bluuebunny/crossref_metadata_2025 huggingface dataset:
"If you don't believe it, it won't help you": use of bush medicine in treating cancer among Aboriginal people in Western Australia
Authors: Shahid Shaouli , Bleam Ryan , Bessarab Dawn , Thompson Sandra C
Published: June 2010

Background

Little is known about the use of bush medicine and traditional healing among Aboriginal Australians for their treatment of cancer and the meanings attached to it. A qualitative study that explored Aboriginal Australians' perspectives and experiences of cancer and cancer services in Western Australia provided an opportunity to analyse the contemporary meanings attached and use of bush medicine by Aboriginal people with cancer in Western Australia

Methods

Data collection occurred in Perth, both rural and remote areas and included individual in-depth interviews, observations and field notes. Of the thirty-seven interviews with Aboriginal cancer patients, family members of people who died from cancer and some Aboriginal health care providers, 11 participants whose responses included substantial mention on the issue of bush medicine and traditional healing were selected for the analysis for this paper.

Results

The study findings have shown that as part of their healing some Aboriginal Australians use traditional medicine for treating their cancer. Such healing processes and medicines were preferred by some because it helped reconnect them with their heritage, land, culture and the spirits of their ancestors, bringing peace of mind during their illness. Spiritual beliefs and holistic health approaches and practices play an important role in the treatment choices for some patients.

Conclusions

Service providers need to acknowledge and understand the existence of Aboriginal knowledge (epistemology) and accept that traditional healing can be an important addition to an Aboriginal person's healing complementing Western medical treatment regimes. Allowing and supporting traditional approaches to treatment reflects a commitment by modern medical services to adopting an Aboriginal-friendly approach that is not only culturally appropriate but assists with the cultural security of the service.
Inverse folding of RNA pseudoknot structures
Authors: Gao James ZM , Li Linda YM , Reidys Christian M
Published: June 2010

Background

RNA exhibits a variety of structural configurations. Here we consider a structure to be tantamount to the noncrossing Watson-Crick and G-U-base pairings (secondary structure) and additional cross-serial base pairs. These interactions are called pseudoknots and are observed across the whole spectrum of RNA functionalities. In the context of studying natural RNA structures, searching for new ribozymes and designing artificial RNA, it is of interest to find RNA sequences folding into a specific structure and to analyze their induced neutral networks. Since the established inverse folding algorithms, RNAinverse, RNA-SSD as well as INFO-RNA are limited to RNA secondary structures, we present in this paper the inverse folding algorithm Inv which can deal with 3-noncrossing, canonical pseudoknot structures.

Results

In this paper we present the inverse folding algorithm Inv. We give a detailed analysis of Inv, including pseudocodes. We show that Inv allows to design in particular 3-noncrossing nonplanar RNA pseudoknot 3-noncrossing RNA structures-a class which is difficult to construct via dynamic programming routines. Inv is freely available at http://www.combinatorics.cn/cbpc/inv.html.

Conclusions

The algorithm Inv extends inverse folding capabilities to RNA pseudoknot structures. In comparison with RNAinverse it uses new ideas, for instance by considering sets of competing structures. As a result, Inv is not only able to find novel sequences even for RNA secondary structures, it does so in the context of competing structures that potentially exhibit cross-serial interactions.
Reversible bone pain and symmetric bone scan uptake in a dialysis patient treated with cinacalcet: a case report
Authors: Lenz Oliver , Sancassani Rhea , Bottino Carla , Fornoni Alessia
Published: June 2010

Introduction

The medical management of secondary hyperparathyroidism in patients with end-stage renal disease involves a combination of dietary restrictions, phosphate binders, active vitamin D analogs, and calcimimetics.

Case presentation

We report the case of a 36-year-old Hispanic dialysis patient, originally from Cuba and now residing in the USA, who developed severe bone pain and muscle twitching after starting low dose cinacalcet, despite normal pre-dialysis ionized calcium and elevated parathyroid hormone. The clinical symptoms correlated with increased symmetrical uptake on bone scan that resolved rapidly upon discontinuation of cinacalcet.

Conclusion

Cinacalcet may induce severe bone pain and a unique bone scan uptake pattern in hemodialysis patients.
Antisense oligonucleotide targeting Livin induces apoptosis of human bladder cancer cell via a mechanism involving caspase 3
Authors: Chuan Liu , Xiaohou Wu , Chunli Luo , Zili Hu , Zhikang Yin , Yunfeng He , Hu Du , Weili Zhang , Qing Jiang , Yanjun Lin
Published: June 2010

Background and Aim

in recent years, Livin, a new member of IAPs family, is found to be a key molecule in cancers. Researchers consider Livin may become a new target for tumor therapy; however, the role of it in bladder cancer is still unclear. The purpose of this article is to investigate Antisense Oligonucleotide (ASODN) of Livin on treating bladder cancer cell and underlying mechanisms.

