bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human Papillomavirus DNA in the Urogenital Tracts of Men with Genital Dermatoses: Evidence for Multifocal Infection
Authors: Hillman R J , Ryait B K , Botcherby M , Walker M M , Taylor-Robinson D 
Published: January 2017

In an attempt to assess the multifocal nature of anogenital HPV infection in men, skin biopsies, urethral swabs and urine specimens were obtained from 100 men with genital dermatoses. The specimens were examined for the presence of human papillomavirus (HPV) types 6, 11, 16, 18, 31 and 33 using the polymerase chain reaction and Southern blotting techniques. HPV DNA was detected in one or more specimens from 39 patients, that is 29 of 100 biopsy specimens, 21 (25%) of 85 urethral swab specimens and 6 (10%) of 59 urine specimens. HPV DNA was more common in men with at least 20 lifetime sexual partners and in those who gave a history of anogenital warts. Twelve (18%) of 66 biopsy specimens with no histological evidence of warty change or neoplasia had detectable HPV DNA. HPV DNA was detected no more frequently in the urethral and urine specimens from men with histological evidence of warts or neoplasia than from men without such changes. HPV types 6 and 11 were most common in biopsy specimens with histological changes of typical HPV infection. HPV type 16 was commonest in biopsy specimens with neoplasia and type 18 with other changes. Furthermore, ‘high-risk’ HPV types were found proportionately more often in urethral swab and urine specimens than in biopsy specimens. There was generally a poor correlation between the detection of HPV DNA at the different sites. A greater understanding of the role of HPV in the production of genital abnormalities is required in order to develop a rational approach to the management of these patients.
Testing for HIV Antibody: A Comparison of Two Services Offered in a Genitourinary Medicine Clinic
Authors: Rowen D , Carne C A , Sonnex C , Jones M , Maloney M E , Lefort W , Wreghitt T G 
Published: January 2017

Summary: Rates of screening for sexually transmissible infections in patients using different services provided by a genitourinary medicine clinic for testing for HIV antibodies are presented. Those patients whose primary reason for attending the clinic was HIV antibody testing and used the same day result (SDR) service were significantly less likely to be screened for other infections than those using the normal waiting time (NWT) service, ( P < 0.00001). This was true for both males and females. Of those patients screened for other infections in the SDR and NWT groups 29% and 35% respectively were found to have a sexually transmitted infection. It would appear that an SDR service offers little benefit for the majority of patients as only a few patients would not have had an HIV antibody test had the SDR not been available.
Clinical Features and Serum β2-Microglobulin Levels in HIV-1 Positive and Negative Tanzanian Patients with Tuberculosis
Authors: Kennedy Nick , Whitelaw Fiona M , Gutmann Jacques , Berger Leslie , Uiso Leonard , Ngowi Frank I , Gillespie Stephen H 
Published: January 2017

Summary: Serum β2-microglobulin (β2M) rises in the later stages of HIV disease and has therefore been used to monitor progression to AIDS. However, little work has been done on patients co-infected with HIV and tuberculosis. We studied clinical features and serum β2-M in 35 Tanzanian patients treated for pulmonary tuberculosis (9 HIV-positive, 26 HIV-negative). The provisional WHO clinical definition of AIDS for use in Africa was fulfilled by 89% of the HIV-positive and 65% of the HIV-negative patients. Median serum β2-M on admission was slightly higher in HIV-positive (3.17 mg/l) than in HIV-negative (2.85 mg/1) patients. Serum β2-M fell during treatment in 17/24 (71%) of HIV-negative and 3/7 (43%) HIV-positive patients followed up for 6 months. We conclude that serum β2-M is frequently raised in active tuberculosis, and is therefore an unreliable indicator of the stage of HIV disease in co-infected patients. The WHO clinical definition of AIDS also proved unreliable in patients with tuberculosis.
Women, Contraception and STDs Including HIV
Authors: Carlin E M , Boag F C 
Published: January 2017

