Pharmacy automation considerations

The three major areas of concern which impact the automation of today's hospital pharmacy send a clear message to vendors. The message is that vendors need to offer an integrated pharmacy management system on the hospital's central computer to offer significant department functionality. The system must have a consistent fit into the technological direction of information systems at the hospital. Such a system provides the ability to gather and access information for numerous hospital departments to support the delivery of high quality clinical care and to support the decision-making process. This provides the hospital the best chance to compete effectively. The hospital's objective must continue to be the main thrust of software development efforts.

Perforation of the terminal ileum with cytomegalovirus vasculitis and Kaposi's sarcoma in a patient with acquired immunodeficiency syndrome

This case report documents a perforation of the terminal ileum in a 40-year-old white male homosexual with the acquired immunodeficiency syndrome. The perforation occurred at a site that had severe cytomegalovirus infection and was in close proximity to multiple nodules of Kaposi's sarcoma. The ileum showed multiple deep ulcers with large numbers of cytomegalovirus inclusions and vasculitis with infected endothelial cells, small-vessel thrombosis, focal disruption, and hemorrhage. We review the evidence that cytomegalovirus infection--and not Kaposi's sarcoma--was responsible for this perforation and, in light of the new medical therapy for such infections, should be regarded as an important cause of gastrointestinal perforation in patients with the acquired immunodeficiency syndrome.

Diffuse pulmonary disease after therapy with nitrogen mustard, vincristine, procarbazine, and prednisone

Pulmonary reactions may follow therapy with nitrogen mustard, vincristine, procarbazine, and prednisone. Two patients with Hodgkin's disease are described who were treated with nitrogen mustard, vincristine, procarbazine, and prednisone and developed diffuse lung disease. Their disease processes were evaluated with serial pulmonary function studies, chest radiography, and open lung biopsy. Hypersensitivity reactions appeared to be responsible, and treatment with corticosteroids was successful. Procarbazine may have been the responsible agent.