Methods

Phosphorathioate modifying was used to synthesize antisense oligonucleotides targeting Livin, followed by transfection into human bladder cancer cell 5637. After transfection, Livin mRNA and protein level, cell proliferation and apoptosis changes, caspase3 level and its effect on human bladder cancer transplantable tumor in nude mice were measured.

Result

results showed Livin ASODN effectively inhibited Livin expression and tumor cell proliferation, and these effects probably through enhanced caspase3 activity and apoptosis of tumor cells. In nude mice transplantable tumor model, Livin expressions were inhibited meanwhile caspase3 expression was increased. Tumor growth slowed down and apoptosis was enhanced.

Conclusion

Our data suggest that Livin plays an important role in inhibiting apoptosis of bladder cancer cells. Livin ASODN may promote cell apoptosis, inhibit bladder cancer growth, and become one of the methods of gene therapy for bladder cancer.
An introduction to family‐centred services for children affected by HIV and AIDS
Authors: Richter Linda
Published: June 2010

Family‐centred services in the context of HIV/AIDS acknowledge a broad view of a “family system” and ideally include comprehensive treatment and care, community agencies and coordinated case management. The importance of family‐centred care for children affected by HIV/AIDS has been recognized for some time. There is a clear confluence of changing social realities and the needs of children in families affected by HIV and AIDS, but a change of paradigm in rendering services to children through families, in both high‐prevalence and concentrated epidemic settings, has been slow to emerge.

Despite a wide variety of model approaches, interventions, whether medical or psychosocial, still tend to target individuals rather than families. It has become clear that an individualistic approach to children affected by HIV and AIDS leads to confusion and misdirection of the global, national and local response. The almost exclusive focus on orphans, defined initially as a child who had lost one or both parents to AIDS, has occluded appreciation of the broader impact on children exposed to risk in other ways and the impact of the epidemic on families, communities and services for children. In addition, it led to narrowly focused, small‐scale social welfare and case management approaches with little impact on government action, global and national policy, integration with health and education interventions, and increased funding.

National social protection programmes that strengthen families are now established in several countries hard hit by AIDS, and large‐scale pilots are underway in others. These efforts are supported by international and national development agencies, increasingly by governments and, more recently, by UNAIDS and the global AIDS community.

There is no doubt that this is the beginning of a road and that there is still a long way to go, including basic research on families, family interventions, and effectiveness and costs of family‐centred approaches. It is also clear that many of the institutions that are intended to serve families sometimes fail and frequently even combat non‐traditional families.
Family‐centred approaches to the prevention of mother to child transmission of HIV
Authors: Betancourt Theresa S , Abrams Elaine J , McBain Ryan , Fawzi Mary C Smith
Published: June 2010

Background

Prevention of mother to child transmission (PMTCT) programmes have traditionally been narrow in scope, targeting biomedical interventions during the perinatal period, rather than considering HIV as a family disease. This limited focus restricts programmes' effectiveness, and the opportunity to broaden prevention measures has largely been overlooked.

Although prevention of vertical transmission is crucial, consideration of the family environment can enhance PMTCT. Family‐centred approaches to HIV prevention and care present an important direction for preventing paediatric infections while improving overall family health. This paper reviews available literature on PMTCT programmatic models that have taken a broader or family‐centred approach. We describe findings and barriers to the delivery of family‐centred PMTCT and identify a number of promising new directions that may achieve more holistic services for children and families.

Methods

Literature on the effectiveness of family‐centred PMTCT interventions available via PubMed, EMBASE and PsycINFO were searched from 1990 to the present. Four hundred and three abstracts were generated. These were narrowed to those describing or evaluating PMTCT models that target broader aspects of the family system before, during and/or after delivery of an infant at risk of acquiring HIV infection (N = 14).

Results

The most common aspects of family‐centred care incorporated by PMTCT studies and programme models included counselling, testing, and provision of antiretroviral treatment for infected pregnant women and their partners. Antiretroviral therapy was also commonly extended to other infected family members. Efforts to involve fathers in family‐based PMTCT counselling, infant feeding counselling, and general decision making were less common, though promising. Also promising, but rare, were PMTCT programmes that use interventions to enrich family capacity and functioning; these include risk assessments for intimate partner violence, attention to mental health issues, and the integration of early childhood development services.

Conclusions

Despite barriers, numerous opportunities exist to expand PMTCT services to address the health needs of the entire family. Our review of models utilizing these approaches indicates that family‐centred prevention measures can be effectively integrated within programmes. However, additional research is needed in order to more thoroughly evaluate their impact on PMTCT, as well as on broader family health outcomes.
Fathers and HIV: considerations for families
Authors: Sherr Lorraine
Published: June 2010

Background

Fathers are intricately bound up in all aspects of family life. This review examines fathers in the presence of HIV: from desire for a child, through conception issues, to a summary of the knowledge base on fathers within families affected by HIV.

