bluuebunny/crossref_metadata_2025 huggingface dataset:
Pegvisomant-Induced Liver Injury Is Related to the UGT1A1*28 Polymorphism of Gilbert’s Syndrome
Authors: Bernabeu Ignacio , Marazuela Mónica , Lucas Tomás , Loidi Lourdes , Alvarez-Escolá Cristina , Luque-Ramírez Manuel , Fernandez-Rodriguez Eva , Paniagua Amalia-Elisa , Quinteiro Celsa , Casanueva Felipe F.
Published: March 2010

Context: Pegvisomant (PEG) therapy has been associated with drug-induced liver dysfunction in acromegalic patients. The mechanism of its toxicity remains unknown.

Objective: The primary objective was to determine whether or not the UGT1A1*28 polymorphism associated with Gilbert’s syndrome influences the development of liver dysfunction during PEG treatment.

Design and Setting: A cross-sectional study was conducted in four Spanish university hospitals.

Patients: Thirty-six acromegalic patients with active disease, resistant to somatostatin analogs, participated.

Results: The prevalence of the UGT1A1*28 homozygous and heterozygous genotypes in acromegalic patients was 14 and 44%, respectively. Ten patients (28%) developed liver function test (LFT) abnormalities. There was a tendency for more frequent liver function abnormalities in males (70% males vs. 30% females, P = 0.058). Carriers of the UGT1A1*28 polymorphism had a higher incidence of LFT abnormalities than the UGT1A1 wild type (43% carriers vs. 7% wild type, P = 0.024). This difference persisted when adjusted in an all-factors multiple regression analysis [coefficient of determination (R2) = 0.463; P = 0.008] for age, gender, alcohol consumption, and UGT1A1*28 polymorphism. A stepwise multivariate likelihood binary logistic regression analysis (R2 = 0.40; P = 0.003) identified male gender (β = 7.21; P = 0.033) and UGT1A1*28 polymorphism (β = 14.1; P = 0.028) as the only significant predictors for the development of LFT abnormalities.

Conclusions: The UGT1A1*28 genotype and male gender predict an increased incidence of LFT abnormalities during PEG therapy in acromegaly.
Homologues of the Arabidopsis thaliana SHI/STY/LRP1 genes control auxin biosynthesis and affect growth and development in the moss Physcomitrella patens
Authors: Eklund D. Magnus , Thelander Mattias , Landberg Katarina , Ståldal Veronika , Nilsson Anders , Johansson Monika , Valsecchi Isabel , Pederson Eric R. A. , Kowalczyk Mariusz , Ljung Karin , Ronne Hans , Sundberg Eva
Published: March 2010

The plant hormone auxin plays fundamental roles in vascular plants. Although exogenous auxin also stimulates developmental transitions and growth in non-vascular plants, the effects of manipulating endogenous auxin levels have thus far not been reported. Here, we have altered the levels and sites of auxin production and accumulation in the moss Physcomitrella patens by changing the expression level of homologues of the Arabidopsis SHI/STY family proteins, which are positive regulators of auxin biosynthesis genes. Constitutive expression of PpSHI1 resulted in elevated auxin levels, increased and ectopic expression of the auxin response reporter GmGH3pro:GUS, and in an increased caulonema/chloronema ratio, an effect also induced by exogenous auxin application. In addition, we observed premature ageing and necrosis in cells ectopically expressing PpSHI1. Knockout of either of the two PpSHI genes resulted in reduced auxin levels and auxin biosynthesis rates in leafy shoots, reduced internode elongation, delayed ageing, a decreased caulonema/chloronema ratio and an increased number of axillary hairs, which constitute potential auxin biosynthesis sites. Some of the identified auxin functions appear to be analogous in vascular and non-vascular plants. Furthermore, the spatiotemporal expression of the PpSHI genes and GmGH3pro:GUS strongly overlap, suggesting that local auxin biosynthesis is important for the regulation of auxin peak formation in non-vascular plants.
Sexual plasticity of ovarian germ cells in rainbow trout
Authors: Yoshizaki Goro , Ichikawa Masaki , Hayashi Makoto , Iwasaki Yoshiko , Miwa Misako , Shikina Shinya , Okutsu Tomoyuki
Published: March 2010

The sexual plasticity of fish gonads declines after the sex differentiation period; however, information about the plasticity of the germ cells themselves after sex differentiation is limited. Using rainbow trout (Oncorhynchus mykiss), we recently established a novel germ cell transplantation system that provides a unique platform with which to dissect the developmental and cellular mechanisms underlying gametogenesis. Using this technique, we show here that transplanted ovarian germ cells isolated from 6- to 9-month-old donors can colonize sexually undifferentiated embryonic gonads and resume gametogenesis. Ovarian germ cells containing oogonia and early oocytes isolated from female rainbow trout were transplanted into the peritoneal cavities of hatching-stage fry of both sexes and the behavior of the donor cells was observed. The transplanted ovarian germ cells migrated towards the recipient gonads, interacted with embryonic gonadal somatic cells, proliferated rapidly, and eventually differentiated into eggs in female recipients and sperm in male recipients. Furthermore, the donor-derived eggs and sperm obtained from the recipient fish were functional and were able to produce normal offspring. These findings indicate that mitotic germ cells, the oogonia, possess a high level of sexual plasticity.
The maize SBP-box transcription factor encoded by tasselsheath4 regulates bract development and the establishment of meristem boundaries
Authors: Chuck George , Whipple Clinton , Jackson David , Hake Sarah
Published: March 2010

