Biotransformation of an uncured composite material

The feasibility of biologically degrading prepreg wastes was studied. The work was conducted with the intention of obtaining baseline data that would facilitate the achievement of two long-range goals. These goals are: (1) the biological remediation of the hazardous components in the prepreg wastes, and (2) providing the potential for recycling the prepreg waste fibers. The experiments examined a prepreg that employs an bismaleimide resin system. Initial results demonstrated an obvious deterioration of the prepreg material when incubated with several bacterial strains. The most active cultures were identified as a mixture of 'Bacillus cereus' and 'Pseudomonas sp'. Gas chromatography analyses revealed seven primary compounds in the resin mixture. Biotransformation studies, using the complete prepreg material, demonstrated on obvious loss of all seven organic compounds. Gas chromatography-mass spectrometry analyses resulted in structure assignments for the two primary components of the resin. Both were analogs of Bisphenol A; one being bismaleimide, and the other being Bisphenol A containing a diglycidyl moiety. The 'diglycidyl analog' was purified using thin-layer chromatography and the biotransformation of this compound (at 27 ug/ml bacterial culture) was monitored. After a seven-day incubation, approximately 40% of the organic compound was biotransformed. These results demonstrate the biotransformation of the prepreg resin and indicate that biological remediation of the prepreg wastes is feasible

Cost-effectiveness of intermediate or long-acting insulin versus Exenatide in type 2 diabetes mellitus patients not optimally controlled on dual oral diabetes medications

Objective: To better understand exenatide¿s role in the treatment of type 2 diabetes, this analysis assessed its cost-effectiveness in comparison to an intermediate (NPH) and long-acting insulin (glargine). Exenatide is a recently approved medication for the treatment of type 2 diabetes for use in addition to frequently used oral diabetes medications. Methods: Two studies were identified by a Medline search (1996-Oct 2005) that were similar in study duration, baseline glycemic control, population size, and primary outcomes to appropriately assess the cost-effectiveness of either insulin in comparison to exenatide on both glycemic and weight control. Results: Both NPH and glargine appear to be more cost effective than exenatide with respect to glycemic control (incremental CE ratios -1,968 and -65,520 respectively). Exenatide appears to be more cost effective for reductions in body weight than either NPH (CE ratio 235) or glargine (CE ratio 128). Conclusions Compared to intermediate and long-acting insulin therapies, exenatide does not appear to be as cost effective for the treatment of type 2 diabetes

Cost-effectiveness of intermediate or long-acting insulin versus Exenatide in type 2 diabetes mellitus patients not optimally controlled on dual oral diabetes medications

Objective: To better understand exenatide¿s role in the treatment of type 2 diabetes, this analysis assessed its cost-effectiveness in comparison to an intermediate (NPH) and long-acting insulin (glargine). Exenatide is a recently approved medication for the treatment of type 2 diabetes for use in addition to frequently used oral diabetes medications. Methods: Two studies were identified by a Medline search (1996-Oct 2005) that were similar in study duration, baseline glycemic control, population size, and primary outcomes to appropriately assess the cost-effectiveness of either insulin in comparison to exenatide on both glycemic and weight control. Results: Both NPH and glargine appear to be more cost effective than exenatide with respect to glycemic control (incremental CE ratios -1,968 and -65,520 respectively). Exenatide appears to be more cost effective for reductions in body weight than either NPH (CE ratio 235) or glargine (CE ratio 128). Conclusions Compared to intermediate and long-acting insulin therapies, exenatide does not appear to be as cost effective for the treatment of type 2 diabetes

Opinions of West Texas pharmacists about emergency contraception.

Background: The pharmacist¿s role in dispensing emergency contraception (EC) has become controversial due to the intersection of personal and professional ethics. Therefore, to examine the issue of EC availability, we surveyed a sample of West Texas pharmacists. West Texas is a religiously and politically conservative region where no methods of EC have been made available. Objective: to survey a sample of pharmacists in West Texas about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC. Methods: We asked a convenience sample of 75 pharmacists about their experience, beliefs, and knowledge of EC both before and after a presentation of the current literature about EC. Results: Sixty-four (85%) pharmacists agreed to complete the study questionnaire. None carries EC in his/her pharmacy, and scientific understanding of EC was generally poor. Fourteen percent stated EC conflicts with their religious views, 17% considered it a method of abortion, 11% would not be willing to fill an EC prescription written by a doctor. 58% would be willing to offer EC over the counter. The presentation encouraged more to offer it over the counter, but in general did not significantly change their beliefs. Conclusion: Our sample of West Texas pharmacists demonstrated very little experience with, a general lack of knowledge about, and some personal and religious objections to EC

