Psychosocial functioning of parents of Dutch long-term survivors of childhood cancer.

Objective: To describe health-related quality of life (HRQoL), post-traumatic stress and post-traumatic growth of parents of long-term survivors of childhood cancer (CCS) and study associated factors.

Methods: Parents of survivors of the Dutch Childhood Cancer Survivor Study LATER cohort below 30 years and diagnosed 1986-2001 were invited to complete the TNO-AZL Questionnaire for Adult's HRQoL (e.g.

Medication reconciliation: the priority that isn't.

Medication reconciliation is a crucial step in safe care, but it is often done inconsistently or inadequately, or missed altogether. This can be dangerous and even deadly for patients, and expensive for the system. In this article, the authors discuss the current status of medication reconciliation in Canada, barriers to its implementation and steps healthcare organizations across the country are taking to introduce medication reconciliation.

24-hour bronchodilation following a single dose of the novel β(2)-agonist olodaterol in COPD.

Background: Current guidelines recommend long-acting bronchodilators as maintenance therapy in COPD when symptoms are not adequately controlled with short-acting agents. Olodaterol is a novel long-acting β(2)-adrenoceptor agonist with a pre-clinical profile that suggests 24-h bronchodilation may be achieved with once-daily administration.

Objective: To assess dose- and time-response in terms of bronchodilator efficacy, and to evaluate pharmacokinetics, safety and tolerability of single doses of olodaterol administered via Respimat(®) Soft Mist™ Inhaler in COPD patients.

Intensive support to improve clinical decision making in cardiovascular care: a randomised controlled trial in general practice.

Objective: To evaluate the effects of feedback reports combined with outreach visits from trained non-physicians on the clinical decision making of general practitioners (GPs) in cardiovascular care.

Design: Pragmatic cluster controlled trial with randomisation of practices to support (intervention group) or no special attention (control group); analysis after 2 years.

Setting: 124 general practices in The Netherlands.

Polymorphic drug metabolism (CYP2D6) and utilisation of psychotropic drugs in hospitalised psychiatric patients: a retrospective study.

Aim: The aim of the current retrospective study was to assess the influence of polymorphic drug metabolism as assessed by genotyping, on the on the utilisation of psychotropic drugs in hospitalised psychiatric patients. The utilisation of psychotropic drugs was assessed using pharmacy records with emphasis on the number of prescriptions and prescriptions for possible side effects.

Methods: CYP2D6 genotype was assessed in 241 psychiatric patients by investigation for the five most common allelic variants ( CYP2D6*3, *4, *6, *7, *8) and the presence of gene duplication using allele-specific polymerase chain reaction.

Provision of information and advice in cardiovascular care: clinical performance of general practitioners.

The aim of this study was to assess the provision of information and advice by general practitioners (GPs) with respect to patients with hypertension, hypercholesterolaemia, or cardiovascular disease. The study relied on the prospective recording of patient encounters by GPs. Performance indicators were selected from the Dutch national guidelines for general practice.

Health perception of patients after cardiovascular risk detection and after intervention in general practice.

BACKGROUND. To explore unfavorable effects, health perception was assessed in patients enrolled in a cardiovascular program in general practice. METHODS.

Blood pressure control in treated hypertensive patients: clinical performance of general practitioners.

Background: The blood pressure of many treated hypertensive patients remains above recommended target levels. This discrepancy may be related to general practitioners' (GPs') actions.

Aim: To assess clinical performance of GPs in blood pressure control in treated hypertensive patients and to explore the influence of patient and GP characteristics on clinical performance.

Cardiovascular risk detection and intervention in general practice: the patients' views.

Objective: To assess patients' views on the organization of (cardiovascular) preventive care.

Design: Prospective questionnaire survey with measurements shortly after risk assessment (T1) and after 1 year of risk intervention (T2).

Setting: Twenty-seven general practices participating in a project to enhance systematic cardiovascular disease prevention in two regions in The Netherlands.

Tailored outreach visits as a method for implementing guidelines and improving preventive care.

Objectives: Authors of successful outreach visit studies stress the importance of tailoring the intervention to the unique attributes and needs of each practice. For a better understanding of the outreach visit method, the tailoring mechanism is explored in this article. The variation among practices in preventive outreach visits to implement guidelines and characteristics that determine the variation (baseline adherence to organizational guidelines, practice and visitor characteristics) are described.

Relationship between practice organization and cardiovascular risk factor recording in general practice.

Background: Research findings suggest that the level of cardiovascular risk factor recording in general practice is not yet optimal. Several studies indicate a relation between the organization of cardiovascular disease prevention at practice level and cardiovascular risk factor recording.

Aim: To explore the relation between the organization of cardiovascular disease prevention and risk factor recording in general practice.

Barriers to preventive care in general practice: the role of organizational and attitudinal factors.

