bluuebunny/crossref_metadata_2025_split huggingface dataset:
Raltegravir-Induced Rash in a Patient Receiving Rifampin
Authors: Fulco Patricia Pecora , Kaatz Jane 
Published: September 2013

Objective: To present what we believe to be the first report of a possible case of raltegravir-induced rash in a patient receiving concurrent rifampin treatment. Case Summary: A 38-year-old man with newly diagnosed HIV and miliary tuberculosis (TB) was started on 4-drug TB treatment in combination with highly active antiretroviral therapy (HAART) including efavirenz, emtricitabine, and tenofovir. Eleven days later, the patient developed a rash and HAART was discontinued. Eight days later, HAART was reinitiated with raltegravir 400 mg twice daily and standard dose tenofovir/emtricitabine 300 mg/200 mg. After 14 weeks on this HAART regimen, the patient achieved an undetectable viral load with immune reconstitution. Twenty-two weeks after raltegravir initiation, the dosage was increased to 800 mg twice daily with continuation of emtricitabine/tenofovir. Sixteen days later, the patient developed a maculopapular rash leading to HAART discontinuation. The rash resolved in 2 weeks, and raltegravir rechallenge was not attempted. Discussion: Raltegravir-associated rash may occur in approximately 6–7.6% of patients with HIV, with onset between 2 and 5 weeks and a usual duration of 2 weeks. Rifampin significantly decreases the raltegravir minimum concentration (Cmin), and doubling the raltegravir dosage is recommended. This results in a slightly improved raltegravir Cmin, with a significant 2.6-fold increase in the maximum concentration. Little is known about the risk factors for raltegravir-associated rash. A concentration-dependent effect may enhance the occurrence of this cutaneous adverse reaction. An objective causality assessment revealed that the adverse drug event was possible, as the patient tolerated raltegravir for 5 months and then presented with a rash after dose escalation. Conclusions: Rifampin significantly alters the raltegravir pharmacokinetic profile. Additional safety and efficacy data are necessary to determine the optimal dosing strategy for raltegravir administered with rifampin.
Roles for Pharmacy Technicians in Community Pharmacy Practice Accreditation
Authors: Mihalopoulos Cleopatra C , Powers Mary F 
Published: September 2013

Objective: To review community pharmacy accreditation and identify opportunities for pharmacy technicians to help community pharmacies meet accreditation standards. Data Sources: Articles were identified through MEDLINE/PubMed (2001–2012) using search terms designed to locate English-language articles describing the role of the pharmacy technician, community pharmacy accreditation, and health care reform. Additionally, resources on community pharmacy accreditation and health care reform were used from the Institutes of Medicine, American Pharmacists Association, Council on Credentialing in Pharmacy, Center for Pharmacy Practice Accreditation, and Utilization Review Accreditation Commission. Study Selection and Data Extraction: Articles describing the role of the pharmacy technician, community pharmacy accreditation, and health care reform were included. Data Synthesis: Pharmacy technicians can help community pharmacies meet accreditation standards by taking on specific roles under 5 main domains: practice management, patient counseling, patient care services, technology, and quality improvement. Technicians can help by engaging in management-related tasks; improving communication between pharmacists, patients, and providers; and collecting and analyzing pharmacy data. Further, with proper training, pharmacy technicians can take on an expanded role to aid pharmacists with advanced patient care services and quality improvement measures. Conclusions: Pharmacy technicians can play a vital role in helping pharmacies meet standards necessary for community pharmacy accreditation.
Identifying Potential Causes of Opioid Toxicity Necessitating a Rapid Response Team Visit
Authors: Bagnola Aaron J , Escaño Alisa K 
Published: September 2013

