Hospitals trending

Market Trends of the 1990s. The United States spice market can be divided into three sectors based on appHcation industrial, ie, food processing and manufacture institutional, ie, restaurants, hospitals, schools, and military and retail. The food manufacturers and institutions account for almost 65% of U.S. spice usage, an increase from about 40% in the 1980s. Retail food outiets make up most of the remainder. 

When the CAST collaborative group performed a meta-analysis of 1ST, CAST, and MAST-I, the trend seen in CAST and 1ST toward a beneficial effect of aspirin on the rate of death or dependency reached the threshold for statistical significance. Early aspirin therapy (160-300 mg/day) conferred an absolute reduction in the rate of recurrent ischemic stroke by 0.7% (7 per 1000 patients treated) (p < 0.001) and reduced the rate of death or dependency by 1.3% (13 per 1000 patients treated) (2p = 0.007). Aspirin caused about 2 hemorrhagic strokes among every 1000 patients treated, but prevented about 11 other strokes or deaths in hospital. 

The same type of reaction can result from overt or covert racial prejudice. A large body of research supports the idea that ethnic-minority clients frequendy receive qualitatively worse care and quantitatively less attention from health care professionals in clinics and hospital. Sometimes a professional is not even aware of treating ethnic-minority clients differently than White clients. Again, counselors and therapists need to observe their own clinical behavior and note when they may be treating clients differently to identify whether there is a racial pattern to that trend. Another way to check on biases is to observe your personal behavior outside the office If you are engaging in biased behavior outside work, you likely will be engaging in biased behavior while at work, even if you attempt not to be. 

Krumholz HM, Philbin DM Jr, Wang Y, Vaccarino V, Murillo JE, Therrien ML et al. Trends in the quality of care for Medicare beneficiaries admitted to the hospital with unstable angina. J Am Coll Cardiol 1998 31(5) 957-63. 

Goldberg RJ, Spencer FA, Okolo J, Lessard D, Yarzebski J, Gore JM. Long-term trends (1986-2003) in the use of coronary reperfusion strategies in patients hospitalized with acute myocardial infarction in Central Massachusetts. Int J Cardiol 2008 [Epub ahead of print]. 

These new techniques are rapidly expanding and are becoming available in an increasing proportion of hospitals, at least in industrialized countries. They are commercially available. They constitute the most important trend in radiation therapy today. 

With regard to long-term toxicity, some reports in the literature have suggested a relationship of secondary malignancies after treatment of childhood ALL with TPMT /TPMT and TPMTVTPMT phenotypes. In a study at St. Jude Children s Research Hospital, SJCRH Total XlllHR, patients with lower TPMT activity showed a trend towards a higher incidence of AML associated with application of the topoiso-merase II inhibitor etoposide (203). 

Until recently, lithium carbonate was the universally preferred treatment for bipolar disorder, especially in the manic phase. With the approval of valproate, aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone for this indication, a smaller percentage of bipolar patients now receive lithium. This trend is reinforced by the slow onset of action of lithium, which has often been supplemented with concurrent use of antipsychotic drugs or potent benzodiazepines in severely manic patients. The overall success rate for achieving remission from the manic phase of bipolar disorder can be as high as 80% but lower among patients who require hospitalization. A similar situation applies to maintenance treatment, which is about 60% effective overall but less in severely ill patients. These considerations have led to increased use of combined treatment in severe cases. After mania is controlled, the antipsychotic drug may be stopped and benzodiazepines and lithium continued as maintenance therapy. 

Because of the problems that resulted from self-regulation, another law, the Dietary Supplement and Non-Prescription Drug Consumer Protection Act, was approved in 2006. This law requires manufacturers, packers, or distributors of supplements to submit reports of serious adverse events to the FDA. Serious adverse events are defined as death, a life-threatening event, hospitalization, a persistent or significant disability or incapacity, congenital anomaly or birth defect, or an adverse event that requires medical or surgical intervention to prevent such outcomes based on reasonable medical judgment. If this requirement were enforced, and consumers cooperated, these reports would make it possible to identify trends in adverse effects and would help to alert the public to safety issues. 

Reasons for the magnitude of the problem being unknown are manifold, but are related to the paucity of national and regional information on antimicrobial drugs use and resistance trends in hospitals and the community. Scarcity of pertinent data complicates attempts to quantify the proportion of resistance problems in humans caused by antimicrobial use in livestock production. Data are even more limited on antimicrobial consumption, antimicrobial use in agriculture, and the prevalence of antimicrobial-resistant zoonotic bacteria in animals and animal-derived food. 

Opiate addiction has also helped spread diseases, such as the human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and tuberculosis among addicts who inject the opiate drugs and share dirty needles. The rate of opiate-associated emergency hospital visits in recent years has significantly increased. Furthermore, the number of deaths related to those opiate overdoses has almost doubled in this period. All of these trends point to the significant social costs associated with opiate abuse in the United States. 

Finally, the director of pharmacy pays special attention to external financial reports. Professional associations such as the American Hospital Association and the American Society for Health-System Pharmacists publish reports that show the national trends in pharmaceutical expenditures and labor productivity in hospitals (American Hospital Association, 2007 Hoffman et ah, 2005). Pharmacy managers can gauge the efficiency of their operations by comparing their financial ratios and other indicators with national averages. 

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