Matching prescription claims with medication data for nursing home residents: Implications for prescriber feedback, drug utilisation studies and selection of prescription claims database

Medication data retrieved from Australian Repatriation Pharmaceutical Benefits Scheme (RPBS) claims for 44 veterans residing in nursing homes and Pharmaceutical Benefits Scheme (PBS) claims for 898 nursing home residents were compared with medication data from nursing home records to determine the optimal time interval for retrieving claims data and its validity. Optimal matching was achieved using 12 weeks of RPBS claims data, with 60% of medications in the RPBS claims located in nursing home administration records, and 78% of medications administered to nursing home residents identified in RPBS claims. In comparison, 48% of medications administered to nursing home residents could be found in 12 weeks of PBS data, and 56% of medications present in PBS claims could be matched with nursing home administration records. RPBS claims data was superior to PBS, due to the larger number of scheduled items available to veterans and the veteran's file number, which acts as a unique identifier. These findings should be taken into account when using prescription claims data for medication histories, prescriber feedback, drug utilisation, intervention or epidemiological studies. (C) 2001 Elsevier Science Inc. All rights reserved.

Epstein-Barr virus encephalitis in a renal allograft recipient diagnosed by polymerase chain reaction on cerebrospinal fluid and successfully treated with ganciclovir

Epstein–Barr virus (EBV) encephalitis has been reported rarely in the context of solid-organ and bone-marrow transplantation [1]. We report a case of a renal transplant recipient who developed EBV encephalitis following OKT3 therapy for acute allograft rejection. The diagnosis was expedited by the detection of EBV DNA in the cerebrospinal fluid (CSF) by nested polymerase chain reaction (PCR). Moreover, clinical recovery and clearance of CSF EBV DNA appeared to follow the institution of parenteral ganciclovir treatment.

Antifungal alkyl amino alcohols from the tropical marine sponge Haliclona n. sp.

Three new amino alcohols presumably deriving from L-alanine were isolated from the tropical marine sponge Haliclona n. sp. and characterized by 2D NMR, while a fourth amino alcohol was characterized as an acetamide derivative. Relative stereochemistry was deduced from the NMR characteristics of oxazolidinone derivatives and absolute stereochemistry secured by preparation and analysis of an MPA ester. The amino alcohol fraction from Haliclona n. sp, acts as an antifungal agent and inhibits the development of larvae of the ascidian Herdmania curvata.

New chlorinated peptides from the tropical marine sponge Dysidea sp.

Five new chlorinated peptides (5)-(9) have been isolated from a Dysidea sp. and identified by two-dimensional NMR spectroscopy. The absolute stereochemistry of the metabolites was deduced by chemical correlation with S-(-)-4,4,4-trichloro-3-methylbutanoic acid (10) and with an alcohol (11). (C) 2001 Elsevier Science Ltd. All rights reserved.

NMR imaging of water sorption into poly(hydroxyethyl methacrylate-co-tetrahydrofurfuryl methacrylate)

The diffusion of water into a series of hydroxyethyl methacrylate, HEMA, copolymers with tetrahydrofurfuryl methacrylate, THFMA, has been studied over a range of copolymer compositions using NMR imaging analyses. For polyHEMA the diffusion was found to be consistent with a Fickian model. The mass diffusion coefficient of water in polyHEMA at 37 degreesC was determined from the profiles of the diffusion front to be 1.5 x 10(-11) m(2) s(-1), which is less than the value based upon mass uptake, 2.0 x 10(-11) m(2) s(-1). The profiles of the water diffusion front obtained from the NMR images showed that stress was induced at the interface between the rubbery and glassy regions which led to formation of small cracks in this region of the glassy matrix of polyHEMA and its copolymers with mole fractions of HEMA greater than 0.6. Water was shown to be able to enter these cracks forming water pools. For copolymers of HEMA and THFMA with mole fractions of HEMA less than 0.6 the absence of cracks was attributed to the ability of the THFMA sequences to undergo stress relaxation by creep.