Plant architecture consists of repeating units called phytomers, each containing an internode, leaf and axillary meristem. The formation of boundaries within the phytomer is necessary to differentiate and separate these three components, otherwise some will grow at the expense of others. The microRNA-targeted SBP-box transcription factor tasselsheath4 (tsh4) plays an essential role in establishing these boundaries within the inflorescence. tsh4 mutants display altered phyllotaxy, fewer lateral meristems and ectopic leaves that grow at the expense of the meristem. Double-mutant analyses of tsh4 and several highly branched mutants, such as ramosa1-3 and branched silkless1, demonstrated a requirement for tsh4 in branch meristem initiation and maintenance. TSH4 protein, however, was localized throughout the inflorescence stem and at the base of lateral meristems, but not within the meristem itself. Double labeling of TSH4 with the ramosa2, branched silkless1 and knotted1 meristem markers confirmed that TSH4 forms a boundary adjacent to all lateral meristems. Indeed, double labeling of miR156 showed a meristem-specific pattern complementary to that of TSH4, consistent with tsh4 being negatively regulated by this microRNA. Thus, downregulation of TSH4 by a combination of microRNAs and branching pathway genes allows the establishment of lateral meristems and the repression of leaf initiation, thereby playing a major role in defining meristem versus leaf boundaries.
Heating rate and symbiont productivity are key factors determining thermal stress in the reef-building coral Acropora formosa
Authors: Middlebrook Rachael , Anthony Kenneth R. N. , Hoegh-Guldberg Ove , Dove Sophie
Published: March 2010

The onset of large-scale coral bleaching events is routinely estimated on the basis of the duration and intensity of thermal anomalies determined as degree heating weeks. Degree heating weeks, however, do not account for differential rates of heating. This study aimed to explore the relationship between different rates of heating above the documented regional winter threshold, and resultant bleaching of the reef-building coral Acropora formosa. Under a relatively low light field, rapid heating of 1°C day−1 from 29°C to 32°C lead to a 17.6% decline in Fv/Fm, concurrent with a rapid increase in xanthophyll de-epoxidation sustained into the dark, whereas slower heating rates of 0.5°C day−1 lead to no decline in Fv/Fm and no change in dark-adapted xanthophyll cycling. At the winter bleaching threshold of 30°C, areal net O2 evolution exceeded the control values for rapidly heated corals, but was lower than the controls for slowly heated corals. At the maximum temperature of 33°C, however, both treatments had net O2 fluxes that were 50% of control values. At 30°C, only symbiont densities in the slowly heated controls were reduced relative to controls values. By 33°C, however, symbiont densities were 55% less than the controls in both treatments. The rate of heat accumulation was found to be an important variable, with rapidly heated corals attaining the same bleaching status and loss of areal O2 production for half the degree heating week exposure as slowly heated corals. The study revealed that it is incorrect to assume that significant dark acclimation disables non-photochemical quenching, because 75% of an increased xanthophyll pool was found to be in the de-epoxidated state following rapid heat accumulation. This has important ramifications for the interpretation of chlorophyll fluorescence data such as dark adapted Fv/Fm.
Adenosinergic modulation of neuronal activity in the pond snail Lymnaea stagnalis
Authors: Malik Aqsa , Buck Leslie Thomas
Published: March 2010

Adenosine has been termed a retaliatory metabolite and its neuroprotective effects have been implicated in the hypoxia tolerance of several species; however, its role in the invertebrate CNS remains unclear. To determine if adenosine modulates neuronal activity in invertebrate neurons, we conducted whole-cell recordings from neurons in the central ring ganglia of the anoxia-tolerant pond snail Lymnaea stagnalis during exposure to adenosine and pharmacological compounds known to modulate the type I subclass of adenosine receptors (A1R). Action potential (AP) frequency and membrane potential (Vm) were unchanged under control conditions, and addition of adenosine decreased AP frequency by 47% (from 1.08±0.22 to 0.57±0.14 Hz) and caused significant hyperpolarization of Vm. The A1R agonist cyclopentyladenosine (CPA) mimicked the results obtained with adenosine whereas antagonism of the A1R with 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) had no effect on AP frequency or Vm but prevented the adenosine and CPA-mediated decreases in neuronal activity. Furthermore, Ca2+ measurements with fluo-4 revealed that A1R activation led to a 12% increase in intracellular Ca2+ concentration and this elevation was also antagonized by DPCPX. Our results suggest that adenosine acting via the adenosine receptor (type I subclass) depresses neuronal activity in the adult L. stagnalis CNS and this depression is correlated with an increase in cytosolic Ca2+ levels.
The scaling of myofibrillar actomyosin ATPase activity in apid bee flight muscle in relation to hovering flight energetics
Authors: Askew Graham N. , Tregear Richard T. , Ellington Charles P.
Published: March 2010