Methods

A mixed‐methods approach is used, given the scarcity of literature. A review is provided on paternal and male factors in relation to the desire for a child, HIV testing in pregnancy, fatherhood and conception, fatherhood and drug use, paternal support and disengagement, fatherhood and men who have sex with men (MSM), and paternal effects on child development in the presence of HIV. Literature‐based reviews and systematic review techniques are used to access available data Primary data are reported on the issue of parenting for men who have sex with men.

Results

Men with HIV desire fatherhood. This is established in studies from numerous countries, although fatherhood desires may be lower for HIV‐positive men than HIV‐negative men. Couples do not always agree, and in some studies, male desires for a child are greater than those of their female partners. Despite reduced fertility, support and services, many proceed to parenting, whether in seroconcordant or serodiscordant relationships. There is growing knowledge about fertility options to reduce transmission risk to uninfected partners and to offspring.

Within the HIV field, there is limited research on fathering and fatherhood desires in a number of difficult‐to‐reach groups. There are, however, specific considerations for men who have sex with men and those affected by drug use. Conception in the presence of HIV needs to be managed and informed to reduce the risk of infection to partners and children. Further, paternal support plays a role in maternal management.

Conclusions

Strategies to improve HIV testing of fathers are needed. Paternal death has a negative impact on child development and paternal survival is protective. It is important to understand fathers and fathering and to approach childbirth from a family perspective.
Data availability on men's involvement in families in sub‐Saharan Africa to inform family‐centred programmes for children affected by HIV and AIDS
Authors: Hosegood Victoria , Madhavan Sangeetha
Published: June 2010

The Joint Learning Initiative on Children and AIDS recently recommended that programmes for children affected by HIV and AIDS in sub‐Saharan Africa direct more support to families. Interest has grown in including men in such family‐orientated interventions by researchers, policy makers, and community and non‐governmental organizations. However, there is a lack of good quality data on men's involvement with children in the diverse settings in sub‐Saharan Africa. In addition, limited research has examined their role in providing emotional, material support and protection for HIV‐ and AIDS‐affected children and families.

In this paper, we describe the availability of data about men and families, in particular fathers, in ongoing sub‐Saharan African surveys and longitudinal population cohorts. We discuss the conceptual and measurement issues associated with data collection on men's involvement in these types of studies. We consider the opportunities for improving the collection of data about men and families in household surveys and population cohorts in order to inform the design and evaluation of family‐centred interventions for children affected by HIV and AIDS.
Survival trends in critically ill HIV-infected patients in the highly active antiretroviral therapy era
Authors: Coquet Isaline , Pavie Juliette , Palmer Pierre , Barbier François , Legriel Stéphane , Mayaux Julien , Molina Michel Jean , Schlemmer Benoît , Azoulay Elie
Published: June 2010

Introduction

The widespread use of highly active antiretroviral therapy (ART) has reduced HIV-related life-threatening infectious complications. Our objective was to assess whether highly active ART was associated with improved survival in critically ill HIV-infected patients.

Methods

A retrospective study from 1996 to 2005 was performed in a medical intensive care unit (ICU) in a university hospital specialized in the management of immunocompromised patients. A total of 284 critically ill HIV-infected patients were included. Differences were sought across four time periods. Risk factors for death were identified by multivariable logistic regression.

Results

Among the 233 (82%) patients with known HIV infection before ICU admission, 64% were on highly active ART. Annual admissions increased over time, with no differences in reasons for admission: proportions of patients with newly diagnosed HIV, previous opportunistic infection, CD4 counts, viral load, or acute disease severity. ICU and 90-day mortality rates decreased steadily: 25% and 37.5% in 1996 to 1997, 17.1% and 17.1% in 1998 to 2000, 13.2% and 13.2% in 2001 to 2003, and 8.6% in 2004 to 2005. Five factors were independently associated with increased ICU mortality: delayed ICU admission (odds ratio (OR), 3.04; 95% confidence interval (CI), 1.29 to 7.17), acute renal failure (OR, 4.21; 95% CI, 1.63 to 10.92), hepatic cirrhosis (OR, 3.78; 95% CI, 1.21 to 11.84), ICU admission for coma (OR, 2.73; 95% CI, 1.16 to 6.46), and severe sepsis (OR, 3.67; 95% CI, 1.53 to 8.80). Admission to the ICU in the most recent period was independently associated with increased survival: admission from 2001 to 2003 (OR, 0.28; 95% CI, 0.08 to 0.99), and between 2004 and 2005 (OR, 0.13; 95% CI, 0.03 to 0.53).

Conclusions

ICU survival increased significantly in the highly active ART era, although disease severity remained unchanged. Co-morbidities and organ dysfunctions, but not HIV-related variables, were associated with death. Earlier ICU admission from the hospital ward might improve survival.
Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study
Authors: den Hartog Alexander W , de Pont Anne-Cornélie JM , Robillard Laure BM , Binnekade Jan M , Schultz Marcus J , Horn Janneke
Published: June 2010

Introduction

A large number of patients resuscitated for primary cardiac arrest arrive in the intensive care unit (ICU) with a body temperature < 35.0°C. The aim of this observational cohort study was to determine the association between ICU admission temperature and neurological outcome in this patient group.