Background: Opioids are labeled as high-risk medications because of their propensity to cause significant harm or toxicity to patients if used inappropriately. Many incidents of opioid toxicity are the result of preventable causes. Objective: To identify and report the frequency and potential causes of opioid toxicity in the acute care setting. Methods: This single-center chart review evaluated patients receiving naloxone for presumed opioid toxicity from January 2008 through July 2010. Patients were identified for this study using rapid response team charted visits. Charts were then reviewed for opioid medications administered, possible causes of opioid toxicity, signs and symptoms of opioid toxicity, patient location by hospital floor, and prescribing physician service. Results: One hundred twenty-nine incidents of opioid toxicity met inclusion criteria and were placed in 1 or more of the applicable categories for possible causes: administration of multiple opioids (43.4%), medication errors (31.6%), and the administration of morphine to patients with impaired renal function (7.2%); 17.8% of the causes were unknown. Conclusions: Most cases of opioid toxicity were determined to be the result of preventable causes. Prevention strategies for opioid toxicity should consist of educating health care professionals as well as incorporating health information technologies shown to reduce errors. Specific areas of focus should include opioid equianalgesic dosing strategies, removal of duplicate opioid orders, and writing of clear administration guidelines for orders of as-needed opioids or multiple dosage forms of opioids.
Rhabdomyolysis after Concomitant Use of Simvastatin and Voriconazole in an Allogeneic Stem Cell Transplant Patient
Authors: Cool Rita M , Gulbis Alison M 
Published: September 2013

Objective: To report a case of rhabdomyolysis after concomitant use of simvastatin and voriconazole. Case Summary: A 65-year-old white male, weight 66 kg, 79 months post allogeneic stem cell transplant for chronic lymphocytic leukemia, was on a stable medication regimen that included voriconazole. He was hospitalized with weakness and elevated creatine kinase a few weeks after initiation of simvastatin for treatment of hyperlipidemia. His symptoms resolved and creatine kinase level returned to within the normal range after fluid administration and discontinuation of simvastatin. Discussion: The use of statins has become a standard in the treatment and prevention of atherosclerotic disease. Most statins are metabolized via the cytochrome P450 enzyme system. For simvastatin, metabolism occurs specifically via the CYP3A4 isoenzyme. Drugs known to inhibit this isoenzyme, such as voriconazole, can increase the risk for toxicities, including rhabdomyolysis, when used concomitantly with simvastatin. This case represents a probable drug-drug interaction, based on the Horn Drug Interaction Probability Scale. Conclusions: Due to the broad use of statins for the treatment and prevention of atherosclerotic disease, as well as the need for azole antifungals in the stem cell transplant population, interactions between these agents are becoming an increasing possibility. Care should be taken to minimize these interactions and, when feasible, a change to an alternative agent may be warranted to avoid adverse effects.
Simvastatin: A Risk Factor for Angioedema?
Authors: Nisly Sarah A , Kara Areeba , Knight Tamara B 
Published: September 2013

Objective: To report a case of simvastatin-induced angioedema in a patient with near nightly episodes of orofacial angioedema. Case Summary: A 75-year-old African American female presented to the emergency department with recurrent face, lip, and tongue swelling. The patient described frequent episodes of orofacial edema, with 4 emergency department visits over the previous 6 months. Her home medications were reviewed and simvastatin was identified as a possible contributing medication. Simvastatin was discontinued with resolution of the symptoms during hospitalization and a significant reduction in episodes. Discussion: Drug-induced angioedema has been documented with several agents, most commonly angiotensin-converting enzyme inhibitors. The association with different drug classes has led to several postulated pathways for the development of angioedema. Notable mechanisms include mediation by bradykinin, inhibition of arachidonic acid metabolism, and complement activation. Each pathway culminates in increasing vascular permeability causing fluid accumulation in subcutaneous tissues. While statin use has been associated with drug-induced angioedema in postmarketing reports, there are no published cases involving simvastatin. Use of the Naranjo probability scale demonstrated a probable relationship between simvastatin use and the patient's recurrent angioedema. Conclusions: While statin use is not commonly associated with angioedema, clinicians must be aware of this possible adverse reaction. Consideration must also be given to potential drug interactions, increasing the risk of this adverse event.
BCOR and BCORL1 mutations in myelodysplastic syndromes and related disorders
Authors: Damm Frederik , Chesnais Virginie , Nagata Yasunobu , Yoshida Kenichi , Scourzic Laurianne , Okuno Yusuke , Itzykson Raphael , Sanada Masashi , Shiraishi Yuichi , Gelsi-Boyer Véronique , Renneville Aline , Miyano Satoru , Mori Hiraku , Shih Lee-Yung , Park Sophie , Dreyfus François , Guerci-Bresler Agnes , Solary Eric , Rose Christian , Cheze Stéphane , Prébet Thomas , Vey Norbert , Legentil Marion , Duffourd Yannis , de Botton Stéphane , Preudhomme Claude , Birnbaum Daniel , Bernard Olivier A. , Ogawa Seishi , Fontenay Michaela , Kosmider Olivier 
Published: September 2013

