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1.
In contrast with cross-sectional designs used in previous studies, this exploratory study compared survey data from 127 matched pairs of clinical pharmacists and physicians working together. Physicians' perceptions of the importance of clinical pharmacy activities for patient care and the competence of pharmacists performing the activities were examined for their influence on prescribing behavior in an institutional setting. Data from a national survey showed that physicians rated pharmacists higher regarding recommendations based on drug use evaluations (p = 0.004) and competency to provide all clinical pharmacy services. Scores for pharmacokinetics ratings were similar between pharmacists and physicians (p = 0.168). Pharmacists rated the importance of recommendations based on cost-effectiveness higher than physicians (p = 0.012). Overall, physicians' perceptions of activity importance for patient care and pharmacist competency appear to dictate pharmacists' influence on physician prescribing behavior (R = 0.723). 相似文献
2.
We report a case of malakoplakia in association with colonic adenocarcinoma. Tumour-associated malakoplakia in the gastrointestinal tract is a rare finding, generally confined to the colon. It may be locally aggressive, with invasion of pericolic tissues, but is always located adjacent to the tumour. This contrasts with the often more diffuse, multifocal distribution of colonic malakoplakia in association with other pathologies. 相似文献
3.
Resistant strains of Escherichia coli were obtained by stepwise cultivation in subinhibitory concentrations of two antimicrobially active amine oxides. Changes in the chemical composition of the outer membrane of the resistant strains were accompanied also by different antigenic reactions. New precipitation lines were revealed by double immunodiffusion and immuno-electrophoretic methods. The results of immunochemical analysis confirm the findings that the resistance to amphiphilic compounds is associated with the outer membrane which limits the access of antimicrobially active molecules to their sites of action in the cytoplasmic membrane. 相似文献
4.
Ronald L. Arenson Dev P. Chakraborty Sridhar B. Seshadri Harold L. Kundel 《Journal of digital imaging》2003,16(1):142-162
Picture archiving and communication systems (PACS) are expected to convert film-based radiology into a computer-based digital environment, with associated cost savings and improved physician communication. The digital workstation will be used by physicians to display these soft-copy images; however, difficult technical challenges must be met for the workstation to compete successfully with the familiar viewbox. Issues relating to image perception and the impact on physicians practice must be carefully considered. The spatial and contrast resolutions required vary according to imaging modality, type of procedure, and class of user. Rule-based software allows simple physician interaction and speeds image display. A consensus appears to be emerging concerning the requirements for the PACS workstation. Standards such as the American College of Radiology/National Electrical Manufacturers Association Digital Imaging and Communication Standard are facilitating commercial applications. Yet much careful study is needed before PACS workstations will be fully integrated into radiology departments.
Abbreviations: CRT = cathode ray tube, H&D = Hurter and Drifield, PACS = picture archiving and communication system, ROC = receiver operating characteristic, S/N = signal-to-noise ratio. Partially supported by grant HL-33332 from the National Heart, Lung, and Blood institute, U.S. Public Health Service. Address reprint requests to R.L.A. Copyright © 1990 by the Radiological Society of North America. Radiology 176:303-315, 1990. Reprinted with permission. 相似文献
5.
Pravin C. Singhal Mohan Pamarthi Robin Shah Dev Chandra Nora Gibbons 《Inflammation》1994,18(3):293-299
Focal glomerulosclerosis is the predominant glomerular lesion in heroin addicts. We studied whether morphine, a metabolite of heroin, could directly affect the formation of superoxide by glomerular mesangial cells. Mesangial cells preincubated with morphine (10–8 M) showed a higher (P<0.001) production of superoxide when compared to control cells (control) 401±21 vs. morphine 610±41 nM/mg protein/h). This effect of morphine on mesangial cells was dose dependent. Naloxone, an opiate antagonist, attenuated morphine-induced formation of Superoxide by mesangial cells [control, 317±4; morphine (10–8 M), 573±9; and naloxone (10–8 M) + morphine (10–8 M), 333±6 nM/mg protein/h]. We conclude that morphine enhances formation of superoxide by mesangial cells and this effect of morphine seems to be mediated through opiate receptors. Since superoxide has been demonstrated to cause mesangiolysis, we propose that morphine may be playing a role in the induction of mesangial injury in patients with opiate abuse.This work was supported by National Institute of Health Grant R01-DA-06753. 相似文献
6.
E. R. O'Brien M. R. Garvin R. Dev D. K. Stewart T. Hinohara J. B. Simpson S. M. Schwartz 《The American journal of pathology》1994,145(4):883-894
Neovascularization in the walls of coronary arteries is associated with the presence of atherosclerotic plaque. The mechanisms responsible for the formation of these intraplaque microvessels are not understood. The purpose of this study is to examine the prevalence of endothelial cell replication in plaque microvessels. Two hundred and one primary and restenotic coronary atherectomy specimens were analyzed for the presence of microvessels and proliferation as reflected by positive immunolabeling for Ulex agglutinin and the proliferating cell nuclear antigen, respectively. In primary but not restenotic specimens, proliferation of any cell type was associated with the detection of microvessels on the same slide. However, intraplaque microvessels were more commonly found in restenotic compared to primary specimens (P = 0.004). Twelve highly vascularized specimens with evidence of replication were subjected to detailed histomorphological and quantitative image analyses. At 200 x, the most vascular optical field of each slide was identified and consistently included plaque macrophages. Total slide endothelial cell replication indices for these specimens varied, but in some instances were remarkably elevated (eg, 43.5%). The role of intraplaque angiogenesis may be analogous to that of tumor or wound angiogenesis and be important in development and progression of coronary artery lesions and restenosis. 相似文献
7.