Methods

Demographics and parameters influencing neurological outcome were retrieved from the charts of all patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia in our ICU from January 2006 until January 2008. Patients were divided into two groups according to their body temperature on ICU admission: a hypothermia group (< 35.0°C) and a non-hypothermia group (≥35.0°C). Neurological outcome after six months was assessed by means of the Glasgow Outcome Score (GOS), with GOS 1 to 3 defined as unfavorable and GOS 4 to 5 as favorable. A logistic regression model was used to analyze the influence of the different parameters on neurological outcome.

Results

The data of 105 consecutive patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia were analyzed. Median ICU admission temperature was 35.1°C (interquartile range (IQR) 34.3 to 35.7). After six months, 61% of the patients had an unfavorable outcome (59% died and 2% were severely disabled), whereas 39% had a favorable outcome (moderate disability or good recovery). Among patients with spontaneous hypothermia on ICU admission, the percentage with unfavorable outcome was higher (69% versus 50%, P = 0.05). Logistic regression showed that age, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores and spontaneous hypothermia on ICU admission all had an increased odds ratio (OR) for an unfavorable outcome after six months. Spontaneous hypothermia had the strongest association with unfavorable outcome (OR 2.6, 95% CI (confidence interval) 1.1 to 5.9), which became even stronger after adjustment for age, presenting heart rhythm, APACHE II and SOFA scores (OR 3.8, CI 1.3 to 11.0).

Conclusions

In this observational cohort study, spontaneous hypothermia on ICU admission was the strongest predictor of an unfavorable neurological outcome in patients resuscitated for primary cardiac arrest.
Adaptor protein Lnk inhibits c-Fms-mediated macrophage function
Authors: Gueller Saskia , Goodridge Helen S , Niebuhr Birte , Xing Hongtao , Koren-Michowitz Maya , Serve Hubert , Underhill David M , Brandts Christian H , Koeffler H Phillip
Published: June 2010

Lnk physically interacts with c-Fms and blunts its activity in-cluding proliferation of macrophage progenitor cells, M-CSF stimulated migration, and generaton of ROS.

The M-CSFR (c-Fms) participates in proliferation, differentiation, and survival of macrophages and is involved in the regulation of distinct macrophage functions. Interaction with the ligand M-CSF results in phosphorylation of tyrosine residues on c-Fms, thereby creating binding sites for molecules containing SH2 domains. Lnk is a SH2 domain adaptor protein that negatively regulates hematopoietic cytokine receptors. Here, we show that Lnk binds to c-Fms. Biological and functional effects of this interaction were examined in macrophages from Lnk-deficient (KO) and WT mice. Clonogenic assays demonstrated an elevated number of M-CFUs in the bone marrow of Lnk KO mice. Furthermore, the M-CSF-induced phosphorylation of Akt in Lnk KO macrophages was increased and prolonged, whereas phosphorylation of Erk was diminished. Zymosan-stimulated production of ROS was increased dramatically in a M-CSF-dependent manner in Lnk KO macrophages. Lastly, Lnk inhibited M-CSF-induced migration of macrophages. In summary, we show that Lnk binds to c-Fms and can blunt M-CSF stimulation. Modulation of levels of Lnk in macrophages may provide a unique therapeutic approach to increase innate host defenses.
NHE3 mobility in brush borders increases upon NHERF2-dependent stimulation by lyophosphatidic acid
Authors: Cha Boyoung , Zhu Xinjun Cindy , Chen Weiping , Jones Michelle , Ryoo Sungwoo , Zachos Nicholas C. , Chen Tien-E , Lin Rong , Sarker Rafiquel , Kenworthy Anne K. , Tse Ming , Kovbasnjuk Olga , Donowitz Mark
Published: June 2010

