scholarly journals Aluminum in Pediatric Parenteral Nutrition Products: Measured Versus Labeled Content

2011 ◽  
Vol 16 (2) ◽  
pp. 92-97
Author(s):  
Robert L. Poole ◽  
Kevin P. Pieroni ◽  
Shabnam Gaskari ◽  
Tessa K. Dixon ◽  
KT Park ◽  
...  
Keyword(s):  
United States ◽  
Parenteral Nutrition ◽  
Clinical Setting ◽  
Aluminum Content ◽  
The United States ◽  
Published Data ◽  
Measured Concentration ◽  
Aluminum Exposure ◽  
Product Release

ABSTRACT OBJECTIVE Aluminum is a contaminant in all parenteral nutrition solutions. Manufacturers currently label these products with the maximum aluminum content at the time of expiry, but there are no published data to establish the actual measured concentration of aluminum in parenteral nutrition solution products prior to being compounded in the clinical setting. This investigation assessed quantitative aluminum content of products commonly used in the formulation of parenteral nutrition solutions. The objective of this study is to determine the best products to be used when compounding parenteral nutrition solutions (i.e., those with the least amount of aluminum contamination). METHODS All products available in the United States from all manufacturers used in the production of parenteral nutrition solutions were identified and collected. Three lots were collected for each identified product. Samples were quantitatively analyzed by Mayo Laboratories. These measured concentrations were then compared to the manufacturers' labeled concentration. RESULTS Large lot-to-lot and manufacturer-to-manufacturer differences were noted for all products. Measured aluminum concentrations were less than manufacturer-labeled values for all products. CONCLUSIONS The actual aluminum concentrations of all the parenteral nutrition solutions were significantly less than the aluminum content based on manufacturers' labels. These findings indicate that 1) the manufacturers should label their products with actual aluminum content at the time of product release rather than at the time of expiry, 2) that there are manufacturers whose products provide significantly less aluminum contamination than others, and 3) pharmacists can select products with the lowest amounts of aluminum contamination and reduce the aluminum exposure in their patients.

Patient preferences for interferon alfa in multiple myeloma.

1997 ◽  
Vol 15 (4) ◽  
pp. 1672-1679 ◽  
Author(s):  
H Ludwig ◽  
E Fritz ◽  
J Neuda ◽  
B G Durie
Keyword(s):  
United States ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Patient Preferences ◽  
Maintenance Treatment ◽  
The United States ◽  
Interferon Alfa ◽  
Medical Decision ◽  
Published Data ◽  
Financial Cost

PURPOSE Interferon alfa treatment in multiple myeloma marginally improves relapse-free and overall survival. Often it does so at the expense of toxicity and financial cost. If patients are unwilling or unable to participate in the decision of whether to initiate such treatment, known patient preferences can serve as guidelines for the physician. We interviewed myeloma patients in the United States to obtain information that might facilitate medical decision-making. PATIENTS AND METHODS Three hundred fifty-five myeloma patients throughout the United States were interviewed by telephone. Without identifying interferon alfa as the treatment agent, interviewers described potential adverse effects, financial cost, and self-injection procedures. The potential benefits of four treatment choices, derived from a meta-analysis of published data, were presented as gains in remission rate (+10%), remission duration (an additional 4 and 7 months, respectively, for induction and maintenance treatment), and overall survival (an additional 3 and 6 months, respectively, for induction and maintenance treatment). Patients' choices for or against use of the unidentified substance were recorded, and interferon was subsequently disclosed as the treatment. The profiles of patients making different choices were determined using multivariate regression techniques. RESULTS Approximately half of the patients accepted the unidentified treatment if remission and/or survival improved by at least 6 months. Accepters were younger and more likely to have used interferon. Of patients who rejected the unidentified treatment, 25% to 50% would have been willing to accept it if the benefits were > or = 12 months. Test/retest reliability of all choices, determined in 36 cancer patients, was 0.896. CONCLUSION In multiple myeloma, interferon therapy and, by inference, other treatments with comparable features are acceptable to approximately half of the patients if a 6-month gain in relapse-free or overall survival can be expected.

Preliminary Results from the Air Mass Transformation Experiment (AMTEX)

1976 ◽  
Vol 57 (11) ◽  
pp. 1346-1355 ◽  
Author(s):  
D. H. Lenschow ◽  
E. M. Agee
Keyword(s):  
United States ◽  
Experimental Period ◽  
The United States ◽  
Published Data ◽  
Data Set ◽  
Air Mass ◽  
Preliminary Results ◽  
Cold Air Outbreak ◽  
Transformation Experiment ◽  
Transformation Processes

The field phases of AMTEX, a GARP subprogram on air-sea interaction implemented by Japan, were conducted over the East China Sea in the environs of Okinawa, Japan, during the last two weeks of February in 1974 and 1975. Investigators from Australia, Canada, and the United States also participated in this experiment. The weather was generally very favorable for this study of air mass transformation processes in 1975 because of an extensive cold air outbreak during most of the experimental period. A basic synoptic data set was obtained from 6 h soundings from an array of aerological stations centered at Okinawa. In addition, satellite, hourly surface and surface marine, oceanographic, boundary layer, radiation, radar, cloud physics, and aircraft data were obtained and have been or will be available in published data reports or on magnetic tape. Preliminary results from 1974 and 1975 reported at the Fourth AMTEX Study Conference and joint United States–Japan Cooperative Science Program Seminar, “Air Mass Transformation Processes over the Kuroshio in Winter,” held in Tokyo, 26–30 September 1975, are presented and discussed.