For all types of locomotion, the overall efficiency with which chemical energy is converted into mechanical work increases with increasing body size. In order to gain insight into the determinants of the scaling of overall efficiency, we measured the scaling of the rate of ATP utilisation during cyclical contractions using glycerinated fibres from the dorsolongitudinal flight muscle of several species of apid bees, covering a ninefold range in body mass. The efficiency of ATP utilisation by the crossbridges is one of the stages that determines the overall efficiency of locomotion. The mechanochemical coefficient was calculated from the ratio of the net power output to the rate of ATP hydrolysis and ranged from 6.5 to 9.7 kJ mol−1 ATP. The corresponding gross myofibrillar efficiency was 15–23%, increasing concomitantly with body mass (Mb) and decreasing with increasing wingbeat frequency (n) and scaling as Mb0.184 and n−1.168 in bumblebees and as Mb0.153 and n−0.482 in euglossine bees. Overall efficiency of hovering in bumblebees and euglossine bees was calculated using previously published metabolic power data and revised estimates of the mechanical power output to take into account the drag due to the leading edge vortex that has not been included in previous models. The scaling of overall efficiency of hovering flight in apid bees was not as pronounced as the scaling of myofibrillar efficiency. Therefore the scaling of myofibrillar efficiency with body mass (or frequency) only explained part of the scaling of overall efficiency, and it is likely that the efficiency of other steps in the transduction of chemical energy into mechanical work (e.g. the efficiency of mitochondrial oxidative recovery) may also scale with body mass.
Influence of wing loading on the trade-off between pursuit-diving and flight in common guillemots and razorbills
Authors: Thaxter C. B. , Wanless S. , Daunt F. , Harris M. P. , Benvenuti S. , Watanuki Y. , Grémillet D. , Hamer K. C.
Published: March 2010

Species of bird that use their wings for underwater propulsion are thought to face evolutionary trade-offs between flight and diving, leading to the prediction that species with different wing areas relative to body mass (i.e. different wing loadings) also differ in the relative importance of flight and diving activity during foraging trips. We tested this hypothesis for two similarly sized species of Alcidae (common guillemots and razorbills) by using bird-borne devices to examine three-dimensional foraging behaviour at a single colony. Guillemots have 30% higher wing loading than razorbills and, in keeping with this difference, razorbills spent twice as long in flight as a proportion of trip duration whereas guillemots spent twice as long in diving activity. Razorbills made a large number of short, relatively shallow dives and spent little time in the bottom phase of the dive whereas guillemots made fewer dives but frequently attained depths suggesting that they were near the seabed (ca. 35–70 m). The bottom phase of dives by guillemots was relatively long, indicating that they spent considerable time searching for and pursuing prey. Guillemots also spent a greater proportion of each dive bout underwater and had faster rates of descent, indicating that they were more adept at maximising time for pursuit and capture of prey. These differences in foraging behaviour may partly reflect guillemots feeding their chicks single large prey obtained near the bottom and razorbills feeding their chicks multiple prey from the water column. Nonetheless, our data support the notion that interspecific differences in wing loadings of auks reflect an evolutionary trade-off between aerial and underwater locomotion.
The substrate as a skeleton: ground reaction forces from a soft-bodied legged animal
Authors: Lin Huai Ti , Trimmer Barry A.
Published: March 2010

The measurement of forces generated during locomotion is essential for the development of accurate mechanical models of animal movements. However, animals that lack a stiff skeleton tend to dissipate locomotor forces in large tissue deformation and most have complex or poorly defined substrate contacts. Under these conditions, measuring propulsive and supportive forces is very difficult. One group that is an exception to this problem is lepidopteran larvae which, despite lacking a rigid skeleton, have well-developed limbs (the prolegs) that can be used for climbing in complex branched structures and on a variety of surfaces. Caterpillars therefore are excellent for examining the relationship between soft body deformation and substrate reaction forces during locomotion. In this study, we devised a method to measure the ground reaction forces (GRFs) at multiple contact points during crawling by the tobacco hornworm (Manduca sexta). Most abdominal prolegs bear similar body weight during their stance phase. Interestingly, forward reaction forces did not come from pushing off the substrate. Instead, most positive reaction forces came from anterior abdominal prolegs loaded in tension while posterior legs produced drag in most instances. The counteracting GRFs effectively stretch the animal axially during the second stage of a crawl cycle. These findings help in understanding how a terrestrial soft-bodied animal can interact with its substrate to control deformation without hydraulic actuation. The results also provide insights into the behavioral and mechanistic constraints leading to the evolution of diverse proleg arrangements in different species of caterpillar.
Functional characterization of Rhesus glycoproteins from an ammoniotelic teleost, the rainbow trout, using oocyte expression and SIET analysis
Authors: Nawata C. Michele , Wood Chris M. , O'Donnell Michael J.
Published: March 2010

