"Medicine / Pharmacy" Essays

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Pharmaceutical Ethics Issues Generally Research Paper

Research Paper  |  6 pages (1,665 words)
Bibliography Sources: 6

SAMPLE TEXT:

In essence, it was one of many examples whereby the powerful corporate lobbyists and their hired technical experts managed to successfully persuade legislators on matters where their respective comprehension of the issues differed greatly and where the former achieved their goals by a combination of "incentives" and obfuscation of relevant issues that lawmakers are ill-equipped to decide based on their lack of fundamental understanding of the merits of the scientific arguments (Tong, 2007).

Finally, the influence of the pharmaceutical industry lobbyists on Washington lawmakers having to do with the lucrative practice of prescribing drugs for so-called "off label" uses either not approved or not yet approved by the Food and Drug Administration (FDA) is yet another example of this dynamic (Santoro & Gorrie, 2005). Currently, it is regulated only by a voluntary code of ethics established by the American Medical Association, no doubt, with the help and influence of pharmaceutical representatives (Santoro & Gorrie, 2005). Naturally, pharmaceutical companies are even les constricted in this regard in the global market than they are domestically in the U.S.

Conclusion

In many respects, the modern pharmaceutical industry has served an extremely valuable purpose furthering human health throughout the 20th century. There is no doubt that the development of many drugs have enabled the medical community in the First World to eradicate some of the worst diseases that had previously caused so much misery in human societies since antiquity. Initially, globalization enabled the populations inhabiting the less developed parts of the world to benefit from some of those important advances in healthcare attributable to pharmaceutical products. However, in the contemporary age of globalization, the pharmaceutical industry is insufficiently regulated to prevent the widespread exploitation of large patient populations, especially in the Third World. Even in the most advanced societies, pharmaceutical lobbyists have succeeded in corrupting the process of government legislation to further their financial interests, substantially at the expense of human health.

References

Beauchamp, T.L. And Childress, J.F. (2009). Principles of Biomedical Ethics, 6th

Edition. Oxford University Press.

Halbert, T. And Ingulli, E. (2009). Law & Ethics in the Business Environment. Cincinnati:

West Legal Studies.

Santoro, M.A. And Gorrie, T.M. (2005). Ethics and the Pharmaceutical Industry.

Cambridge, UK:…… [read more]


Should HPV Vaccination Article Critique

Article Critique  |  3 pages (1,237 words)
Bibliography Sources: 1

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HPV Vaccine

In Decision Scenario number one, a thirteen-year-old girl is about to transfer to a new school in a new state that has a mandated law to vaccinate all adolescent girls against the Human Papilloma Virus before being allowed to register for class or allowed to start school. Although it is a requirement for entrance to the school, the girl's father does not want her to have to get that vaccine because he feels it is unnecessary since she is not sexually active, nor is the vaccine researched enough to merit its usage so freely and mandatorily (Muson, p.103). The major moral issue at hand here is not that this vaccine is condoning sex before marriage, but that the young girl is not having a say in something that is going to directly affect her body (Richardson). Whose interest should be valued more? Is anyone allowing the young girl who will be having this vaccine injected into her to have an opinion on the matter? Who, in this situation, fully knows what is best for the thirteen-year-old girl? It is this issue that we shall analyze and distinguish the possible implications in effect.

The Human Papilloma Virus (HPV) vaccine is a relatively new development. With HPV's direct link to cervical cancer, it has become an issue of not only preventing an unfortunate illness, but also protecting someone before any chance of contracting this virus is even possible. HPV is a sexually transmitted disease, one that is so common, that doctors and vaccine producers are now directly recommending girls as young as 11 or 12 years to get this vaccine before any opportunity of contracting the virus is even possible (CDC). But whose best interest is at mind? One side of this argument can be supported by the fact that this is indeed protecting the girls who are being mandated to get this vaccine. By assuring that the adolescent girls get the HPV vaccines, doctors, parents, and any who will be involved if a mishap occurs will not have to worry about the possibility of anyone who has gotten the HPV vaccine to get HPV in the future. Although this is not allowing the girls to have a say in this issue that is directly affecting them, it is indeed providing them with some sort of protection from something that would eventually cause them harm. Some argue that it is wrong to get this vaccine so early on, it has a protection window span of five years, which is about the average age of the beginning of sexual activity for teenagers in the United States (CDC). Granted, not every teenager is the same or acts in the same ways, but if a young woman wants to become sexually active later on in life, and has not gotten the vaccine, they are putting themselves at risk for catching the vaccine if the partner who she has decided to have sex has had sex in the past with another partner who had… [read more]


H Pylori the Cause of Peptic Ulcers Research Paper

Research Paper  |  3 pages (891 words)
Bibliography Sources: 3

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Pylori the Cause of Peptic Ulcers

Helicobacter Pylori (H. Pylori) is known to be a bacteria found in the inner lining of the human stomach. Once in the stomach lining, it is known to produce a lot of chemicals into the human stomach that potentially damage the stomach lining. The infection is very difficult to eradicate and can persist for years over and even in some cases for life (Gastroenterological Society of Australia, 2006).

H. pylori causes inflammation of the persistent inflammation of the inner lining of the stomach (gastritis) hence counted as one of the top causes of ulcers in the world. It has been observed that the H. pylori is commonly spread or transmitted through contaminated food or water or through infected person to another person contact (Dennis Lee, 2011).

Dennis further estimates that 30% of all Americans are infected by the bacterium and among them, 50% are infected at the age of 60 years and above as Dennis Lee postulates. The infection is very common among the people living under crowded neighborhoods since it is easy to pass it from one person to the other as well as from one family to the next. Poor sanitation also exacerbates the situation with an estimated 90% of the adults living in the extremely poor sanitation conditions being prone to infection.

Once the person is infected, he carries the infection indefinitely unless he undergoes thorough treatment and medication to eradicate the bacterium from the body. It is estimated that one out of every six patients of the bacterium will suffer from ulcers of the duodenum or stomach. H. pylori is also associated with the stomach cancer and to some extent the rare kind of lymphocytic tumor of the stomach called MALT lymphoma.

Diagnosis of H. pylori

There are accurate and quite simple ways of diagnosing the presence of H. Pylori in the contemporary medical fields. These tests include urea breath test, endoscopic biopsies (gastroscopy), antibody test and stool antigen tests.

Antibody testing; this relies on the detection of lgG antibodies that are specific to the H. pylori bacterium. It is widely used because it is cheap and readily available. There are various testing mechanisms available like Western blot testing, immunochromatography, and enzyme-linked immunosorbent assay (ELISA). However, this test can only be used to detect the presence of H. pylori and not to confirm the effectiveness of the antibiotics administered since there can be persistent presence of the antibodies even after the H. pylori has been cleared (The BreathID System, 2011).

Endoscopy (gastroscopy); this is where the physicians take a clear look at the condition in the digestive tract and extracting samples of the stomach or…… [read more]


Role of Antibiotic Therapy Essay

Essay  |  7 pages (2,560 words)
Style: Harvard  |  Bibliography Sources: 15

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" (Lopez, et al., 2006) Subgingival plaque samples were also reported to have been taken from all teeth at baseline 3, 6, 9 and 12 months for the counts of 40 subgingival species using checkerboard DNA -- DNA hybridization." (Lopez, et al., 2006) The study results report "…Mean PD was reduced from 2.80 _ 0.45 at baseline to 1.95 _… [read more]


Care for Patients During Poor Air Quality Essay

Essay  |  2 pages (793 words)
Bibliography Sources: 2

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Asthma Patient Care on Poor Air Quality Days

Poor air quality is caused by a combination of ground level ozone and air pollution can worsen asthma symptoms, triggering wheezing, coughing, trouble breathing, and even lead to hospitalization in the most serious cases.

The most important factor for a nurse to be effective with the patient on a poor air quality day is the daily Asthma Care Plan. This should provide the patient with specific recommendations for how and when to use relief medications, list the warning signs of severe attacks, and provide guidance when a patient should seek medical care.

Special considerations for patients with asthma and other respiratory conditions should be instructed to stay indoors and follow these steps to optimize their breathing:

Stay indoors as much as possible.

Run the air conditioner.

If patients need to venture out, limit the time outdoors. It is very important to restrict strenuous activities to pre- and post- traffic hours, of early morning and later evening, when air quality improves. They can plan activities over the next few days by checking air quality forecasts from AIRNow, a website developed to monitor air quality across the country. Patients can arrange their schedules for major activities, such as grocery shopping for the cooler, safer hours of early morning and after sundown.

2) Keep medications on hand.

Now is the time to take preventative asthma medications, such as Advair or Flovent as prescribed, and have patients keep their rescue inhaler handy in case of an asthma attack. Also, be careful to check the expiration date of the inhaler to ensure that it is effective. Renew prescriptions as needed.

Precautionary note: If the patient is using their inhaler more than twice a week, this may be indicative that they need a preventative medication, or if currently taking one, that the dosage needs to be changed. Discuss this with a doctor.

The doctor's visit is also the time to discuss and outline the patient's Asthma-Action Plan. This would show them how to handle worsening asthma symptoms, and keep them prepared and ready for most circumstances.

Poor air quality days may be the cause of stepping up the patient's Asthma-Action Plan to a higher level, and thus being prepared for these more challenging days.

Considerations for Special Populations

Children

Older children should have a written Asthma Plan for school, with activity restricted to indoors…… [read more]


Community-Based Intervention Public Health Planning Case Study

Case Study  |  3 pages (970 words)
Bibliography Sources: 3

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Study Limitations

The primary limitation the authors cited was their reliance solely on the Citywide Immunization Registry, which likely consists of records that haven't been kept up-to-date by pediatricians (Findley et al., 2008). The prevalence of out-of-date records could be as high as 85%. The authors suggested that examining parent-held vaccination records would have provided a more accurate assessment, but the cost of such an approach was probably prohibitive.

Whether the same or similar program could be implemented nationwide would depend a great deal on each community's willingness to commit resources to a more intense program of reminding, tracking, and community outreach activities. Northern Manhattan could represent an exceptional neighborhood when compared to other urban communities of color across the country, in terms of having in place a vibrant social infrastructure consisting of social and housing services, faith-based organizations, childcare and primary providers, and city health department. Three factors therefore seem to be the primary determinants of whether such a program could be implemented successfully in the general population: the will to do so, resources, and a robust social infrastructure.

An alternative Research Strategy Proposals

The first study the authors conducted used a prospective cohort design (Findley et al., 2004) and the second used a retrospective cohort design (Findley et al., 2008). A potentially more powerful experimental strategy would be to randomize the neighborhoods or communities selected for participation in the Start Right program. For example, neighborhoods or school districts could be matched in terms of ethnicity, income level, Medicaid coverage, and provider density (Fu, Cowan, McLaren, Engstrom, and Teach, 2009), and then selected at random for participation in the Start Right program. The impact of community-wide trends in childhood vaccination rates would be averaged out over multiple neighborhoods or school districts. If necessary, multiple cities could be enrolled to increase the statistical power of the experiment.

References

Findley, Salley E., Irigoyen, Matilde, Sanchez, Martha, Guzman, Letty, Mejia, Miriam, Sajous, Michelle et al. (2004). Community empowerment to reduce childhood immunization disparities in New York City. Ethnicity and Disease, 14, S1-134 -- S1-141.

Findley, Sally E., Irigoyen, Matilde, Sanchez, Martha, Stockwell, Melissa S., Mejia, Miriam, Guzman, Letty et al. (2008). Effectiveness of a community coalition for improving child vaccination rates in New York City. American Journal of Public Health, 98(11), 1959-1962.

Findley, Salley E., Sanchez, Martha, Mejia, Miriam, Ferreira, Richard, Pena, Oscar, Matos, Sergio et al. (2009). REACH 2010: New York City: Effective strategies for integrating immunization promotion into community programs. Health Promotion Practice, 10(2), 128S-137S.

Fu, Linda Y., Cowan, Nuala, McLaren, Rosie, Engstrom, Ryan, and Teach, Stephen J. (2009). Spatial accessibility to providers and vaccination compliance among children with Medicaid. Pediatrics, 124,…… [read more]


Macroeconomic Case Study

Case Study  |  2 pages (679 words)
Bibliography Sources: 2

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Macro Economic Case Study

Vaccinations

It has been brought to our attention that there have been a number of shortages taking place (over the last ten years) for the flu vaccine. At the heart of this issue, is the overall quality of supply on the market. What has been happening is there were two different situations in 2001 and 2005 that were occurring. These illustrated how vulnerable stock piles were to these issues. This is because, the total number of regulations made it difficult to open a drug manufacturing plant in the United States. At the same time, the amounts of high risk people have increased dramatically. As there are currently 90 million Americans who require these vaccinations, due to the fact they could have a weak immune system or suffer from a chronic condition (such as: cancer, diabetes and hypertension). This is important, because it is showing how demand for these vaccines has increased, while the total amount of supply (that is manufactured in the United States) has decreased. ("Flu Vaccine Case Study")

As a result, over the last several decades the total number of suppliers providing vaccines has declined dramatically. Evidence of this can be seen by looking at: the total number of drug manufacturers with facilities, located in the U.S. over the last 35 years. as, this number declined from: a total of 25 to 5, which is making the underlying situation even worse. This is having a dramatic impact upon the quality of available supplies, with many manufacturing companies using foreign-based laboratories to create these vaccines. At which point, a shift took place in the market place, as demand increased and manufacturing was essentially outsourced. This lead to calls from economists and industry experts; that this exposing the available supply to: disruptions from a limited number of producers. Commenting about what was taking place former Health and Human Services Secretary Tommy Thompson said, "The flu vaccine marketplace has been withering away for years." This significant, because it shows how the underlying problem has been continuing…… [read more]


Ethical Issues Associated With This Marketing Strategy? Case Study

Case Study  |  2 pages (680 words)
Bibliography Sources: 2

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¶ … ethical issues associated with this marketing strategy?

Physicians have an ethical obligation to prescribe the most suitable treatment for a patient, based upon their medical knowledge, not upon persuasive techniques used by salespersons. For many years, the pharmaceutical industry has been dogged with charges that it uses 'freebies' like dinners, stationary, and food to persuade physicians that a name-brand drug is superior to others on the market. "The doctor is not going to prescribe something he or she has never heard of, and it's the drug representative's job to get the products' names in front of the physicians" not to improve patient health (Morreim 2011).

There are serious ethical implications regarding this charge. For example, if physicians are persuaded, even subliminally, to overprescribe, then there may be a rise in antibiotic-resistant bacteria, due to overuse of antibiotics. Children might be prescribed medication to treat ADHD and bipolar disorder as a means of first rather than last resort. Physicians may be more apt to bow to pressure from patients who ask for a specific drug, simply because the patient saw the pharmaceutical advertized on television and the doctor was the target of an in-house advertising campaign.

Overly aggressive physician targeting may thus encourage over-prescription, or may cause physicians to prescribe drugs rather than making consumers aware of generics, which are cheaper than name brand drugs. In this specific instance, training physicians to market the drug is designed to create an image of objectivity and trust, without fully informing the listeners that the physicians are disseminating sponsored materials. Even if there is a disclaimer, a small disclaimer will not necessarily fully convey the extent to which what the audience is seeing is 'advertising' rather than information.