The epithelial brush border (BB) Na+/H+ exchanger NHE3 is associated with the actin cytoskeleton by binding both directly and indirectly to ezrin; indirect binding is via attachment to NHERF family proteins. NHE3 mobility in polarized epithelial cell BBs is restricted by the actin cytoskeleton and NHERF binding such that only ~30% of NHE3 in the apical domain of an OK cell line stably expressing NHERF2 is mobile, as judged by FRAP analysis. Given that levels of NHE3 are partially regulated by changes in trafficking, we investigated whether the cytoskeleton association of NHE3 was dynamic and changed as part of acute regulation to allow NHE3 trafficking. The agonist studied was lysophosphatidic acid (LPA), an inflammatory mediator, which acutely stimulates NHE3 activity by increasing the amount of NHE3 on the BBs by stimulated exocytosis. LPA acutely stimulated NHE3 activity in OK cells stably expressing NHERF2. Two conditions that totally prevented LPA stimulation of NHE3 activity only partially prevented stimulation of NHE3 mobility: the phosphoinositide 3-kinase (PI3K) inhibitor LY294002, and the NHE3F1 double mutant which has minimal direct binding of NHE3 to ezrin. These results show that LPA stimulation of NHE3 mobility occurs in two parts: (1) PI3K-dependent exocytic trafficking to the BB and (2) an increase in surface mobility of NHE3 in BBs under basal conditions. Moreover, the LPA stimulatory effect on NHE3 mobility required NHERF2. Although NHE3 and NHERF2 co-precipitated under basal conditions, they failed to co-precipitate 30 minutes after addition of LPA, whereas the physical association was re-established by 50-60 minutes. This dynamic interaction between NHERF2 and NHE3 was confirmed by acceptor photobleaching Förster Resonance energy Transfer (FRET). The restricted mobility of NHE3 in BBs under basal conditions as a result of cytoskeleton association is therefore dynamic and is reversed as part of acute LPA stimulation of NHE3. We suggest that this acute but transient increase in NHE3 mobility induced by LPA occurs via two processes: addition of NHE3 to the BB by exocytosis, a process which precedes binding of NHE3 to the actin cytoskeleton via NHERF2-ezrin, and by release of NHERF2 from the NHE3 already localized in the apical membrane, enabling NHE3 to distribute throughout the microvilli. These fractions of NHE3 make up a newly identified pool of NHE3 called the ‘transit pool’. Moreover, our results show that there are two aspects of LPA signaling involved in stimulation of NHE3 activity: PI3K-dependent stimulated NHE3 exocytosis and the newly described, PI3K-independent dissociation of microvillar NHE3 from NHERF2.
MDM2 and Fbw7 cooperate to induce p63 protein degradation following DNA damage and cell differentiation
Authors: Galli Francesco , Rossi Mariangela , D'Alessandra Yuri , De Simone Marco , Lopardo Teresa , Haupt Ygal , Alsheich-Bartok Osnat , Anzi Shira , Shaulian Eitan , Calabrò Viola , La Mantia Girolama , Guerrini Luisa
Published: June 2010

Tight control of p63 protein levels must be achieved under differentiation or apoptotic conditions. Here, we describe a new regulatory pathway for the ΔNp63α protein. We found that MDM2 binds ΔNp63α in the nucleus promoting its translocation to the cytoplasm. The MDM2 nuclear localization signal is required for ΔNp63α nuclear export and subsequent degradation, whereas the MDM2 ring-finger domain is dispensable. Once exported to the cytoplasm by MDM2, p63 is targeted for degradation by the Fbw7 E3-ubiquitin ligase. Efficient degradation of ΔNp63α by Fbw7 (also known as FBXW7) requires GSK3 kinase activity. By deletion and point mutations analysis we have identified a phosphodegron located in the α and β tail of p63 that is required for degradation. Furthermore, we show that MDM2 or Fbw7 depletion inhibits degradation of endogenous ΔNp63α in cells exposed to UV irradiation, adriamycin and upon keratinocyte differentiation. Our findings suggest that following DNA damage and cellular differentiation MDM2 and Fbw7 can cooperate to regulate the levels of the pro-proliferative ΔNp63α protein.
Myoferlin regulation by NFAT in muscle injury, regeneration and repair
Authors: Demonbreun Alexis R. , Lapidos Karen A. , Heretis Konstantina , Levin Samantha , Dale Rodney , Pytel Peter , Svensson Eric C. , McNally Elizabeth M.
Published: June 2010

Ferlin proteins mediate membrane-fusion events in response to Ca2+. Myoferlin, a member of the ferlin family, is required for normal muscle development, during which it mediates myoblast fusion. We isolated both damaged and intact myofibers from a mouse model of muscular dystrophy using laser-capture microdissection and found that the levels of myoferlin mRNA and protein were increased in damaged myofibers. To better define the components of the muscle-injury response, we identified a discreet 1543-bp fragment of the myoferlin promoter, containing multiple NFAT-binding sites, and found that this was sufficient to drive high-level myoferlin expression in cells and in vivo. This promoter recapitulated normal myoferlin expression in that it was downregulated in healthy myofibers and was upregulated in response to myofiber damage. Transgenic mice expressing GFP under the control of the myoferlin promoter were generated and GFP expression in this model was used to track muscle damage in vivo after muscle injury and in muscle disease. Myoferlin modulates the response to muscle injury through its activity in both myoblasts and mature myofibers.
Ant traffic rules
Authors: Fourcassié Vincent , Dussutour Audrey , Deneubourg Jean-Louis
Published: June 2010