Recent experimental evidence from rainbow trout suggests that gill ammonia transport may be mediated in part via Rhesus (Rh) glycoproteins. In this study we analyzed the transport properties of trout Rh proteins (Rhag, Rhbg1, Rhbg2, Rhcg1, Rhcg2, Rh30-like) expressed in Xenopus oocytes, using the radiolabeled ammonia analogue [14C]methylamine, and the scanning ion electrode technique (SIET). All of the trout Rh proteins, except Rh30-like, facilitated methylamine uptake. Uptake was saturable, with Km values ranging from 4.6 to 8.9 mmol l−1. Raising external pH from 7.5 to 8.5 resulted in 3- to 4-fold elevations in Jmax values for methylamine; Km values were unchanged when expressed as total or protonated methylamine. Efflux of methylamine was also facilitated in Rh-expressing oocytes. Efflux and influx rates were stimulated by a pH gradient, with higher rates observed with steeper H+ gradients. NH4Cl inhibited methylamine uptake in oocytes expressing Rhbg1 or Rhcg2. When external pH was elevated from 7.5 to 8.5, the Ki for ammonia against methylamine transport was 35–40% lower when expressed as total ammonia or NH4+, but 5- to 6-fold higher when expressed as NH3. With SIET we confirmed that ammonia uptake was facilitated by Rhag and Rhcg2, but not Rh30-like proteins. Ammonia uptake was saturable, with a comparable Jmax but lower Km value than for total or protonated methylamine. At low substrate concentrations, the ammonia uptake rate was greater than that of methylamine. The Km for total ammonia (560 μmol l−1) lies within the physiological range for trout. The results are consistent with a model whereby NH4+ initially binds, but NH3 passes through the Rh channels. We propose that Rh glycoproteins in the trout gill are low affinity, high capacity ammonia transporters that exploit the favorable pH gradient formed by the acidified gill boundary layer in order to facilitate rapid ammonia efflux when plasma ammonia concentrations are elevated.
Functional study of the pectoral spine stridulation mechanism in different mochokid catfishes
Authors: Parmentier E. , Fabri G. , Kaatz I. , Decloux N. , Planes S. , Vandewalle P.
Published: March 2010

Mochokidae are able to produce pectoral spine stridulation sounds. During sound production, high speed videos were used to study the pectoral fin movements to identify the mechanisms involved. A call consisted of a series of pulses and occurred during a spine sweep, which was in fact made up of a series of jerky movements. The morphology of the pectoral spines and associated muscles was also observed in different species. The contractions of adductor profundus and superficial adductor allows adduction and abduction movements (sweep) of the spine, respectively. Simultaneously, the contraction of the arrector ventralis or the arrector 3 of the pectoral spine allows the pulling and pressing the ridges of the dorsal process, against the rough lateral face of the spinal fossa. This results in the rubbing of the ridges of the dorsal process, producing sounds. In Synodontis the analogy for sound production would be a brake shoe pressing against a wheel.
Octopamine promotes rhythmicity but not synchrony in a bilateral pair of bursting motor neurons in the feeding circuit of Aplysia
Authors: Martínez-Rubio C. , Serrano G. E. , Miller M. W.
Published: March 2010

Octopamine-like immunoreactivity was localized to a limited number (<40) of neurons in the Aplysia central nervous system, including three neurons in the paired buccal ganglia (BG) that control feeding movements. Application of octopamine (OA) to the BG circuit produced concentration-dependent (10−8–10−4 mol l−1) modulatory actions on the spontaneous burst activity of the bilaterally paired B67 pharyngeal motor neurons (MNs). OA increased B67's burst duration and the number of impulses per burst. These effects reflected actions of OA on the intrinsic tetrodotoxin-resistant driver potential (DP) that underlies B67 bursting. In addition to its effects on B67's burst parameters, OA also increased the rate and regularity of burst timing. Although the bilaterally paired B67 MNs both exhibited rhythmic bursting in the presence of OA, they did not become synchronized. In this respect, the response to OA differed from that of dopamine, another modulator of the feeding motor network, which produces both rhythmicity and synchrony of bursting in the paired B67 neurons. It is proposed that modulators can regulate burst synchrony of MNs by exerting a dual control over their intrinsic rhythmicity and their reciprocal capacity to generate membrane potential perturbations. In this simple system, dopaminergic and octopaminergic modulation could influence whether pharyngeal contractions occur in a bilaterally synchronous or asynchronous fashion.
PERSPECTIVE—Absorbing the Concept of Absorptive Capacity: How to Realize Its Potential in the Organization Field
Authors: Volberda Henk W. , Foss Nicolai J. , Lyles Marjorie A.
Published: March 2010

The purpose of this perspective paper is to advance understanding of absorptive capacity, its underlying dimensions, its multilevel antecedents, its impact on firm performance, and the contextual factors that affect absorptive capacity. Twenty years after the Cohen and Levinthal 1990 paper, the field is characterized by a wide array of theoretical perspectives and a wealth of empirical evidence. In this paper, we first review these underlying theories and empirical studies of absorptive capacity. Given the size and diversity of the absorptive capacity literature, we subsequently map the existing terrain of research through a bibliometric analysis. The resulting bibliometric cartography shows the major discrepancies in the organization field, namely that (1) most attention so far has been focused on the tangible outcomes of absorptive capacity; (2) organizational design and individual level antecedents have been relatively neglected in the absorptive capacity literature; and (3) the emergence of absorptive capacity from the actions and interactions of individual, organizational, and interorganizational antecedents remains unclear. Building on the bibliometric analysis, we develop an integrative model that identifies the multilevel antecedents, process dimensions, and outcomes of absorptive capacity as well as the contextual factors that affect absorptive capacity. We argue that realizing the potential of the absorptive capacity concept requires more research that shows how “micro-antecedents” and “macro-antecedents” influence future outcomes such as competitive advantage, innovation, and firm performance. In particular, we identify conceptual gaps that may guide future research to fully exploit the absorptive capacity concept in the organization field and to explore future fruitful extensions of the concept.
Dynamic Managerial Capabilities and the Multibusiness Team: The Role of Episodic Teams in Executive Leadership Groups
Authors: Martin Jeffrey A.
Published: March 2010