A collaborative cardiologist-pharmacist care model to improve hypertension management in patients with or at high risk for cardiovascular disease

Physician led collaborative drug therapy management utilizing clinical pharmacists to aid in the medication management of patients with hypertension has been shown to improve blood pressure control. With recommendations for lower blood pressures in patients with coronary artery disease, a cardiologist-pharmacist collaborative care model may be a novel way to achieve these more rigorous goals of therapy. Objective: The purpose of this project was to evaluate this type of care model in a high cardiac risk patient population. Methods: A retrospective cohort study determined the ability of a cardiologist-pharmacist care model (n=59) to lower blood pressure and achieve blood pressure goals (< 130/80 mmHg) in patients with or at high risk for coronary artery disease compared to usual cardiologist care (n=58) in the same clinical setting. Results: The cardiologist-pharmacist care model showed a higher percentage of patients obtaining their goal blood pressure compared to cardiologist care alone, 49.2% versus 31.0% respectively, p=0.0456. Greater reductions in systolic blood pressure (-22 mmHg versus -12 mmHg, p=0.0077) and pulse pressure (-15 mmHg versus -7 mmHg, p=0.0153) were noted in the cardiologist-pharmacist care model. No differences in diastolic blood pressure were found. There was a shorter duration of clinic follow-up (7.0 versus 13.2 months, p=0.0013) but a higher frequency of clinic visits (10.7 versus 3.45, p<0.0001) in the cardiologistpharmacist care model compared to usual care. The number of antihypertensive agents used did not change over the time period evaluated. Conclusion: This study suggests a team-based approach to hypertensive care using a collaborative cardiologist-pharmacist care model improves blood pressure from baseline in a high cardiac risk patient population and was more likely to obtain more stringent blood pressure goals than usual care.La gestión de la terapéutica en colaboración con los médicos utilizando farmacéuticos clínicos para ayudar con la medicación de pacientes con hipertensión ha demostrado mejorar el control de la presión arterial. Con las recomendaciones de menores presiones arteriales para los pacientes con enfermedad coronaria, un modelo de colaborativo cardiólogo-farmacéutico puede ser un método novedoso de conseguir resultados terapéuticos más rigurosos. Objetivo: El propósito de este proyecto fue evaluar este tipo de cuidados en una población de pacientes en alto riesgo cardiovascular. Métodos: Un estudio de cohorte retrospectiva (n=59) determinó la capacidad de que un modelo de cuidados cardiólogo-farmacéutico baje la presión arterial y alcance los objetivos de presión arterial (<130 mmHg) en pacientes con o en riesgo de enfermedad coronaria comparado con el cuidados normales de un cardiólogo (n=58) en el mismo establecimiento clínico. Resultados: El modelo de cuidados cardiólogofarmacéutico mostró un mayor porcentaje de pacientes alcanzando su objetivo de presión arterial comparado con el cuidado del cardiólogo solo, 49,2% vs 31,0%, respectivamente, p=0,0456. Se encontraron mayores reducciones de presión arterial sistólica (-22 mmHg vs. -12 mmHg, p=0.0077) y presión de pulso (-15 mmHg vs. -7 mmHg, p=0.0153) en el modelo de cuidados cardiólogo-farmacéutico. No se encontraron diferencias en la presión arterial diastólica. Hubo menor duración del seguimiento (7.0 vs. 13.2 meses, p=0.0013) pero mayor frecuencia de visitas a la clínica (10.7 vs. 3.45, p<0.0001) en el modelo colaborativo comparado con el cardiólogo solo. El número de antihipertensivos utilizado no cambió durante el periodo evaluado. Conclusión: Este estudio sugiere que un abordaje de los cuidados de la hipertensión en equipo usando un modelo de cuidados colaborativo cardiólogofarmacéutico mejora la presión arterial en una población de pacientes en riesgo cardiaco elevado, y alcanzó los objetivos de presión arterial más rigurosamente que la atención normal