Many animals take part in flow-like collective movements. In most species, however, the flow is unidirectional. Ants are one of the rare group of organisms in which flow-like movements are predominantly bidirectional. This adds to the difficulty of the task of maintaining a smooth, efficient movement. Yet, ants seem to fare well at this task. Do they really? And if so, how do such simple organisms succeed in maintaining a smooth traffic flow, when even humans experience trouble with this task? How does traffic in ants compare with that in human pedestrians or vehicles? The experimental study of ant traffic is only a few years old but it has already provided interesting insights into traffic organization and regulation in animals, showing in particular that an ant colony as a whole can be considered as a typical self-organized adaptive system. In this review we will show that the study of ant traffic can not only uncover basic principles of behavioral ecology and evolution in social insects but also provide new insights into the study of traffic systems in general.
Application of homotopy perturbation method to find an analytical solution for magnetohydrodynamic flows of viscoelastic fluids in converging/diverging channels
Authors: Shadloo M S , Kimiaeifar A
Published: June 2010

In this article, an analytical solution for magnetohydrodynamic flows of viscoelastic fluids in converging/diverging channels is presented. A similarity transform reduces the Navier—Stokes and energy equations to a set of non-linear ordinary differential equations that are solved analytically by means of the homotopy perturbation method (HPM). The results obtained in this study are compared with numerical results and previous studies. Close agreement of the two sets of results indicates the accuracy of HPM. An expression that is acceptable for all values of effective parameters is obtained by HPM. The numerical solution of the similarity equations is developed and the results are in good agreement with the analytical results based on HPM.
A Pragmatic Approach to the Condition monitoring of Hydraulic Level Crossing Barriers
Authors: Roberts C , Márquez F P G , Tobias A M
Published: June 2010

This study started with a full failure mode and effects analysis covering the 13 required functions of a barrier machine, the respective modes in which failure can occur, and, finally, their effects and the maintenance tasks they necessitate. Voltage, current, displacement, and pressure signals were then monitored at barriers on five sites in the UK, and both upper and lower thresholds were calculated for the purpose of condition monitoring and fault detection. The approach was found to detect around one-third of the total failures.
Frontotemporal dementias: development of an integrated care pathway through an experiential survey of patients and carers
Authors: Davies M , Larner A J
Published: June 2010

The frontotemporal lobar degenerations (FTLDs) constitute one form of neurodegenerative dementia, which presents with behavioural or linguistic symptoms which often elude precise diagnosis in the early stages of disease, to the frustration of both patients and carers. Based on experiential data from patients and carers seen in both the voluntary care sector (the Alzheimer's Society) and a dedicated Cognitive Function Clinic over periods of 3 to 4 years, a provisional integrated care pathway for FTLDs has been developed which seeks to ensure timely diagnosis and access to appropriate care needs.
Rituximab Skin Reaction; Skin Hyperpigmentation with Minocycline; Baclofen-Induced Psychosis; Tyrosine Kinase Inhibitors and Hypothyroidism; Myoclonus with Low-Dose Hydromorphone; Hyponatremia with Newest Antidepressant; Lingual Lesions with Orally Disintegrating Risperidone; Quetiapine-Induced Erythema Multiforme Minor
Authors: Shuster Joel
Published: June 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 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. Write to Dr. Shuster at ISMP, 1800 Byberry Road, Suite 810, Huntingdon Valley, PA 19006 (call 215-947-7797; fax 215-914-1492; E-mail: joel.shuster@temple.edu ). Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices in cooperation with the FDA's medWatch Program and Temple University School of Pharmacy. ISMP is an FDA medWatch partner.
A Site Specific, Clinical and Distributive Based Pharmacist Competency Workshop
Authors: Peshek Stephanie C. , Komorny Kenneth M. , Letting-Mangira Dorcas , Ewald Jacqueline R. , Cubera Kathleen , Bon John J. , Pasquale Timothy R. , Chesser Stephen
Published: June 2010

Summa Health System Department of Pharmacy Services performs a workshop based competency program to assess the ability of our clinical staff pharmacists to perform both clinical and distributive functions that are required for practice in our institutions. One day each month is devoted to this program, which consists of several modules designed to measure, sharpen, and update skills. Pharmacists are scheduled to attend one of the sessions each year. The topics change yearly to include current issues in disease state management, patient safety, clinical skills, and pharmacy technology. Modules are led by clinical lead pharmacists and department management.
The Predictability of Urinary Pathogens Based on the Urinalysis Nitrite Test in Hospitalized Patients
Authors: Christensen Russell L. , Creekmore Freddy M. , Strong Michael B. , Lugo Ralph A.
Published: June 2010

Purpose

Some urinary tract pathogens are capable of reducing nitrates to nitrites, including Escherichia coli, Klebsiella, Proteus, and Serratia. A urinalysis (UA) is commonly performed in patients with symptoms of a urinary tract infection (UTI) in order to detect the presence of nitrites in the urine. The objectives of this study were: 1) to assess the predictive value of the nitrite test in distinguishing nitrate-reducing pathogens from non-reducing pathogens; 2) to determine whether the results of the nitrite test can predict the susceptibility of the urine pathogen to several common antibiotics.