This grounded theory-building multiple-case study examines the executive leadership group that comprises the general manager (GM) that heads each of the firm's business units in a multibusiness organization. Because each GM exercises control and authority over their business unit's resources, they operate at the nexus of firm-level strategy and strategy implementation through the development of business-unit-level strategy and tactics. Moreover, they play an essential role in adapting the organization by collectively sensing, seizing, and reconfiguring resources and thereby capturing product-market opportunities that emerge. However, there is little direct empirical understanding of this important executive leadership group. This study begins to address this gap in the literature by exploring the relationship between the characteristics of the set of business-unit general managers and firm performance in six firms operating in the high-dynamic software industry with an in-depth comparative case study. New theory is developed that begins to open the “black box” of executive leadership groups, and in so doing contributes new understanding of executive leadership groups and dynamic managerial capabilities, and thereby introduces the notion of an episodic team.
Risk of Cutting Certain Medication Patches; Warfarin by Generic Name; Why Doctors Must Include Medication Purpose on Prescriptions; Carac-Kuric Mix-Ups
Authors: Cohen Michael R. , Smetzer Judy L.
Published: March 2010

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the United States Pharmacopeia (USP) Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices (ISMP). If you have encountered medication errors and would like to report them, you may call USP toll-free, 24 hours a day, at 800–233–7767 (800–23-ERROR).

Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported through the ISMP ( www.ismp.org ) or USP ( www.usp.org ) Web sites or communicated directly to ISMP by calling 800-FAIL-SAFE or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Acute Angle-Closure Glaucoma Associated with Flavoxate; Zolpidem-Induced Sleep-Driving; Two Different Problems with Tumor Necrosis Factor Inhibitors in Patients with Psoriasis; Mirtazapine-Induced Akathisia; Clomipramine-Induced Diabetes; Diabetic Ketoacidosis Associated with Aripiprazole
Authors: Shuster Joel
Published: March 2010

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices (ISMP) in cooperation with the FDA's MedWatch program and Temple University School of Pharmacy. ISMP is an FDA MedWatch partner.
Safety and Efficacy of Intensive Insulin Therapy in Patients with Thermal Injury
Authors: Patel Mallika P. , Weant Kyle A. , Ritter Britt A. , Cairns Bruce A.
Published: March 2010

Purpose

To evaluate the safety and efficacy of intensive insulin therapy (IIT) versus traditional corrective insulin management (CIM) for the treatment of hyperglycemia in adult patients with thermal injury who are under intensive care.

Methods

Using a searchable pharmacy database, a retrospective, observational chart review was conducted of adult patients who were admitted to the surgical burn service intensive care unit (ICU) at the University of North Carolina Hospitals (UNCH) from January 2004 through December 2005 and who had received insulin therapy.

Results

Seventy-one patients qualified for analysis. The average morning serum blood glucose value while patients were receiving IIT, defined as 80 to 110 mg/dL, was 107 mg/dL compared with 124 mg/dL while patients were receiving CIM ( P < 0.001). Of morning serum blood glucose values taken, 49% were within the target range in patients receiving IIT compared with 34% in patients receiving CIM ( P < 0.001). No significant differences were found between the 2 groups with regard to mortality, ICU stay, or hospital stay. More patients experienced hypoglycemia (blood glucose value less than 50 mg/dL) while receiving IIT compared with CIM (36.4% vs 31.3%; P = 0.732); however, none of the patients had symptomatic hypoglycemia. There was a significantly higher rate of hypoglycemia among nonsurvivors compared with survivors (66.7% vs 26.4%; P = 0.006).

Conclusion

IIT lowers average morning blood glucose in the thermal injury population when compared with CIM. Differences in hypoglycemic events were observed in this review; however, none of the episodes were symptomatic. Although further study is needed, IIT appears to be a safe and effective method of controlling serum blood glucose values in this specialized population.
New Drugs Approved by the FDA; New Dosage Forms and Indications Approved by the FDA; Agents Pending FDA Approval; New Drug Applications Filed by Manufacturer; Supplemental Applications Filed by Manufacturer; Significant Labeling Changes or “Dear Health Care Professional” Letters Related to Safety
Authors: Baker Danial E.
Published: March 2010

This monthly feature will help readers keep current on new drugs, new indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of this information; however, if there are any questions, please let us know at hospitalpharmacy@drugfacts.com .
The Environment of E-prescribing and Its Impact on the Pharmacy Department
Authors: Fox Brent I. , Felkey Bill G. , Fortier Christopher
Published: March 2010

This month we address a topic that initially may seem a process that only affects our colleagues in the community but of which we believe all pharmacists should be aware: electronic prescribing, or e-prescribing. An overview of e-prescribing is provided, including a brief historical perspective, the government's role, obstacles, and incentives. We conclude with a discussion of the relevance of e-prescribing to hospitals and departments of pharmacy.
A Review of Critical Differences among Loop, Thiazide, and Thiazide-Like Diuretics
Authors: Min Bokyung , White C. Michael
Published: March 2010

Diuretics are a drug class with heterogeneous assortments. This article reviews general pharmacologic mechanisms and clinical implications of loop, thiazide, and thiazide-like diuretics.