David J Stewart MD FRCP Michael T Richard Herman Hugenholtz Jean Dennery Dev Nundy Judith Prior Vital Montpetit Harry S Hopkins 《Journal of neuro-oncology》1984,2(4):315-324
Thirty-four consenting patients received VM-26 50–100 mg/m2 I.V. before surgical resection of intracerebral tumor, and drug was measured using a high pressure liquid chromatographic technique. Sufficient tumor for analysis was obtained from 29 patients. Brain metastases (13 patients) had higher concentrations of V M-26 than did gliomas (13 patients). Concentrations were comparable in brain metastases and meningiomas (3 patients). Prolonged (24 h) infusion of V M-26 did not appear to result in higher tumor drug concentrations in 5 patients than did rapid (1 h) infusion in 24 patients. Pretreatment with Amphotericin-B 10 mg/m2 12 h and 1 h before VM-26 did not appear to have any effect on VM-26 uptake into 4 intracerebral tumors, although data were limited, and VM-26 concentrations were very high in 1 metastasis. Pretreatment with oral glycerol 500 mg/kg 18 h, 12 h, 6 h, and immediately before I.V. VM-26 may have resulted in increased penetration of VM-26 into 9 tumors, although confirmation is required. Amphotericin-B, glycerol, and operative conditions did not appear to alter VM-26 plasma pharmacokinetics.VM-26
4-demethylepipodophyllotoxin 9-(4-6-O-thenylidene-B-D-glucopyranoside)
- VP-16
4-demethylepipodophyllotoxin 9-(4-6-O-ethylidene-B-D-glucopyranoside)
Presented in Part at the 74th Annual Meeting of the American Association for Cancer Research, San Diego, California, May 25–28, 183(1). 相似文献
8.
Maternal and Child Health Journal - While the city offers economic opportunities for women in many countries, their safety and security remain vulnerable to urban violence, especially in poor... 相似文献
9.
Dev D Hughes C Smith MJ Tillotson G Basran GS 《International journal of antimicrobial agents》1997,8(2):93-95
In this study we determined the pharmacokinetics of higher IV doses of ciprofloxacin (Cipro) in patients with pleuro-pulmonary diseases undergoing treatment for various bacterial infections. Cipro IV was infused over 30-45 min in 11 patients (seven on 400 mg bid, four on 200 mg bid). Blood samples were taken at intervals of up to 4 h and assayed for Cipro using the HPLC method. The 'mean' peak concentration (C(max)) was 6.9 +/- 2.2 (S.D.) and 11.8 +/- 5.2 (S.D.) for the 200 and 400 mg groups, respectively. The mean concentrations at 1.5 h were 1.2 and 2.6 mg/l and the area under the curve in 0-4 h was 4.6 +/- 0.9 (S.D.) and 7.5 +/- 2.4 (S.D.), respectively for the 200 and 400 mg groups. Steady state serum concentrations of 400 mg were approximately double those for the 200 mg group. IV 200 mg did not reach the required levels to cover the minimum inhibitory concentrations (MICs), whereas, 400 mg IV dose clearly will provide an improved coverage for the commonly encountered organisms with MICs in the 1-4 mg/l range. 相似文献
10.
The "new health consciousness" that emerged in the developing countries in the 70s and 80s, has contributed to consider exercise as an element of health promotion. But it can establish simplistic relationships between exercise and health, particularly critical for professionals who develop promotion programmes. In this paper, five problematic aspects linked, to exercise and health relationships both in children and youngsters, are discussed and should be taken into account when promoting health programmes. We refer to: 1) the problematic role of exercise in health promotion and in physical education curriculum as an area of privileged action in children and youngsters; 2) the automatic relationship between fitness and health, when the former addresses to high levels of performance and the later is linked to moderate, regular and frequent exercise; 3) problems of fitness tests as a measure of health-related physical activity; 4) the assumption that any kind of physical activity is health-related; and 5) the quantity of exercise necessary for health as a practical problem. From the discussion different proposals are offered in order to develop health-related exercise promotion programmes such as to consider the risks of doing physical activity as a criteria to select exercises; to emphasize the qualitative instead of quantitative aspects of practice; to reconceptualize fitness and sport towards a health focus; to include a broad range of activities which offer the opportunity to every child and youngster to participate; to reduce the importance of testing in evaluation programmes; and other educational considerations which can help to maintain exercise practice beyond the schooling period. 相似文献