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In Belcher v. Charleston Area Medical Center W.Va. 1992 ; , for example, the parents of a 17-year-old child who was suffering from muscular dystrophy and related serious illness executed a "do not resuscitate" order. After the child died, the parents sued the hospital, alleging that the child's consent to the order was required. The court recognized the common law mature minor exception to parental consent and remanded the case for a determination of whether the child was mature. If the child was mature, the child's consent was needed, but otherwise the parents' consent was sufficient. p.345 ; . So, let me get this straight: the parents asked the hospital not to resuscitate the kid, and then sued the hospital for doing as they asked? How did this come about? And what was the outcome? This little "Nutshell" book leaves me hanging! Some facts or data cited by the book may surprise the reader: "According to a 1999 study, approximately 2-5% of adults in the United States are compulsive and problem gamblers. By contrast, 6-12% of 13-17-year-olds have serious gambling problems" p. 435 ; . I suspect the study's definition of a "gambling problem" skewed the results--if, for example, they used "law-breaking" as an aspect of having a "gambling problem, " many kids would be unfairly labeled, since certain gambling activities are legal for adults, but not for minors. ; Elsewhere, the book states without qualification, "many sex offenders are not recidivists" p. 235 ; --not surprising to me, but contrary to the currently-accepted view of a "sex offender". As I said, reading this stuff can be depressing--there's not much here to help individual kids or the youth rights movement --but it's good to know where we stand. The inadequacy of the case descriptions might motivate a reader to do further research. And the authors do occasionally express a bit of sympathy for kids, as in this passage: By characterizing commitment as voluntary and assuming that custodians act in the child's best interests, Parham reached a stark conclusion about the custodial status of children: Children's views play only a negligible role in the commitment process, at least as a constitutional matter p. 324.
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Maximum Dose - discussion from the September meeting tasked EDS with uncovering data regarding requests for physical health medications at doses 200% greater than the FDA recommended dose. Research of the high dose DUR alert for October showed no such claims. The same research did reveal, however, that claims for maintenance ophthalmic preparations are being submitted inappropriately in many situations. Data revealed that pharmacies are submitting claims for 5 and 10ml bottles of medication for as little as a 5 day supply when the 10ml bottles based on FDA dosing guidelines ; should essentially last for up to 50 days. The Board agreed to the medications being placed on a pharmacy limitation edit at a rate of 1 3 the medication being given to waste.
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Can anyone tell me if it clinically important to give vitamin K to babies within 1 hour of birth vs several hours later? Currently, we are giving IM vitamin K to our babies in labor and delivery. I would like to change our practice to giving vitamin K in the nursery due to errors where the baby inadvertently was given IM oxytocin Pitocin and the mom received vitamin K ; . This would eliminate the possibility of medication errors, but may result in the baby getting vitamin K outside the 1hour policy. --Al Carlson Fairview Ridges Hospital Burnsville, MN.
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Stimulant medications: This class of medications is considered to be the most controversial, although it is also the best studied and validated. They are often prescribed to treat Attention Deficit Hyperactivity Disorder ADHD ; . Stimulants enhance attention span and reduce impulsivity, which can result in better work productivity and help children benefit more readily from instruction. Stimulant medication is often most beneficial when combined with other strategies such as teaching social skills.
Second generation photosensitiser for photodynamic therapy. # Given i.v. temoporfin is widely distributed around the body but malignant tissue has impaired elimination, resulting in accumulation in cancer cells. When exposed to laser light, temoporfin is activated, releasing energy which causes cancer cell death up to a depth of 15mm, without damaging the surrounding tissue collagen structure. This allows normal cells to regrow without scarring or ulceration in most cases. Temoporfin can be activated by many commercially available pumped dye and diode lasers, unlike most other photosensitisers. # The FDA has granted orphan drug status to temoporfin for the palliative treatment of recurrent, refractory or second primary squamous cell carcinomas of the head and neck. After an initial negative opinion it was approved in the EU in June 2001. : emea .int pdfs human opinion 1739801en However, the company is not in a strong financial position and is in talks with a preferred bidder for future development and funding of the product and mexitil.
Fourth Quarter 2003 Dollars in Millions, Except per Share Data Net Sales Gross Margin Net Earnings 1 ; Earnings per Common Share: Basic Diluted 3 ; Dividends declared per common share Cash and cash equivalents Marketable securities As Reported $5, 665 3, 563 $ 506 $ .26 $ .26 $ .28 $2, 444 $3, 013 Fourth Quarter As Previously As Reported Restated $4, 794 $4, 811 3, 028 $ 374 -- $ 374 $ 427 38 $ 465.
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Purpose. The scope of medication therapy management services MTMS ; is defined, opportunities for pharmacists to influence change in the pharmacy profession by embracing MTMS, current challenges in providing MTMS, possible solutions to these challenges, and the tipping point that MTMS represents to the pharmacy profession are discussed. Summary. Pharmacist services include a spectrum of activities involving face-toface interaction between a pharmacist and a patient to improve health outcomes, and MTMS is at the high end of this spectrum. MTMS can be provided to fee-for-service and managed care patients as well as to Medicare Part D enrollees. The pharmacy profession faces challenges in implementing MTMS, including inadequate pharmacist participation in and documentation of the value of MTMS.