A study of the vacuum gamma-radiolysis of two aromatic polyimide fluoropolymers containing phenylphosphine oxide

The vacuum gamma -radiolysis of two fluorinated polyimides containing phenylphosphine oxide units, TOR-RC and TOR-RC ODPA, have been studied at 77 K and 300 K. The phenyl phosphine oxide units provide protection of the polymers towards oxidation by oxygen atoms and the bulky fluoromethyl groups reduce the colouration of the polymers by limiting donor-acceptor complex formation through the aromatic units. At 77 K the radicals formed were identified to be a mixture of neutral radicals (60%) and anion radicals. At 300 K only neutral radicals were found. The G-values for radical formation were found to be 0.50 and 0.42 at 77 K and 0.051 and 0.052 at 300 K for TOR-RC and TOR-RC ODPA, respectively. Little change was observed in the visible spectra of the polyimides following vacuum radiolysis at 300 K up to a dose of 3.3 MGy, and the polymers were shown to undergo net cross linking with a gel dose of 0.45 MGy.

An ESR study of the gamma radiolysis of aromatic polyesters containing isomeric naphthalene links

Six polyesters were synthesised from 4,4 ' -oxy-bis(benzoyl chloride) and 1,4-, 1,5-, 1,6-, 2,3-, 2,6-, and 2,7-naphthalenediol isomers. The structures of the polyesters were characterised by means of IR, inherent viscosities in tetrachloroethane (TCE), solutions at 303 K and thermal analysis. The glass transition temperatures were in the range of 425-494 K by DSC thermal analysis. All of the polyesters were irradiated in an AECL Gammacell 220 unit at a dose rate of approximately 6.7 kGy/h to doses in the range of 0-15 kGy at 77 and 300 K. ESR spectroscopy was used to examine the radicals formed during radiolysis and to measure their yields. The G-values for radical formation in the polyesters were found to be in the range 0.18-1.41 at 77 K and 0.19-0.78 at 300 K. At 77 K, up to 15% of the radicals formed on radiolysis were found to be photo-bleachable anion radicals. Annealing experiments were carried out in order to identify the neutral radicals, which were assigned to naphthyl- or phenyl- and phenoxyl-type radicals. (C) 2001 Elsevier Science Ltd. All rights reserved.

The use of F-19 NMR for new structure determination in the radiolysis of FEP

The radiation chemistry of poly(tetrafluoroethylene-co-perfluoropropylene), FEP, with a mole fraction of tetrafluoroethylene, TFE, of 0.90 has been studied under vacuum using Co-60 gamma -radiation over absorbed dose ranges up to 3.0 MGy. The radiolysis temperatures were 300, 363, 423 and 523 K. New structure formation in the copolymers was analyzed by solid-state F-19 NMR. The new structures formed in the copolymers have been identified and the G-values for the formation of new -CF3 groups was 2.2 at the lower temperatures and increased to 2.9 at 523 K. The G-value for the loss of original -CF3 groups was approximate to1.0 at all temperatures. At the lower temperatures there was a net loss of -CF-groups on irradiation, G(CF) of -1.3, -0.9 and -0.5 at 300, 363 and 423 K, respectively, but at 523 K there was a net gain with G(CF) equal to 0.8. (C) 2001 Elsevier Science B.V. All rights reserved.

An ESR study on gamma-irradiated poly(vinyl alcohol)

The formation of radicals in poly(vinyl alcohol), PVA, powder irradiated at 77 K by gamma -rays and the transformations of these radicals during photolysis with visible wavelengths and on thermal annealing have been studied. After irradiation a four-line ESR spectrum was observed. It was assigned to a triplet of the C-alpha-radical (38%), with a splitting of 3.27 mT, superimposed on a doublet (62%) with a splitting of 2.7 mT. The doublet appears to be composed of two radicals, one of which is photo-bleachable (58%) and the other which is not photo-bleachable (42%). This suggests that the latter radical is a neutral radical. The photo-bleachable component of the doublet has been assigned to a carbonyl anion radical. but the second doublet due to a neutral radical is unassigned. The total G-value for formation of radicals at 77 K was found to be 2.41 +/- 0.03. Upon illumination with visible light, the anion radicals were removed and the doublet components or the spectrum diminished in intensity, while the three-line spectrum of the C-alpha-radical became more clearly visible. This transition was due to the photo-detachment of electrons from traps which were proposed to be located on carbonyl groups in the polymer resulting from incomplete hydrolysis of the vinyl acetate. The photo-decay of the anion radicals could be satisfactorily described by a two-stage process. The first stage comprised the decay of approximately 80% of the anion radicals present, while the second stage was associated with the decay of the remaining 20%. Subsequent thermal annealing of a photolysed sample to 290 K led to a change in the shape of the spectrum to form a more clearly defined triplet, As the doublet of the neutral radical decays on thermal annealing between 150 and 250K, the C-alpha-radical is formed. (C) 2001 Elsevier Science Ltd. All rights reserved.