Summary: It is estimated that eight million women are infected with the human immunodeficiency virus (HIV) worldwide. Heterosexual transmission is the predominant mode of HIV transmission on a global basis and is becoming increasingly important in the Western world. Women have long used contraceptives as a means of protection against an unwanted pregnancy, some of which may also protect against sexually transmitted disease (STD) including HIV. We review the relationship between contraceptive methods and STD acquisition and transmission; HIV acquisition and transmission; and the implications of contraceptive use, particularly regarding disease progression, in those women who are already infected with the virus. It is important for all women that protection against both unwanted pregnancy and HIV acquisition and transmission are considered together and not in isolation as nowhere is the argument for a broad based multi-disciplinary approach more cogent.
HIV in UK Prisons: A Review of Seroprevalence, Transmission and Patterns of Risk
Authors: Curtis Simon P , Edwards Anne 
Published: January 2017

Summary: Prisons contain individuals at high risk of HIV infection, notably through intravenous drug use. For complex political, social and legal reasons penal institutions in the UK are unable to provide condoms and clean needles. The outbreak of HIV and hepatitis B that occurred in a Scottish prison in 1993 focused attention on the potential problems. Debate about the issue is hampered by a lack of useful information. Current data about risk behaviour and seroprevalence is reviewed, and compared with experience in other countries. Injecting drug use in prison appears to be common, and the majority who inject in prison share equipment, which can be used many times. Sexual activity may be a smaller risk factor, but does occur between men in prison. In addition, prisoners appear to have high rates of partner change between sentences. The true prevalence of HIV in UK prisons is difficult to assess, but the available data suggest it is between 0.1 and 4.5%, lower than in Southern Europe and the USA. A window of opportunity still exists to prevent further outbreaks of HIV in UK penal institutions and to maintain these low prevalence rates. Strenuous, and possibly unpalatable measures are needed now.
Spectrum of Opportunistic Infections among AIDS Patients in Tamil Nadu, India
Authors: Kumarasamy N , Solomon Suniti , Paul S A Jayaker , Venilla Rosy , Amalraj R Edwin 
Published: January 2017

Summary: A retrospective case note review of 100 AIDS patients attending a large Indian centre was performed. Of these 100 patients, 94% gave a history of heterosexual HIV transmission, 68% were male. The majority of females were aged 21 to 30 years. The most common mode of presentation was tuberculosis (61%), both pulmonary (46%) and extrapulmonary (15%). Oral candidiasis extending on to the oesophagus was the second most predominant opportunistic infection. This study also highlights the difficulty in detecting AIDS cases in India owing to difficulties in taking a sexual history and lack of laboratory facilities.
Feasibility of Hydrogen Utilization in Gas Turbine Engines
Authors: Najjar Yousef S.H. , Zahed A.H. , Bashir M.D. , Alp Talip 
Published: January 2017

The gas turbine engine has a promising future in different applications. Hydrogen, on the other hand, is being considered as a good candidate fuel in combustion processes. In this work, a model two-shaft gas turbine engine was run on LPG under different operating conditions of compressor and free power turbine speeds. Performance parameters such as torque, power, specific fuel consumption, and thermal efficiency were calculated. Comparison of performance with hydrogen was carried out based on simulation studies, especially fuel-air ratio, and specific fuel consumption, which showed clearly improved performance with hydrogen.
Protection by extracellular glutathione against sulfur mustard induced toxicity in vitro
Authors: Amir A , Chapman S , Gozes Y , Sahar R , Allon N 
Published: January 2017

1 The present study characterizes the role of extracellularly added glutathione in protection against sulfur mustard (HD) toxicity in a macrophage monocyte cell line J774. 2 Toxic effects of HD depend on dose and duration of exposure with an ED50 of 50 and 75 mM for dividing and confluent cells respectively. 3 Exposure to HD, 100-200 mM caused *15% decrease in the cellular glutathione (GSH) content 2 h after exposure, pretreatment with GSH, 0.2-10 mM, elevated cellular GSH *61.5. 4 GSH pretreatment increased cell viability after HD 2-3-fold. Similar protective effects of GSH treatment were found in a human epidermoid carcinoma cell line (KB). 5 Protection by post treatment with GSH was apparent even 60 min post HD exposure. 6 No protection was afforded when the intracellular GSH concentration was elevated prior to exposure and the extracellular GSH had been washed out. However, GSH depleted cells were more sensitive to HD than normal cells, and were also protected by addition of GSH to the growth medium, although the intracellular GSH content remained low. 7 We conclude that it is essential for the GSH to be present extracellularly in order to protect cells from HD toxicity. 8 Our findings have therapeutic implications in particular for the protection of lungs after inhalation exposure to HD vapor.
The pre-clinical assessment of QT interval prolongation: a comparison of in vitro and in vivo methods
Authors: Davis A Stewart 
Published: January 2017

