The Role of Clinical Pharmacists in Patient-Centric Comprehensive Multiple Sclerosis Care.

Background: Individuals with multiple sclerosis (MS) may experience a variety of visible and invisible symptoms and, as they age, comorbidities related and unrelated to their MS. This can result in a complex medication regimen that includes disease-modifying therapies, symptom management drugs, and prescriptions for other comorbid disorders.

Methods: We reviewed the existing literature to discover how to optimally integrate neurology clinical pharmacists into the MS care team and how clinical pharmacists can directly support both providers and patients through their expertise in pharmacology and medication management.

Prevalence of self-reported nonmedical use of prescription stimulants in North Carolina Doctor of Pharmacy students.

Objectives: To evaluate the prevalence, associated factors, and opinions regarding nonmedical use of prescription stimulants (NMUPS) in Doctor of Pharmacy (PharmD) students.

Methods: An electronic survey was distributed to professional year 1 through 4 for students at 2 schools of pharmacy (public and private) in North Carolina. The survey was available for 3 weeks.

[Use and acceptance of classical natural and alternative medicine in Germany--findings of a representative population-based survey].

Background: The use of classical natural therapies and alternative medicine is becoming increasingly popular in Germany and other European countries. Only few population-based studies in Germany have investigated the use and acceptance of a variety of classical and alternative methods, including their possible determinants.

Methods: Cross-sectional survey of a nationally representative sample of men and women aged 18 to 69 years, applying a standardized self-administered questionnaire, that included questions on 21 different healing methods, on personal reasons for use, on individual attitudes to natural therapies, and on the socioeconomic background.

[Effects of Kneippism, a standardized complex therapy, on pain, quality of life and use of medicines: cohort study with a one-year follow-up].

Background: Inpatient as well as outpatient cure in a spa environment with commonly 3- to 4-week duration features a combination of different treatments customized according to the needs of the individual patient. The physiological rationale and the mode of action are widely accepted. However, firm quantitative evidence of the clinical effectiveness is incomplete.

[Hemorheologic findings in diabetes and their clinical relevance].

Diabetics mostly display a deterioration of blood flow properties. Studies of various hemorheological factors in 163 diabetics (96 females, 67 males; 52 subjects with uncomplicated and 49 with proliferative retinopathy) disclosed in comparison to 79 matched controls: Concentrations of macromolecular proteins, especially of fibrinogen, were raised independently of actual diabetic metabolic situation; this was linked with an increase in plasma viscosity and in erythrocyte aggregation, specially pronounced in patients with renal affection. Erythrocyte flexibility assessed by filtration testing was deteriorated in dependence of metabolic control, impairment increasing in patients with progressing diabetic proliferative retinopathy.

Effect of metabolic control and concomitant diseases upon the rheology of blood in different states of diabetic retinopathy.

The flow properties of blood are abnormal in diabetes. The red cell deformability (RCD) is reduced and depends on the metabolic state; the red cell aggregation (RCA) and plasma viscosity are increased independent of the metabolism. According to the following nosological factors 157 diabetics were studied: duration of diabetes, type of therapy, ophthalmoscopic status, metabolic state and general health status.

[Coagulation studies and rheological measurements during streptokinase therapy of myocardial infarction (author's transl)].

In a multicenter, randomized trial of streptokinase in acute myocardial infarction one group of patients was given streptokinase for 24 h; the remainder served as controls and received a placebo infusion instead. Coagulation assays and rheological measurements were serially performed on patients entered into the trial at one of the participating centers. Streptokinase was found to improve considerably the flow properties of blood for a period of time exceeding the duration of its administration.

[Treatment of decompensated valvular disease with nitroglycerin (author's transl)].

The effects of parenteral nitroglycerin after acute and continuous infusion were investigated in 12 patients with mitral and (or) aortic valvular disease (stage IV of the New York Heart Association) and severe therapy-resistant pulmonary congestion. Intravenous injection of 1 mg led to immediate and marked decrease of right atrial mean pressure, and pulmonary artery and pulmonary capillary mean pressures, whereas mean arterial blood pressure, stroke volume index, cardiac frequency, and cardiac index remained unchanged. With a dosage of 3-10 mg/h the pressure lowering of the right circulation could be sustained.

Hemorrheological abnormalities in different states of diabetic retinopathy. Effect of metabolic control and subsequent diseases.

The flow properties of blood are abnormal in diabetes. The red cell deformability (RCD) is reduced and depends on the metabolic state, the red cell aggregation (RCA) and plasma viscosity are increased independent of the metabolism. 157 diabetics were studied according the following nosological factors: duration of diabetes, type of therapy, ophthalmoscopic status, metabolic state and general health status.

[Dopamine and dobutamine in the treatment of severe cardiac failure (author's transl)].

Ten patients in severe cardiac failure were treated with dopamine (4 microgram/kg . min) and dobutamine (7.5 microgram/kg.

[Treatment of bradycardiac arrhythmias with depot-orciprenaline (author's transl)].

24 patients with bradycardiac arrhythmias of various origin were treated with a new depot preparation of orciprenaline. The special galenical preparation guarantees effectiveness ofr 8-10 hours. In 21 patients (87%), therefore, one dragee morning and evening was sufficient to obtain a mean rise in frequency of 57%.

Red cell aggregation in blood flow. II. Effect on apparent viscosity of blood.

The apparent viscosity of blood strongly increases at low shear in rotational viscometers, this phenomenon is based on the reversible formation of red cell aggregates. The magnitude of this increase strongly depends on the hematocrit value, on plasma viscosity and lastly on the microrheological properties of the aggregates. The independent measurement of the microrheological behavior and the effects on viscosity allows a detailed analysis of the hemodynamic effects of red cell aggregates under defined flow conditions in vivo.

Red cell aggregation in blood flow. I. New methods of quantification.

The rheological behavior of normal and pathological red cell aggregates in viscometric flow (artificial flow in cone plate chamber) is studied by direct microscopy, (rheoscopy) viscometry and photometry. Marked differences between normal and pathological blood are measured in the microrheological properties of red cell aggregates; only discreet differences are measured by blood viscometry (macrorheology). Both in normal and abnormal blood, red cell aggregation is a reversible process in the presence of adequate shear forces; their respective influences on apparent blood viscosity at low rates of shear are complex functions of shear rate, shear time, hematocrit and plasma viscosities.