Loop diuretics act in the loop of Henle by blocking the sodium-potassium-chloride (Na+-K+-2Cl-) symport. They are effective in relieving congestive symptoms and edematous signs of heart failure. Activation of the neurohormonal system and subsequent pathologic myocardial remodeling limit the use of loop diuretics unless fluid balance is not met to relieve patients' symptoms with life-saving pharmacologic modalities. Adverse effects on electrolyte balance may cause life-threatening consequences. The combination of K+-sparing diuretics or angiotensin-converting enzyme inhibitors with loop diuretics may not only prevent life-threatening complications caused by electrolyte imbalance, but also may delay progression of the disease with proven mortality benefit. Recent findings of worsening renal function and higher mortality rate with the use of oral and intravenous loop diuretics further demands appropriate use of these drugs.

Thiazide diuretics and thiazide-like diuretics act in the distal convoluted tubule by blocking Na+-Cl-symport. Thiazide diuretics reduce cardiovascular mortality by achieving target blood pressure in patients with hypertension. Compared with other antihypertensive drugs, thiazide diuretics have less desirable metabolic effects. However, it has not yet been shown that the negative metabolic effects of these drugs are associated with negative mortality and morbidity. Based on the need for a multidrug regimen to reach target blood pressure in most patients with hypertension, thiazide diuretics may be used in addition to a drug or drugs without metabolic complications.
The Safety of Intravenous Drug Delivery Systems: Update on Current Issues since the 1999 Consensus Development Conference
Authors: Sanborn Michael , Gabay Michael , Moody Mary Lynn
Published: March 2010

This review was prepared in advance of the Second Consensus Development Conference on the Safety of Intravenous Drug Delivery Systems that was held at Hotel Sofitel in Rosemont, Illinois, from August 7 to 9, 2008. The purpose of this conference was evaluation of the safety of intravenous (IV) infusion systems used for medication administration. Specifically, the purpose was to build on the work from the initial Consensus Development Conference that convened in 1999. At that time, an interdisciplinary expert panel of physicians, nurses, and pharmacists reviewed 6 IV drug delivery systems (IV push systems, volume-control chambers, augmented IV push systems, point-of-care activated systems, pharmacy-based IV admixture systems, and manufacturer-prepared products) with regard to safety, cost, simplicity of use, and amount of education and training required for proper use. The Second Consensus Development Conference expanded on the initial conference findings through presentations regarding the impact of medication errors, a review of related standards and guidelines released since 1999, and analyses and perspectives on the different IV drug delivery systems. The invited faculty and audience provided comments on a preliminary report issued during the meeting. The interdisciplinary expert panel produced a final report, which will be published at a later date, by the end of the one-and-a-half-day conference.
Are Personal Health Records on Your Pharmacy Department's Radar Screen?
Authors: Felkey Bill G. , Fox Brent I.
Published: March 2010

Ongoing initiatives within the private and public health sectors underscore the blurred line between care that patients receive in the community and care that is provided in health care institutions. The quest for interoperability of information systems further indicates that information must be shared across locations and levels of care. One component of this need to share information focuses on providers having access to information that patients maintain or that is generated through patients' activities. This column addresses the sharing of that information.
When gentlemen are first and ladies are last: Effects of gender stereotypes on the order of romantic partners' names
Authors: Hegarty Peter , Watson Nila , Fletcher Laura , McQueen Grant
Published: March 2010

A preference to name stereotypically masculine before stereotypically feminine individuals explains why men are typically named before women, as on the Internet, for example (Study 1). Heterosexual couples are named with men's names first more often when such couples are imagined to conform to gender stereotypes (Studies 2 and 3). First‐named partners of imaginary same‐sex couples are attributed more stereotypically masculine attributes (Study 4). Familiarity bounds these effects of stereotypes on name order. People name couples they know well with closer people first (Study 5), and consequently name familiar heterosexual couples with members of their own gender first (Study 6). These studies evidence a previously unknown effect of the semantics of gender stereotypes on sentence structure in the everyday use of English.
Evidence for a workspace model of working memory from semantic implicit processing in neglect
Authors: Della Sala Sergio , van der Meulen Marian , Bestelmeyer Patricia , Logie Robert H.
Published: March 2010