"A recent letter in the Journal of the American Medical Association illustrates how effective drug advertising can be. It describes a patient who came into the hospital with an infected insect bite. The intern who first saw the patient first sensibly wanted to prescribe a nice, inexpensive penicillin…the resident overruled the intern and…decided the…… [read more]


Drug Database Article Review

Article Review  |  1 pages (339 words)
Bibliography Sources: 0

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¶ … National prescription drug database slowly becoming reality

Journal: Government Technology

Online at: http://www.govtech.com/e-government/National-Prescription-Drug-Database-Slowly-Becoming.html

One problem for law enforcement is the lack of a consistent medical and legal bookkeeping strategy for individuals being prescribed addictive prescription painkillers. Prescription drug addicts will often go from doctor to doctor, crossing state lines to get their 'fix' and often succeed in persuading unsuspecting doctors to give them more opiates. The 2005 National All Schedules Prescription Electronic Reporting allocated $50 million to states to create a program that will allow doctors interstate access to patient records, to make sure that the patient is not 'doctor swapping.' Although the program is still under-funded, and many states, including Vermont, are not actively participating in the program, it is hoped it will cut down on the number of patients using doctors to provide them with their 'fix.'

Author's Points: A coherent system across all 50 states is required for doctors to have the security of knowing that they have a full and complete picture of…… [read more]


Five Forces and Pharmaceutical Companies Case Study

Case Study  |  2 pages (604 words)
Bibliography Sources: 2

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Rivalry causes companies to seek a competitive advantage over their rivals, to ensure profitability.

Barriers to entry are when existing companies protect their high profitability by inhibiting additional rivals from entering the market. Some companies may see rivals or competition as a major problem, a way to lower profitability. Companies may intentionally lower their prices to keep competition out; once the treat is no longer there they may then raise the price.

People are concerned about the pressure pharmaceuticals companies put on PBM, when then pressure doctors. The PMB pressure the doctors to write prescriptions that are lower in cost. The drug companies cannot pressure the doctors directly, since it is against the law to put that type of pressure on doctors. Pharmaceutical companies are not allowed to give doctors expensive gifts or do anything that may seem like a bribe. These are guidelines to protect the rights of patients (Higgins, 2006). Medication affects the health and wellness of individuals and their medical decisions should not be influenced by pharmaceutical companies. The forces in the industry place a lot of pressure on the pharmaceutical industry that then move that pressure to doctors and PBM. Doctors should have the freedom to write the prescription based on the patients needs. Many PBM offer discounts for buying generic drugs and some PBM may not pay for brand name drugs. This puts pressure on the doctors to write certain prescriptions and abstain from others. Patients should feel as though their doctor have their best interest in mind when treating them.

References

Higgins, M. (2006). Stricter gift ethics urged for doctors; study sees influence on diagnosis. The Washington Times.

Porter, M.E. (2010). Strategic management. Retrieved from http://www.quickmba.com/strategy/porter.shtml… [read more]


Excessive Use of Antibiotics Essay

Essay  |  2 pages (949 words)
Bibliography Sources: 1

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Excessive Use of Antibiotics

Alexander Fleming was the one to discover penicillin in 1929. He discovers the substance in 1940, with the help of other specialists, thus making one of the most important discoveries in the history of human kind. Selman Waksman coined the term "antibiotic." He used it in 1942 to name every each of the substances that are formed by a microorganism which is antagonistic to the development of other microorganism in high intensity. The definition that Selman Waksman used did not relate to the substances that are not formed by microorganism but kill the bacteria (gastric juices and hydrogen peroxide). Also the text did not include anything about synthetic antibacterial compounds (sulfonamides).

Now days, most of the antibiotics are semi-synthetic modifications of different natural compounds. For example the beta-lactam antibacterials include the carbapenems, the cephalosporins and the penicillins, which is a substance produced by fungi. Aminoglycosides are substances that are detached from living organism. They are also antibacterials that are synthetic products, the sulfonamides and the guinolones, for example. Antibacterials are divided in two groups: bactericidal agents and bacteriostatic agents. The first ones are killing bacteria, while the second are only slowing down bacteria growth.

Antibiotics are not only killing the "bad" bacteria but the ones that are benefic too. The most important benefic bacteria for human body are lactobacillus acidophilus and bifidobacterium bifidus. These bacteria help the human body in fighting against "bad" bacteria. Destroying this organism can make the human body less immune to bacteria, fungi, parasites and viruses. An excessive use of antibiotics destroys these benefic organisms, and, in this manner, leads to the yeast infection and other infections that can be even more harmful to the body. In the same time, antibiotics affect nutrients, such as vitamin a and C, which are needed in the fight against infections. Diarrhea is the one common effect of excessive use of antibiotics. This effect causes an important loss of nutrients, such as magnesium and zinc. Another effect of excessive use of antibiotics is the fact that the individual develops resistance to the substance. The bacteria become immune to the drugs, and create a new generation of bacteria, one that is stronger than the first. In this line of ideas, there are some infectious diseases that are unaffected by drugs. So, consequently, the excessive use of antibiotics is not helping the disease disappear, decreases immunity and makes diseases stronger, given that bacteria are not killed by the treatment.

Also, it is important that before the administration of the antibiotic one makes sure that there are no alternatives available. The U.S. Centers for Disease Control and Prevention (CDC) says that more than 10 millions antibiotics are prescribed for viral diseases that can be treated with an easier treatment.

Farmers and ranchers use antibiotics in an excessive way too. They use antibiotics not…… [read more]


Medical Research Funding - Government Business Proposal

Business Proposal  |  2 pages (772 words)
Bibliography Sources: 2

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Much of the funding provided for the HGP served the development of new technologies, rather than the sequencing of the human genome itself. In addition, Celera started much later than the HGP and could take advantage of the experience gained by the HGP, which, as a publicly-funded project, made much of its work available as a basis upon which Celera could build.

While religious groups are readily providing funding for medical studies, they often place tight restrictions on study design, based on their views. On the other hand, depending on the medical condition being researched and the degree to which a cure could benefit the members of a church congregation, religious organizations may be a viable funding source.

HHMI Personnel and Qualification Summary

The Howard Hughes Medical Institute (HHMI) is best suited for this project. We are one the leading nonprofits for medical research. The organizational structure would include: the Board of Trustees, various advisory boards, and officers. Duties for officers include: managing funding, collaboration, monitoring the Janelia Farm Research Campus, and operations of the foundation.

These different elements are important, because they allow each project staffer to focus on specific activities.

The various members of HHMI that are filling key staff positions include: Robert Tjian (President), Craig Alexander (Vice President / General Council), and Sean Carroll (Vice President for Science Education). Robert Tjian has formal training as a biochemist and has been the President of HHMI since 2009. He received a Bachelor Degree from Berkeley and a PHD from Harvard University. The greatest contribution that Tjian has made to medical research is through his groundbreaking work, regarding how genes are turned on and off. Craig Alexander has acted as legal counsel for HHMI since 1994 and has been the Vice President since 2006. He has a Law Degree from the Georgetown University Law Center. Sean Carroll is in charge of Science Education for HHMI. He has been working as an HHMI investigator at the University of Wisconsin Madison, where he is a world famous biologist.

Partnerships and cooperating agencies include: 18 Nobel Prize winners, the National Academy of Sciences, and 335 HHMI investigators around the world. The various board members include: James Baker, Garnett Keith, Fred Lummis and Paul Nurse. All of the different individuals made annual contributions…… [read more]


Drug Companies and Poor Nations Term Paper

Term Paper  |  2 pages (683 words)
Bibliography Sources: 1

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Drug Companies and Poor Nations

The idea of easing international patent laws for medical drugs has polarized the political and business community for sometime. It is clear that the World Trade Organization (WTO) is a central hub for this discussion, the key points are: keeping the drug supply up to standards and safe; allowing pharmaceutical countries a way to recoup their R&D costs; provide greater services to LDC (lesser developed countries). It is also clear that many drug companies now see poorer nations as emerging markets for their products, particularly in areas in which there are fewer regulatory issues.

The safety and requirements of pharmaceuticals is paramount: there must be an organization that monitors and ensures that the required chemicals and percentages are used. One of the U.S. FDAs most stringent comments about the use of foreign pharmaceuticals is that they have to set standard of ingredients and, in many cases, might do more harm than good. Similarly, it is important to all countries that pharmaceutical organizations continue to research and develop new substances, if they are prevented from that, and their rights to intellectual property, they will no longer have any impetus to fund research (e.g. It can cost millions of dollars to get even one new drug approved, and estimates range from 80-90% of those that are put on trial never make it to production). Other countries do not have such standards, saving pharmaceuticals millions of dollars in costs, as well as the threat of litigation that looms in the developed world.

In the current world of globalization, though, the prevailing economic thought it that individual countries will produce and export their best resources, while importing, or manufacturing, needed items. A large country like India, for instance, with a large amount of human capital and investment opportunities, could indeed form a new pharmaceutical industry, if not research and development, at least production. This could, of course, happen in two ways: 1) International companies could open manufacturing plants in India. It has 30 major ports for importing of supplies, a…… [read more]


Translating Biomedical Innovation / Mental Term Paper

Term Paper  |  14 pages (4,501 words)
Bibliography Sources: 1

SAMPLE TEXT:

With the ethical compliance requirements not so transparent in the private sector and their primarily commercial interest in biomedical research leads to several problems. In a collaborative setting, conflicts of interest arise out of such a situation. For instance, as the authors state, a federal research employee "would have official responsibilities with an outside organization with which that employee has… [read more]


Biology Vaccines Term Paper

Term Paper  |  4 pages (1,232 words)
Bibliography Sources: 3

SAMPLE TEXT:

Biology

Vaccines

Almost everyone across the country gets vaccines. People often want to understand what vaccines are prepared out of, if they are effective, and whether they are harmless or not. They also want to understand why there are numerous vaccines and whether they are all actually needed. More often than not, they really want to understand what they are really receiving when they obtain a vaccine (Offit and Bell, 2003).

In recent years, new vaccines have become accessible; some vaccines have been replaced with others and some have been withdrawn. Parents have had doubts in regards to the security of an additive that was being used in a lot of vaccines and a number of writings have maintained that may result in sudden infant death syndrome, persistent joint disease, aggressive behavior, autism, diabetes and multiple sclerosis (Offit and Bell, 2003). So, just what are these vaccines anyway?

A vaccine is any solution proposed to create resistance to an illness by invigorating the creation of antibodies. Vaccines include solutions of dead microorganisms, or offshoots of microorganisms. The frequent technique of giving vaccines is by inoculation, but several are administered by other ways. Vaccines are extensively and regularly given internationally founded on the ordinary standard that it is improved to keep people from getting sick than to care for them once they become sick. Distress, disability, and fatality are evaded. Vaccination prevented about two million casualties in 2002. Additionally, infection is decreased, tension on health systems is relieved, and funds are regularly accumulated that can be utilized for additional health services (Vaccines, 2010).

Initiating a little quantity of smallpox virus by breathing in by way of the nose or by administering a number of tiny pierces through the skin, called variolation, in order to generate opposition to the illness appears to have started in the tenth or eleventh century in Central Asia. This extended into Asia and Africa, by way of the nasal technique. At the time in Europe it consisted of skin pierces. Variolation was brought into England in 1721. In 1798, Edward Jenner, after studying the victory of variolation with cowpox in defensive against smallpox, started to perform vaccinations in opposition to smallpox. This was the initial organized attempt to manage an illness by way of vaccination. In 1885, Louis Pasteur invented the first inoculation to defend people in opposition to rabies. Toxoids in opposition to diphtheria and tetanus were initiated in the 1900's; the bacillus Calmette-Guerin inoculation, against tuberculosis, was initiated in 1927; the Salk polio inoculation in 1955; and inoculations in opposition to measles and mumps in the 1960's (Vaccines, 2010).

Vaccines, as with all things overlooked by the FDA, experience a meticulous evaluation of laboratory and clinical statistics to guarantee the security, effectiveness, wholesomeness and influence of these products. Vaccines accepted for selling are also mandated to go through further studies in order to advance assess the inoculation and often to deal with exact questions in regards to the inoculations safety, efficiency or likely side effects.… [read more]


Ethical Decision-Making in Dentistry Term Paper

Term Paper  |  2 pages (580 words)
Bibliography Sources: 0

SAMPLE TEXT:

DENTAL ETHICS -- "NO ANTIBIOTICS NEEDED for DENTAL TREATMENT"

Ozar and Sokol-Based Ethical Analysis

According to Ozar and Sokol, their ethical framework for analysis and resolution of ethical dilemmas in dentistry considers the following specific issues and ranks their relative importance in the same order: First, the life and general health of the patient; second, the oral health history of the patient; third, patient autonomy; fourth, preferred practice values of dentists; fifth, esthetic values; and sixth, resource efficiency. There is no question that the Ozar-Sokol analysis requires the dentist to oppose the general practitioner's orders.

First, it is well-known that various acute and systemic infections, such as those capable of being caused by streptococci and staphylococcus bacteria are on a dramatic rise in the United States, particularly in connection with antibiotic-resistant strains. Because clinical experience and empirical research have conclusively established that, despite complete protocol compliance, invasive dental work (and other surgery more generally) can provide opportunities for bacterial infection, it is good general practice to prescribe a broad-spectrum antibiotic before invasive procedures. Since there is no question that it is in every patient's best interest to avoid unnecessary post-surgical complications and infections, the first Ozar-Sokol issue requires prophylactic antibiotic treatment.

Second, the oral health history of this patient is largely irrelevant to this particular dilemma, at least where that history is devoid of prior infectious complications. In that case, the first Ozar-Sokol principle requires antibiotics. However, if the patient's oral health history included any previous infections, the second Ozar-Sokol principle would become directly relevant and absolutely require prophylactic antibiotic treatment.

Third, patient autonomy is not directly relevant to this dilemma, only because the matter concerns different clinical judgment by practitioners. However, patient autonomy could be incorporated into a possible…… [read more]


Position Statement in Occupational Therapy Reaction Paper

Reaction Paper  |  2 pages (700 words)
Bibliography Sources: 3

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Occupational Therapy Position Statement

The current academic and professional climate is such that there are increasing demands not only for professional research and quality service, but also for the empirical basis of such research and service. Hence, empirical trials have become increasingly important in all fields of study. Occupational therapy is included in this phenomenon. The profession focuses on health and social care for individuals in need of this. The market is therefore increasingly demanding a high level of quality from professionals in the field, while also increasingly demanding that the service delivered by based upon empirical research. For this reason, one might surmise that the importance of clinical trials in the field is rising, and that this is vital not only for improving the quality of care provided, but also for targeted health care reform where this is most needed.

According to Unsworth (2000, p. 148), clients, insurers and employers have been particularly adamant regarding the quality and empirical nature of care received from occupational therapists. That such care must be evidence-based is coupled with the requirement that it be provided at the lowest possible cost. One of the best ways in which to achieve such a combination of quality and cost-effectiveness is by means of empirical evidence as obtained by means of clinical trials.

Authors such as Sperling (2009) also emphasize the importance of clinical trials in terms of the effect upon the ability of the medical profession to solve the problems it faces. In general, new treatments and drugs can only be approved when their efficacy are proved by means of clinical trials. In other words, such research validates the profession and its tools.

Although occupational therapy has not traditionally been regarded as subject to clinical trials, these have become increasingly important in the light of validation for the profession. As Unsworth (2000, p. 156), occupational therapy will only be transported to the 21st century by means of measurable outcomes achieved via clinical trials. In the profession itself, it is therefore important to increase the number of clinical trials conducted. This will have various effects and advantages.…… [read more]


What Can We Do About Antibiotic Resistant Bacteria? Lab Report

Lab Report  |  2 pages (669 words)
Bibliography Sources: 2

SAMPLE TEXT:

¶ … Lab Report Template (Save as: YourName_Module#_Report.doc)

Antibiotics were once called 'wonder drugs' because of their ability to fight some of the most serious diseases plaguing humankind. However, just as other species have changed through natural selection, bacteria that are resistant to antibiotics have survived and reproduced in greater number than less resistant strains. Slower development of new antibiotics and a spike in antibiotic prescriptions has precipitated the evolution of hardier and more virulent strains of antibiotic-resistant bacteria.

