A 47-year-old male had bilateral upper extremity thrombophlebitis after use of intravenous amiodarone for sustained ventricular tachycardia complicating myocardial infarction. Intravenous amiodarone has been widely used since it was introduced 20 years ago for severe intractable arrhythmias. Superficial thrombophlebitis was frequently noted in the early case reports when high-dose intravenous amiodarone was used. Superficial thrombophlebitis could extend hospitalization and become a significant source of distress to our patients. Some authors recommend insertion of a central line to administer intravenous amiodarone especially with expected extended use of therapy. The treating physician should be vigilant and switch from intravenous therapy to oral therapy as soon as the patient's condition stabilizes and oral therapy can be started.

Doxorubicin is one of the most potent anticancer drugs used in the treatment of wide spectrum of neoplastic diseases including breast, thyroid, colon and liver cancer. However, doxorubicin use is associated with undesirable side effects including cardiomyopathy and congestive heart failure. In the present study we have established that treatment of rat cardiac myoblasts (H9c2 cells) with doxorubicin resulted in H9c2 cell injury in a dose and time dependent manner with almost 50% cell death obtained at 5 μM of doxorubicin treatment for 24 hours. We have selected about 50% cell injury as optimum doxorubicin-induced cell injury because once this threshold is reached, cells became irreversibly injured and could not respond to protective treatment. Another potent antineoplastic drug cyclophosphamide had no cardiotoxic effects on H9c2 cells even at 35 μM concentration and up to 72 hours of treatment. Pretreatment of H9c2 cells for 24 hours with dexamethasone, cortisol, corticosterone or progesterone, significantly protect H9c2 myoblasts against subsequent 5 μM doxorubicin treatment for 24 hours in a concentration dependent manner with maximum protection obtained at 100 nM dexamethasone, 100 nM progesterone, 500 nM cortisol and 500 nM corticosterone. However, testosterone or dehydroepiandrosterone had no protective effects even at 10 μM concentration. It is concluded that both glucocorticoids and progesterone protect H9c2 cells against doxorubicin-induced cell injury.

Problem: There are a significant proportion of patients taking acetylcholinesterase inhibitors (ChEi) for cognitive dysfunction also taking medications with anticholinergic (ACh) properties that may counteract their effects. As the number of ACh medications, burden, increases so does the likelihood of an adverse outcome.Background: ACh medications are frequently used in the elderly population (Carnahan 2004) even those with dementia or AD (Roe et al., 2002; Giron et al., 2001; Altavela 2003; Gill et al., 2005; Kogut et al., 2005). Methods: Hospitalized patients > 65 years of age with dementia (AD, other dementias, or with inferred dementia based on ChEi or NMDA antagonist medication use) were studied using UHC clinical database. This document was created in Microsoft Word 2000. Results: Dementia patients on ChEi therapy were more likely to receive an ACh (chi-square 70.1, df=l, pConclusion: A person's age and mental health status along with their current drug regimen, such as ChEi therapy, need to be closely and carefully considered before deciding to use unnecessary ACh drugs in this population which can have detrimental effects.

SAMMANFATTNING Syfte: Syftet med denna studie var att på ett sjukhus i Mellansverige undersöka hur tillfredställda patienterna var med information om läkemedelsbiverkningar Syftet var även att undersöka grad av oro över eventuella biverkningar och jämföra om det fanns någon könskillnad gällande detta. Metod: Studiens design var en kvantitativ tvärsnittsstudie med deskriptiv och jämförande statistik. Data samlades in genom en Studiespecifik enkät. Antalet svarande var 29 inneliggande patienter under 10 veckor som uppfyllde inklusionskriterierna. Resultat: Resultatet visade att hälften av deltagarna inte hade fått information om läkemedelsbiverkningar och att 78 % uppgav sig vilja ha mer information. Nio av tio deltagare instämde till att vara oroliga över eventuella biverkningar och 64 % uppgav att de var osäkra eller inte visste vart de skulle vända sig vid frågor om biverkningar. Trots detta var drygt hälften av deltagarna delvis eller helt nöjda med den information de fått. Ingen statistik signifikant könsskillnad kunde påvisas i grad av oro. Slutsats: Resultatet visar att mer och tydligare information bör ges till patienterna om eventuella läkemedelsbiverkningar. Vidare forskning är nödvändigt då mätningen av tillfredställelse ger ett motsägelsefullt resultat. / ABSTRACT Aim: The aim of this study was to investigate how satisfied patients where with information about medical side effects in a hospital in central Sweden. The aim was also to investigate the level of worry for any side effects and compare the level of worry between genders. Method: The design of the study was quantitative, cross-sectional. Data were collected through a study specific questionnaire. Respondents were 29 hospitalized patients who met the inclusion criteria during a 10 week period. Findings: The results showed that half of the participants had not received information about medical side effects and that 78% claimed they wanted more information. Nine out of ten participants agreed with being concerned about possible medical side effects and 64% said they were unsure or did not know where to turn with questions about side effects. Despite this, over half of the participants were partially or completely satisfied with the information they had received. No difference was detected in the level of worry between genders. Conclusion: The results show that more information and more distinct information should be given to patients about possible medical side effects. Further research is necessary since the measuring of satisfaction gives a contradictory result