The literature was searched for in vivo dog studies reporting QT prolongation and in vitro studies reporting increased myocardial action potential duration, which indicates the potential to prolong QT interval, for nine non-cardiac drugs that have been reported to produce QT prolongation in man. The drugs were: astemizole; terfenadine; erythromycin; sparfloxacin; cisapride; probucol; terodiline; risperidone and sertindole. 1 There were reports of the appropriate finding with in vitro methods for six of the drugs and with in vivo methods for seven of the drugs. No reports were found concerning the remaining drugs with each method. This indicates that both methods are effective and each method would have correctly identified the drugs in question as having the potential to prolong the QT interval in man in all cases for which studies were reported. 2 This suggests that, if properly conducted, either method alone is sufficient for the pre-clinical assessment of QT interval prolongation. This does not support the routine use of both methods before the administration of new drugs to man.
Predicting the effectiveness of the Finnish population-based colorectal cancer screening programme
Authors: Chiu Sherry Yueh-Hsia , Malila Nea , Yen Amy Ming-Fang , Chen Sam Li-Sheng , Fann Jean Ching-Yuan , Hakama Matti 
Published: January 2017

Objective Because colorectal cancer (CRC) has a long natural history, estimating the effectiveness of CRC screening programmes requires long-term follow-up. As an alternative, we here demonstrate the use of a temporal multi-state natural history model to predict the effectiveness of CRC screening. Methods In the Finnish population-based biennial CRC screening programme using faecal occult blood tests (FOBT), which was conducted in a randomised health services study, we estimated the pre-clinical incidence, the mean sojourn time (MST), and the sensitivity of FOBT using a Markov model to analyse data from 2004 to 2007. These estimates were applied to predict, through simulation, the effects of five rounds of screening on the relative rate of reducing advanced CRC with 6 years of follow-up, and on the reduction in mortality with 10 years of follow-up, in a cohort of 500,000 subjects aged 60 to 69. Results For localised and non-localised CRC, respectively, the MST was 2.06 and 1.36 years and the sensitivity estimates were 65.12% and 73.70%. The predicted relative risk of non-localised CRC and death from CRC in the screened compared with the control population was 0.86 (95% CI: 0.79–0.98) and 0.91 (95% CI: 0.85–1.02), respectively. Conclusion Based on the preliminary results of the Finnish CRC screening programme, our model predicted a 9% reduction in CRC mortality and a 14% reduction in advanced CRC.
A Principal-Agent Approach to Foreign Economic Policy: State-Business Relations during U.S. Debt Crisis Management
Authors: Dombrowski Peter 
Published: January 2017

U.S. officials often rely on American corporations to achieve public policy objectives within the international economy. For example, commercial banks played an integral role in U.S. debt crisis management efforts. The reliance on American businesses to achieve policy ends challenges theoretical assumptions about relations between private firms and the American state. It also forces analysts to develop new methodological tools for analyzing policy implementation. When foreign policy outcomes depend on the behavior of private firms, traditional models must be modified to account for the complexity of state-business relations in a globalized political economy. To analyze the contribution of American firms to U.S. economic policy objectives, this paper draws upon institutionalist approaches to social science. Institutional analysis, and in particular economic views of organizations, focus on the role of incentives and information asymmetries in inter-organizational relations. This paper develops an analytic framework based on principal-agent theory and uses it to assess U.S. efforts to manage the global debt crisis.
Loss of Efficacy during Long-Term Cifenline Therapy: Development of Antiarrhythmic Resistance?
Authors: Mohiuddin Syed M. , Hee Tom T. , Hunter Claire B. , Hilleman Daniel E. , Sketch Michael H. 
Published: January 2017

