Universal patient identifier

In principal, data on the epidemiology of anaphylaxis will help to identify causes, risk factors and circumstances of the reaction. It will support the medical commimity to develop measures for the protection of affected patients. A true incidence of anaphylaxis has not been established, reasons are diverse study designs and the fact that there has been no universal consensus as to the definition of anaphylaxis [ 1 ]. 

One of the most convincing demonstrations of the effect of placebos on asthma was conducted by a research team led by Thomas Luparello, a psychiatrist at the State University of New York.41 Luparello s team asked 40 asthmatic patients to inhale what they presented as irritants or allergens previously identified by the subjects as triggers for their asthmatic attacks. In fact, the substance they inhaled was an inert saline solution - simple table salt dissolved in water. Nineteen of the 40 asthmatic patients reacted with a significant increase in airway resistance, and 12 of them developed full-blown bronchospasm attacks. These asthma attacks were then reversed by the administration of a placebo presented as an asthma medication. 

Until now, the composition of positive IHC controls resemble that of the patient sample. Pathologic discard tissue sections that express the biomarker in question are almost universally used as positive controls. Clinical laboratories bear the responsibility for identifying and validating the controls, typically from previous cases. An alternative QC material, which is especially popular for HER2 testing, is to use cell lines expressing the biomarker in question (as described in Chapter 6). Positive controls comprised of tissue sections or cell lines resemble patient samples in that they are cellular in nature. 

In 1705 patients, aged 65 years or over, who had recently started to take lithium, identified from the 1.3 million adults in Ontario receiving universal health care coverage, the rate of treatment with thyroxine was 5.65 per 100 person-years, significantly higher that the rate of 2.70/100 person-years found in 2406 new users of valproate (629). Of 46 adults taking lithium in a psychiatric clinic, 17% developed overt hypothyroidism while 35% had subclinical hypothyroidism (raised concentrations of thyroid stimulating hormone, TSH) (630). 

About the Author Dr. Chui is currently an Assistant Professor at the University of Wisconsin in Madison, Wisconsin. She earned a B.A. in biological sciences from the University of California, Davis, a Pharm.D. from Creighton University, and an M.S. and Ph.D. in pharmacy administration from Purdue University. Her areas of research focus on identifying and disseminating evidence to prove the worth of community pharmacists in the overall health care system and improving the work life for community pharmacists so that they can focus on patient care. 

Using various forms of empathic or reflecting responses, universal statements, and probing questions, pharmacists can learn to identify the specific causes of noncompliance. For example, questions such as It sounds like you are unsure about how to take this medication (reflecting response), Tell me more about how this medication makes you feel dizzy (probing question), and Many patients will feel sleepy after taking this medication (universal statement) can be useful in determining the nature of the patient s problem. 

Some research projects promoted or initiated by the Foundation are currently ongoing. A European research consortium, with the participation of different countries, is proposed to study the influence of pharmaceutical care in the control and treatment of minor diseases from community pharmacists, and it has submitted to the European Community in Brussels asking for economic support. Such research will be coordinated by the School of Pharmacy of the University of Manchester, United Kingdom. A project promoted by the European Society of Clinical Pharmacy is currently studying the number of drug related problems (DRP) identified by community pharmacists on patients discharged from the hospital. A research study on the number of DRP identified by pharmacists in patients admitted to emergency services of hospitals was initiated... 

Table 37-8 describes the treatment goals for patients with HE and contrasts the differences between acnte and chronic HE. The general approach to the management of HE is to first identify and treat any precipitating factors, which often results in prompt resolution of the encephalopathy. The development of mental status changes in cirrhosis is associated with increased morbidity and mortality. However, universal treatment of patients with suhclinical HE is not recommended because the consequences of motor and attention deficits are considered minor, and prevention of progression to more severe HE has not been studied. ... 

---