12 research outputs found
Critical appraisal of bepotastine in the treatment of ocular itching associated with allergic conjunctivitis
No full textJeremy B Wingard, Francis S MahUPMC Eye Center, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USAAbstract: Bepotastine besilate 1.5% solution is an H1-antihistamine recently approved by the Food and Drug Administration for the topical treatment of ocular itching associated with allergic conjunctivitis. Several clinical studies have demonstrated its safety as well as its efficacy versus placebo. This review finds that bepotastine besilate 1.5% solution is a suitable alternative to other agents within the class of H1-antihistamines, but there are no clinical trial data to suggest that it holds any specific advantages over other agents.Keywords: allergic conjunctivitis, antihistamine, ocular itchin
An exploratory survey on the awareness and usage of clinical practice guidelines among clinical pharmacists
No full textBackground: The NHLBI has not developed clinical practice guidelines since 2007. As a result, multiple organizations have released competing guidelines. This has created confusion and debate among clinicians as to which recommendations are most applicable for practice.
Objectives: To explore preliminary attitudes, awareness, and usage of clinical practice guidelines in practice and teaching for hypertension, dyslipidemia and asthma among clinical pharmacists.
Methods: Clinical pharmacists across the US were surveyed electronically over a two week period in Spring 2019 regarding utilization and knowledge of practice guidelines for hypertension, dyslipidemia, and asthma. Clinical cases were included to evaluate application of guidelines. Descriptive statistics, Chi-square analysis, and Wilcoxon signed-rank test were conducted. Statistical significance level was set to 0.01 to account for multiple tests conducted on the same survey participants.
Results: Forty-eight, 34, and 28 pharmacists voluntarily completed hypertension, dyslipidemia, and asthma survey questions, respectively. Interactions by disease state (p \u3c 0.001) revealed more pharmacists (93%) reporting to have ≤50% patient load in managing asthma and more pharmacists (95%) had read the full summary/report of the most recent hypertension guideline. Primary reasons why the most recent guideline was not selected were also significantly different by disease state (interaction; p \u3c 0.001). For dyslipidemia and asthma, pharmacists had a higher mean rating of agreement (p \u3c0.007) in having the most confidence in the most recent as compared to older guidelines. Proportionally more clinical cases were answered correctly (interaction; p \u3c0.001) when pharmacists applied the most recent guideline for hypertension (84%), while the opposite outcome was found for asthma (27%).
Conclusion: While more pharmacists selected the most recent guideline for practice and teaching, there was inconsistent application of guidelines to clinical cases. Further studies with a larger representation of pharmacists are warranted to more definitively determine factors influencing guideline preference and usage
A MIQE-Compliant Real-Time PCR Assay for Aspergillus Detection
No full textPMCID: PMC3393739This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Effect of ambient particulate matter exposure on hemostasis
No full textEpidemiological studies have linked levels of particulate matter (PM) in ambient air to cardiovascular mortality and hospitalizations for myocardial infarction (MI) and stroke. Thrombus formation plays a primary role in potentiating acute cardiovascular events, and this study was undertaken to determine whether pulmonary exposure to PM alters hemostasis. PM was collected from the Chapel Hill, NC airshed and was administered to mice by intratracheal instillation at a dose previously shown to exacerbate myocardial ischemia-reperfusion injury. Twenty- four hours after exposure, an increase occurred in the number of circulating platelets and plasma concentrations of fibrinogen and soluble P-selectin. The concentration of tissue factor pathway inhibitor (TFPI) in plasma was decreased, whereas the plasma concentration of plasminogen activator inhibitor (PAI-1) was increased. Consistent with these observations, bleeding time from a tail-tip transection was shortened. These results provide evidence that PM exposure alters hemostasis in otherwise healthy animals and may thereby promote clot formation and impede clot resolution in susceptible individuals. The results also establish definite hemostatic endpoints that can be used to further investigate the effects of dose and particle characteristics on the toxicity of ambient particles
Pharmacokinetic/pharmacodynamic modelling approaches in paediatric infectious diseases and immunology