Methods

A retrospective cross-sectional chart review identified inpatients who had a UA and a positive urine culture (UC). Patients were divided into nitrite-positive and -negative groups based on UA results. Urine pathogens were identified by culture and antibiotic susceptibilities and were compared within the groups.

Results

Eighty-six UAs were included. A nitrite-positive UA had a 90.6% positive predictive value in identifying a nitrite-producing pathogen. A nitrite-negative UA had a negative predictive value of 33.3% in identifying a non-nitrite producing pathogen. There was no difference in the antibiotic susceptibility for ampicillin, gatifloxacin, and trimethoprim/sulfamethoxazole between the groups.

Conclusions

A nitrite-positive result indicates a high likelihood of the presence of a nitrite-producing organism. However, a negative nitrite test is a poor predictor of the absence of nitrite-producing pathogens. Therefore, patients with a positive nitrite test on UA can be treated empirically for a nitrite-producing organism until confirmatory laboratory studies can be completed. A nitrite-negative UA is not useful in ruling out a nitrate-reducing organism.
Posaconazole Oral Suspension
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: June 2010

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD-ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The January 2007 monograph topics are telbivudine, budesonide/formoterol inhalation aerosol, ciclesonide nasal spray, eculizumab, ceftobiprole medocaril. The DUE is telbivudine.
New Drugs Approved by the FDA; New Dosage Forms and Indications; Agents Pending FDA Approval Significant Labeling Changes
Authors: Baker Danial E.
Published: June 2010

This monthly feature will help readers keep current on new drugs, indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@drugfacts.com .
Effective Pharmacy Department Leadership
Authors: White Sara J.
Published: June 2010

The Directors Forum series is written and edited by Robert Weber and Michael Sanborn and is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. Another specific goal of this column is to address many of the key challenges that pharmacy directors face today, while providing information to foster growth in pharmacy leadership. This month's Forum was written by guest author Sara J. White and focuses directly on some of the critical elements that exemplify strong pharmacy leadership, as well as the director's role in staff development.
Dasatinib; Panitumumab
Authors: Bussey J. Abigail , Waddell J. Aubrey , Solimando Dominic A.
Published: June 2010

The increasing complexity of cancer chemotherapy increases the requirement that pharmacists be familiar with these highly toxic agents. This column will review various issues related to preparation, dispensing, and administration of cancer chemotherapy, and review various agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr., President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, E-mail: OncRxSvc@aol.com ; or J. Aubrey Waddell, Associate Professor, University of Tennessee College of Pharmacy; Oncology Pharmacist, Pharmacy Department, Blount Memorial Hospital, 907 E. Lamar Alexander Parkway, Maryville, TN 37804, E-mail: waddfour@charter.net .
A Retrospective Study of the Etiologies and Outcomes of Patients Admitted to a University Hospital with Presumed Acetaminophen Toxicity
Authors: Alaniz Cesar , Janusz Jenna
Published: June 2010

We evaluated the characteristics and outcomes of patients admitted with presumed acetaminophen (APAP) toxicity in a large university hospital over a 3-year period. There were 128 adults (mean age, 36 + 12.5 y) and 51 pediatric patients (mean age, 14.3 + 4 y). Seventy-eight (60.9%) adult patients presented with intentional toxic ingestion, 47 (36.7%) unintentional toxic ingestion, and seven (5.5%) cases in whom the intent of APAP ingestion was unknown. Conversely, 42 (82.4%) of the pediatric cases were intentional ingestion ( P= 0.01 vs adults). Patients admitted with unintentional toxic ingestion had a greater degree of hepatic impairment; although, significant differences in serum chemistries were not seen in the pediatric patients. However, in the adult group, those with unintentional toxic ingestion had significantly greater peak serum concentrations of aspartame aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, and prothrombin time (PT). There were 56 cases of unintentional toxic ingestion (47 adult, 9 pediatric). Acetaminophen was used for the treatment of pain in 37 adults (78.7%) and four children (44.4%); headache was the most frequent cause of pain (10 [27%] adult and three [75%] pediatric patients). Use of other potentially hepatotoxic medications was noted in 23 adult patients (62.2%), with hydrocodone/APAP (Vicodin) being used most frequently (51.4%). There were 31 patients who experienced fulminant hepatic failure. Eighteen (32%) patients developed fulminant hepatic failure following unintentional toxic APAP ingestion compared to 10 (8.3%) patients who had intentional toxic ingestion ( P< 0.001) (see Table 4 ). Fulminant hepatic failure occurred most frequently in adults (26 patients, 93%) and in females (71%). The ubiquity of over-the-counter APAP and the ever increasing use of APAP prescription products have increased the risk in a population largely unaware of the potential toxicity. Health care providers need to document all medications that patients are ingesting and provide education to those who are at risk of APAP toxicity.
New Drugs Approved by the FDA; New Dosage Forms and Indications; Agents Pending FDA Approval; Significant Labeling Changes
Authors: Baker Danial E.
Published: June 2010