According to the Centers for Disease Control (2005) antibiotic-resistant bacteria develop when mutant strains of resistant bacteria survive a treatment, and "that one bacterium can then multiply and replace all the bacteria that were killed off. Exposure to antibiotics therefore provides selective pressure, which makes the surviving bacteria more likely to be resistant. In addition, bacteria that were at one time susceptible to an antibiotic can acquire resistance through mutation of their genetic material or by acquiring pieces of DNA that code for the resistance properties from other bacteria."

Antibiotic-resistant bacteria are dangerous because these "bacteria are able to cause serious disease and this is a major public health problem. Important examples are methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE) and multi-drug-resistant Mycobacterium tuberculosis (MDR-TB)," which have become epidemic in many healthcare environments when large numbers of ill people are in contact with one another ("Antibiotic-resistant bacteria," Better Health Channel. 2009). Unless proper precautions are taken, patients and healthcare providers alike can become unwitting transmitters of diseases.

Patients and doctors both share some of the blame for the development of antibiotic-resistant bacteria. Doctors may prescribe an antibiotic for what is likely to be a viral infection (which cannot be cure by an antibiotic) to placate a demanding patient, and patients may want to take an antibiotic, even when it is likely to be ineffective 'just in case' they might have a bacterial infection.

Materials and Methods:

The experiment was conducted on a 'macro' population level as well as a micro population level. To confirm that…… [read more]


Out of Trend Results Term Paper

Term Paper  |  2 pages (620 words)
Bibliography Sources: 1

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¶ … Alasandro, Mark; James Bergam; Laura Faust, Marianne Gorko et al. (2003, April).

Identification of Out-of-Trend stability results: A review of the potential regulatory issue and various approaches. Pharmaceutical Technology.

Retrieved June 21, 2010 at http://pharmtech.findpharma.com/pharmtech/data/articlestandard//pharmtech/152003/52982/article.pdf

Out-of-trend results (OOT) are an important topic both for political and economic reasons in the pharmaceutical industry: they can affect how a drug is prescribed, administered, and regulated. Simply stated, an OOT is a statistical result about a drug that falls outside of expected parameters. A pharmaceutical company might attempt to establish an expiration date for a new medication, but an OOT result testing for drug efficacy can complicate setting such standards. Ideally, when reviewing statistical information, an alarm is sounded only when needed, and the risk of false alarms is minimized, while significant results are not overlooked.

When testing a batch, an anomalous result is usually flagged if three consecutive results are outside a preset limit or "the difference between consecutive results is outside of half the difference between the prior result and the specification" (Alasandro et al., 2003, p.42). Other red flags might be if results from the tests are greater or less than 5% of the initial result or the mean of all previous results or 3% of the previous result of the test.

A regression chart, a statistical by-time-point approach (to determine whether a result is within expectations in comparison with other batches measured at the same time), and a slope control chart method are all ways to examine the significance of deviations. Degradation of quality is of particular concern for pharmaceuticals, and "unlike batch-release results, which represent one point in time for a batch, stability results may change over the shelf life of the batch" (Alasandro et al.,, 2003, p.48). Thus while determining whether a batch is of a particular level of quality is vital, even more challenging…… [read more]


Medication Errors Term Paper

Term Paper  |  4 pages (1,464 words)
Bibliography Sources: 3

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Medication Errors in Nursing

Medication errors are a very serious concern to nursing staff. A medication error occurs when the wrong medication is given to a patient resulting in potential serious harm that could have been prevented (Hidle). Medication errors occur at a high rate with death occurring as frequently as once a day due to adverse drug events (ADE)… [read more]


Diphtheria Is a Bacterial Infection Caused Article

Article  |  2 pages (542 words)
Bibliography Sources: 1

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Diphtheria is a bacterial infection caused by the gram-positive bacteria Corynebacterium diphtheria. Reported as early as 5th century BC by Hippocrates, diphtheria is a serious infection of the upper respiratory tract causing severe respiratory distress. Corynebacterium ulcerans is another bacterial species that primarily causes cutaneous diphtheria, a skin infection that does not cause any respiratory symptoms. Though widespread vaccination has literally wiped out diphtheria in the U.S. And many other developed nations, recent outbreaks have been witnessed in several states of the former Soviet Union indicating waning of immunity. With most children routinely immunized, recent infections are more commonly occurring among adults above age 40. The fact that as many as 5000 causalities were reported in the 1990-95 outbreak in Russia and other former Soviet states clearly indicates the dangers. Asymptomatic human carriers are the most important reservoirs for the bacterium and transmission occurs through nasal secretions, respiratory droplets and via shared clothes. C Diphtheria sticks on to the mucosal membrane cells and secretes an exotoxin that interferes with the normal protein synthesis of the host cell resulting in cell necrosis. More serious damage can result once the toxin is carried through blood or the lymphatic system to other regions of the body. Particularly, since the cells of the myocardium, kidneys and nerve tissues have receptors for the exotoxin they can be severely affected. [Allysia & Mark, 2009]

Diphtheria has a typical incubation period of 2 to 5 days and symptoms ranging from sore throat, fever, headache to mild pharyngeal inflammation and swollen neck are common. As the infection progresses, a new psuedomembrane may form along the respiratory tract, and left…… [read more]


Should Vaccinations Be Mandatory Essay

Essay  |  3 pages (1,079 words)
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Vaccinations

Should vaccinations be mandatory

Vaccination is an important decision that a parent has to make for their child. It is also a decision that has become controversial and the debate about whether to vaccinate or not has become heated in recent years. The official recommendation for child vaccination is as follows: children should be vaccinated against Hepatitis B; DPT: Diphtheria; Tetanus; Pertussis; H. Influenza type b, as well as Polio, measles, mumps, Rubella or German measles. (SHOULD VACCINATION BE REQUIRED? (CHILDHOOD VACCINATIONS: THE BIOMEDICINE PERSPECTIVE). All American states require and recommend that children be vaccinated before enrolling at school

While vaccinations have been accepted as a means of combating dangerous diseases, in recent years concerns have emerged from various quarters about the safety of certain vaccinations, and the suitability of the vaccine process in general. Although these vaccinations are formally endorsed by the American Academy of Pediatrics and the U.S. Public Health Service there are concerns; for example, "…many parents and health providers consider the DPT vaccine to be risky." (SHOULD VACCINATION BE REQUIRED...) This sense of doubt about vaccinations is also felt in other sectors of the medical and healthcare arena. For example, "Manufacturers are less willing to produce vaccines for fear of lawsuits by parents of injured children. There is an active anti-vaccine movement in this country…" (SHOULD VACCINATION BE REQUIRED...)

On the one hand, medical authorities, such as The American Academy of Pediatrics and the American Medical association are of the opinion that public health priorities with regard to vaccinations should supersede personal preferences. However, this view is sharply and critically opposed by organizations such as Dissatisfied Parents Together or DPT. This group insists that an estimated "….943 deaths, 11,666 cases of long-term neurological damage, and 10,377 episodes of post shot screaming episodes have been recorded" are as a result of certain vaccinations. (SHOULD VACCINATION BE REQUIRED...)

This suggests a number of different views on the subject. Some are of the opinion that the individual should have the right to decide on the issue of vaccination based on the facts as he or she sees them. Others view compulsory vaccination an important policy that will ensure the best health for all. In essence this boils down to a debate about the rights of the individual as opposed to needs of needs. The question should rather be stated as; "How do we balance the rights of the individual against the perceived needs of society? (SHOULD VACCINATION BE REQUIRED...) The point that will be made in this paper is that mandatory vaccination should be endorsed as it not only provides the best means of protecting most people but also that it relates to the proven benefits of herd immunity

The argument against mandatory vaccination consists of two important points. The first is that vaccinations might not be as safe as many previously assumed. For example, one report on this issue states that many children have experienced negative effects from the mandatory Hepatitis B vaccination. For instance, a father… [read more]


Prevent Medication Errors Adverse Patient Incidents Research Proposal

Research Proposal  |  3 pages (1,096 words)
Bibliography Sources: 3

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¶ … Prevent Medication Errors

Adverse patient incidents can assume a wide variety of events, including falls with injury, fires involving patients, and even patient abuse, but one of the most common and preventable incidents is medication errors. Because the clinical outcomes involving medication errors can be life-threatening, the subject has been the focus of an increasing amount of attention in recent years and clinicians in both tertiary healthcare facilities as well as outpatient settings have identified a number of methods that can be effective in reducing the number of medication errors. To determine the prevalence and type of medication errors being reported across the country and what healthcare providers are doing about the problem, this paper provides a review of the relevant peer-reviewed literature followed by a summary of the research and important findings in the conclusion.

Review and Discussion

Among the various quality assurance measures typically in place in many healthcare settings and one of the key measures of patient safety is the prevalence of medication errors (Anson, 2000). One of the problems associated with identifying and comparing precise levels of medication errors in various healthcare settings across the country, though, is a lack of operationalization of what constitutes a medication error. In this regard, Meadows (2003), a consultant with the U.S. Food and Drug Administration (FDA), reports that, "Since 1992, the Food and Drug Administration has received about 20,000 reports of medication errors. These are voluntary reports, so the number of medication errors that actually occur is thought to be much higher. There is no 'typical' medication error, and health professionals, patients, and their families are all involved" (p. 20). Indeed, author Gordon and physician McCall (1999), emphasize that, "When patients act as their own nurse or doctor, they often make mistakes and may die as a result. And when family members are required to fill in for professional nurses there are similar hazards" (p. 11).

Based on its analysis of fatal mediation errors reported during the period from 1993 to 1998, the FDA determined that the most common types of errors involved administering an improper dose (41%), providing the incorrect medication (16%), and the use of the incorrect path for administration (16%) (Meadows, 2003). The most commonly cited causes for the medication errors reviewed by the FDA were performance and knowledge deficits account for almost half of all medication errors (44%) as well as simple communication errors (16%) (Meadows, 2003). In addition, nearly 50% of the fatal medication errors involved patients over the age of 60 years, and Meadows emphasizes that the elderly are at particular risk for medication errors because of the large number of different medications they are typically prescribed (Meadows, 2003).

Likewise, young people also represent a high-risk segment of the population since medications are frequently dosed based on their weight, and accurate calculations are absolutely essential (Meadows, 2003). This point is also made by registered nurses Stratton, Blegen, Pepper and Vaughn (2004), "Medication administration errors can threaten patient outcomes and are a… [read more]


Regulatory Aspect in Biotechnology Thesis

Thesis  |  1 pages (307 words)
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¶ … politics play in the FDA's accelerated approvals process and what are the implications of this process for public health?

I want to know the answer because: The FDA approvals process for most treatments is complicated. The industry is facing demands for expanded clinical trials, which is increasing the length of time and the expense of gaining approvals. Yet, when rapid approval of a drug is politically expedient, such as with the H1N1 vaccines, the process is streamlined. To me, this raises some public health and ethics issues. The press release for the H1N1 vaccine approvals mentions that testing was on adults only and "clinical studies under way will provide additional information about the optimal dose in children." Yet parents are vaccinating their children, without any FDA study. Either the normal approvals process is needlessly rigorous or the accelerated approvals process is based on political, rather than health, motivations.

I would find…… [read more]


Human Papillomavirus Vaccine Thesis

Thesis  |  2 pages (720 words)
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Nursing

Human Papillomavirus Vaccine

Cervical cancer was once the leading claim on the lives of American women than any other type of cancer. Fortunately over the last 40 years, widespread cervical cancer screening using the Pap test and treatment of pre-cancerous cervical irregularities have resulted in a significant reduction in cervical cancer cases (HPV Vaccine Information for Clinicians, 2008).

In June of 2006 the FDA approved the first HPV vaccine. Even though the vaccine is being called the cervical cancer vaccine the vaccine only protects against the two strains of HPV that cause most cases of cervical cancer. Since there are 11 other strains that are also potentially cancer causing women will still need to get regular Pap smears to prevent the consequences of the disease (Boskey, 2007).

HPV is a very common sexually transmitted virus across the United States. Most sexually active people will be exposed to one or more strains of the virus at some point during their lives. Up to a quarter of people in any particular age group are infected at any one time across the country. The virus is so common that exposure is essentially certain. It is thought that if you are sexually active, you will be exposed to the virus. Even consistent condom use is no guarantee of protection, since the virus is transmitted skin to skin, and condoms only protect the areas of skin that they cover (Boskey, 2007).

There are approximately 20 million people currently infected with genital human papillomavirus (HPV). As many as half of those infected are adolescents and young adults who range in age from 15 to 24. HPV is so common that it is thought that most sexually active adults will become infected at some point in their lives. Of the more than 40 types of HPV that infect human mucosal surfaces, most infections are asymptomatic and transient, which makes the spread even easier (HPV Vaccine Information for Clinicians, 2008).

The HPV vaccine is routinely recommended for girls who are 11 and 12 years old. The vaccine series can be started as early as age 9. A catch-up vaccination is recommended for 13 through 26-year-old females who…… [read more]


Presentation on Regulatory Affairs in Biotechnology Thesis

Thesis  |  2 pages (805 words)
Bibliography Sources: 10

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Biotech Regulation

Regulation in Biotechnology

FDA

The Food and Drug Administration has been in existence since 1902

Even prior to the biotechnology age, the FDA had regulatory power over drugs and certain medical devices

In the mid 1980s, major reforms of FDA powers and responsibilities were instituted

The Coordinated Framework for Regulation of Biotechnology (1986)

Legislation and policy reform that led to greater coordination between federal agencies

Established clearer criteria for biotechnological advances and products

FDA works within similar parameters to the USDA and the EPA, ensuring the quality and safety -- both personally and to the environment -- of biotechnological developments

Time and Costs Associated with Regulation

The FDA's drug approval process is slow and arduous, requiring large amounts of capital from producing companies

Information from independent clinical trials is often utilized by the FDA in the decision making process, leading to some concerns regarding bias and reliability

A lack of adequate funding and a still-present reluctance to rely on outside expertise continue to hamper the FDA's regulatory efforts and slow the approval process

Phase 1 Drug Trials

Phase 1 drug trials represent the first time a new drug is administered to human beings, after having been extensively studied chemically and in other organisms

Safety and side effect concerns, rather than efficacy, are the primary areas of research interest during Phase 1 trials

Small groups of healthy individuals -- less than 100 -- are administered the drug and carefully monitored in studies often contracted out by the manufacturer

Phase 1 Controversies

Recent studies have found that Phase 1 trial results are far less likely to be published than other medical research findings, including the results of later trial studies

Manufacturers argue that confidentiality is essential in the industry, and that the need to protect proprietary information is of greater importance than making early findings public

Critics suggest that there is failure in ethical duty when the dangers and risks of a new drug are not made available to physicians or the public in the form of publication

Phase 2 Trials

Phase 2 trials consist of larger groups of people being administered the drug; safety of the drug is still a major concern during Phase 2 trials

Determining the efficacy of the drug in combating specific diseases and/or symptoms is the primary research goal during a Phase 2 trial

Phase 2 participants generally have some symptomology of the disease/condition the drug is…… [read more]


In the News Swine Flue and the Vaccine Research Proposal

Research Proposal  |  2 pages (655 words)
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Swine Flu and the Vaccine

Reasons for the H1N1 Vaccine Shortage

Although many people are aware of the importance of being vaccinated for H1N1, there's little they can currently do to obtain the vaccine as early as needed. The article H1N1 running rampant amid shortage of vaccine (Fiore, 2009) reveals the implications for a shortage of the H1N1 vaccine and a high-level reason supply lags demand as this paper summarizes. but, the devil is in the details of explaining underlying policies and actions that have led to poor preparation and response.