No full textPharmacokinetic/pharmacodynamic (PKPD) modelling is used to describe and quantify dose-concentration-effect relationships. Within paediatric studies in infectious diseases and immunology these methods are often applied to developing guidance on appropriate dosing. In this paper, an introduction to the field of PKPD modelling is given, followed by a review of the PKPD studies that have been undertaken in paediatric infectious diseases and immunology. The main focus is on identifying the methodological approaches used to define the PKPD relationship in these studies. The major findings were that most studies of infectious diseases have developed a PK model and then used simulations to define a dose recommendation based on a pre-defined PD target, which may have been defined in adults or in vitro. For immunological studies much of the modelling has focused on either PK or PD, and since multiple drugs are usually used, delineating the relative contributions of each is challenging. The use of dynamical modelling of in vitro antibacterial studies, and paediatric HIV mechanistic PD models linked with the PK of all drugs, are emerging methods that should enhance PKPD-based recommendations in the future
2018 STD surviellance
No full textSexually Transmitted Disease Surveillance 2018 presents statistics and trends for STDs in the United States through 2018. This annual publication is intended as a reference document for policy makers, program managers, health planners, researchers, and others who are concerned with the public health implications of these diseases. The figures and tables in this edition supersede those in earlier publications of these data.The surveillance information in this report is based on the following sources of data: (1) notifiable disease reporting from state and local STD programs; (2) projects and programs that monitor STDs in various settings, including the National Job Training Program, the STD Surveillance Network, and the Gonococcal Isolate Surveillance Project; and (3) national surveys and other data collection systems implemented by federal and private organizations.Four STDs are nationally notifiable, chlamydia, gonorrhea, syphilis, and chancroid, and state and local STD control programs provide CDC with case reports for these conditions. These case reports are the data sourcefor many of the figures and most of the statistical tables in this publication; however, it is important to note that these case reports reflect only a portion of STDs occurring in the US population. First, other common STDs, such as human papillomavirus (HPV) and herpes simplex virus (HSV) are not nationally notifiable diseases. Additionally, STDs are often asymptomatic and may not be diagnosed; therefore, case report data underestimate the number of infections that occurred.In January 2018, a revised case definition for syphilis went into effect, including changing the stage previously termed \u201cearly latent syphilis\u201d to \u201csyphilis, early non-primary non-secondary\u201d. This change in terminology more accurately reflects this stage of infection, as neurologic symptoms, including ocular syphilis, can occur at this stage. Additionally, the stages of \u201clate latent syphilis\u201d and \u201clate syphilis with clinical manifestations\u201d were removed and \u201csyphilis, unknown duration or late\u201d was added. More information on syphilis morbidity reporting and the current case definition can be found in Appendices A and C of this report.Sexually Transmitted Disease Surveillance 2018 consists of four sections: the National Profile, the Special Focus Profiles, the Tables, and the Appendix. The National Profile section contains figures that provide an overview of STD morbidity in the United States. The accompanying text identifies major findings and trends for selected STDs. The Special Focus Profiles section contains figures and text that describe STDs in selected populations that are a focus of national and state prevention efforts. The Tables section provides statistical information about STDs at county, metropolitan statistical area, regional, state,and national levels. The Appendix includes information on how to interpret the STD surveillance data used to produce this report, as well as information about Healthy People 2020 STD objectives and progress toward meeting these objectives, Congressional Budget Justification goals and progress toward meeting these goals, and STD surveillance case definitions.Suggested citation: Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2018. Atlanta: U.S. Department of Health and Human Services; 2019. DOI: 10.15620/cdc.79370.STDSurveillance2018-full-report.pdf201910.15620/cdc.79370673
Better regional ocean observing through cross-national cooperation: A case study from the Northeast Pacific
No full textThe ocean knows no political borders. Ocean processes, like summertime wind-driven
upwelling, stretch thousands of kilometers along the Northeast Pacific (NEP) coast. This
upwelling drives marine ecosystem productivity and is modulated by weather systems
and seasonal to interdecadal ocean-atmosphere variability. Major ocean currents in the
NEP transport water properties such as heat, fresh water, nutrients, dissolved oxygen,
pCO2, and pH close to the shore. The eastward North Pacific Current bifurcates offshore
