Subjects presented at ASHP Midyear Clinical Meetings, 1967-90

The subject matter and trends of presentations made at ASHP Midyear Clinical Meetings (MCMs) were studied. A computerized database of information from MCM and Annual Meeting (AM) program and abstract books was created. The data were analyzed to determine the distribution of MCM presentations by subject and by author for the period 1967 to 1990, determine if there were differences in subjects covered between MCMs and AMs, explore the proposition that there has been duplication of material in MCM presentations, and evaluate the frequency with which MCM presentations have been published in ASHP journals. The total number of presentations made at MCMs from 1967 through 1990 was 8180, while the total for the AMs was 1547 for the two periods (1962-71 and 1985-90) studied. The most common keywords in titles were "pharmacy," "drug," "patient," "hospital," and "service." All International Pharmaceutical Abstracts subject categories and two other categories were represented; presentations in the institutional pharmacy practice category were the most frequent, while pharmacognosy-related presentations were least frequent. The overwhelming number of authors made only one presentation and were listed as the first author. The subjects of presentations were similar between AMs and MCMs. A tendency toward duplication of material was found. Of the 8180 MCM presentations, at least 1005 were published in an ASHP journal. Between 1967 and 1990, presentations at MCMs covered a wide range of subjects but were sometimes duplicative or not on the cutting edge.     

Three-year outcome after balloon aortic valvuloplasty. Insights into prognosis of valvular aortic stenosis

BACKGROUND: To identify predictors of long-term outcome after balloon aortic valvuloplasty, we analyzed data on 674 adults (mean age, 78 +/- 9 years; 56% were women) undergoing this procedure at 24 clinical centers who had a mean initial increase in aortic valve area of 0.3 cm2. METHODS AND RESULTS: Baseline data included clinical, echocardiographic, and catheterization variables. Follow-up data included mortality, cause of death, rehospitalization, 6-month echocardiography, and functional status. Kaplan-Meier curves and log-rank tests were used to evaluate survival in subgroups. Multivariate Cox regression models were used to identify independent predictors of survival. Overall survival was 55% at 1 year, 35% at 2 years, and 23% at 3 years, with the majority of deaths (70%) classified as cardiac by an independent review committee. Rehospitalization was common (64%), although 61% of survivors at 2 years reported improved symptoms. Echocardiography at 6 months (n = 115) showed restenosis from the postprocedural valve area of 0.78 +/- 0.31 cm2 to 0.65 +/- 0.25 cm2 (P < .0001). With stepwise multivariate analysis, sequentially adding clinical, echocardiographic, and catheterization variables, the overall model identified independent predictors of survival as baseline functional status, baseline cardiac output, renal function, cachexia, female gender, left ventricular systolic function, and mitral regurgitation. Baseline and postprocedural variables were examined to identify which subgroup of patients has the best outcome after aortic valvuloplasty. A "lower-risk" subgroup (28% of the study population), defined by normal left ventricular systolic function and mild clinical functional limitation, had a 3-year survival of 36% compared with 17% in the remainder of the study group. CONCLUSIONS: Long-term survival after balloon aortic valvuloplasty is poor with 1- and 3-year survival rates of 55% and 23%, respectively. Although survivors report fewer symptoms, early restenosis and recurrent hospitalization are common.     

Thermodynamic magnetization discontinuity between the A and B phases of superfluid3he

We present data for the magnitude of the thermodynamic magnetization discontinuity at the equilibrium A-B transition in superfluid³He, M_AB, over its entire pressure-temperature-magnetic field phase diagram. The data was taken by measuring flux changes in a SQUID pick-up coil, which was calibrated by a novel first-principles technique. We compare our results with those of NMR experiments, and find that the two types of measurements yield different values, and this discrepancy is not the result of thermometry or field errors.     

Evidence for Glass–glass Interfaces in a Columnar Cu–Zr Nanoglass

Comprehensive analyses of the atomic structure using advanced analytical transmission electron microscopy-based methods combined with atom probe tomography confirm the presence of distinct glass–glass interfaces in a columnar Cu-Zr nanoglass synthesized by magnetron sputtering. These analyses provide first-time in-depth characterization of sputtered film nanoglasses and indicate that glass–glass interfaces indeed present an amorphous phase with reduced mass density as compared to the neighboring amorphous regions. Moreover, dedicated analyses of the diffusion kinetics by time-of-flight secondary ion mass spectroscopy (ToF SIMS) prove significantly enhanced diffusivity, suggesting fast transport along the low density glass–glass interfaces. The present results further indicate that sputter deposition is a feasible technique for reliable production of nanoglasses and that some of the concepts proposed for this new class of glassy materials are applicable.     

Synthesis,structural and optical properties of nanoparticles (Al,V) co-doped zinc oxide

The synthesis by the sol–gel method, structural and optical properties of ZnO, Zn_0.99Al_0.01O (AlZ), Zn_0.9V_0.1O (VZ) and Zn_0.89Al_0.01V_0.1O (AlVZ) nanoparticles was reported. The approach was slow release of water for hydrolysis by esterification reaction followed by a supercritical drying in ethyl alcohol. After thermal treatment at 500^°C in air, the obtained nanopowders were characterized by various techniques such as transmission electron microscopy, X-ray diffraction and photoluminescence (PL) spectroscopy. The structural properties showed that the ZnO nanoparticles with an average particle size of 25 nm exhibit hexagonal wurtzite structure. From the optical studies, it was found that the optical band gap was located between 2.97 and 3.17 eV. The obtained electrical properties showed the potential application of the samples in optoelectronic devices. The powder of AlVZ presented a strong luminescence band in the visible range. The PL band energy position presented a small blue shift with the increase of measurement temperature. Different possible attributions of this emission band will be discussed.     