Key PointsDespite a low frequency of mutations, BCOR might be considered as a key gene in risk stratification. Deep sequencing technologies show that BCOR mutations commonly arise after other concomitant mutations in MDS.
Prostaglandin E2 enhances long-term repopulation but does not permanently alter inherent stem cell competitiveness
Authors: Hoggatt Jonathan , Mohammad Khalid S. , Singh Pratibha , Pelus Louis M. 
Published: September 2013

Key Points16-16 dimethyl-PGE2 treatment enhances long-term HSC repopulation without lineage bias or transformation. Treatment of HSC with 16-16 dimethyl-PGE2 does not alter long-term competitiveness.
Methylglyoxal modulates endothelial nitric oxide synthase-associated functions in EA.hy926 endothelial cells
Authors: Su Yang , Qadri Syed M , Wu Lingyun , Liu Lixin 
Published: September 2013

AbstractBackgroundIncreased levels of the sugar metabolite methylglyoxal (MG)in vivowere shown to participate in the pathophysiology of vascular complications in diabetes. Alterations of endothelial nitric oxide synthase (eNOS) activity by hypophosphorylation of the enzyme and enhanced monomerization are found in the diabetic milieu, and the regulation of this still remains undefined. Using various pharmacological approaches, we elucidate putative mechanisms by which MG modulates eNOS-associated functions of MG-stimulated superoxideO2•-production, phosphorylation status and eNOS uncoupling in EA.hy926 human endothelial cells.MethodsIn cultured EA.hy926 endothelial cells, the effects of MG treatment, tetrahydrobiopterin (BH4; 100 μM) and sepiapterin (20 μM) supplementation, NOS inhibition by NG-nitro-L-arginine methyl ester (L-NAME; 50 μM), and inhibition of peroxynitrite (ONOO-) formation (300 μM Tempol plus 50 μM L-NAME) on eNOS dimer/monomer ratios, Ser-1177 eNOS phosphorylation and 3-nitrotyrosine (3NT) abundance were quantified using immunoblotting.O2•-–dependent fluorescence was determined using a commercially available kit and tissue biopterin levels were measured by fluorometric HPLC analysis.ResultsIn EA.hy926 cells, MG treatment significantly enhancedO2•-generation and 3NT expression and reduced Ser-1177 eNOS phosphorylation, eNOS dimer/monomer ratio and cellular biopterin levels indicative of eNOS uncoupling. These effects were significantly mitigated by administration of BH4, sepiapterin and suppression of ONOO-formation. L-NAME treatment significantly blunted eNOS-derivedO2•-generation but did not modify eNOS phosphorylation or monomerization.ConclusionMG triggers eNOS uncoupling and hypophosphorylation in EA.hy926 endothelial cells associated withO2•-generation and biopterin depletion. The observed effects of the glycolysis metabolite MG presumably account, at least in part, for endothelial dysfunction in diabetes.
Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial
Authors: Toledo Estefania , Hu Frank B , Estruch Ramon , Buil-Cosiales Pilar , Corella Dolores , Salas-Salvadó Jordi , Covas M Isabel , Arós Fernando , Gómez-Gracia Enrique , Fiol Miquel , Lapetra Jose , Serra-Majem Luis , Pinto Xavier , Lamuela-Raventós Rosa M , Saez Guillermo , Bulló Mònica , Ruiz-Gutiérrez Valentina , Ros Emilio , Sorli José V , Martinez-Gonzalez Miguel Angel 
Published: September 2013

Abstract

Background
Hypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern.