This monthly feature will help readers keep current on new drugs, indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@wolterskluwer.com .
Diversion in the Pharmacy
Authors: O'neal Brian , Siegel Jerry
Published: June 2010

This is the first of a six-part series on diversion of controlled substances in an acute health care setting. The six articles are meant to accompany the recommendations in the Hospital Pharmacy article ‘Controlled Substance Diversion Detection: Go the Extra Mile’ for a comprehensive analysis of all aspects of controlled substance handling. 1 The series focuses on preventing diversion from automated dispensing cabinets (ADCs), the operating room, and at all handling points within a pharmacy. The objective of the series is to provide practical recommendations to aid pharmacy managers as they seek to prevent or detect diversion. Experience is key to diversion detection; however, a pharmacy should not have to experience their own diversion in order to learn from it. The collective experience of pharmacy leaders at the Ohio State University Medical Center and the University of Kansas Hospital are gathered to assist other pharmacy leaders in the hopes that they do not have to gain this experience firsthand.
Recent Publications on Medications and Pharmacy
Authors: Sterling Jacyntha
Published: June 2010

Hospital Pharmacy presents this feature to keep pharmacists abreast of new publications in the medical/pharmacy literature. Articles of interest will be abstracted monthly regarding a broad scope of topics. Suggestions or comments may be addressed to: Jacyntha Sterling, Drug Information Specialist at Saint Francis Hospital, 6161 S Yale Ave., Tulsa, OK 74136 or E-mail: jasterling@saintfrancis.com .
Danger of Giving Topical Thrombin Intravascularly: Drug Shortage Causes Error The Five Rights: a Destination without a Map
Authors: Cohen Michael R. , Smetzer Judy L.
Published: June 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 in your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the USP Medication Errors Reporting Program (MERP), which is presented in cooperation with the Institute for Safe Medication Practices. 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.
SSRIs and the Risk for Increased Fractures Epidural Corticosteroid Injections Causing Hematomas with Spinal Paresis Choroidal Detachment Associated with Tamsulosin and Terazosin Mania Associated with Pramipexole Dactinomycin-Induced Cutaneous Toxic Effects Hyperglycemia in a Child Receiving Aripiprazole Two Reports of Herbals Causing Pancreatitis and Gynecomastia
Authors: Shuster Joel
Published: June 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 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. Write to Dr. Shuster at ISMP, 1800 Byberry Road, Suite 810, Huntingdon Valley, PA 19006 (call 215-947-7797; fax 215-914-1492; e-mail: joel.shuster@temple.edu ). Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices in cooperation with the FDA's medWatch Program and Temple University School of Pharmacy. ISMP is an FDA MEdWatch partner.
Multifaceted Approach to Reduce Use of Meperidine in an Acute Care Setting
Authors: Pisupati Radhika
Published: June 2010

Purpose

A system-wide approach to reduce inappropriate use of meperidine in a 651-bed teaching hospital is described.

Baseline review indicated significant inappropriate usage of meperidine at our institution. Results of the review were presented to multidisciplinary committees in the institution. In addition to educational interventions, several strategies to effectively reduce meperidine usage were considered, including pharmacist follow-up of every order with the prescriber. However, to avoid delays in the treatment of pain and to prevent unnecessary exposure to a problem-prone agent, a guideline-based automatic conversion by the pharmacist was adopted.

Conclusion

A pharmacist-led multidisciplinary effort resulted in a significant reduction in meperidine use at our institution. A multifaceted approach that includes educational interventions as well as automatic therapeutic interchanges is an efficient way to optimize medication use.
Telbivudine
Authors: Cada Dennis J. , Levien Terri , Baker Danial E.
Published: June 2010

Each month, subscribers to The Formulary Monograph Service receive five to six well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to your Pharmacy and Therapeutics Committee. Subscribers also receive monthly one-page summary monographs on the agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation (DUE) is also provided each month. With a subscription, the monographs are sent to you in print and CD-ROM forms and are available online. Monographs can be customized to meet the needs of your facility. Subscribers to the The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X.

Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. If you would like information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The April 2007 monograph topics are mesalamine, hydroxocobalamin for injection, mifamurtide, satraplatin, and vernakalant. The DUE is on mesalamine.
New Drugs Approved by the FDA: Agents Pending FDA Approval Supplemental Applications Filed by Manufacturer Significant Labeling Changes
Authors: Baker Danial E.
Published: June 2010

This monthly feature will help readers keep current on new drugs, indications, dosage forms, and safety-related changes in labeling or use. Efforts have been made to ensure the accuracy of the information; however, if there are any questions, let us know at hospitalpharmacy@wolterskluwer.com .