“Effective Disembodiment:” Female Patienthood and Reproductive Health in Elisa Albert’s After Birth and Pamela Erens’s Eleven Hours

2019 ◽  
Vol 13 (1) ◽  
pp. 34-52
Author(s):  
Haleigh R Williams
Keyword(s):  
United States ◽  
Reproductive Health ◽  
Female Patient ◽  
Clinical Setting ◽  
Healthcare Workers ◽  
The United States ◽  
Pregnancy And Childbirth ◽  
Fictional Narratives ◽  
The Status ◽  
Shed Light

Abstract Historically, female patienthood has been defined by an expectation of passivity and the concession of bodily autonomy. After Birth by Elisa Albert (2015) and Eleven Hours by Pamela Erens (2016) shed light on the status of the modern female patient through the lens of her treatment throughout the process of childbirth in a clinical setting. The increasing medicalization of pregnancy and childbirth in the United States has added a compelling layer to the existing tension between women and the institution of medicine. Positioning these texts in conversation with the treatment of women at the hands of healthcare workers allows us to contextualize the fictional narratives, which themselves offer a dialectal framework to facilitate our understanding of female patienthood.

scholarly journals Don't Get Wound Up: Revised Fluoroquinolone Breakpoints for Enterobacteriaceae and Pseudomonas aeruginosa

2019 ◽  
Vol 57 (7) ◽  
Author(s):  
Tam T. Van ◽  
Emi Minejima ◽  
Chiao An Chiu ◽  
Susan M. Butler-Wu
Keyword(s):  
United States ◽  
Pseudomonas Aeruginosa ◽  
Side Effects ◽  
Antimicrobial Agents ◽  
Susceptibility Testing ◽  
The United States ◽  
Published Data ◽  
Content Type ◽  
Clinical Laboratories ◽  
Level Resistance

ABSTRACT Fluoroquinolones remain some of the more commonly prescribed antimicrobial agents in the United States, despite the wide array of reported side effects that are associated with their use. In 2019, the Clinical and Laboratory Standards Institute revised the fluoroquinolone antimicrobial susceptibility testing breakpoints for both Enterobacteriaceae and Pseudomonas aeruginosa. This breakpoint revision was deemed necessary on the basis of pharmacokinetic and pharmacodynamic analyses suggesting that the previous breakpoints were too high, in addition to the inability of the previous breakpoints to detect low-level resistance to this antibiotic class. In this minireview, we review the published data in support of this revision, as well as the potential challenges that these breakpoint revisions are likely to pose for clinical laboratories.

Analysis of Inpatient and Emergency Department Serial Troponin Testing Intervals in the United States

2020 ◽  
Author(s):  
Andrew Fletcher ◽  
Erik Forsman ◽  
Brian R Jackson
Keyword(s):  
United States ◽  
Emergency Department ◽  
Median Time ◽  
Emergency Departments ◽  
The United States ◽  
Published Data ◽  
Time Interval ◽  
Time Intervals ◽  
Convenience Sample ◽  
Facility Level

Abstract Background Serial measurement of cardiac troponins (cTn) is central to the diagnosis of myocardial infarction. The time intervals between individual measurements may impact the speed and reliability of diagnosis. Published recommendations exist for these time intervals, but there is little previously published data on actual intervals in routine clinical settings. Methods Retrospective analysis of cTn testing intervals was performed from a convenience sample of 37 hospitals. All 37 provided data on inpatient tests and 19 also provided separate data for tests ordered in their emergency departments. Facilities included both academic and community hospitals across the United States. For each facility, the median time interval between serial cTn order collections was determined separately for inpatient orders and emergency department orders. Results The facility-level median time intervals between serial inpatient cTn test orders ranged from 3.17 to 7.32 hours. Facility-level median time intervals between serial emergency department cTn orders ranged from 1.48 to 4.23 hours. There was no observed difference between academic and nonacademic facilities. Conclusion Typical time intervals between serial cTn orders varied widely across hospitals, and in many cases reflected suboptimal care. Time intervals were generally shorter for cTn testing ordered in emergency departments. Existing testing protocols should be re-examined.

scholarly journals Cutting to the Core of the Issue: Emerging Strategies To Reduce Prostate Biopsy-Related Infections

2016 ◽  
Vol 54 (10) ◽  
pp. 2431-2435 ◽  
Author(s):  
Robin R. Chamberland
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Biopsy ◽  
Current Trend ◽  
The United States ◽  
Infectious Complications ◽  
Published Data ◽  
The Core ◽  
Link Type ◽  
Transrectal Prostate Biopsy

Over 1 million men undergo biopsy in the United States each year to evaluate for prostate cancer (S. Loeb, H. B. Carter, S. I. Berndt, W. Ricker, and E. M. Schaeffer, J Urol 186:1830–1834, 2011,http://dx.doi.org/10.1016/j.juro.2011.06.057). In recent years, there has been a rise in infectious complications related to these procedures. This review aims to provide an overview of the guidelines that direct transrectal prostate biopsy, to describe associated infection, and to evaluate the published data driving the current trend toward prebiopsy screening for resistant organisms.

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