Following this morning "pre-brushing" assessment, subjects brushed with the assigned dentifrice and then had plaque immediately reassessed (morning post-brushing). Subjects also reported to the imaging clinic for an afternoon plaque regrowth assessment. Subjects were again required to avoid food and drink for one hour prior to this measurement. RESULTS: The SnF2 dentifrice was observed to produce statistically significant reductions in dental plaque, measuring 24.4% in the morning pre-brushing, and 27.9% in the afternoon assessment. Tooth brushing was observed to significantly reduce plaque on the teeth in the morning post-brushing for subjects using either the standard NaF or the SnF2 dentifrice. There were no statistically significant differences in plaque coverage on teeth following tooth brushing with the NaF (6.3% coverage) or SnF2 (6.2% coverage) dentifrices. CONCLUSION: Use of a 0.454% SnF2 dentifrice produced statistically significant reductions in dental plaque formation as compared to the similar use of a standard 0.243% NaF dentifrice. 相似文献