As of middle of October 2009, more than 5,000 cases of H1N1 flu have been reported in 2009 resulting in more than 800 deaths. Only 25% of the vaccine that was expected by the end of October will actually be available. This is a large problem because, typically, flu spikes happen in January, but the H1N1 virus is already spiking in October. Unfortunately, there will not be widespread availability of the vaccine until the middle of November. In addition to the lack of H1N1 vaccine, there is not enough pediatric Tamiflu available, an issue that is causing concern because children are a high-risk group for complications and death from the H1N1 flu virus.

Health and Human Services Secretary Kathleen Sebelius attributes the vaccine shortage on lower than predicted yields from vaccine manufacturers and on manufacturing glitches. The country is only working with five manufacturers to produce the vaccine. She expects the situation to be resolved moving forward into November and the vaccine will both be safe and effective. In the interim, there are concerns that hospitals are ill equipped to deal with widespread outbreaks where as many as 300,000 flu patients could require ICU treatment this year. The only action appears to be updated guidance to schools, governments and the private sector on how to handle outbreaks.

Although, the article assigns no blame for the shortage of the H1N1 vaccination, it certainly raises red flags and…… [read more]


Proseminar in Biotechnology Thesis

Thesis  |  1 pages (417 words)
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Targeted Investors

The choice of 'B' reflects the superiority of choosing a multi-pronged approach of government financing, venture capital, and 'angel' investors. This choice reflects the reality of the fact that creating a new drug is a financially demanding process for a company, as well as time-consuming. The drug must be both safe and effective. After the product is developed, it will require considerable testing on animals and a series of clinical trials. Even then, there is a finite limit on profitability when its patent runs out or a competitor organization develops a similar product, as occurred with the competition between Eli Lilly's Prozac and its SSRI (selective serotonin reuptake inhibitors) imitators, like Pfizer's Zoloft.

The federal government might be willing to provide funding and even valuable guidance to a pharmaceutical company, if the proposed drug can reduce the spread of a dangerous disease, particularly a public health threat like swine flu. While too much government oversight may be unwelcome at times, the government's support might also facilitate FDA approval. The expense of drug development means that family and friends' contributions will simply not be enough to be meaningful, in financial terms. Paying such individuals back within a reasonable frame of time would be almost impossible. Banks are…… [read more]


Cedillo v. Secretary of Health &amp Human Essay

Essay  |  2 pages (580 words)
Style: Chicago  |  Bibliography Sources: 1

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Cedillo v. Secretary of Health & Human Services

NEGLIGENCE/INTENTIONAL HARM/VACCINE ACT

Cedillo v. Secretary of Health and Human Services (2009)

United Stated Court of Federal Claims

http://www.uscfc.uscourts.gov/sites/default/files/Cedillo_Opinion_Order.pdf

Plaintiff = Theresa and Michael Cedillo, Parents and Guardians of Michelle Cedillo

Defendant = United States Secretary of Health and Human Services

Procedural History: P. filed a claim for compensation under negligence under the Vaccine Act on December 9, 1998. P. asserted that the MMR vaccine given to daughter Michelle caused her to suffer an encephalopathy. On January 14, 2002, P changed their petition from "Table Injury" to "Causation in Fact" claim. P. alleged that vaccines containing thimerosaol, in combination with the MMR vaccine, cause autism, now diagnosed for Michelle by certified medical specialists.

P.'s case is one of approximately 5,000 Vaccine Act cases pending that allege autism, or similar disorder was caused by one or more of the Federally approved vaccines. In an effort to manage such a large group of cases, on July 3, 2002, an Omnibus Autism Proceeding was initiated, and this case agreed to be utilized as one of the test cases within the rubric of causation.

On February 12, 2009, Special Master ruled to deny the P's petition citing that they had failed to demonstrate that thimerosal containing vaccines harm the infant immune system in general, and specifically that thimerosal containing vaccines were the primary cause of Michelle's disability; and that the MMR vaccine causes autism in general and specifically for Michelle. Further, the ruling stated that Michelle's conglomerate issues were decidedly the cause of the vaccines.

On March 13, 2009, P's filed a motion for reconsideration, requesting an overturning of the February decision based on new evidence not available at the June 2007 hearing, ruled on in…… [read more]


Nurses Relate the Contributing Factors Involved in Medication Errors Thesis

Thesis  |  2 pages (582 words)
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¶ … Nurses Relate the Contributing Factors Involved in Medication Errors" (2007), the authors examine in-depth the views of nurses on the factors which contribute to medication errors with the overall goal being to improve upon the current medication administration process in hospitals and clinics. In order to accomplish this goal, the authors include their aims and objectives, design and methods, results, and conclusions relevant to clinical practice via main factors and conditions.

Although the authors of this article discuss a number of important points related to medication errors, three stand out above all others. First and foremost, the authors make some very relevant comments in their introduction section pertaining to the fact that the administration of drugs and medication "remains a traditional task of nurses, consuming up to 40% of work time" and involving great responsibility via making sure that patients receive the right medication and the proper dosage (Tang, Sheu, Yu, Wei and Chen, 2007, p. 448). Also, as a result of the huge increase in the number of available medications for an entire plethora of disorders, the task of providing medications to patients has become more complex and difficult. For instance, in 1961, only 656 medications were available for patient illnesses as compared to more than 8000 as of 1995 with some 17,000 trade and generic drugs, numbers which surely will increase as the "baby boomer" generation ages and requires ever more medication (Tang, Sheu, Yu, Wei and Chen, 2007, p. 448).

Second, there are currently four stages through which a medication/drug must pass before being administered to a patient -- the prescription itself, transcription in an office setting, dispensing and lastly, administration to the patient. Obviously, all of these stages require correctness and accuracy, and as shown…… [read more]


Management Stages of Change: How to Foster Thesis

Thesis  |  2 pages (718 words)
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¶ … Management

Stages of change: How to foster and support change in the life of a thirty-year-old HIV-positive man refusing to take his medications

Change rarely happens swiftly in an individual's life. However, in the case of a thirty-year-old man refusing to take his antiretroviral drugs, it is only natural for a caseworker to wish to hasten the man's progress in moving to a positive lifestyle change, given that a delay could result in a compromise of the patient's long-term health. According to James Prochaska and Carlo DiClementea's studies of drug abusers, the stages of change when an individual embarks upon a profound shift in behavior and lifestyle are: precontemplation (or denial), contemplation (awareness of a problem but uncertainty about the feasibility or desirability of change), preparation and determination to make a change, taking action and having the willpower to change, maintaining the new behavior, and relapsing into the old habits (Kern 2008).

This model suggests that it is critical to determine why the patient is not taking his medications, to move him out of a state of denial and precontemplation. Does the act of taking the medication uncomfortably affirm his illness, in this patient's mind? Or is he depressed and suicidal, and is refusing medical treatment as a passive form of suicide? Dealing with the reality of his illness as a chronic condition but not a death sentence, and affirming his right to live, when perhaps his partner or friends have died, is vitally important. Unlike a drug addiction, which often has a physical component, refusing to take medication is more likely to be rooted in psychological barriers, although financial or social pressures may also have their influence on the patient's noncompliance.

Once these initial psychological barriers are addressed, and the caseworker has a better idea of why the man is not taking his medication, the caseworker must help the man contemplate how to make a change and convince the man of the feasibility of overcoming logistical barriers to taking his medication. Helping the man find financial access and transportation to affordable healthcare clinics can demonstrate how change is easier than the man thought. During the contemplation…… [read more]


Medical Ethics and Embryonic Stem Cell Research Essay

Essay  |  2 pages (557 words)
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Medical Ethics and Embryonic Stem Cell Research

In the United States, a debate over stem cell science evolved in the last two decades of the 20th century. By the turn of the 21st century, conservatives succeeded in pushing strict limitation on the use of federal funding through Congress that excluded the most promising avenues of stem cell science: embryonic stem cell research. In the U.S., that has the same effect as an outright ban, simply because more than 90% of institutional medical research is funded by government grants and not private funding.

Meanwhile, just the tip of the iceberg of stem cell science has already provided significant therapies for numerous human diseases and demonstrated tremendous future potential for other medical applications. It is apparent that stem cell research probably holds the key to the first effective treatment for human cancer, cystic fibrosis, diabetes, and dozens of other debilitating diseases. It is equally clear that stem cell science will eventually provide methods of restoring lost limbs and even enable the growing of replacement organs from tissue that is genetically identical to the patient.

Several specific lines of argument have been offered to support ethical opposition to embryonic stem cell research: (1) that human embryos are already entitled to "personhood" and protected rights because human life begins at the moment of conception; (2) that only God can rightfully create or destroy human life; and (3) that stem cell research is a "slippery slope" away from human cloning and irresponsible genetic breeding.

In between conception and birth, the fertilized human egg develops through many stages, including the first stage of cell mitosis during which the zygote consists of only a few…… [read more]


Hepatitis B Virus (Hbv) Infection Among Makerere Research Proposal

Research Proposal  |  4 pages (1,185 words)
Bibliography Sources: 1

SAMPLE TEXT:

¶ … Hepatitis B virus (HBV) Infection Among Makerere University Medical Students written by Pido and Kagimu has no formal literature and provides minimal background information regarding historical literature in the area of scope and scale within the introduction and closing discussions. The introduction provides a very limited literary development while the discussion follows with a greater description, through peer reviewed literature of the importance of the research. The fact that the population of Ugandan medical students is at greater risk for the infection and transmission of HBV as well as the fact that HBV is endemic in the region are supported in these two sections and are supported by the research conducted.

The study design offers the reader a cross-sectional look at pre-clinical and post-clinical medical students attending a single university and sets the stage for further research and understanding regarding the prevalence of HPV among the population and also supports the increased risk of clinical experience among these students, with some evidence that the population rate of 11% HBV positive individuals almost doubled for medical students at about 20%. Increased exposure risk periods were also identified (i.e. year III post clinical students) and recommendations regarding the improvement of pre-clinical vaccination as well as childhood vaccination improvements were also made.

3. Though the scale of the study was limited to an overall size of only 182 students it represents a good cross sectional population of students in the larger group. Conversely there are only three medical schools in Uganda and this study was conducted at one of those three and included the majority of students at all levels of medical school in it. The fact that the study was also inclusive of both post-clinical and pre-clinical students also lends well to the fact that there is a suspicion of heightened risk during the clinical transition for both issues of maturity (i.e. greater sexual exposures) and clinical exposures associated with work.

4. The study has a duel objective one to create a baseline understanding of the number of medical students who have HBV and to determine how, why and when these students are at greater risk for acquiring HBV in either a public manner, via HBV exposure at work, or via private means as a result of exposure in their private lives, through sexual contact or drug use exposure. The study does not exclude any possible mode of infection.

5. The statistical analysis of the findings was limited to reporting the findings on scale, including demographic, prevalence, risk factor reporting at both a baseline level and among the reports of current cohort, one group with active infection and the second with historical infection. The statistical analysis was comprehensive and inclusive of the double objective of the study. The research study is limited to simple means and average reporting and does not offer more in depth statistical analysis though it does compare findings to other populations, including the general population as well as referring to other research that can be assumed… [read more]


Pathophysiology Interrelatedness: Delusion and Medication Research Proposal

Research Proposal  |  3 pages (924 words)
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Pathophysiology Interrelatedness Case Study: Delusion and Medication of Cardiac Conditions

The scenario described in the case study is centered on the frequently problematic intercession between psychological illness and the need for treatment of regular bodily health concerns. In the case of the subject here, the presence of delusional thinking has confounded regular treatment of high blood pressure and placed the subject in direct danger of ailment or fatality due to myocardial infarction. From a nursing perspective, the primary goal in the scenario is to return the patient to a state of compliance with respect to medication of the hypertension as this is the only conceivable outcome which would reduce the health threat currently facing the patient.

One distinctly complicating factor of the particular scenario is the fact that delusional thinking demands a careful interpretation. The processes which enter into delusional thinking are not always immediately clear. So is this reinforced by the definition drawn from the source by Franklin (1997), which reports that "the DSM-IV defines delusions as "erroneous beliefs that usually involve a misinterpretation of perceptions or experiences." Delusions may be bizarre, that is, 'clearly implausible, not understandable, and not derived from ordinary life experiences' or nonbizarre, that is, involving 'situations that can conceivably occur in real life.' One problem with the DSM-IV definition is that it is not always possible to empirically determine whether the content of a belief is false. Thus, delusions can be placed on a continuum reflecting the availability of evidence that would confirm or disconfirm them." (Franklin, 1)

In the case of the subject of our discussion, this is especially problematic because the patient has selectively determine that it was appropriate to cease taking her blood pressure medication. The decision to suddenly stop t aking one's medication can have damaging and potentially even fatal results. However, it is also directly within one's rights to make the decision that medicating a condition is either an undesirable or ineffective approach. This means that where the patient is concerned, one could make the argument absent the condition of dementia that there are notable positive and negative effects which may be associated with the use of antihypertensives, and that a patient could make the independent decision to withdraw from regular usage.

Indeed, according to some evidence, the long-term usage of diuretic antihypertensives to reduce the presence of excess salts in the body can lead to liver or kidney damage in some cases. (Wikipedia, 1) It has also been connected to kyperkalemia in some instances, which can impact cardiac function as well. (Wikipedia, 1) However, given that the subject of this discussion also suffers from an elevated risk of myocardial infarction, the danger of cardiac arrest or general heart failure is of greater concern than the presence of side effects from…… [read more]


Ethics of Stem Cell Research Stem Cells Thesis

Thesis  |  3 pages (831 words)
Style: MLA  |  Bibliography Sources: 1+

SAMPLE TEXT:

Ethics of Stem Cell Research

Stem cells are probably the most important area of medical research since the discovery of antibiotics in the middle of the 20th century. They will likely produce cures for a wide range of human diseases and other afflictions including traumatic paralysis from injury. Yet, their use provokes intense ethical controversy, mainly from the Religious Right because of their belief that human life begins at conception.

Stem cells are undifferentiated cells with the potential to develop into virtually every type of human tissue under the right conditions (Levine, 2008; Sagan, 1997). They

are capable of being extracted from various different sources but with different potential usefulness depending on their source (Levine, 2008; Pollack, 2007). Generally, stem cells extracted from fetal tissue and umbilical cord blood are hold the greatest potential for medical use because they are the most flexible in terms of their ability to develop into specific tissues. While stem cells can also be extracted from the bone marrow of adult human beings, the process is complicated, expensive, and painful, and those cells are considerably less flexible in their capacity for development into different types of tissues

(Kinsley, 2007).

Beneficial Uses of Stem Cells:

The benefits of stem cells are tremendous: so far, considerable research has demonstrated that continued development of stem cell science will eventually enable physicians to treat, cure, and prevent Alzheimer's, Cystic Fibrosis, Cancer, Diabetes,

Parkinson's, Rheumatoid Arthritis, Sickle Cell, and Tay-Sachs Disease. Furthermore,

because stem cells can be stimulated to develop into complete functioning biological organs such as kidneys, livers, hearts, and lungs, they could very well entirely eliminate the need for donor organs (Sagan, 1997).

