Pharmacist-provided direct patient care has favorable effects across various patient outcomes, health care settings, and disease states. Incorporating pharmacists as health care team members in direct patient care is a viable solution to help improve US health care.

The oxidative capacity of the ligninase from Phanerochaete chrysosporium toward monomethoxylated and dimethoxylated aromatic compounds was investigated. Phenylacetic acid derivatives were shown to be decarboxylated by the ligninase, via C-C bond cleavage. Dimethoxylated substrates were much more readily oxidised by the ligninase than were monomethoxylated derivatives, but oxidation of the latter could be stimulated by catalytic amounts of 1,4-dimethoxybenzene or veratryl alcohol. A mechanism based upon the ability of radical cations to function as one-electron oxidants is described. The role of redox mediators in lignin degradation, and the biological significance of veratryl alcohol as a secondary metabolite of P. chrysosporium are discussed. Ligninase Radical cation Redox mediator Veratryl alcohol Lignin degradation Decarboxylation

Aim. The aim of this retrospective study is to illustrate clinical utility and impact of pulmonary embolism (PE) diagnostics of up to date Ventilation ⁄ Perfusion SPECT (V ⁄ P SPECT ) applying holistic interpretation criteria.Material and methods. During a 2-year period 2328 consecutive patients referred to V ⁄ P SPECT for clinically suspected PE were examined. Final diagnosis was established by physicians clinically responsible for patient care. To establish the performance of V ⁄ P SPECT negative for PE, patients were followed up by medical records for 6 months.Results. Ventilation ⁄ Perfusion SPECT was feasible in 99% of the patients. Data for follow-up were available in 1785 patients (77%). PE was reported in 607 patients (34%). Normal pattern was described in 420 patients (25%). Pathology other than PE such as a pneumonia, left heart failure, obstructive lung disease, tumour was described in 724 patients (41%). Report was nondiagnostic in 19 patients (1%). Six cases were classified as falsely negative because PE was diagnosed at follow-up and was fatal in one case. Six cases were classified as falsely positive because the clinician decided not to treat. In 608 patients with final PE diagnosis, 601 patients had positive V ⁄ P SPECT (99%). In 1177 patients without final PE diagnosis 1153 patients had negative V ⁄ P SPECT (98%).Conclusions. Holistic interpretation of V ⁄ P SPECT, yields high negative and positive predictive values and only 1% of nondiagnostic findings and was feasible in 99% of patients. It is a responsibility and a challenge of nuclear medicine to provide optimal care of patients with suspected PE by making V ⁄ P SPECT available.

No abstract

IAH occurs commonly in major burn patients, and ACS is seen regularly in patients with more than 70% body surface area burns. We recommend bladder pressure measurements after infusion of more than 0.25 L/kg during the acute resuscitation phase and for peak inspiratory pressures greater than 40 cm H2O. Whereas ACS warrants surgical decompression of the abdominal cavity, IAH usually responds to conservative therapy.