Background: There are numerous barriers to preventive care. In this paper we focus on barriers related to the organization of preventive services and to the general practitioners' (GPs') attitudes and self-efficacy expectations. The prevention of cardiovascular disease was taken as a case study.

Changing preventive practice: a controlled trial on the effects of outreach visits to organise prevention of cardiovascular disease.

Objectives: To assess the effects of outreach visits by trained nurse facilitators on the organisation of services used to prevent cardiovascular disease. To identify the characteristics of general practices that determined success.

Design: A non-randomised controlled trial of two methods of implementing guidelines to organise prevention of cardiovascular disease: an innovative outreach visit method compared with a feedback method.

Effects of medroxyprogesterone acetate on appetite, weight, and quality of life in advanced-stage non-hormone-sensitive cancer: a placebo-controlled multicenter study.

Purpose: To investigate the effects of medroxyprogesterone acetate (MPA) on appetite, weight, and quality of life (QL) in patients with advanced-stage, incurable, non-hormone-sensitive cancer.

Patients And Methods: Two hundred six eligible patients were randomized between double-blind MPA 500 mg twice daily or placebo. Appetite (0 to 10 numerical rating scale), weight, and QL (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC-QLQ-C30]) were assessed before the start of treatment (t = 0), and 6 weeks (t = 6) and 12 weeks (t = 12) thereafter.

Clinical significance of intranodal and extranodal growth in lymph node metastases of non-small cell lung cancer.

In non-small cell lung cancer with mediastinal lymph node metastasis, intranodal growth is regarded as prognostically more favourable than extranodal growth. We evaluated the clinical implications. Mediastinal lymph node metastases removed at mediastinoscopy and/or surgery were classified as intranodal, extranodal or indefinite.

Identification with liquid chromatography-ionspray mass spectrometry of the metabolites of the enantiomers N-methyl dextrorphan and N-methyl levorphanol after rat liver perfusion.

To gather more information on stereochemical factors in the hepatic disposition of organic cations, mass spectrometry coupled to liquid chromatography was used to determine the identity of the metabolites excreted in bile after isolated rat liver perfusions with the quaternary ammonium derivatives of the enantiomeric drugs dextrorphan and levorphanol. Ionspray mass spectrometry was chosen for its soft ionization and absence of thermal degradation of labile compounds. The drugs were labelled with a stable (2H) isotope and mixed with unlabelled drugs to create an artificial isotope pattern in the mass spectrum and facilitate the recognition of unknown metabolites.

Impact of structural differences on the in vitro glucuronidation kinetics of potentially dopaminergic hydroxy-2-aminotetralins and naphthoxazines using rat and human liver microsomes.

The in vitro glucuronidation of seven monohydroxy-2-aminotetralins and two naphthoxazines has been determined using human and rat liver microsomes. All these compounds stimulate the D2 dopamine receptor. The influence of the position of the phenolic hydroxyl group was studied with rat microsomes in monohydroxy-2-(N,N-dipropylamino)-tretralins.

Metabolism and disposition of the dopamine agonist 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin in conscious monkeys after subsequent i.v. oral, and ocular administration.

The metabolism of 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (N-0437) was investigated in conscious monkeys after subsequent i.v., oral, and ocular administration.

Ocular and systemic disposition of the dopamine agonist N-0437 in monkeys after ocular administration.

The ocular and systemic disposition of the new dopamine agonist 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (N-0437) was investigated in conscious monkeys after ocular administration of 0.56 mg N-0437. HCl (corresponding to 0.

Metabolic conversion of cyoctol during skin passage in humans.

Upon application of 14C-labeled cyoctol to the forearm of healthy volunteers, no parent cyoctol was detectable in ipsilateral blood plasma. The 14C activity was largely accounted for by a component with higher lipophilicity than the parent compound, as justified from their HPLC retention. Thus, this study suggests that human skin is capable of nearly complete cutaneous first-pass metabolism, resulting in negligible systemic availability of cyoctol.

Disposition and metabolic profiling of the penetration enhancer Azone. I. In vitro studies: urinary profiles of hamster, rat, monkey, and man.

Chain-labeled 14C-Azone was intravenously administered to hamster, monkey, and rat, to compare its metabolic profile with that obtained previously in humans after dermal application. Azone-derived radioactivity was excreted predominantly in the urine for both hamster and monkey, which is similar to the disposition in humans. Metabolic profiling in urine revealed extensive systemic metabolism to occur in all species studied.

The metabolic fate of the dopamine agonist 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin in rats after intravenous and oral administration. II. Isolation and identification of metabolites.

1. The in vivo metabolic pathways of 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin (I) in rats have been established, using in vitro metabolism as a complementary technique. 2.

The metabolic fate of the dopamine agonist 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin in rats after intravenous and oral administration. I. Disposition and metabolic profiling.

1. The disposition and metabolic profiling of 2-(N-propyl-N-2-thienylethylamino)-5-hydroxytetralin(I), a dopamine agonist, were studied in anaesthetized rats after i.v.