Currently, thousands of patients die every year in the United States alone, simply because too few donor organs become available in time to save them (Kinsley, 2007;

Pollack, 2007). Likewise, even the lucky recipients of donor organs must take powerful anti-rejection drugs for the rest of their lives to prevent rejection of the transplanted organs. Those drugs have numerous serious side effects such as the suppression of the entire immune system which causes numerous other medical problems and shortens the lives of organ donors considerably (Levine, 2008).

By generating organs from the combination of the patient's own tissue with fetal stem cells, it will be possible to eliminate this problem in addition to ensuring the survival of the majority of patients on organ recipient lists who do not survive long enough for a transplant organ to be found for them…… [read more]


Acid Base Disorders Term Paper

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Acid-Based Disorders:

Gastroesophageal Reflux

In the article "Eosinophilic Esophagitis Attributed to Gastroesophageal Reflux: Improvement with an Amino Acid-Based Formula," the authors describe a brand-new type of treatment for gastroesophageal reflux which "may be effective in patients with an eosinophilic infiltration of the esophagus" (2009, p. 1503), being the introduction of gastric juices into the esophagus, thus causing common heartburn. As part of their study, the authors point out that patients with chronic gastroesophageal reflux did show some improvement by using a new type of amino acid formula, even when "specific dietary proteins were re-introduced during open food challenges" (2009, p. 1506).

As a disease, gastroesophageal reflux can be described as the backflow of the contents of the stomach into the esophagus "that is often the result of incompetence of the lower esophageal sphincter," a part of the esophagus which normally prevents gastric juices from entering the lower and middle sections of…… [read more]


Molecular Microbiology Essay

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Molecular Microbiology

"RsaL provides quorum sensing homeostasis and functions as a global regulator of gene expression in Pseudomonas aeruginosa." By Giordano Rampioni, Martin Schuster, Everett Peter Greenberg, Iris Bertani, Marco Grasso, Vittorio Venturi, Elisabetta Zennaro, Livia Leoni.

Published in Molecular Microbiology. (2007) 66.6: 1557-1565

One of the most virulent and antibiotic resistant pathogens is Pseudomonas aeruginosa. It is commonly found in both soil and water and its effect on humans can be severe. It can cause acute and chronic infections in patients who have compromised immune systems or are suffering from other ailment which may put them at risk for infection. Pseudomonas aeruginosa, "…is the major cause of death in cystic fibrosis patients and the main cause of chronic wounds." (Rampioni, et. al. 1557)

The authors realize the importance of controlling this pathogen and have targeted quorum sensing as a primary first line defense in regulating this bacteria's virulent growth rate and debilitating effect in human beings. Quorum sensing can be compared to a social behavior determinant which helps to regulate the overall population density of the bacterial community of Pseudomonas aeruginosa. In effect it is the controlling mechanism that senses the environment around the bacteria and starts or stops a population explosion of the pathogen. Finding the key chemical in the molecules of this genetic trigger is of primary concern tot he authors. Using Molecular microbiological techniques to control the gene expression may be far more effective that simple antibiotic treatments, which bacterial strains can become immune to over time in just a few generations of the population.

Finding the control mechanism is no small task as quorum sensing in Pseudomonas aeruginosa, as in most organisms, is a rather complex function with more than one causal chemical reactant to trigger the response. One of the key signal compunds is N-O-oxo-dodecanoyl-honioserine lactone (SOC1rHSL). This element is essential is required for completing the entire circuit of reaction. This begins the positive regulation of the genetic expression. However the authors focus is on negative regulators that create homeostasis in the pathogens reproduction. While Pseudomonas aeruginosa quorum sensing is influence by many different chemical genetic controls, the RsaL transcriptional regulator is what the author believed to be the ideal negative regulator for the bacteria.

The RsaL transcriptional regulator, encoded by the rsaL gene, represses LasI expression by binding the promoter of !asl (P/asl) (de Kievit oraL, 1999; Rampioni etal., 2006). Besides LasR, RsaL is the only regulator known to bind Plasl, and among the OS repressors characterized to date it displays the most dramatic effect on 30C12-HSL production. (Rampioni, et. al. 1558)

METHODS RESULTS

Bacterial strains for Pseudorncnas aeruginoss PAOI (wild type) and its reaL derivative strain (rsaL::ISlacZlhah) were obtained from the Washington University's Genome Center's P. aeruglnosa mutant library. The bacterial strains were grown at 37°C in Luria-Bertani broth with aeration and antibiotics to reduce E-coli and other non-specific bacterial growth. The Pseudorncnas aeruginoss double -- mutant strain (PAO-DM1) was generated by using the plasimd pMARLI and then cloning in pMosblue in… [read more]


Evolution ? Sharma S, Kunimoto Dy Research Proposal

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Evolution ?

Sharma S, Kunimoto DY, Garg P, and Rao GN. "Trends in antibiotic resistance of corneal pathogens: Part I. An analysis of commonly used ocular antibiotics." Indian J. Ophthalmol [serial online] 1999

The authors of this study examine bacterial keratitis as the primary pathogen and analyze it root causes as well as the effects of antibiotics that are commonly in use in the current treatment of the disease. They also focus on two age groups that are particularly susceptible to this disease, the elderly population and the pediatric cohort. Both are sensitive to the debilitating effects of this pathogen. The authors hope to refine and improve the current diagnostic procedure and treatment of the disease.

Part I of this series is addressed mainly to community-based ophthalmologists who do not have access to extensive microbiology facilities, and discusses the in-vitro effectiveness of commonly used ocular antibiotics describing their coverage of bacterial species, in the hope that this information will aid in the decision-making of empiric initial treatment. (Sharma, Kunimoto, Garg, & Rao)

Bacterial keratitis is a sight-threatening degenerative disease. One particular dangerous feature of this pathogen is its rapid progression. Complete corneal destruction may occur in under forty-eight hours with some of the more virulent strains of the bacteria. Corneal ulceration, stromal abscess formation, surrounding corneal edema, and anterior segment inflammation are primary characteristic of this infection. (Murillo-Lopez)

According to the authors the main purpose of this study was "…to analyze commonly used ocular antibiotics and determine their in-vitro efficacies against bacterial keratitis pathogens." (Sharma, Kunimoto, Garg, & Rao) the method used was first a review of the microbiology records held at LV Prasad Eye Institute in Hyderabad, India. In these records they identified 1,633 bacterial keratitis isolates and using standard methods they obtained corneal scrapings which they cultivated in culture dishes to produce strains of the bacteria. They presented the following results after testing seven antibiotics in table 2 of their article, table 1 for this review.

Table 1: (Sharma, Kunimoto, Garg, & Rao)

For ophthalmologists without access to microbiology facilities and treating patients on an empirical basis, [Table - 2] provides information which may guide the clinician in making a decision when a change in antibiotic is necessary due to an unsatisfactory clinical response to initial antibiotic therapy. (Sharma, Kunimoto, Garg, & Rao)

However, the authors' results propose that no one antibiotic they had tested would be "appropriate…… [read more]


Kyle, M. ). "The Role of Firm Research Proposal

Research Proposal  |  2 pages (528 words)
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Kyle, M. (2006). "The role of firm characteristics in pharmaceutical product launches." The Rand Journal of Economics (37) 3, pp. 602-18.

The goal of this study was to determine the role that pharmaceutical company set up and market situations had on the release of new pharmaceutical companies. Specific components that the author looked at included market saturation with existing products in relation to the development and release of new products, and the country where the pharmaceutical company has its headquarters.

The time period examined in this study began in 1980 and continued through 2005, shortly before the article was submitted for publication. The quarter-century of data that the author compiled, along with her attempts to collect current information, resulted in accurate and reliable conclusions that are still entirely relevant. This data was collected from a variety of sources, including other journal articles, pharmaceutical company data (largely a matter of public record, and also reported in many other articles). The journal articles consulted for this study had a wide range of topics, from pricing patterns and fluctuations in the pharmaceutical industry to the ethics of drugs development and even the effects of brand loyalty on pharmaceutical consumers.

As with the broad time period covered in the study, this range of information provides a broad picture of the market and firm characteristic effects on pharmaceutical development and new product releases. The many angles from which the author of the study viewed the topic of new drug releases ensures as much as possible that no causes of differentiation were overlooked. Also, the number of sources consulted heightens…… [read more]


Decisions in the Generic Pharmaceutical Industry Research Proposal

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¶ … Decisions in the Generic Pharmaceutical Industry

In this study, author Fiona M. Scott Morton attempted to define the trends of market entry by generic pharmaceutical manufacturers after initial patents with the FDA by branded pharmaceutical companies have expired. Her attempt was not to describe the times and situations when companies should enter new generic markets -- the author repeatedly stresses that the available data did not allow her to draw any conclusions regarding the efficiency of market entry at different times -- but rather to describe the observed behavior of companies in the pharmaceutical industry. The period studied was from 1984 to 1994, and the author collected data from both the Food and Drug Administration and outside sources about company policy.

One suspects that her repeated mention about the unavailability of data due to the "institutional setting" reflects the extreme secrecy with which the branded companies especially tend to operate. It is unlikely that these companies would have shared information regarding strategy with Morton. Several managers of generic manufacturers responded to phone calls, however, and provided qualitative data regarding entry decisions and the considerations of competition, cost of manufacture, and profit potential that were a part of these decisions. The secrecy of the industry does not stop with the branded companies, however, and the generic companies are not immune to its forces, either. Like most businesses, the managers Morton spoke to believed that revealing certain information could reduce a company's competitiveness in a given area or overall. To illustrate this fact, Morton found only one instance in all of her research in which the entry of a company into a new generic market was announced.

Secrecy, this study finds, is a way of limiting the addition of…… [read more]


Global Economy Essay

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Global Economy

The Constant Gardener" (2005): What should be the role of the United States in promoting global economic justice and human flourishing?

The first response of most viewers upon seeing "The Constant Gardener" (2005) which details the use of experimental drugs on poor Africans is that of horror. Surely that could never happen in 'the real world,' it is tempting to cry. However, issues of equity and access to healthcare make the central premise of the film not so far-fetched. First of all, even within America, because of a lack of access to affordable healthcare, many individuals subject themselves to drug trials, hoping for a cure but also simply access to the types of drugs they need to survive. Healthcare access is a pervasive international problem.

The Constant Gardener" demonstrates how untold numbers of individuals in the developing world lack basic access to care. Giving women access to birth control, ensuring decent sanitation, and other measures would save lives and make for a better planet in the long run for all of us, by controlling infectious diseases, reducing the chances of political instability in the region, and allowing economic development to take place. Individuals who can control their family size, drink clean water, and receive vaccinations are more likely to resort to positive, non-violent ways of improving conditions in their country than those citizens who do not have these things.

However, compassion and long-term concerns have seldom guided policies in regards to Africa. One example of this is AIDS treatment, where many individuals struggle to obtain antiretroviral drugs because of the drugs' expense. Under pressure, Western drug companies that sell the drug have offered them to the sick at a discounted rate, but even this is often too much for the poorest of the poor. Pharmaceutical companies have benefited from government protection and the funds of the developed world, and it is within the United…… [read more]


Psychotropic Medications Thesis

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Psychotropic medications treat clinical disorders at the neurological level. All affect neurotransmitters, by increasing or decreasing their availability, processing power, or reuptake. Psychotropic medications are becoming more sophisticated and effective because of advancements in neuroscience. The medications are important adjuncts to psychotherapy because of their ability to minimize symptoms. However, psychotropic medications create side-effects, many of which are harmful, uncomfortable, and in rare cases fatal. Therefore, health care workers must monitor patients taking any psychotropic medications. Other medications, diet, or lifestyle habits may also interfere with the action of the psychotropic drugs. Contraindications must be thoroughly examined before recommending psychotropic medications as a treatment option.

Antidepressants treat mainly major depressive disorder, dysthymic disorder, and can also be used during the depressed phase of bipolar disorder. During the manic phase of bipolar disorder, different medications or treatments may be recommended. Lithium is a commonly prescribed psychotropic drug for treating both the depressive and the manic phases of bipolar disorder (NIMH). The two main classifications of antidepressant medications are monoamine oxidase inhibitors (MAOIs)…… [read more]


Nursing the Clinical Problem Is Identified Immediately Term Paper

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Nursing

The clinical problem is identified immediately in the article. Authors point out that measuring blood pressure is "one of the most commonly used techniques in the diagnosis and treatment of various health care problems," and because of that accurate blood pressure measurements are absolutely necessary (Foster-Fitzpatrick, Ortiz, Sibilano, Marcantonio & Brown, nd, p. 94). An inaccurate measurement could mean an incorrect diagnosis, which in turn might lead to patients being mistreated. Blood pressure varies depending on a number of conditions and the authors postulate that leg positioning might be one of the most important factors in determining accuracy of blood pressure readings. Specifically the authors hypothesize that blood pressure readings will be more accurate when patients keep both feet on the floor. The research is particularly relevant for nursing practice, as blood pressure readings are a routine part of patient intake and ongoing care.

A brief but thorough literature review follows the introduction to the research article. Citing research that denies the relevance of leg positioning during blood pressure readings, the authors provide a balanced point-of-view regarding their hypothesis. The authors also defend their hypothesis by pointing out weaknesses in prior research that might have minimized the effect of leg positioning on blood pressure reading accuracy. Furthermore, the authors explain the reasoning for their hypothesis by citing research about the direct effect of leg crossing on blood pressure. Foster-Fitzpatrick et al. (nd) admit that findings related to the relationship between leg crossing and blood pressure are "inconsistent," (p. 95).

In the introduction to the research article, Foster-Fitzpatrick et al. (nd) state, "The current study was initiated to determine if blood pressure measurement is affected by the leg crossed at the knee as compared with feet flat on the floor," (p. 94). The researchers also explain how they measured blood pressure and which…… [read more]


Manage Care Delivery for Diagnostic Testing and Nursing Term Paper

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Manage Care

Simon: A Case Study

What preparations should you make for Simon's return to the ward post-operatively?

Simon must be well-situated in a bed where he is able to have the necessary pain and antibiotic medication administered intravenously through a cannula and can be closely monitored by hospital staff. It is essential that a member of the staff monitor Simon immediately after the surgery for any complications or changes in his condition. Also, as much as possible, Simon and his mother must be made cognizant of what has occurred. His mother must be made aware of the need to take notes to prepare her for the treatment of Simon's postoperative condition upon discharge, such as monitoring his pain threshold. The usual prescription for nursing care is to elevate and immobilize the affected leg to prevent swelling, as well as to dress the other areas treated by the surgery with antibiotic-treated dressing. The dressings must be changed daily on the exposed wounds motion ("Fractures of the tibia and fibula," 2008, Chapter 21: Practical Plastic Surgery).

Question 2: Based on Simon's story what observations are you going to perform on Simon in the first 8 hours after his return from theatre?

Swelling in his leg and around his open wounds, loss of sensation in the affected leg, headache from a possible concussion that may be the as-yet undiscovered result from his fall, examining him for possible stress fractures or other fractures that were not immediately obvious upon his entry into the hospital should all be part of his continuing evaluation.

Question 3: Simon complains of increasing pain and tingling in his lower left leg. You notice swelling of his toes. What could be happening and what interventions need to be performed?

It is possible that Simon's circulation is affected from the immobilization of his leg. It is also possible that his vascular status is affected by the injury, or that he may have an arterial injury. To screen for arterial injuries it is advised to check if Simon's capillary refill and the circulation on the top of the foot and behind the posterior tibia's artery. If signs of circulation are not present, a serious arterial injury might be suspected. Simon should also be evaluated for evidence of nerve dysfunction or injury, and he should be checked for sensation in the deep nerve of the first web space on between the big toe and the second toe, the plantar surface of the foot or posterior tibial nerve and the lateral aspect of the foot or sural nerve. He should also be checked as much as possible for active ankle motion and toe motion within the confines of his injury and immobilization ("Fractures of the tibia and fibula," 2008, Chapter 21: Practical Plastic Surgery).