in the NEP, delivering open-ocean signals south into the California Current and north
into the Gulf of Alaska. There is a large and growing number of NEP ocean observing
elements operated by government agencies, Native American Tribes, First Nations
groups, not-for-profit organizations, and private entities. Observing elements include
moored and mobile platforms, shipboard repeat cruises, as well as land-based and
estuarine stations. A wide range of multidisciplinary ocean sensors are deployed to
track, for example, upwelling, downwelling, ocean productivity, harmful algal blooms,
ocean acidification and hypoxia, seismic activity and tsunami wave propagation. Data
delivery to shore and observatory controls are done through satellite and cell phone
communication, and via seafloor cables. Remote sensing from satellites and landbased
coastal radar provide broader spatial coverage, while numerical circulation and
biogeochemical modeling complement ocean observing efforts. Models span from the deep ocean into the inland Salish Sea and estuaries. NEP ocean observing systems are
used to understand regional processes and, together with numerical models, provide
ocean forecasts. By sharing data, experiences and lessons learned, the regional ocean
observatory is better than the sum of its parts.The lead author and K.
Juniper contributed to this paper while being members on the
North Pacific Marine Science Organization’s (PICES) Advisory
Panel on North Pacific Coastal Ocean Observing Systems. This
is contribution number 4875 from the NOAA Pacific Marine
Environmental Laboratory.FacultyReviewe
Predicting variables associated with disordered eating in Mexican American female adolescents
No full textIncludes bibliographical references
Long-Term Antecedents and Outcomes of Perceived Control
No full textPerceived control plays an important role in shaping development throughout adulthood and old age. Using data from the adult lifespan sample of the national German Socio-Economic Panel (SOEP; N > 10,000, covering 25 years of measurement), we explored long-term antecedents, correlates, and outcomes of perceived control and examined if associations differ with age. Targeting correlates and antecedents of control, findings indicated that higher concurrent levels of social participation, life satisfaction, and self-rated health as well as more positive changes in social participation over the preceding 11 years were each predictive of between-person differences in perceived control. Targeting health outcomes of control, survival analyses revealed that perceived control predicted 14-year hazard rates for disability (n = 996 became disabled) and mortality (n = 1,382 died). The effect for mortality, but not for disability, was independent of socio-demographic and psychosocial factors. Overall, we found very limited support for age-differential associations. Our results provide further impetus to thoroughly examine processes involved in antecedent-consequent relations among perceived control, facets of social life, well-being, and health.Control, lifespan development, disability, mortality, psychosocial
Statistical methods for the time-to-event analysis of individual participant data from multiple epidemiological studies
No full textBackground Meta-analysis of individual participant time-to-event data from multiple prospective epidemiological studies enables detailed investigation of exposure-risk relationships, but involves a number of analytical challenges. Methods This article describes statistical approaches adopted in the Emerging Risk Factors Collaboration, in which primary data from more than 1 million participants in more than 100 prospective studies have been collated to enable detailed analyses of various risk markers in relation to incident cardiovascular disease outcomes. Results Analyses have been principally based on Cox proportional hazards regression models stratified by sex, undertaken in each study separately. Estimates of exposure-risk relationships, initially unadjusted and then adjusted for several confounders, have been combined over studies using meta-analysis. Methods for assessing the shape of exposure-risk associations and the proportional hazards assumption have been developed. Estimates of interactions have also been combined using meta-analysis, keeping separate within-and between-study information. Regression dilution bias caused by measurement error and within-person variation in exposures and confounders has been addressed through the analysis of repeat measurements to estimate corrected regression coefficients. These methods are exemplified by analysis of plasma fibrinogen and risk of coronary heart disease, and Stata code is made available. Conclusion Increasing numbers of meta-analyses of individual participant data from observational data are being conducted to enhance the statistical power and detail of epidemiological studies. The statistical methods developed here can be used to address the needs of such analyses. © The Author 2010; all rights reserved
