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101.
102.
Rosemary C. Baggish Amy Wheaton Sheila W. Wellington 《Administration and policy in mental health》1981,8(3):194-201
The use of short-term isolation (STI) in a children's psychiatric hospital was examined using the Joint Commission on Accreditation of Hospitals (JCAH) quality assurance mode. A Clinical Care Evaluation addressed two questions: Are we providing quality use of STI? And are we adequately documenting its use? A medical record audit of 78 discharged patients and a review of unit records provided hospital staff with utilization and demographic statistics; structured interviews with staff and inpatients were conducted that provided information about their opinions of STI. The data gathered served as the basis for recommendations that led to planned, informed program changes. 相似文献
103.
The use of heroin by American adolescents is at its highest levels since the heroin epidemic of the 1960s. This clinical perspective
reviews medical issues associated with adolescent heroin dependence. Older, as well as potential newer, treatments for adolescent
heroin dependence are discussed. Multiple obstacles face a heroin-dependent adolescent who seeks treatment, including a lack
of evidenced-based research on pharmacotheraputic agents for this population, strict restrictions on medications with demonstrated
efficacy in adults, and a general lack of clinical experience in treating this population. 相似文献
104.
The conduct of in vitro and in vivo drug-drug interaction studies: a Pharmaceutical Research and Manufacturers of America (PhRMA) perspective. 总被引:12,自引:0,他引:12
Thorir D Bjornsson John T Callaghan Heidi J Einolf Volker Fischer Lawrence Gan Scott Grimm John Kao S Peter King Gerald Miwa Lan Ni Gondi Kumar James McLeod R Scott Obach Stanley Roberts Amy Roe Anita Shah Fred Snikeris John T Sullivan Donald Tweedie Jose M Vega John Walsh Steven A Wrighton 《Drug metabolism and disposition》2003,31(7):815-832
Current regulatory guidances do not address specific study designs for in vitro and in vivo drug-drug interaction studies. There is a common desire by regulatory authorities and by industry sponsors to harmonize approaches, to allow for a better assessment of the significance of findings across different studies and drugs. There is also a growing consensus for the standardization of cytochrome P450 (P450) probe substrates, inhibitors and inducers and for the development of classification systems to improve the communication of risk to health care providers and to patients. While existing guidances cover mainly P450-mediated drug interactions, the importance of other mechanisms, such as transporters, has been recognized more recently, and should also be addressed. This article was prepared by the Pharmaceutical Research and Manufacturers of America (PhRMA) Drug Metabolism and Clinical Pharmacology Technical Working Groups and represents the current industry position. The intent is to define a minimal best practice for in vitro and in vivo pharmacokinetic drug-drug interaction studies targeted to development (not discovery support) and to define a data package that can be expected by regulatory agencies in compound registration dossiers. 相似文献
105.
106.
In a large sample of Gulf War veterans (N = 2301) we examined the relations between PTSD symptoms assessed immediately upon returning from the Gulf War and self-reported health problems assessed 18–24 months later. PTSD symptomatology was predictive of self-reported health problems over time for both men and women veterans, even after the effects of combat exposure were removed from the analysis. Female veterans reported significantly more health problems than male veterans, however, there was no interactive effect of gender and PTSD on health problems. These findings provide further support for the theory that psychological response to stressors impacts health outcome. 相似文献
107.
Glenn Liu George Wilding Mary Jane Staab Dorthea Horvath Kelly Miller Amy Dresen Dona Alberti Rhoda Arzoomanian Rick Chappell Howard H Bailey 《Clinical cancer research》2003,9(11):4077-4083
PURPOSE: In this single institution Phase II trial, we evaluated the efficacy of the vitamin D analogue, 1alpha-OH-D(2), in patients with advanced hormone-refractory prostate cancer. Experimental Design: The patients initially received 1alpha-OH-D(2) at 12.5 micro g p.o. every day, which was dose adjusted for hypercalcemia. Given the cytostatic nature of the drug, the primary study end point was progression-free survival for a minimum of 6 months. The secondary end point was further characterization of drug toxicity. RESULTS: A total of 26 patients was enrolled. Using the intent-to-treat population, stable disease was seen for an average of 19.2 weeks (median 12 weeks, range 3-108 weeks). Twenty patients were evaluable for response. The one patient that achieved disease stabilization for >2 years elected to come off-study because of patient preference. His last disease evaluation showed no evidence of progression. No objective responses were seen. Previous and ongoing clinical observations strongly imply that PSA could be a misleading surrogate marker for clinical effect with this type of drug. Therefore, prostate-specific antigen was not used as a marker for disease response. Toxicity was as expected with mild hypercalcemia and associated symptoms like constipation and prerenal azotemia seen in some patients. Six (30%) evaluable patients experienced stable disease for >6 months, suggesting possible cytostatic activity. CONCLUSION: The results of this and other trials suggest further clinical investigation in this disease with vitamin D analogues alone or in combination with other agents, such as chemotherapy, should be pursued. 相似文献
108.