The main findings from this focused study showed: The Colorado Medicaid program rate 72.0 percent ; for the first measure, Use of Appropriate Medications for People With Asthma, was above the 2003 NCQA National Medicaid HEDIS 90th Percentile of 70.9 percent. The Use of Appropriate Medications for People With Asthma measure rates for the two health plans CO Access and RMHP ; were consistently lower than the rates for PCPP and FFS. The average Colorado Medicaid member with asthma received 3.9 canisters for inhaled, shortacting beta-agonists. Members in the 18-56 year age group were prescribed short-acting beta-agonists nearly twice as often as the other age groups. For those members who received 12 or more canisters of a shortacting beta-agonist, the average member received 18.3 canisters. There appears to be a direct correlation between the first measure, Use of Appropriate Medications for People With Asthma, and the second measure for Overuse of Inhaled, ShortActing Beta-Agonists. A high rate for the first measure is usually associated with a low rate for the second measure. The rates show that the Colorado Medicaid program performs well for asthma medication management. The results from the two quality indicators tend to indicate the vast majority of members with asthma appear to be in control, as defined by this focused study. However, for those members who used more than 12 canisters of a short-acting beta-agonist, the results indicate these members may need more intense case management. HSAG recommends that the data from this study be used to identify members overusing shortacting beta-agonists for targeted intervention. Typically, the older members had a higher rate for overuse of short-acting beta-agonists. In addition, the use of study data to identify members who failed to fill monthly prescriptions for inhaled corticosteroids can further refine the target group. Provider-prescribing practices can also be profiled to identify outliers regarding dispensing, prescribing, and adherence to asthma management guidelines. These targeted physicians can provide a study base in which to implement a practice-based asthma disease management intervention.
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Intravenous antibiotics as an effective therapy concept in chronic recurrent erysipelas. Hautarzt. 1999; 50: 34-38. Stevens DL, Bisno AL, Chambers HF et al. Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis. 2005; 41: 1373-1406. IMS Data: 2003. Wertheim HFL, Melles DC, Vos MC et al.The role of nasal carriage in Staphylococcal aureus infections. Lancet Infect Dis. 2005; 5: 751-762. Creech CB, Kernodle DS et al. Increasing rates of nasal carriage of methicillin-resistant Staphylococcus aureus in healthy children. Pediatr Infect Dis J. 2005; 24: 617-621. Nouwen J, Boelens H, van Belkum A, Verbrugh H. Human factor in Staphylococ-cus aureus nasal carriage. Infect Immun. 2004; 72: 6685-6688. Ellis MW, Hospenthal DR et al. Natural history of communityacquired Methicillin-resistant Staphylococcus aureus colonization and infection in soldiers. Clin Infect Dis. 2004; 39: 971-979. Roth HL opic dermatitis revisited. Int J Dermatol. 1987; 26: 139-149. Gilani SJK, Gonzalez M, Hussain I, Finlay AY, Patel GK. Staphylococcus aureus re-colonization in atopic dermatitis; beyond the skin. Clin Exp Dermatol. 2004; 30: 10-13. Hon KL, Lam MC, Leung TF, et al. Clinical features associated with nasal Staphylococcus aureus colonisation in chinese children with moderate-to-severe atopic dermatitis. Ann Acad Med Singapore. 2005; 34: 602-605. Chiang FY, Climo M. Staphylococcus aureus carriage and healthcare-acquired infection. Curr Infect Dis Rep. 2002; 4: 498-504. Harbarth S, Dharan S, Liassine N, et al. Randomized, placebo-controlled double-blind trial to evaluate the efficacy of mupir-ocin for eradicating carriage of Methicillinresistant Staphylococcus aureus. Antimicrob Agents Chemother. 1999; 43: 1412-1416. Webster J. Handwashing in a neonatal intensive care nursery: product acceptability and effectiveness of chlorhexidine gluconate 4% and triclosan 1%. J Hosp Infect. 1992; 21: 137-141.
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Meda expands the collaboration with Recordati, a European pharma company based in Italy, by signing a long-term agreement for marketing a new combination product in Spain one of the largest European markets. The combination product consists of lfrcanidipine calcium antagonist ; and enalapril an ACE inhibitor ; two well-known pharmaceutical substances. The product is indicated for the treatment of high blood pressure. Meda already has marketing rights for this combination product in Germany and Scandinavia. The product launch has started in Germany and will be registered in Spain through the mutual recognition procedure.
The NCDA project has demonstrated that community chemists can play an effective role in treating and preventing STIs in resource-constrained settings. The NCDA pilot exemplifies a potential intervention for non-formal community health care workers who can become active caregivers or agents of change in preventing the spread of disease and managing care. Much more can and will be done in the future to strengthen the skills of Nepal's private-sector community chemists. Likewise, other groups or sectors who can play critically important community health roles need encouragement through similar interventions. Nepal's non-formal community health care workers outside of the chemist community include informal health practitioners, ayurvedic doctors, female midwife practitioners and "jhakaris, " or traditional medicine men. These community health care providers come with a variety of formal and very informal education and experiences, but serve essential roles among specific ethnic groups. In some communities, the female midwife practitioners are the first reference point for local health care prior to the chemist. In other communities, the informal health practitioner is considered the local medical expert and may be the preferred service point for disenfranchised individuals. Another related group that could be trained in STI HIV prevention and care is the medical manufacturers'.
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