A comparative study of the radiation resistance of four optically transparent polyimides

A comparative study of the high energy radiation resistance to formation of radicals in two pairs of polymers is reported. In one pair of polymers the phenyl groups containing the imide rings are separated by an ether linkage and in the other pair they are separated by an hexafluoroisopropylidine group. Two of the polymers contained aromatic amine units linked through an ether linkage and the other two polymers contained a trifluoromethyl biphenyl diamine. The polymers were shown to retain a high level of transparency in the visible region following radiolysis to doses as high as 8 Gy. ESR studies of the resistance to radical formation on radiolysis. at 77 K revealed that the polymers containing ether linkages were more stable than their fluorinated analogues, but all were less stable than Kapton (R). (C) 2001 Elsevier Science Ltd. All rights reserved.

An ESR study of irradiated poly(tetrafluoroethylene-co-perfluoropropyl vinyl ether) (PFA)

Poly(tetrafluoroethylene-co-perfluoropropyl vinyl ether) (PFA) with 2 mol% perfluoropropyl vinyl ether (PPVE) was exposed to gamma -irradiation in vacuum at both 77 K and room temperature and the ESR spectra recorded. Both the main chain, similar to CF2-(CF)-F-.-CF(2)similar to, and end chain, similar to (CF2CF2)-F-. radicals were identified at both temperatures and their thermal stabilities measured, No radicals unique to the radiolytic cleavage at the PPVE units were observed at room temperature, either due to the low concentration of the comonomer or beta -scission to form a chain end radical and a nonradical species. G-values for radical formation at room temperature and 77 K were found to be 0.93 and 0.16, respectively. (C) 2001 Elsevier Science Ltd. All rights reserved.

The behaviour of phenylphosphine oxide containing polyimides in a water plasma following gamma-radiolysis

The surface oxidation of two polyimides containing fluorinated phenylphosphine oxide units, TOR-RC and TOR-RC ODPA, have been studied by (XPS) spectroscopy following gamma -radiolysis under vacuum or in air and subsequent treatment in a water plasma. The changes in the O 1s/C 1s ratios obtained from (XPS) analysis showed that on exposure to the water plasma the ratio increases and then levels to a constant value which is similar to that found for exposure to the plasma without prior gamma -radiation treatment. Evidence for the formation of phosphate species was also obtained from the (XPS) analyses. (C) 2001 Elsevier Science Ltd. All rights reserved.

The use of NMR for determination of new structures in irradiated TFE/PMVE fluoropolymers

The radiation chemistry of two TFE/PMVE copolymers with TFE mole fractions of 0.66 and 0.81 has been studied under vacuum using Co-60 gamma -radiation over absorbed dose ranges up to 4.2 MGy. The radiolysis temperature was 313 K for both TFE/PMVE copolymers. New structure formation in the copolymers was identified by solid-state F-19 NMR and the G-values for new chain ends of 2.1 and 0.5 and for branching sites of 0.9 and 0.2 have been obtained for the TFE/PMVE with TFE mole fractions of 0.66 and 0.81, respectively. The relative yields of-O-CF3 and -CF2-CF3 chain ends were found to be proportional to the copolymer composition, but the yields of the -CF2-CF3 chain ends and -CF- branch points mere not linearly related ia the composition. rather they wets correlated with the radical yields measured at 77 K. (C) 2001 Elsevier Science Ltd. All rights reserved.