109.
A fully human antimelanoma cellular adhesion molecule/MUC18 antibody inhibits spontaneous pulmonary metastasis of osteosarcoma cells in vivo. 总被引:6,自引:0,他引:6
Eric C McGary Amy Heimberger Lisa Mills Kristy Weber Gary W Thomas Mikhail Shtivelband Dina Chelouche Lev Menashe Bar-Eli 《Clinical cancer research》2003,9(17):6560-6566
PURPOSE: The melanoma cellular adhesion molecule, also known as MUC18, is highly expressed on several tumors, including bone sarcomas. The level of MUC18 expression has been found to correlate directly with tumor progression and metastatic potential. These observations have established MUC18 as a candidate mediator of tumor growth and metastasis, and suggest that blockade of MUC18 might be a potential target for immunotherapy against several MUC18-expressing tumors, including human bone sarcomas. EXPERIMENTAL DESIGN: To investigate whether blockade of MUC18 might be a potential target for immunotherapy against osteosarcoma, we have recently developed a fully human anti-MUC18 antibody, ABX-MA1. We studied the effect of ABX-MA1 on growth, adhesion, invasion, and metastasis of human osteosaroma cells both in vitro and in vivo. RESULTS: MUC18 was widely expressed on both osteosarcoma and Ewing's sarcoma cells. ABX-MA1 had no effect on the proliferation of osteosarcoma cells in vitro, nor did it significantly inhibit the growth of KRIB human osteosarcoma cells when they were orthotopically implanted into the tibias of nude mice. However, after 6 weeks, significantly fewer ABX-MA1-treated mice developed spontaneous pulmonary metastases than did IgG-treated control mice. Additionally, ABX-MA1 decreased the invasion of osteosarcoma cells through Matrigel-coated filters and disrupted homotypic adhesion between osteosarcoma cells and their heterotypic interaction with human vascular endothelial cells. CONCLUSIONS: Our findings demonstrate that MUC18 plays a central role in the metastasis of osteosarcoma and suggest that targeted inhibition of this antigen by ABX-MA1 may be a novel immunotherapeutic approach in the management of this tumor. 相似文献
110.
Edward C. Ditkoff Jennifer Plumb Amy Selick Mark V. Sauer 《Journal of assisted reproduction and genetics》1997,14(3):145-147
Purpose: Our purpose was to characterize and describe anesthesia practice in programs performing IVF in the United States.
Methods: We used a telephone survey requiring respondents to be either the program director, a physician, or a nurse familiar with
the practice. Two hundred seven (78%) Society of Assisted Reproductive Technology (SART) registered programs agreed to participate.
Programs were divided by geographic region and type of practice (academic versus private).
Results: Ninety-one private (68%) and 41 academic (56%) programs used personnel provided by the Department of Anesthesiology. Conscious
sedation was performed most commonly (95%). The remaining 5% used primarily either general, regional, or local anesthesia.
Typical recovery times were 90 to 120 min. Average costs of anesthetic administration were $300–$400 and were similar among
groups except for the Eastern academic programs, with a higher mean cost of $543. Programs using personnel from anesthesiology
reported higher costs compared to programs utilizing their own staff ($391±15 vs $157±11; P<0.05). Complications were infrequent
(<10%); no hospitalizations or serious life-threatening incidents were reported.
Conclusions: A large number of programs safely used their own trained personnel to deliver anesthesia, and realized a significant reduction
in cost. 相似文献