OBJECTIVE: To describe the possible development of antiarrhythmic resistance to cifenline, an investigational Class I agent. METHODS: Forty patients with chronic ventricular premature depolarizations (VPDs) underwent dose-ranging studies with cifenline, an investigational Class I antiarrhythmic agent. Patients had a minimum of 30 VPDs/h detected by ambulatory electrocardiographic (ECG) monitoring over a 48-hour baseline placebo lead-in period. Twenty-two patients (55 percent) who initially responded received long-term cifenline therapy. Ambulatory ECG monitoring over 24 hours was repeated during active cifenline therapy at three-month intervals and during placebo reintroduction at six-month intervals. RESULTS: After an average follow-up of 28 months, VPD frequency during cifenline therapy was similar to that during initial baseline placebo therapy in 8 of the 22 patients (36 percent) who initially responded. Placebo reintroduction following cifenline failure showed a VPD frequency similar to that with active therapy. All patients had further cifenline dosage increases without success. Plasma cifenline concentrations increased in all patients and were in the high therapeutic range. All 8 patients were switched to other Class I antiarrhythmic agents with successful VPD suppression during treatment with the first alternative drug. CONCLUSIONS: We conclude that antiarrhythmic resistance occurred with cifenline in these patients as (1) initial efficacy was established for a minimum of two years, (2) VPD frequency was similar during cifenline therapy and placebo reintroduction, (3) cifenline therapy failure continued despite further dosage titration, and (4) alternative Class I antiarrhythmic therapy was successful in all patients. Repeat intermittent ambulatory ECG monitoring is necessary not only to assess the continued need for antiarrhythmic drug therapy, but also to establish continued long-term efficacy.
High Transdermal Fentanyl Requirements in a Patient with Chronic Cancer Pain
Authors: Lehr Victoria Tutag , Renaud Elizabeth A. 
Published: January 2017

OBJECTIVE: To report a case of high transdermal fentanyl dosage requirements in a patient with chronic cancer pain. DATA SOURCES: Clinical studies, review articles, and relevant laboratory information. CASE SUMMARY: A 42-year-old woman with cervical cancer was admitted for control of her pain. Her outpatient analgesic regimen was a continuous intravenous infusion of morphine sulfate (MS) via an ambulatory infusion device. Upon admission, supplemental doses of intravenous MS were administered in an effort to eliminate the pain. Transdermal fentanyl therapy was initiated on hospital day 1 at 100 μg/h and the MS continuous intravenous infusion dosage was increased. Over the next four days, the patient experienced episodes of inadequate pain control and the transdermal fentanyl dosage was increased in increments of 100 μg/h. On hospital day 4 the MS continuous infusion was converted to patient-controlled analgesia (PCA). The patient reported acceptable pain control with a regimen of transdermal fentanyl 500 μg/h and MS via PCA and she was discharged home on hospital day 7. CONCLUSIONS: This patient's high transdermal fentanyl dosage requirement was related to disease progression. She experienced an acute pain episode that may have been effectively managed by increasing the dosage of her continuous intravenous MS infusion.
Ondansetron in the Treatment of Intractable Nausea Associated with Theophylline Toxicity
Authors: Sage Therese A. , Jones William N. , Clark Richard F. 
Published: January 2017

OBJECTIVE: To report the efficacy of ondansetron in the treatment of a patient poisoned with theophylline. PATIENT: A 36-year-old man who ingested 6 g of sustained-release theophylline. INTERVENTION: Ondansetron 8 mg intravenously after clinical failure of other antiemetics. RESULTS: Subjective relief of nausea within minutes, enabling the patient to tolerate multiple doses of activated charcoal and whole bowel irrigation. CONCLUSIONS: Ondansetron may offer an alternative to present antiemetic therapy in the poisoned patient.
Effect of Seven Fluoroquinolones on the Determination of Serum Creatinine by the Picric Acid and Enzymatic Methods
Authors: Massoomi Firouzan , Mathews Herbert G. , Destache Christopher J. 
Published: January 2017