Question 4: Simon's IV cannula has become red and swollen since he had a dose of antibiotics. What…… [read more]


Vaccines and Autism Term Paper

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Vaccines and Autism

The work of Bob McChesney (2001) entitled: "Policing the Unthinkable" states that over the past twenty years due to "...neoliberal deregulation and new communication technologies, the media systems across the world have undergone a startling transformation." (McChesney, 2001) This is due to fewer companies that are larger in size and exert more control from a "vast empires… [read more]


Healthcare Ethics - Gardasil Term Paper

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Healthcare Ethics - Gardasil

HEALTHCARE ETHICS: GARDASIL

Recommendations about widespread public inoculating against the two strains of human papilloma virus (HPV) responsible for 70% of cervical cancers every year in the U.S. is probably a good idea. In principle, it is not any different than other mandatory inoculations administered to school-age children, such as for polio and measles at 5 or 6. Like those deadly childhood diseases, HPV is also deadly, accounting for the deaths of more than one third of the 10,000 (mostly) women diagnosed with cervical cancer; also like polio, HPV is a childhood disease with severe consequences. The only real difference is that HPV remains (in effect) "dormant" until adulthood.

On the other hand, there are several potential issues for relevant inquiry before implementing Merck's suggestions for wide inoculations using its new vaccine Gardasil: (1) the drug was rushed through the Federal Drug Administration (FDA) approval process; (2) critics point out that longer clinical trials would be more appropriate before making the decision; (3) two members of the FDA…… [read more]


New Pharmaceuticals Term Paper

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New Pharmaceuticals

From the time a new chemical compound is discovered, to the time when (and if) it is available for marketing, it may be many years. Any new drug must be evaluated by a clinical trial - a research study in which human beings are administered the drug and then observed for side effects or physical problems. The clinical trials are broken into several different phases:

Phase I trials use an experiment drug on a very small group. This may be done to identify safety issues or side effects. It can also be used to determine what the dose range for a medication should be.

Phase II trials give the drug to a larger number of people, mostly to see if it works for a certain type of condition, or for more safety testing.

Phase III trials give the drug to a large group, maybe up to 3,000 people. These patients will often have the condition the drug is being used to treat, and this allows the scientists to review information about the treatment and more safety testing.

Phase IV trials are done after the drug has already been out on the market, and tests are continued in an attempt to evaluate the drug's safety and effectiveness.

At any point in the testing process, the drug study may be discontinued, especially if there appears to be a safety issue or else if the drug is thought to have too many side effects for marketability. The cost of the trials falls on the pharmaceutical company, who hopes that the drug will be successful. It is estimated by the FDA (2002) that for 100 drugs that enter Phase I testing, one drug will eventually make it to market.

Anyone can apply to take part in…… [read more]


Pharmaceutical Companies Spend Millions of Dollars Advertising Term Paper

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Pharmaceutical companies spend millions of dollars advertising directly to patients or potential consumers of their products. Advertisements bombard our psyche with everything from erectile dysfunction remedies, blood pressure and cholesterol drugs to acne meds. Pharmaceutical representatives visit physicians daily leaving them with samples and other goodies. Does such commercialization of drugs increase their costs or is the real high cost of drugs due to the research and development? Should the U.S. allow patients to import expensive medications from other countries?

To be as fair to 'big pharma' as possible, it must be observed that it is indeed expensive to create new drugs and to test the drugs extensively on animal or human subjects. Even if some drugs are relatively inexpensive to produce or to bring from lab to market, other drugs, like antiretroviral drugs, were quite costly to bring to fruition, and their initial prices often reflect years of research. Also, because drug patents are of limited duration, it is in the drug company's interest to make as much money off of a new pharmaceutical before the patent runs out and cheaper generic drugs flood the market. Even before a drug's patent is exhausted, quite often very similar drugs from competitor…… [read more]


Proteus Vulgaris Term Paper

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¶ … diseases associated with the bacterium called Proteus vulgaris, outlines its history, explains how the bacterium is transmitted, and its diagnosis, besides discussing prevention of the diseases that proteus vulgaris causes, and their treatment. It also includes an outline of the paper and bibliography.

What is Proteus Vulgaris?

Proteus vulgaris (also known as P. vulgaris) is a rod-shaped, gram… [read more]


Cement Shortage Lakkireddy, Et Al. ) Examined Term Paper

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Cement Shortage

Lakkireddy, et al. (2005) examined the effect of Povidone-iodine pocket irrigation on the rate of infection from permanent pacemakers (PMs) and implantable cardioverter defibrillators (ICDs). Compared with a control group that received PMs or ICDs irrigated in saline solution, the patients whose devices were irrigated with Povidone-iodine did not experience a lower rate of infection. Povidone-iodine pocket irrigation is, however, commonly used as a preventative measure against the infections that may occur after implantation. The substance is an antiseptic also known as Betadine.

The Lakkireddy et al. (2005) study was comprehensive, involving over 2500 patients over an eight-year period. Slightly less than half of the patients received saline irrigation in the pocket and slightly more than half of the patients' pockets were irrigated with Povidone-iodone. Contrary to the hypothesis, there were no significant differences in the rate of infection between the two groups.

About one-third of all the patients who did experience infection had diabetes. Therefore, other intervening factors may have affected the development of the infection regardless of the whether the pocket was irrigated with the Povidone-iodine or not. Infections were treated immediately with a course of antibiotics but some complications did arise including one patient death as the result of septic shock.

Lakkireddy et al. (2005) note that implanting PMs, ICDs or any other invasive device demands the strictest aseptic procedures. Povidone-iodine is one way to topically irrigate the pocket before implantation as a means to prevent infection. Combined with antibiotics, the Povidone-iodine irrigation may prevent complications but antibiotics may be contraindicated.

The authors questioned the role of Povidone-iodine vs. other antiseptics, noting that…… [read more]


Autism and Immunizations Term Paper

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Autism refers to a group of disorders of the brain that undermine the normal cognitive development and the general sensory perception and processing in children. Regressive autism is one of the forms wherein children who had developed normally start to loose their cognitive motor skills and progressively fall into autism. There is much debate surrounding the MMR and DPT vaccinations and their possible link with the development of regressive autism. The timing of these vaccinations at 15 months and 18 months fall in the same period when most children contract regressive autism (18 to 24 months). This gives enough reason for researchers to suspect a positive link between the two. The following discussion is based on two articles that have differing viewpoints about vaccination and the link to autism. A brief overview would provide us with a better insight on the issue.

In the first article, Dr. Mary Megson, strongly opines that MMR and DPT vaccination could have a direct relation to development of regressive autism in children. Dr. Megson says that the increase in number of autistic children is due to the increasing vaccinations, particularly, the MMR and DPT vaccines. The DPT vaccine contains pertusis toxin known to cause defective G. alpha protein. She states that DPT vaccination causes G-Alpha Protein Defects, which separates the G. protein from its retinoid receptors resulting in depletion of vitamin a and night vision impairment, a common symptom in autistic children. She explains that an intact G. alpha protein is critical not only for vision but also for touch, hearing and other sensory perceptions. Also, vitamin a is known as the "anti - infective agent" and its depletion makes the children immunosuppressed leaving them open to other opportunistic infections.

Dr. Megson argues that since G. alpha proteins control various metabolic pathways any disruption in them could trigger gluconeogenesis, hyperlipidemia and cellular malignancies. She further expounds that the MMR vaccine given earlier affects aproptosis by cross-reacting with the cytoplasmic intermediate filaments. This affects cellular communication and the ability of the cells to destroy abnormal cells in the vicinity. So as per Dr. Megson, MMR and DPT constitute a deadly combination. She urges the government to implement a new vaccine policy with safety of the children as the first priority. [Mary Megson]

The other article by Michelle meadows contradicts the hypothesis linking autism and vaccines. Quoting studies across the U.S., UK, Denmark and Sweden the article tries to disprove the vaccine theory for regressive autism disorder. While admitting that 'Thimerosal', a mercury-based…… [read more]


Autism vs. Vaccines Does One Cause Term Paper

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Vaccination and Autism: A Causal Relationship

The debate over whether or not autism actually exists independent of vaccinations has been ongoing for decades. DPT, diphtheria, pertussis, tetanus), commonly known as the three-in-one vaccination, until the 1980s, when the outcry about the possibility of the combination of these drugs being administered in a single injection, causing some children to have an adverse reaction to the combination, and leaving those children in a condition largely diagnosed as "autistic," resulted in the three-in-one vaccination being discontinued as a single injection. This, only after much evidence documenting the causal relationship between certain childhood conditions, sometimes death that could be closely linked to the three-in-one drug combination. However, even in the face of the vast body of evidence supporting the link between the DPT and neurological damage suffered by young children; the vaccinations continue to be given to children, albeit usually separately administered by pediatricians today, as opposed to the combination in which they were once administered.

The Evidence

The evidence supporting the neurological and other kinds of permanent damage done to children by the DPT vaccines is vast. It is best to approach the evidence has been documented and presented to the public by authors like Harris Coulter and Barbara Loe Fisher, in their books DPT: A Shot in the Dark (1985), and Vaccination, Social…… [read more]


Admin Law Term Paper

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Vaccines

The issue at hand is why federal agencies will not take liability for the use of the Swine Flu Vaccine or the Anthrax Vaccine, both of which are clearly needed and could save many lives if administered in a wide basis. The issue was first raised with the swine flu epidemic in 1976, at which time President Gerald Ford… [read more]


Contraceptive Seasonale Term Paper

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Contraceptive Seasonale

Contraceptive: Seasonale

The contraceptive Seasonale is the first product that has been approved to prevent pregnancy on a 91 day cycle, with 84 therapeutically active pills and 7 placeboes. The medication is a combined oral contraceptive, containing a form of both progesterone and estrogen, in this case, levonogestrel 0.15 mg and ethinyl estradiol 0.03 mg. The length of the cycle of the medication attempts to create a situation where the woman taking the medication only has one period every 84 or so days, reducing the number of periods per year from approximately 13, on a normal 28 day cycle to only 4 on a 91 day cycle. (DuraMed, 2003, Seasonale Insert)

Seasonale has a reliability, if taken correctly of 99% with the incidence of unexpected pregnancy with perfect use being less than 1% and with typical use being approximately 5%. (Paulo Alto Medical Foundation Website "Seasonale" 2003) This is comparable to all other forms of combined oral contraceptives a clear indication that the length of the cycle does not deter effectiveness. (DuraMed, 2003, Seasonale Insert) the incidence of unintended pregnancy does go up significantly when doses are missed, especially during crucial cycle days, yet this is also similar to 28 day cycle combined oral contraceptives.

The most significant advantage to taking Seasonale include the obvious, a reduced number of periods per year as well as decreased intensity of symptomatic periods. In a sense the indication that any form of combined oral contraceptive can be taken for such a long cycle without causing unintended or unusual side effects as compared to other COC, is a significant step in the COC offerings of the industry as it effectiveness is a testament to its use.

Some disadvantages to taking Seasonale include: like other forms of oral contraceptives it is essential to take it daily, and usually around the same time every day. Furthermore, like other forms of OCs it can cause serious side effects like, blood clots stroke and heart attack side effects which increase in risk if the patient smokes cigarettes while taking the medication. The disadvantages which are specific to Seasonale include the difficulty of awareness of unintended pregnancy without the monthly reminder of the…… [read more]


Psychologic Social and Economic Issues Facing Homeless People and Ways to Increase Compliance Term Paper

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Psychological, social and economic issues facing homeless people and ways to increase compliance among them.

Within the homeless population there are many individuals that require medication for a psychological illness or problem. Unfortunately, many of these individuals do not receive the medication that they need for their mental disorders as there are psychological, social, and economic issues that affect their ability and their desire to seek treatment and to remain on a medication once it is prescribed to them. Where psychological issues are concerned, many people with mental illnesses stop taking medication once they start to feel better because they convince themselves that they are 'cured.' Socially, these individuals may also have a difficult time with taking medication because they often find that they are already ridiculed enough by many segments of society and therefore they do not want to take medications that might stigmatize them further. Economically, they often cannot afford their medications. If they are homeless, they already have serious problems with their finances and if their day of asking for handouts or working as a day-laborer nets them profit they…… [read more]


Fighting Cancer Is Among Medical Term Paper

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Prior to my full-time medical research work I was involved in Pfizer's file enrichment program, developing process chemistry methods. Our research team conducted platform chemistry reactions including high-throughput library synthesis and parallel synthesis of small drug-like compounds. In a similar vein, as assistant to the senior scientist of the project, I selected regeant monomers and evaluated optimized conditions for chemistry library protocols.

Another highlight of my career so far is my contribution to the synthesis of Cytosine and its analogs. Cytosine shows promise as a treatment for Alzheimer's disease, Parkinson's disease, pain, addiction to smoking, ulcerative colitis, obesity and anxiety disorder. However, no synthetic Cytosine is available in clinical settings yet, so further research is required in this area. Our goal was to prove the possibility of parallel synthesis of different cytosine analogs using Arqule technology and methodology. Our team successfully developed a template for synthesis, a protocol involving eight different reaction steps.

As you can glean from this brief explanation of the work I have done so far, my talents in the laboratory are proven and I look forward to contributing further to the scientific community through…… [read more]


Infectious Disease Staphylococcus Aureus Term Paper

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Infectious disease - Staphylococcus aureus

Review of the Epidemiology of Staphylococcus aureus

As the percentage of elderly in the United States continues to increase, it is reasonable to expect more and more people to become hospitalized for one reason or another in the coming years. One of the more challenging problems associated with hospitals stays to date has been nosocomial… [read more]


Neutropenic Patients With Fever Term Paper

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Like other blood cells, neutrophils arise from the hemtopoietic stem cells which exhibit pluripotential. Some of the drugs already mentioned actually effect the cells within the marrow. This may occur at any point during the cellular maturation process or after the cell is released into circulation. Europhiles also have distinctive surface antigens which may make the susceptible to immune mediated cytolysis somewhat similar to that which is seen in an auto-immune related hemolysis. The cells then begin increased margination and become excessively adhesive to the vascular endothelium or trapped within the lungs and the spleen. Sequestration of the neutrophils within the spleen in such a case may lead to splenic enlargement. This in turn can lead to an activation of the complement cascade, resulting in increased margination, increased vascular adhesiveness.

There may be no specific sign of neutropenic fever in a MICU patient other than manifestation of those causative infections which may be present. Any other associated symptoms are likely associated with the severity of the condition, the duration of the neutropenia and of course the cause. Patients should be monitored with serial complete blood counts to include a differential count as well as blood cultures for bacterial and fungal pathogens. Bone marrow biopsy is most likely the most effective and useful laboratory evaluation in the patient with neutropenic fever, and may help discern leukemia, infiltrative or myeloproliferative disorders. The exact cause of the neutropenia may be difficult to determine. A neutrophilic antibody count may be helpful when no other obvious cause may be determined.

Treatment will be directed toward causative organisms as well as supportive therapy, and the duration and nature of the neutropenia. Acute and severe neutropenia with infection and fever always requires intensive treatment with a broad spectrum antibiotic until specific etiology can be determined. Should there be any suspicion that the neutropenia is secondary to a drug side effect, then obviously the effecting agents should be discontinued immediately. Antibiotics should be continued, even when cultures are negative, until the patient is afebrile for 24 to 48 hours, or until an alternative diagnosis and prognosis are clearly defined.