Microalgae-Based Biohybrid Microrobot for Accelerated Diabetic Wound Healing

A variety of wound healing platforms have been proposed to alleviate the hypoxic condition and/or to modulate the immune responses for the treatment of chronic wounds in diabetes. However, these platforms with the passive diffusion of therapeutic agents through the blood clot result in the relatively low delivery efficiency into the deep wound site. Here, a microalgae-based biohybrid microrobot for accelerated diabetic wound healing is developed. The biohybrid microrobot autonomously moves at velocity of 33.3 µm s⁻¹ and generates oxygen for the alleviation of hypoxic condition. In addition, the microrobot efficiently bound with inflammatory chemokines of interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) for modulating the immune responses. The enhanced penetration of microrobot is corroborated by measuring fibrin clots in biomimetic wound using microfluidic devices and the enhanced retention of microrobot is confirmed in the real wounded mouse skin tissue. After deposition on the chronic wound in diabetic mice without wound dressing, the wounds treated with microrobots are completely healed after 9 days with the significant decrease of inflammatory cytokines below 31% of the control level and the upregulated angiogenesis above 20 times of CD31⁺ cells. These results confirm the feasibility of microrobots as a next-generation platform for diabetic wound healing.     

Wavelet transforms for detecting microcalcifications in mammograms

Clusters of fine, granular microcalcifications in mammograms may be an early sign of disease. Individual grains are difficult to detect and segment due to size and shape variability and because the background mammogram texture is typically inhomogeneous. The authors develop a 2-stage method based on wavelet transforms for detecting and segmenting calcifications. The first stage is based on an undecimated wavelet transform, which is simply the conventional filter bank implementation without downsampling, so that the low-low (LL), low-high (LH), high-low (HL), and high-high (HH) sub-bands remain at full size. Detection takes place in HH and the combination LH+HL. Four octaves are computed with 2 inter-octave voices for finer scale resolution. By appropriate selection of the wavelet basis the detection of microcalcifications in the relevant size range can be nearly optimized. In fact, the filters which transform the input image into HH and LH+HL are closely related to prewhitening matched filters for detecting Gaussian objects (idealized microcalcifications) in 2 common forms of Markov (background) noise. The second stage is designed to overcome the limitations of the simplistic Gaussian assumption and provides an accurate segmentation of calcification boundaries. Detected pixel sites in HH and LH+HL are dilated then weighted before computing the inverse wavelet transform. Individual microcalcifications are greatly enhanced in the output image, to the point where straightforward thresholding can be applied to segment them. FROG curves are computed from tests using a freely distributed database of digitized mammograms.     

Refining the level for anticipated hepatotoxicity in acetaminophen poisoning

Treatment of an acetaminophen overdose with N-acetyl cysteine usually is based on the position of the 4-h acetaminophen (APAP) level on the Rumack-Matthew nomogram; however, there is disagreement on the level at which clinically relevant hepatotoxicity occurs. A retrospective review of all acute adult formulation APAP exposures reported to our poison center between 1986 and 1993 was performed and cases corresponding to the "possible risk or toxicity" range on the nomogram were identified. Our current poison center protocol for APAP poisoning does not recommend treatment with N-acetylcysteine (NAC) in low-risk patients if the 4-h serum APAP level or the extrapolated equivalent falls within the possible toxicity range on the nomogram. Seventeen cases met the inclusion criteria for the study and received no NAC; six additional patients met inclusion criteria but received one or two doses of NAC before therapy was discontinued. No patients in either group demonstrated clinical evidence of hepatotoxicity. This pilot study suggests that patients with no risk factors and APAP levels in the "possible risk" range may not require NAC therapy.     

GPU-based real-time approximation of the ablation zone for radiofrequency ablation

Percutaneous radiofrequency ablation (RFA) is becoming a standard minimally invasive clinical procedure for the treatment of liver tumors. However, planning the applicator placement such that the malignant tissue is completely destroyed, is a demanding task that requires considerable experience. In this work, we present a fast GPU-based real-time approximation of the ablation zone incorporating the cooling effect of liver vessels. Weighted distance fields of varying RF applicator types are derived from complex numerical simulations to allow a fast estimation of the ablation zone. Furthermore, the heat-sink effect of the cooling blood flow close to the applicator's electrode is estimated by means of a preprocessed thermal equilibrium representation of the liver parenchyma and blood vessels. Utilizing the graphics card, the weighted distance field incorporating the cooling blood flow is calculated using a modular shader framework, which facilitates the real-time visualization of the ablation zone in projected slice views and in volume rendering. The proposed methods are integrated in our software assistant prototype for planning RFA therapy. The software allows the physician to interactively place virtual RF applicator models. The real-time visualization of the corresponding approximated ablation zone facilitates interactive evaluation of the tumor coverage in order to optimize the applicator's placement such that all cancer cells are destroyed by the ablation.