OBJECTIVE: To investigate in vitro the interaction of seven fluoroquinolone antibiotics with the determination of serum creatinine by the picric acid and enzymatic methods. DESIGN: This blind, in vitro study assayed duplicate serum samples for creatinine by the picric acid and enzymatic methods with averaged spiked concentrations of 2.71, 13.56, 27.12, and 108.47 μmol/L of ciprofloxacin, fleroxacin, lomefloxacin, ofloxacin, 1-ofloxacin, sparfloxacin, and temafloxacin. Cefoxitin (in concentrations of 233.9, 1169.6, 1754.4, and 2339.2 μmol/L) was used as a positive control for the picric acid assay. SETTING: University-affiliated hospital, Department of Pharmaceutical Services and Clinical Chemistry section of the Department of Pathology. MAIN OUTCOME MEASURE: The serum creatinine samples spiked with the seven substituted fluoroquinolones and cefoxitin were assayed by both the picric acid and enzymatic assays. Statistical analysis compared the spiked samples with blank serum by Student's t-test and concentration ranges were compared by analysis of variance. A statistically significant interference with serum creatinine was p<0.05. RESULTS: None of the substituted fluoroquinolones interfered significantly with the determination of serum creatinine by either method. Cefoxitin significantly interfered with the determination of serum creatinine by the picric acid method. CONCLUSIONS: Fluoroquinolones do not interfere with the determination of serum creatinine by either the picric acid or enzymatic method.
Natural Products and the Athlete: Facts and Folklore
Authors: Barron Richard L. , Vanscoy Gordon J. 
Published: January 2017

OBJECTIVE: To contrast scientific facts with suggested manufacturers' claims regarding food supplements (natural products) marketed for enhanced athletic prowess. DATA SOURCES: A MEDLINE search was performed to obtain documentation supporting the claims of natural-product manufacturers. In addition, several references pertaining to pharmacognosy, natural products, herbs, pharmacy practice, and sports medicine were reviewed. Claims were obtained from promotional advertisements in bodybuilding magazines, product labels, and fact sheets for sales representatives in nutrition and health-food stores. DATA EXTRACTION: We reviewed all of the clinical trials, published between 1966 and 1992, relative to the manufacturers' claims regarding these products. DATA SYNTHESIS: Pertinent human and/or animal studies supporting each natural product were compared with the manufacturers' claims. CONCLUSIONS: We found that there was no published scientific evidence to support the promotional claims for a large proportion of the products (8/19,42 percent). Only 4 of 19 products (21 percent) were associated with any documented human clinical trials supporting their promotional claims. Six of 19 agents (32 percent) had some scientific documentation to support their promotional claims; however, these products were judged to be marketed in a misleading manner.
Unmasking the Significant Enzyme-Inducing Effects of Phenytoin on Serum Carbamazepine Concentrations during Phenytoin Withdrawal
Authors: Chapron Dennis J. , LaPierre Barbara A. , Abou-Elkair Mervet 
Published: January 2017

OBJECTIVE: We report on two patients who appeared to exhibit profound induction of carbamazepine metabolism during cotherapy with phenytoin. Gradual withdrawal of phenytoin confirmed this impression. DESIGN: Two case studies. RESULTS: Two patients receiving carbamazepine and phenytoin as combination anticonvulsant therapy were admitted for comprehensive rehabilitation. A 23-year-old man had therapeutic serum phenytoin concentrations, but his serum carbamazepine concentrations were so low that they were nonquantifiable. Doubling the daily carbamazepine dosage did not yield quantifiable serum concentrations. When the daily phenytoin dosage was tapered from 500 to 200 mg, the carbamazepine concentration rose to 10.0 μg/mL. No further changes in serum carbamazepine concentrations were observed when the phenytoin was discontinued. A 49-year-old man was receiving large daily dosage of phenytoin (600 mg) and carbamazepine (2300 mg). In the process of tapering and discontinuing phenytoin, the patient became lethargic and confused. These signs and symptoms suggested carbamazepine toxicity. The patient was eventually stabilized on a carbamazepine dosage of 1200 mg/d, which produced a serum concentration of 8.4 μg/mL. When this patient had been receiving concurrent phenytoin therapy, approximately twice as much carbamazepine (2300 mg) was required to maintain a similar serum concentration. CONCLUSIONS: Phenytoin is a potent inducer of carbamazepine metabolism. Whenever phenytoin dosages are tapered and discontinued in patients receiving these medications concomitantly, frequent serum carbamazepine monitoring is recommended during the ensuing deinduction phase.