Transfusions may be helpful in patients with severe neutropenia, but the risk vs. benefit must be carefully weighed. Donor matching is difficult; sensitization may occur transfusion should not be considered in any patient in whom it would be considered to be prophylactic. Bone marrow stimulation with androgenic steroids, vitamin infusions or other agents is generally unsuccessful. The recovery of cell counts with cell stimulation agents or hematopoetic growth factors after chemotherapy may be of use, but in the acutely neutropenic patient the benefit may be of limited use.

Reference:

Finberg RW, Talcott JA: Fever and neutropenia -- how to use a new treatment strategy. N Engl J. Med 1999 Jul 29; 341(5): 362-3

Vial T, Gallant C, Choquet-Kastylevsky G: Treatment of drug-induced agranulocytosis with haematopoietic growth factors- A…… [read more]


Cellular Reproduction Term Paper

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They can replace damaged cells in patients with spinal cord injuries or heart disease.

We have made great strides with cell reproduction. What the opposition doesn't realize is that reproduction has been in effect for many years. The vaccine for Jaundice as well as other vaccinations and drugs used today are from reproduction. We are now able to offer patients with certain diseases a new chance at life. Society has taken a medical and made it a political issue. Shouldn't the end justify the means?

Oligodendrocytes: cells the cover the nerves with a fatty substance and enable them to relay messages to the brain.

Blastocyst: an embryo that is five-day-old and has taken spherical shape.

Stem Cell: a basic cell that can develop into different types of mature cells.

Articles:

Current Science

5/6/2005

Page: 1

The Problem of Medical Ethics

British…… [read more]


Merck and Vioxx -- Research Term Paper

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At the time of the study's release, Merck stated that the resulting difference was merely caused by the heart-protective effect of naproxen rather than the heart-risk effect of Vioxx, not by any additional risk. (Steyer, 2004) But in later data showed that the heart-risk effects of Vioxx exceeded any potential screening capabilities from attacks on the part of naproxen.

What are the limitations and significance of the research data?

This highlights the dangers of using two drugs during a clinical research study. Naproxen may indeed have a heart-protective capacity -- but that does not mean that Vioxx cannot compromise many patients' heart health. Nor is the heart-protective capability of naporoxen entirely proven. Regardless, "preliminary data from an FDA-financed study, using patient data compiled by the Kaiser Permanente health maintenance organization, says patients who took Vioxx had a higher cardiovascular risk than patients who took Celebrex," although Merck disputes the independent FDA study's methodology. The "FDA posts a more detailed version of the study on its Web site in November, but says the article hasn't been subject to standard peer review." (Steyer, 2004)

Works Cited

"Merck's Vioxx emails scrutinized." (1 Nov 2004) CNN.com. CNN Money. Retrieved 22 Jun 2005 at http://money.cnn.com/2004/11/01/news/fortune500/merck/

Steyer, Robert. (18 Nov 2004) "The Murky history of Merck's Vioxx." The Street. Retrieved 22 Jun 2005 at http://www.thestreet.com/_googlen/stocks/biotech/10195104.html?cm_ven=GOOGLEN& cm_cat=FREE& cm_ite=NA… [read more]


Cloning Dolly, the World's First Term Paper

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On a related note, perfecting the cloning procedure would enable gay couples to become biological parents. Currently, gays are restricted from adopting children and are even prohibited from marrying in most states and countries. Cloning would allow gay and lesbian couples to have children and overcome some of the legal obstacles standing in their way.

One of the most promising applications of cloning is medical research. Through cloning, scientists can grow organs and tissues that can be transplanted into sick people. Spinal cord injuries, Down's syndrome, kidney, liver, and heart disease, and even cancer can be potentially cured through cloning. Cloning can also be used to heal severe burns or as an adjunct in plastic or reconstructive surgeries. Cloned body parts can serve in a variety of helpful capacities in this way, which would eliminate the ethical problems with cloning an entire human being just to harvest the organs. The ban on cloning might be cutting short the lives of many individuals who could be easily helped through the medical breakthroughs that cloning can offer.

Understandably, people are afraid that cloning could cause two main problems. First, the story of Dr. Frankenstein shows how cloned creatures could be imperfect, even monstrous. A cloned human might indeed be viewed and treated differently by his or her parents and peers. Furthermore, until cloning is perfected, there will be many sad victims of botched procedures. So far, many animals have died because the cloning process did not work properly. Other drawbacks of cloning include the abuse of the practice by people who would clone human beings just so that they could harvest organs; it would definitely be unethical to clone a human being only to keep it alive for organ harvesting purposes. Finally, cloning also raises important questions regarding the affordability of the procedure, for only wealthy people might be able to take advantage of cloning.

When all things are considered, cloning can be of enormous benefit to the human community. Medical benefits include the production of healthy organs and tissues for the sick, an alternative to fertility drugs, and assisting gay couples in having children of their own. Fears about cloning are understandable, but will be alleviated as more research is performed. The only way we can know if human cloning is viable and feasible is to conduct and fund more research. Therefore, the ban on cloning should be lifted and money should be channeled into the cloning process. Politicians should reconsider the ban and scientists should be able to pursue one of the most promising scientific developments of this century.

Works Cited

Dixon, Patrick. "Human Cloning Headlines." Online at .

'Dolly." HowStuffWorks.com. Online at .

Smith, Simon. "All the Reasons to Clone Human Beings." HumanCloning.org. Online at .… [read more]


Helicobacter Pylori Helicobacter (Genus) Term Paper

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Immune Response Avoidance

The severe immune response to H. pylori is characterized by an increase in IgG antibodies in the plasma that remain present for months following infection. Production of IgA antibodies also increase upon infection by H. pylori. An intense inflammatory response also follows infection by H. pylori, which leads to infiltration of numerous B. And T cells into the gastric mucosa. H. pylori is able to increase the number of T cells infiltrating the mucosa. It is thought that this ability to influence T cell activity may be the key to H. pylori's evasion of the immune response (Hofman et al. 19).

Diagnosis

Tests for the detection of H. pylori infection include blood antibody tests, urea breath tests, stool antigen tests and endoscopic biopsies (Pellicano et al. 130; Nakayama and Graham 604). Blood antibody tests are good for diagnosing infection, but they are not good for determining if antibiotics have successfully eradicated the bacterium. The urea breath test is a safe, easy, and accurate test for the presence of H. pylori in the stomach. Ten to 20 minutes after swallowing a capsule containing "labeled" urea, a breath sample is collected and analyzed for labeled carbon dioxide. The presence of labeled carbon dioxide in the breath means that there is active infection. Endoscopy is an accurate test for diagnosing H. pylori as well as the inflammation and ulcers that it causes ("Which Test for Helicobacter Pylori in Primary Care?" 71). During endoscopy, small tissue biopsies from the stomach lining are placed on special slides containing urea. If the urea is broken down by H. pylori in the biopsy, there is a simple color change around the biopsy sample on the slide. The most recently-developed test for H. pylori is a test in which the presence of the bacterium can be diagnosed with a sample of stool. The stool test can be used to diagnose infection with H. pylori as well as shortly after treatment to determine if the bacterium has been eradicated.

Therapy

In gastric ulcer patients where H. pylori is present, the first-line therapy is the eradication of the organism causing the ulcer. The standard first-line therapy is a 1 week triple-therapy of amoxicillin, clarithromycin and omeprazole (Nakayama and Graham 604). Occasionally, a different proton pump inhibitor is substituted, or metronidazole is used in place of amoxicillin in those allergic to penicillin. Such a therapy has revolutionized the treatment of gastric ulcers and has made a cure to the disease possible, where previously symptom-control using antacids or H2-antagonists was the only option. Unfortunately, an increasing number of infected individuals are found to harbor bacteria resistant to first-line antibiotics. This results in initial treatment failure and requires additional rounds of antibiotic therapy (Nakayama and Graham 604; McLoughlin et al. 45).

Works Cited

Delaney, B., P. Moayyedi, and D. Forman. "Helicobacter Pylori Infection." Clin Evid.10 (2003): 535-48.

Hofman, P., et al. "Pathogenesis of Helicobacter Pylori Infection." Helicobacter 9 Suppl 1 (2004): 15-22.

Malcolm, C.A., et al. "Helicobacter Pylori in Children… [read more]


Harris, Gardener Feb 2005) Term Paper

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Naproxen would have been even more effective than aspirin to explain the greater number heart complaints of the group taking the COX-2 inhibitors vs. The Naproxen group.

However, it is still unclear why COX-2 drugs affected body chemicals that determine the stickiness of blood and, thus, the likelihood that someone taking them might experience a heart attack, stroke or similar problem. What is clear from the current controversy is how important it is for consumers to be well informed about the drugs that they take. The COX-2 inhibitor drugs were ubiquitous in their advertising, dominating television and radio, with little explanation of how their chemical composition was different to other painkillers. Although they may have a place for individuals suffering chronic pain, for ordinary arthritis and other minor or temporary pain relief needs, clearly the risks outweigh the benefits. Although this is true of the elderly people whom these drugs were primarily designed to treat, the persuasive quality of pharmaceutical advertising could be applied to drugs for people of all ages, from antidepressants for young people, to weight loss drugs for the middle aged.

The research studies also raise provoking and unanswerable questions about the way drug research is conducted -- how does one validate a hypothesis in an accurate fashion, without depriving the control group of necessary treatment, and yet still produce scientifically valid research?… [read more]


Innovations Term Paper

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Global positioning has also been used in warfare to bomb with more precision than ever before.

Knowledge about atomic energy grew tremendously in the second half of the 20th century. The H. bomb, far worse than the original A bomb, was developed. While at first all the major countries worked as hard as they could and as fast as they could to develop rockets so they could use A bombs if necessary to destroy their enemies, the knowledge that countries could do that to each other may have prevented World War III (Gillmor, 1999). It could be argued that the growing realization that would could wipe out the human race with the push of a few buttons forced the major powers of the world, especially the United States and Russia, to reconsider whether they ever wanted to go to war again. Since the development of easily used nuclear warheads, we have continued to se wars, but the haven't become world wars.

Finally, vaccines and antibiotics should be mentioned. My grandparents say that the diseases childhood vaccines prevent really could be terrible, especially polio. Smallpox has been eradicated. People get flu shots instead of the flu. The importance of vaccines was obvious in the news this year because there wasn't enough flu vaccine to go around. Antibiotics have also greatly improved health. In my grandparents' day, children who got strep throat could develop Rheumatic Fever and die of heart complications. Today if someone gets strep throat, they go to the doctor, get an antibiotic, and are back in school 24 hours later.

SOURCES

Gillmor, Dan. 1999. "The 20th century's most significant tech advances." Knight Ridder/Tribune News Service, Aug. 25.

Maney,…… [read more]


Canine Epilepsy Term Paper

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Canine Epilepsy is a chronic condition characterized by recurrent seizures. It is a disorder of the brain where abnormal electrical activity triggers further uncoordinated nerve transmission. This uncoordinated and haphazard nerve tissue activity scrambles messages to the muscles of a dog's body and the coordinated use of the muscles is then inhibited. Because there are many causes of chronic recurrent seizures in dogs, canine epilepsy is not considered a specific disease or a single syndrome, but rather a diverse category of disorders. Canine Epilepsy is divided into idiopathic and symptomatic disorders. Idiopathic Epilepsy, also called primary epilepsy, means that there is no identifiable brain abnormality other than seizures; in other words the cause is not known. Symptomatic epilepsy, also called secondary epilepsy, is seizures that are the consequence of an identifiable lesion or other specific identifiable causes.

Many of the primay epileptics have inherited epilepsy, epilepsy caused by a mutation in a specific gene which they inherited from their parents. Dogs with primary epilepsy frequently begin seizing at between one and three years of age. Underlying factors that are known to cause seizures in secondary epilepsy include:

Congenital hypoglycemia (low blood sugar),

Hypothyroidism (low thyroid function),

Infections causing brain damage (such as canine distemper, cryptococcosis),

Ingestion of toxins (such as lead paint chips, insecticides)

Brain tumors,

Portosystemic shunts (improperly routed intestinal blood vessels bypass the liver - one of the body's important waste-product detoxifiers), and Vaccinations.

Epilepsy is one of the most common neurologic diseases in dogs. Some studies estimate that up to four percent of all dogs are affected. In some breeds, the incidence may be higher and some families may have up to fourteen percent epileptics. Several breeds have a real problem with epilepsy, some of which epilepsy is believed to have a genetic basis. It has been found to be very common in German Shepherds, Belgian Tervurens, Keeshondens, Beagles, Cocker Spaniels, Golden Retrievers, Irish Setters, Labrador Retrievers, Poodles, Saint Bernards, Siberian Huskies, and Wire-haired Fox Terriers.

There are four classifications of seizures in canine epilepsy:

Mild (Petit Mal) seizures can be a simple as momentarily staring into space, or upward eye movement.

Moderate (Grand Mal) seizures are characterized by the dog falling down, losing consciousness and extending its limbs rigidly. Paddling of limbs, salivation followed by possible loss of control of bladder and bowels and vocalization (blood curdling scream) may follow. This may occur for up to three minutes and is most often followed by a period of restlessness, pacing, bumping into objects and loss of balance known as the Post Ictal period. The dog is conscious but may appear deaf, blind and disoriented. Great care must be taken to prevent the dog from injuring itself at this time.

Status Epilepticus can occur as one continuous seizure lasting ten minutes or more, or a series of multiple seizures in a short time with no period of normal consciousness. This type of seizure may be life threatening.

Cluster Seizures involve multiple seizures within a twenty four-hour period time… [read more]


Pharmaceutical Industries: Merck &amp Co., Inc Term Paper

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Pharmaceutical Industries: Merck & Co., Inc.

Order ID: Benchmarks in the Rise of Big Gov. 1901 -- 1981

International Pharmaceutical Industry

The purpose of this work is to perform a general analysis of the international trends of the pharmaceutical industry in terms of global or local issues as well as the strategies of the leading company, Merck & Co., Inc. And to review the governmental policies toward the pharmaceutical industry.

The Global Pharmaceutical Industry/Supply Chain:

The pharmaceutical industry is global industry. Global pharmaceutical sales grew 10% at a constant rate in 2000 equaling $317.2 billion in total sales which was up from the 1999 amount of sales equaling $295.9 billion. Japan was the largest consumer in the 2000 pharmaceutical industry at 88% of total global consumption.

Investor Concerns:

The largest concerns of the investors in the industry are that:

Government action will make it harder to get patents on products giving a rise to generic drugs.

Medicare drug benefits could end up with legislation in Washington price-setting drugs.

Open-ended class action market

III. Trade in the Industry/Market & Network

Merck Anticipates Full-Year 2005 Earnings Per Share Range of $2.42 to $2.52. Continued growth and development of newer franchises is planned by Merck in 2005 as well as extending the recent launches of ZETIA and VYTORIN, which have been a success thus far. New products are planned to be launched. Plans for the second half of 2005 are inclusive of plans by Merck in submission of three vaccines to the FDA for their approval. The vaccines which are planned for submittal are as follows:

Rotavirus vaccine: "A 'highly contagious' virus that causes gastroenteritis and results in the hospitalization of nearly 50,000 children under age 5 each year in the United States."

HPV vaccine: "This vaccine is engineered to reduce human papillomavirus infection and complications of cervical dancer that kills more women than any other disease each year.

Shingles Vaccine: A Vaccine that reduces the pain that is part of the condition of shingles and is suffered by 1 million American adults per year.

