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Background: Assessing the quantity and quality of pharmacist-patient communication is important to create strategies for improving communication. Findings from studies on pharmacist-patient communication differ on the extent of communication by pharmacists. This disagreement could be because of different methods of data collection, samples, and concepts used to measure communication., Objectives: This research compared findings from 2 widely used methods of data collection (survey and observation) to identify: (1) the extent to which pharmacists ask questions to patients and provide information on directions, side effects, and adverse effect, (2) agreement between observation and patient report data on pharmacist information giving and question asking, and (3) how patient perceptions of question asking vary according to the structure of the question asked., Methods: A cross-sectional fieldwork design was used to collect data from a stratified random sample of 30 community pharmacies in Southeast and South-central Wisconsin. At each pharmacy, the dispensing pharmacist and 12 patients filling prescriptions were recruited. Each patient was observed for their interaction with the pharmacist and completed a survey while exiting the pharmacy. Both the survey and the observation tool consisted of items pertaining to recording of pharmacist information provision related to direction, side effects, and interactions, and pharmacist's question-asking behaviors. Descriptive analyses and correlations are reported., Results: There was good agreement between the 2 methods regarding pharmacist information provision behaviors (r=0.091, P<.001), this was less true of question asking (r=0.28, P=.034). Certain types of questions showed greater concordance with the observed pharmacist questions. Patients were less likely to report having been asked a question when it took the form of a nonspecific closed-ended questions, that is, "Do you have any questions?", Conclusions: One of the most frequent questions pharmacists ask patients may not be either remembered or perceived by patients as a serious question, let alone an invitation to raise a concern. Secondly, during the selection of a specific method of data collection, researchers need to weigh strengths and weaknesses of various methods. Multimethod studies are encouraged., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: T-wave alternans (TWA) and electrophysiology study (EPS) are used for risk stratification for sudden death., Objective: The purpose of the study was to determine the effect of bundle branch block or intraventricular conduction delay on TWA and EPS., Methods: 386 patients with coronary artery disease, nonsustained ventricular tachycardia, and left ventricular ejection fraction < or =40% underwent TWA and EPS, and were followed for 40 +/- 19 months., Results: Patients with wide QRS were more likely than narrow QRS patients to have nonnegative TWA (77% vs 63%, P <.01) or positive EPS (60% vs 48%, P = .03). Nonnegative TWA predicted the combined endpoint of ventricular tachyarrhythmia or death in narrow QRS (HR = 1.64, P = .04) but not wide QRS patients (HR = 1.04, P = .91). Similarly, positive EPS predicted the combined endpoint in narrow QRS (HR = 2.28, P <.001) but not wide QRS patients (HR = 0.94, P = .84). In multivariate analysis, QRS width and TWA, as well as QRS width and EPS, were independent predictors of events. There was no TWA- or EPS-based difference in arrhythmia-free survival within any specific wide QRS morphology., Conclusion: TWA and EPS are more often abnormal in patients with a wide QRS than in those with a narrow QRS. In patients with narrow QRS, both TWA and EPS stratify patients according to their risk of ventricular tachyarrhythmia or death. However, among patients with a wide QRS, regardless of specific QRS morphology, the risk is high and comparable regardless of TWA or EPS results. Therefore, the only truly low-risk group consists of those patients with negative test results and a narrow QRS.

A rapid and sensitive high-performance thin-layer chromatographic (HPTLC) method was developed and validated for the quantitative estimation of boswellic acids in formulation containing Boswellia serrata extract (BSE) and 11-keto beta-boswellic acid in human plasma. Simple extraction method was used for isolation of boswellic acid from formulation sample and acidified plasma sample. The isolated samples were chromatographed on silica gel 60F(254)-TLC plates, developed using ternary-solvent system (hexane-chloroform-methanol, 5:5:0.5, v/v) and scanned at 260 nm. The linearity range for 11-KBA spiked in 1 ml of plasma was 29.15-145.75 ng with average recovery of 91.66%. The limit of detection and limit of quantification for 11-KBA in human plasma were found to be 8.75 ng/ml and 29.15 ng/ml. The developed method was successfully applied for the assay of market formulations containing BSE and to determine plasma level of 11-keto beta-boswellic acid in a clinical pilot study.

Objectives: The purpose of this study was to test whether a prolonged (>/=6 seconds) period of AV block in response to adenosine triphosphate (ATP) identifies additional patients at risk for bradycardia who may benefit from pacemaker implantation., Background: Bradycardia is a common etiology for syncope in patients without underlying structural heart disease. Conventional testing using electrophysiologic and tilt table studies often fail to identify patients prone to episodes of symptomatic bradycardia., Methods: Adenosine testing was performed in 92 consecutive patients (64 women, age 55 +/- 21 years) with syncope of uncertain origin referred for tilt table testing. The adenosine test measured the maximal R-R interval after bolus administration of intravenous adenosine 150 mug/kg to upright patients. A positive adenosine AV block response was defined as a maximal R-R interval > or =6 seconds., Results: A total of 21 patients (23%) had a positive response. During mean follow-up of 14.3 +/- 5.9 months, 14 patients (16%) had recurrent syncope. Among patients with a positive adenosine response, 3 patients (14%) had recurrent syncope. In comparison, 11 of 69 patients (16%) without adenosine-induced AV block had recurrent syncope (P = 1.00)., Conclusions: Prolonged adenosine-induced AV block in patients with unexplained syncope failed to predict recurrent syncopal episodes. These data do not support therapeutic interventions (e.g., pacemaker implantation) based on a positive adenosine AV block response alone.