Three experiments tested the hypothesis that activation of semantic memory from perceptual input does not require initial retention of the perceptual material in working memory as assumed by a widely held view of information processing. In Expt 1, two brain‐damaged patients with left‐sided unilateral spatial neglect were tested. They were asked to listen to and read a series of familiar (British) and unfamiliar (foreign) proverbs and to choose which proverb was the best match to a depicted figure shown with the target object(s) on the left (neglected side) of the patients' visual field. Expt 2 simulated the testing conditions for the neglect patients with healthy participants using subliminal presentation of one half of each picture. Using different materials, Expt 3 replicated the outcomes of Expts 1 and 2 with a third neglect patient and a new group of controls. In all three experiments, participants appeared to be unaware of target features; however they selected familiar, but not unfamiliar, target proverbs above chance. The results showing implicit processing of semantic material can be explained by a model in which working memory is a separate system that deals with activated contents of semantic memory, and in which there is direct activation of semantic memory from perception without intermediate stages of processing in working memory.
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for Use of Tumor Markers in Liver, Bladder, Cervical, and Gastric Cancers
Authors: Sturgeon Catharine M , Duffy Michael J , Hofmann Barry R , Lamerz Rolf , Fritsche Herbert A , Gaarenstroom Katja , Bonfrer Johannes , Ecke Thorsten H , Grossman H Barton , Hayes Peter , Hoffmann Ralf-Thorsten , Lerner Seth P , Löhe Florian , Louhimo Johanna , Sawczuk Ihor , Taketa Kazuhisa , Diamandis Eleftherios P
Published: March 2010

Background: Updated National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines for the use of tumor markers in the clinic have been developed.

Methods: Published reports relevant to use of tumor markers for 4 cancer sites—liver, bladder, cervical, and gastric—were critically reviewed.

Results: α-Fetoprotein (AFP) may be used in conjunction with abdominal ultrasound for early detection of hepatocellular carcinoma (HCC) in patients with chronic hepatitis or cirrhosis associated with hepatitis B or C virus infection. AFP concentrations >200 μg/L in cirrhotic patients with typical hypervascular lesions >2 cm in size are consistent with HCC. After a diagnosis of HCC, posttreatment monitoring with AFP is recommended as an adjunct to imaging, especially in the absence of measurable disease.

Although several urine markers have been proposed for bladder cancer, none at present can replace routine cystoscopy and cytology in the management of patients with this malignancy. Some may, however, be used as complementary adjuncts to direct more effective use of clinical procedures.

Although carcinoembryonic antigen and CA 19-9 have been proposed for use gastric cancer and squamous cell carcinoma antigen for use in cervical cancer, none of these markers can currently be recommended for routine clinical use.

Conclusions: Implementation of these recommendations should encourage optimal use of tumor markers for patients with liver, bladder, cervical, or gastric cancers.
Comparison of Cystatin C and Creatinine as Predictors of Cardiovascular Events in a Community-Based Elderly Population
Authors: Beilby John , Divitini Mark L , Knuiman Matthew W , Rossi Enrico , Hung Joseph
Published: March 2010

Background: Reduced renal function is an established risk factor for cardiovascular events. We compared 3 measures of renal function—serum cystatin C, serum creatinine, and calculated creatinine clearance—as predictors of subsequent cardiovascular events in a community-based population of elderly individuals.

Methods: Comprehensive cardiovascular risk factor data were available for 1410 surviving participants of previous Busselton health surveys who were ≥60 years old. Hazard ratios for risk of incident coronary heart disease and cardiovascular disease over 10 years of follow-up were derived for each baseline measure of renal function by use of Cox regression.

Results: All measures of renal function were significantly related to risks of morbidity and mortality from coronary heart disease and cardiovascular disease. There were 453 incident cardiovascular disease events; and the age- and sex-adjusted hazard ratios (95% CIs) were 1.34 (1.23–1.46), 1.32 (1.20–1.45), and 1.22 (1.06–1.41) per 1-SD deterioration in cystatin C, creatinine, and creatinine clearance, respectively. All 3 measures gave approximately the same age-adjusted relative risk estimates. After further adjustment for established cardiovascular risk factors, the relative risk estimates were all reduced but remained statistically significant (P < 0.05). Cystatin C was not a significant predictor for cardiovascular disease after adjustment for creatinine clearance.

Conclusions: In relation to predicting risk for coronary heart disease or cardiovascular disease over a 10-year follow-up in a community-based population of elderly subjects, there was no evidence that cystatin C was a better risk predictor than creatinine or creatinine clearance.
Accessible Health Care: More Than Just Getting Through the Door
Authors: Gardner-Bonneau Daryle J. , Kailes June Isaacson
Published: March 2010

FEATURE AT A GLANCE: Access to health care requires more than mere access to a health care facility. It requires access to medical equipment and devices. Currently, many older adults and people with disabilities have difficulty accessing medical equipment, including examination chairs and tables, weight scales, and exercise and rehabilitation equipment. This article outlines the problem and its consequences for patients and describes the ergonomics requirements that must be met to ensure accessibility of this equipment for all patients.
Indonesia in Motion: An Interview With Leonard Retel Helmrich
Authors: MacDonald Scott
Published: March 2010

An interview with Leonard Retel Helmrich, a Dutch–Indonesian documentary filmmaker whose recent work (The Eye of the Day, The Shape of the Moon) reflects the increasing impact of Islamic fundamentalism on Indonesian society. He discusses his commitment to the idea of cinema as motion and his innovations in equipment design.
1968 Olympic Dreams and Tlatelolco Nightmares: Imagining and Imaging Modernity on Television
Authors: de Bustamante Celeste González
Published: March 2010