Methods
The PREDIMED primary prevention trial is a randomized, single-blinded, controlled trial conducted in Spanish primary healthcare centers. We recruited 7,447 men (aged 55 to 80 years) and women (aged 60 to 80 years) who had high risk for cardiovascular disease. Participants were assigned to a control group or to one of two Mediterranean diets. The control group received education on following a low-fat diet, while the groups on Mediterranean diets received nutritional education and also free foods; either extra virgin olive oil, or nuts. Trained personnel measured participants’ BP at baseline and once yearly during a 4-year follow-up. We used generalized estimating equations to assess the differences between groups during the follow-up.

Results
The percentage of participants with controlled BP increased in all three intervention groups (P-value for within-group changes: P<0.001). Participants allocated to either of the two Mediterranean diet groups had significantly lower diastolic BP than the participants in the control group (−1.53 mmHg (95% confidence interval (CI) −2.01 to −1.04) for the Mediterranean diet supplemented with extra virgin olive oil, and −0.65 mmHg (95% CI -1.15 to −0.15) mmHg for the Mediterranean diet supplemented with nuts). No between-group differences in changes of systolic BP were seen.

Conclusions
Both the traditional Mediterranean diet and a low-fat diet exerted beneficial effects on BP and could be part of advice to patients for controlling BP. However, we found lower values of diastolic BP in the two groups promoting the Mediterranean diet with extra virgin olive oil or with nuts than in the control group.

Trial registration
Current Controlled Trials ISRCTN35739639
Cytokine-induced changes in the gene expression profile of a human cerebral microvascular endothelial cell-line, hCMEC/D3
Authors: Lopez-Ramirez Miguel Alejandro , Male David Kingsley , Wang Chunfang , Sharrack Basil , Wu Dongsheng , Romero Ignacio Andres 
Published: September 2013

Abstract

Background
The human cerebral microvascular endothelial cell line, hCMEC/D3, has been used extensively to model the blood–brain barrier (BBB) in vitro. Recently, we reported that cytokine-treatment induced loss of brain endothelial barrier properties. In this study, we further determined the gene expression pattern of hCMEC/D3 cells in response to activation with TNFα and IFNγ.

Findings
Using a microarray approach, we observed that expression of genes involved in the control of barrier permeability, including inter-brain endothelial junctions (e.g. claudin-5, MARVELD-2), integrin-focal adhesions complexes (e.g. integrin β1, ELMO-1) and transporter systems (e.g. ABCB1, SLC2A1), are altered by pro-inflammatory cytokines.

Conclusions
Our study shows that previously-described cytokine-induced changes in the pattern of gene expression of endothelium are reproduced in hCMEC/D3 cells, suggesting that this model is suitable to study inflammation at the BBB, while at the same time it has provided insights into novel key molecular processes that are altered in brain endothelium during neuroinflammation, such as modulation of cell-to-matrix contacts.
Diabetes induces stable intrinsic changes to myeloid cells that contribute to chronic inflammation during wound healing in mice
Authors: Bannon Pauline , Wood Sally , Restivo Terry , Campbell Laura , Hardman Matthew J. , Mace Kimberly A. 
Published: September 2013

Summary
Acute inflammation in response to injury is a tightly regulated process by which subsets of leukocytes are recruited to the injured tissue and undergo behavioural changes that are essential for effective tissue repair and regeneration. The diabetic wound environment is characterised by excessive and prolonged inflammation that is linked to poor progression of healing, and, in humans, the development of diabetic foot ulcers. However, the underlying mechanisms contributing to excessive inflammation remain poorly understood. Here we show in a murine model that the diabetic environment induces stable intrinsic changes in haematopoietic cells. These changes lead to a hyper-responsive phenotype to both pro-inflammatory and anti-inflammatory stimuli, producing extreme M1 and M2 polarised cells. During early wound healing, myeloid cells in diabetic mice show hyper-polarisation towards both M1 and M2 phenotypes, whereas, at late stages of healing, when non-diabetic macrophages have transitioned to an M2 phenotype, diabetic wound macrophages continue to display an M1 phenotype. Intriguingly, we show that this population predominantly consists of Gr-1+ CD11b+ CD14+ cells that have been previously reported as 'inflammatory macrophages' recruited to injured tissue in the early stages of wound healing. Finally, we show that this phenomenon is directly relevant to human diabetic ulcers, for which M2 polarisation predicts healing outcome. Thus, treatments focused at targeting this inflammatory cell subset could prove beneficial for pathological tissue repair.
Age, Body Mass, Usage of Exogenous Estrogen, and Lifestyle Factors in Relation to Circulating Sex Hormone–Binding Globulin Concentrations in Postmenopausal Women
Authors: Goto Atsushi , Chen Brian H , Song Yiqing , Cauley Jane , Cummings Steven R , Farhat Ghada N , Gunter Marc , Van Horn Linda , Howard Barbara V , Jackson Rebecca , Lee Jennifer , Rexrode Kathryn M , Liu Simin 
Published: September 2013