The thesis has closely examined that an important shortcoming of the Keynesian analysis is the neglect of potential tax-induced aggregate supply effects, and therefore, just as Marshall's proverbial scissors with one "misplaced" blade, the government cannot make proper policy decision. Hence, this paper incorporates the tax-induced aggregate supply effects into the analysis. When a model does not include the supply-side effects of tax-induced, it degrades to a Ramirez (1986) and cannot be sued for policy assignment. On the other hand, a model incorporates the tax-induced aggregate supply effects remedies the flaws in Ramirez (1986) and can be used for appropriate policy assignment.

No description available.

Sripada and Konrath (forthcoming) use Structural Equation Modeling techniques to provide empirical evidence for the claim that implicit and automatic inferences about people’s dispositions, and not normative judgments, are the driving cause behind the pattern of folk judgments of intentional action in Knobe’s (2003a) chairman case. However, I will argue that their evidence is not as strong as they claim due to the potential of methodological and statistical problems with the way they tested their model. After correcting for these problems, I show that even after accounting for the role of dispositional inferences, normative judgments are still playing a significant role in folk judgments of intentional action.

A possible treatment for patients with lymphoma and myeloma is stem cell transplantation (SCT). SCT is preceded with cytostatic treatment. There are several side effects related to this treatment, for example fatigue, nausea, constipation/diarrhoea, pain, mucositis and loss of appetite. Aim: Investigate which side effects related to the treatment where most troubling after SCT and if nurse assessment and patient assessment differ. Methods: A quantitative empirical study with repeated measuring. The two groups of nurses and patients answered a form independently. Results: Loss of appetite and fatigue are the most troubling side effects according to both nurse and patient. Older patients tended to be more affected by fatigue. The nurses estimated the side effects such as loss of appetite, fatigue, diarrhoea and nausea lower than the patients did. Conclusion: No definitive conclusion could be made because of the small patient/nurse sample. However, there is a tendency showing difficulty for nurses to estimate correctly the side effects suffered by the patients. The nurses tend to estimate the side effects lower than the patients do.

No description available.

Background: Cancer-related fatigue is one of the most common symptom experienced by cancer patients throughout their cancer trajectory. However, very little effort has been made within many oncology practices to assess this clinical problem and to provide timely nursing interventions to reduce its impact. While there have been tremendous advancements in the treatments of the disease aspects of cancer in term of medicine and advanced technology, basic assessment of related physiological concerns, such as fatigue, have not seen the same progress. Purpose: The purpose of this quality improvement project was to develop an evidence-based cancer-related fatigue assessment guideline and a screening protocol adopted from the National Comprehensive Cancer Network algorithm to assess cancer-related fatigue for oncology patients at their initial visit to the oncology unit toward timely intervention. Theoretical Framework: The ADAPTE collaboration model was used. This is an international framework that provides guidance on guidelines development and modification for healthcare providers. Method: This initiative began with a series of formal and informal conversations with major key stakeholders who were primarily the front-line oncology nurses at the practice unit. Based on the need of the unit, a consensus was reached to modify an existing clinical tool currently used to screen patients for emotional distress and to develop a clinical tool and guideline to screen cancer patient to reduce cancer-related fatigue as well. Outcome and Result: A clinical assessment tool was developed based on the patient population needs and the nursing staff concerns to yield an outcome that met the needs of this patient population. An evidence-based assessment guideline was introduced to key stakeholders and recommendations were made to integrate the new revised guideline into practice. The research department, professional practice, and the performance leadership continue to revise the current protocol to include continuous assessment of cancer-related fatigue into policy and procedure. Conclusion: This quality improvement project once implemented will benefit cancer patients as well as oncology practitioners by use of available resources and evidence-based guidelines to improve nursing practice and patient quality of life.