Juxtaposing televised news coverage of the 1968 student movements and Olympics in Mexico City, the author examines the mass media's role during this politically volatile year for the country and the world. Through an analysis of news scripts located in Televisa's news archive, the article demonstrates that news executives and government officials pursued a similar goal—to portray the country as modern, orderly, and peaceful. At the same time, through the use of alternative sources of media, students delivered their messages to the public, telling a much different story.
Chicago lindo y querido si muero lejos de ti: el pasito duranguense, la onda grupera y las nuevas geografías de la identidad popular mexicana
Authors: Ramírez-Pimienta Juan Carlos
Published: March 2010

Utilizando como punto de partida las muertes de Jorge Negrete, el icono del cine y música mexicana, y de Sergio Gómez, vocalista del grupo K-Paz de la Sierra, ocurridas en diciembre de 1953 y diciembre de 2007 respectivamente, este ensayo arguye que en décadas recientes ha ocurrido un desplazamiento del paradigma de mexicanismo forjado en la imagen del Centro y el Bajío mexicano (es decir la tierra del tequila, del charro y de la música del mariachi) hacia uno radicado en la frontera norte y en Estados Unidos.
Recovery of pituitary function in the late-postoperative phase after pituitary surgery: results of dynamic testing in patients with pituitary disease by insulin tolerance test 3 and 12 months after surgery
Authors: Berg C , Meinel T , Lahner H , Mann K , Petersenn S
Published: March 2010

The insulin tolerance test (ITT) is considered the gold standard for assessment of GH and ACTH reserve in patients with pituitary disease following pituitary surgery and is usually performed after 6–12 weeks. However, abnormal axes may not be completely recovered by then. The aim of this study was to evaluate dynamic testing 3 and 12 months after transsphenoidal pituitary surgery.

Design and patients

Serial dynamic testing was performed in 36 patients (13 women, age 18–78) at 3 and 12 months after transsphenoidal surgery.

Results

Compared with 3-month results, median GH peak levels during ITT after 12 months increased by 38% (P<0.05). In patients initially classified as GH deficiency (GHD), median GH peak increased after 12 months by 23% (P<0.05). At 3 and 12 months, 36% (13/36) and 47% (17/36) were GH sufficient respectively. Median cortisol peak levels after 12 months increased by 17% (P<0.01) compared with 3-month ITT. In ACTH-insufficient (AI) patients, peak cortisol levels increased significantly by 12% (P<0.05) at 12 months, and in ACTH-sufficient patients, peak cortisol levels increased significantly by 13% (P<0.05). At 12 months, there was recovery from AI in 11% of the patients, and recovery from GHD in 11% of patients.

Conclusions

Serial dynamic testing results in a change in classification by ITT results in a relevant proportion of patients. Dynamic testing should be repeated during follow-up.
Diagnosis and localisation of insulinoma: the value of modern magnetic resonance imaging in conjunction with calcium stimulation catheterisation
Authors: Druce Maralyn R , Muthuppalaniappan Vasantha M , O'Leary Benjamin , Chew Shern L , Drake William M , Monson John P , Akker Scott A , Besser Michael , Sahdev Anju , Rockall Andrea , Vyas Soumil , Bhattacharya Satya , Matson Matthew , Berney Daniel , Grossman Ashley B
Published: March 2010

Context

Preoperative localisation of insulinoma improves cure rate and reduces complications, but may be challenging.

Objective

To review diagnostic features and localisation accuracy for insulinomas.

Design

Cross-sectional, retrospective analysis.

Setting

A single tertiary referral centre.

Patients

Patients with insulinoma in the years 1990–2009, including sporadic tumours and those in patients with multiple endocrine neoplasia syndromes.

Interventions

Patients were identified from a database, and case notes and investigation results were reviewed. Tumour localisation by computed tomography (CT), magnetic resonance imaging (MRI), octreotide scanning, endoscopic ultrasound (EUS) and calcium stimulation was evaluated.

Main outcome measure(s)

Insulinoma localisation was compared to histologically confirmed location following surgical excision.

Results

Thirty-seven instances of biochemically and/or histologically proven insulinoma were identified in 36 patients, of which seven were managed medically. Of the 30 treated surgically, 25 had CT (83.3%) and 28 had MRI (90.3%), with successful localisation in 16 (64%) by CT and 21 (75%) by MRI respectively. Considered together, such imaging correctly localised 80% of lesions. Radiolabelled octreotide scanning was positive in 10 out of 20 cases (50%); EUS correctly identified 17 lesions in 26 patients (65.4%). Twenty-seven patients had calcium stimulation testing, of which 6 (22%) did not localise, 17 (63%) were correctly localised, and 4 (15%) gave discordant or confusing results.

Conclusions

Preoperative localisation of insulinomas remains challenging. A pragmatic combination of CT and especially MRI predicts tumour localisation with high accuracy. Radionuclide imaging and EUS were less helpful but may be valuable in selected cases. Calcium stimulation currently remains useful in providing an additional functional perspective.