AbstractBACKGROUNDCirculating concentrations of sex hormone–binding globulin (SHBG) have been associated with cardiovascular diseases, type 2 diabetes, metabolic syndrome, and hormone-dependent cancers; however, correlates of SHBG concentrations are not well understood.METHODSWe comprehensively investigated correlates of SHBG concentrations among 13 547 women who participated in the Women's Health Initiative and who had SHBG measurements. We estimated study- and ethnicity-specific associations of age, reproductive history, usage of exogenous estrogen, body mass index (BMI), and lifestyle factors such as physical activity, smoking, alcohol consumption, coffee intake, and dietary factors with SHBG concentrations. These estimates were pooled using random-effects models. We also examined potential nonlinear associations using spline analyses.RESULTSThere was no significant ethnic difference in the age-adjusted mean concentrations of SHBG. Age, exogenous estrogen use, physical activity, and regular coffee intake were positively associated with SHBG concentrations, whereas BMI was inversely associated with SHBG concentrations after adjustment for potential confounding factors. Similar patterns were observed among both ever users and never users of exogenous estrogen. The spline analysis indicated nonlinear relations of regular intake of coffee, age, and BMI with SHBG concentrations. Two or more cups/day of regular coffee consumption and age of 60 years or older were associated with higher SHBG concentrations; the inverse BMI–SHBG relation was especially strong among women whose BMI was below 30.CONCLUSIONSIn this large sample of postmenopausal women, age, exogenous estrogen use, physical activity, regular coffee intake, and BMI were significant correlates of SHBG concentrations, presenting potential targets for interventions.
Operation Strategies to Minimize Methanol Recovery in Batch Distillation of Hydroalcoholic Mixtures
Authors: De Lucca Franco , Munizaga-Miranda Raúl , Jopia-Castillo David , Gelmi Claudio A. , Pérez-Correa José R. 
Published: September 2013

Abstract
This work focuses on applying dynamic simulation to explore operating conditions of a packed batch distillation column for reducing the relative concentration of methanol in the distillate. Based on trial-and-error, we studied different cooling rate trajectories of the partial condenser, which has a direct impact on the reflux and distillate rates. Simulations showed that higher cooling rates and smaller cut times achieved lower relative concentrations of methanol in the distillate. Our study suggests that the best operating strategy cannot reduce the relative methanol concentration in the distillate more than 25% compared with the relative methanol concentration in the wine.
Measuring Water Retention Curves for Rough Joints with Random Apertures
Authors: Wang Y. , Li J. H. , Zhang L. M. , Li X. , Cai C. Z. 
Published: September 2013

Abstract
A water retention curve for joints is a crucial parameter function in the numerical modeling of slopes, liners, and covers containing cracks or joints. In this study, a laboratory apparatus was designed and used to measure the water retention curves for rough joints at very low suctions. The aperture characteristics of the joint change spatially and are described by random-field theory. The apparatus incorporates a uniquely designed end cap and a water-content monitoring and pressure-control system. Suctions can be applied to the joint at an accuracy of 0.005 kPa. Visual observations of the flow process reveal that capillary flow is dominant in a rough epoxy joint with an average aperture size of 0.4 mm. The air-entry value is 0.23 kPa for the joint and decreases with increasing joint aperture size. When the applied suction becomes high, the water phase becomes discontinuous and a residual condition is attained. The residual degree of saturation is 0.26 for the joint with an average aperture size of 0.4 mm and decreases with increasing average aperture size. The rough joint can be viewed as a heterogeneous porous medium. The van Genuchten model can be used to describe the measured water retention curves for the rough joint.