Merck and Co., Inc. is a "global research-driven pharmaceutical company that focuses on discovering, developing, manufacturing and marketing a broad range of innovative products to improve human health both directly as well as through its joint ventures. Merck & Company, Inc. announced on September 30, 2004 "a worldwide withdrawal of VIOXX (rofecoxib) its arthritis and acute pain medication." According to the report the decision is 'effective immediately' and is 'based on a new, three-year data from a prospective, randomized placebo-controlled clinical trial, the APPROVe (Ademonatous Polyp Prevention on VIOXX) trial."

The stated adverse effects of stroke or heart attack have been cited to be caused by VIOXX in certain patients. Merck is presently reimbursing all customers for unused prescriptions which have been filled by the patient. "Recently announced by Merck on November 23, 2004 is that: "the…… [read more]


Motivation. To Pursue My Passion Term Paper

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This is the type of diversity of technique I hope to bring back to my own country. Someday, I hope to found a chiropractic school in Taiwan that functions independently much like Cleveland Chiropractic College. If I cannot accomplish this immediately upon my return to Taiwan, I would try to have my school affiliated with Medical University in Taiwan.

Thus it is diversity above all that motivates my desire to study at Cleveland Chiropractic College, to learn a diversity of techniques while pursuing the study of a medical practice that treats the individual's body and spirit in a holistic fashion. To make maximum use of the personalized nature of chiropractics, one must master the maximum diversity of techniques. Moreover, I believe that my experiences in Taiwan will bring a welcome diversity to the American classroom, and I hope to bring the diversity of techniques, practices, and experiences I shall share in while in the United States back to my home country and the institution I hope to…… [read more]


Psychopharmacology Term Paper

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Patients should be alerted that Chinese foods with MSG can cause major problems. There are also foods that should be eaten in smaller quantities and with caution (Lippmann, 1990 p. 202).

Because of strong marketing efforts as well as the major increase in antidepressant usage, most people have heard of the more recent medications such as the brand names Prozac (fluoxetine) and Paxil (paroxetine). Others are Luxov (fluvoxamine) and Zoloft (sertraline). These are also known as the SSRIs or selective serotonin reuptake inhibitors, because they primarily affect the serotonin.

As noted, the SSRIs inhibit reuptake of serotonin. Reuptake is the first step in the process of deactivating this neurotransmitter in the brain. After serotonin is released from neurons, it is removed from these reuptake sites, located on the cell membrane. SSRIs allow serotonin to remain active in the synapse longer, thereby correcting a presumed deficit in the activity of this neurotransmitter (Trujillo, 1996).

Because SSRIs are more targeted, they have a lower incidence of some of the side effects associated with tricyclic antidepressants and MAOIs (e.g., blurred vision, dizziness, constipation, dry mouth). More important to their current popularity, SSRIs have less potential for overdose than the tricyclics or MAOIs, and are therefore considered safer than these other drug classes. Their most common side effects include trouble sleeping, nausea, and dizziness. Less common side effects include headache, drowsiness, less sex drive, and delayed ejaculation (Yale New Haven, Health Library). They should not be mixed with alcohol, and the doctor should be made aware of other medications being taken.

Although some reports suggest that SSRIs may have more rapid actions than the tricyclics or MAOIs, this does not appear to be the case (Trujillo, 1996). Like other classes of antidepressants, clinical response to the SSRIs may take anywhere from two to six weeks to appear.

When talking with their patients, physicians should address a couple of other issues concerning antidepressants. First, are expectations (Yudofsky, 1991 p. 46). Most people are used to having a headache or stomach ache, taking a pill and having a very fast reaction to the pain. Antidepressants take up to six weeks to work, if they do have an affect. Many patients have to try several medications before finding one that offers the least side effects and best treats the condition. In addition, some patients have partial but not full results. Other drugs may be taken for augmentation. The patients must also understand that medications are not the total answer. They should be used along with therapy and other psychiatric measures.

Patients must also be told that antidepressants work differently than many other medications in the sense that they need to be taken on a continual basis, in the necessary dosage, and often at a particular time of day. Starting and stopping and restarting the drugs is definitely not advised, nor is taking larger dosages for greater affect. Further, if a patient has been on a medication for some time and is starting to feel better, he/she should… [read more]


Discovery / Development Term Paper

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Unable to get the financial backing in England for further development of the drug, Chain and Florey went to the U.S.A. And got the support to start large-scale production of the miracle drug. By the end of World War II, enough penicillin was available for the Allied soldiers to prevent the appalling number of deaths caused by infectious diseases during the First World War. Soon, penicillin and other antibiotics that were developed in its wake became available commercially and were instrumental in man's fight against several deadly diseases.

Let us see why penicillin, rather than some other invention, deserves the 'honor' of being crowned the greatest discovery of the last century. Among other strong contenders are the automobile, the airplane, the wireless, electricity, the transistor and the personal computer. The automobile and electricity are technically disqualified as they were invented in the previous centuries. Out of the rest, the airplane and personal computer were the result of development of existing technologies rather than breakthrough ideas. For example, the steam engine (discovered in the 18th century), had already made rapid propulsion possible by burning fuel. Development of the airplane and the automobile were the inevitable next step in refinement of an existing technology. Similarly, development of the computer was based on utilizing the unique ability of the transistor to control the flow of electric current. In my opinion, the discovery of the 'transistor' is almost as important as that of penicillin as it has made the hugely influential 'information revolution' possible. Penicillin's ability to save lives rather than merely making lives easier, however, beats the transistor into second place.

In the end, it is safe to say that the development of penicillin has had a more profound effect on the health of humanity than perhaps any other invention in history. It, therefore, truly deserves to be called the greatest discovery of the last century.

A the head of the Sir William Dunn School of Pathology at Oxford

The first automobile was produced in the late 19th century while the origins of electricity can be traced to mid 1800s or even earlier. However, their mass production became possible only in…… [read more]


FDA Drug Approval Process Term Paper

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5-year period. This phase further tests the drug's biological and chemical activity as well as its safety profile, including safe dosage range. Phase II of clinical trials follows, in which 100 to 300 patient volunteers with the targeted disease are tested to evaluate the new drug's effectiveness and to determine any possible side effects. This phase takes approximately 2 years to complete. In phase III of clinical trials 1000 to 3000 patients with the targeted disease are studied for approximately 3.5 years. The large number of volunteers used in this phase minimize error caused by variable courses of the disease, observer bias, placebo effect, double or triple blind studies, or hidden toxicities. Tests in this phase confirm effectiveness of the new drug, and long-term use is monitored to determine any adverse reactions.

After all three phases of clinical trials have been completed, the company analyzes the data collected thus far and, if the data show effectiveness and safety, files a New Drug Application (NDA) with the FDA. The NDA is generally an immense document that must contain all of the detailed scientific information known about the drug up to this point. In 1996, the average review time for new drugs approved was almost 1.5 years.

After review by the FDA, the NDA may be approved and the new drug may be available by prescription from physicians. For several years following approval, the pharmaceutical company must submit annual reports on the new drug to the FDA. These reports must contain quality-control records and any cases of adverse reactions to the drug experienced by patients. Often times the FDA also requires a sixth phase, post-marketing testing, in order to further investigate possible effects of long-term use of the new drug. If results of these additional studies indicate no long-term adverse effects, the new drug may continue to help patients for years to come.

References

Siegfried,…… [read more]


Financial Analysis Understanding Term Paper

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CONCLUSION:

Historically pharmaceutical companies such as Johnson & Johnson, Pfizer and Merck have managed to sustain relatively average or good financial ratios in the areas of leverage, liquidity, efficiency and profitability. Part of the reason for this, in a volatile market when the dynamics of population interest and buying habits frequently vary, the need for pharmaceutical products and new and improved products is always increasing. Part of this is driven by customer demand, which over time has proven to increase and always demand the best when related to pharmaceuticals, or the health of the population.

Even though the current state of the economy is in a slump, the pattern of valuation for Johnson and Johnson over time has shown overall improvement. For example, according to statistics the valuation ratio's for J & J. had improved steadily from 1996-2000, growing from a book value of $4.07/share to $6.07/share (JNJ, 2003). Net profit margin for this company grew approximately 3% during the same time frame, indicating an overall "successful" financial gain for the company (JNJ, 2003). The leverage ratio for the company maintained an average between 1.7-1.9, and compared to other companies in the industry the "Price to Earnings Ratio" varied from 100.9% to 78%.

Not bad given the current poor state of economic affairs.

Pfizer has exhibited tremendous profitability and efficiency in the last few years. Why? Among many things "pricing advantages and private information." (Pfizer, 2003). Pfizer holds the patent on Viagra, a prescription that has become very profitable, efficient and in high demand, resulting in exceptional ratios for the company (Pfizer, 12003).

And what of Merck? Merck company exhibited as recently as 2001 a profit margin of 15.20%, and a return on equity of 44.98% (MBA 681, 2002).

Measuring financial ratios assists in determining stock price, profitability of companies to investors and long-term success The financial ratios of leverage, liquidity, efficiency and profitability over time have successfully proven that pharmaceutical companies, when compared to other companies in various industries have been successful in maintaining efficiency, longevity and fair to great profit margins. The increasing ill health of the population as a whole will ultimately result in better than average profit ratios for these companies. The Net Income of profitability of pharmaceutical companies, as indicated by financial ratios over the last several years indicates an trend toward longevity and increased stability.

When assessing financial ratios for investment purposes, one would be wise to consider the above-mentioned pharmaceutical companies for long-term financial gain.

References

http://www.investor.jnj.com/trading_stats.cfm?page=ratios

Calculating and Interpreting Financial Ratios. http://aolsearch.aol.com/redir.adp?appname=MS&query=Pfizer%20efficiency%20and%20profitability%20ratios&url=http%3a%2f%2fwww%2efool%2ecom%2fportfolios%2frulemaker%2f2001%2frulemaker010531%2ehtm&datasource=Google&partner=Google&clickedItemRank=2&requestId=cns92890&component=websearch.google.http.tcl&searchType=MS

MBA 681, Fall 2002. "Financial Analysis." http://aolsearch.aol.com/redir.adp?appname=MS&query=Merck%20profitability%20and%20efficiency%20ratios&url=http%3a%2f%2fwww%2emgmtguru%2ecom%2fmgt499%2fTN4%5f3%2ehtm&datasource=Google&partner=Google&clickedItemRank=5&requestId=cns41327&component=websearch.google.http.tcl&searchType=MS… [read more]


Amoxicillan vs. Penicillin for Use Term Paper

Term Paper  |  4 pages (1,156 words)
Bibliography Sources: 1+

SAMPLE TEXT:

Any past reaction to a penicillin - containing antibiotic, or any form of medication for that matter, should be reported to your physician so he or she can avoid prescribing them for you. The medication is rapidly cleared by the kidneys as fast as it is absorbed from the gastrointestinal tract.

The efficacy of penicillin is superior in killing bacteria and other microorganisms -- other antibiotics prevent the invaders from reproducing but penicillin destroys the cell walls.

Penicillin V is not active against the penicillinase-producing bacteria, which include many strains of staphylococci. The drug exerts high in vitro activity against staphylococci (except penicillinase-producing strains), streptococci (groups A, C, G, H, L, and M), and pneumococci. Other organisms susceptible in vitro to penicillin V areCorynebacterium diphtheriae, Bacillus anthracis, clostridia, Actinomyces bovis, Streptobacillus moniliformis, Listeria monocytogenes, Leptospira, and Neisseria gonorrhoeae.Treponema pallidium is extremely susceptible. Penicillin V has the distinct advantage in being resistant to inactivation by gastric acid. It may be given with meals; however, blood levels are slightly higher when the drug is given on an empty stomach. Average blood levels are 2 to 5 times higher than those following the same dose of oral penicillin G. And also show much less individual variation. Once absorbed, about 80% of penicillin V is bound to serum protein.

Side Effects

The most important side effect of any antibiotic can be a serious allergic reaction, although this usually occurs following injection of the drug. This is generally common among people who have asthma, hay fever or other allergies.

Other common side effects include upset stomach, rash, nausea, diarrhea, coated tongue and abdominal pain. Pseudomembranous colitis has also been reported and the seriousness can vary from mild to more critical. If diagnosed, appropriate measures should be taken.

As with any drug, periodic testing should be done to check renal, hepatic and hematopoietic function. Also, high urine concentrations may results in false positive reactions hen testing for glucose in the urine.

If pregnant or breastfeeding, antibiotics can be passed into the breast milk. Reactions are also likely to occur in older people. Individuals who receive injections of penicillin may become lethargic, dizzy, confused, anxious or depressed.

Food and Drug Interactions

Antibiotics should not be taken with fruit juice or soda because the acid in these drinks can destroy the effects of the drug. Most penicillins are best absorbed on an empty stomach and should be taken 1 hour before or 2 hours after a meal. However amoxicillin can be taken without regard to food.

Antibiotics may interfere with the effectiveness of oral contraceptives and may intensify the effectiveness of beta blocking drugs. Large doses of injectable penicillin can increase the effects of blood-thinning drugs such as coumadin.

An overdose of an antibiotic is unlikely but if it occurs, diarrhea and upset stomach are the primary symptoms. A massive overdose can result in seizures or excitability.

Antibiotics work best when there is a constant amount in the blood or urine. To achieve this therapeutic level, the patient… [read more]


Stem Cell Research Term Paper

Term Paper  |  8 pages (2,149 words)
Bibliography Sources: 1+

SAMPLE TEXT:

"Some scientists say that, given enough money and time, they can build a tower of knowledge that can answer all questions about humankind. Until that distant day, however, it is lawmakers who have to slog through competing scientific claims and decide where to put federal dollars for medical research and what ethical restraints to put on such studies. That's what is going on right now in the hot-button debate over human stem-cell research (Munro pg 65).. Scientists are divided over the priorities and ethics of stem-cell research. One broad faction maintains that the promise of stem-cell research is so great, the federal government should add its money and prestige to what so far has been a strictly private-sector research effort. This faction also says federal research money should go to research on all kinds of stem cells-both the highly versatile ones drawn from human embryos, and the somewhat less versatile ones drawn from human adults. The opposing faction says federal research should be done only on stem cells from adults, so as not to encourage additional abortions, or the manufacture, and destruction, of human embryos (Munro pg 65). "

All of these causes and arguments place a burden on the politicians who have to decide to fund it. One of the answers may be to stop asking the government and search exclusively ion private sectors. This will mean competition in the market place however, if it gets the research funded than it might be the best solution (Broadway, B09).

Because of the federal debate issues and the funding problems the research is years behind what scientists feel it should be. The research shows promise to make people who have become paralyzed able to walk again, as well as other neurological cures but without finding and approval it remains stalled in a time warp (Johnson pp PG). The plan calls for the research to take its projects to the private sector and allow the private companies to provide the funding for the research to continue. This allows the medical community to move forward while at the same time working on the political community to support the efforts. The public will warm to the idea, just as it has the past medical breakthroughs. There was time that people believed seizures were devil possessions of those having them. Eventually the public learned better. It is the same scenario with the stem cell research debate. The public will warm and when it does politicians will support it but until then the field must move ahead so that when the public says yes the community is ready.

Works Cited

Capell, Kerry "Science & Technology: Stem Cells: AT RISK: A GOLDEN OPPORTUNITY IN BIOTECH.," Business Week, 09-10-2001, pp 85

Munro, Neil SCIENCE: A Debate That Stems From Human Cells., National Journal, 05-26-2001. pp 65

A.S. Wang, MIT president joins other university heads in supporting stem cell research., University Wire, 04-11-2001. pp 70

US DEPT OF HHS: Fact sheet on stem cell research., M2 PressWIRE, 02-01-1999.

Polgar,… [read more]