bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do Sugar Substitutes Have Any Impact on Glycemic Control in Patients with Diabetes?
Authors: Behnen Erin M Timpe , Ferguson McKenzie C , Carlson Amy 
Published: September 2013

Objective: To evaluate the impact of nonnutritive sugar substitutes on glycemic control in patients with diabetes. Data Sources: A comprehensive review of the literature was conducted in PubMed (1966-March 2012) and Scopus. A combination of MeSH terms and keywords were used, including acesulfame, aspartame, diabetes, neotame, rebiana, saccharin, stevia, and sucralose. Study Selection and Data Extraction: Clinical studies evaluating the impact of nonnutritive sweeteners on measures of diabetic control, including, but not limited to, blood glucose levels, postprandial blood glucose, and hemoglobin A1c were selected for review. Searches were limited to only nonnutritive sweeteners available in the US. Data Synthesis: Nine clinical trials that evaluated nonnutritive sweeteners in a total of 490 patients with diabetes were found. Doses of sweeteners in the studies varied from below acceptable daily intake levels for 3 consecutive days to daily dosing for up to 18 weeks and up to 3.5 times the acceptable daily intake levels. No significant differences in overall effects on glycemic control and insulin response were found. Conclusions: Nonnutritive sweeteners do not appear to affect glycemic control in patients with diabetes. Patients should be counseled to maintain an appropriate energy balance in their diet, with or without the use of nonnutritive sweeteners.
Role of CYP450 in Antiplatelet Therapy: Considerations for Patients at Risk for Further Cardiovascular or Cerebrovascular Problems
Authors: Linn Chase E , Shah Niren K , Epstein Benjamin J 
Published: September 2013

Objective: To determine how interactions with cytochrome P450 ( CYP450) isoenzyme pathways may influence the selection of antiplatelet therapy in patients with cardiovascular and cerebrovascular disease. Data Sources: A MEDLINE search (1966-September 2012) was performed using the following MeSH search terms: clopidogrel, prasugrel, ticagrelor, aspirin, dipyridamole, drug interactions, polymorphism, cytochrome P450, platelets, platelet reactivity testing, and platelet function. In addition, reference citations were reviewed. Study Selection and Data Extraction: Selected studies analyzed the effects of CYP450 isoenzymes on the efficacy of antiplatelet therapy and potential drug-drug interactions. Data Synthesis: Antiplatelet therapy is pivotal in reducing the risk of acute coronary syndromes. Thienopyridines are commonly prescribed for antiplatelet drug therapy; however, a multitude of factors can influence their efficacy, given that thienopyridines require activation through CYP450 isoenzymes. Genetic polymorphisms in CYP450 isoenzymes and the susceptibility of drug-drug interactions mediated through the CYP450 system have led to variability in antiplatelet response. Two factors in particular have been prime targets in elucidating the role of CYP450 isoenzymes on thienopyridine activity and bioavailability: CYP2C19*2 polymorphisms and drug interactions with proton pump inhibitors. Additionally, many studies have surfaced in an attempt to quantify a patient's response to antiplatelet therapy but, to date, none has determined whether platelet reactivity testing is mandatory prior to initiation of therapy or whether it correlates with clinical efficacy. This review spotlights the pharmacokinetic and pharmacodynamic influences that CYP450 isoenzymes exert on antiplatelet therapies and attempts to categorize the role of platelet reactivity testing in determining the clinical significance of drug interactions. Conclusions: Suboptimal responses to antiplatelet therapy may occur because of interactions with CYP450 isoenzyme pathways. Further studies are warranted to clarify the impact of genetic polymorphisms and drug-drug interactions on clinical outcomes in patients with cardiovascular/cerebrovascular disease.
Ipilimumab-Induced Pneumonitis: A Case Report
Authors: Mis Lydia , Clarke Jeffrey M 
Published: September 2013

Objective: To report a case of ipilimumab-induced pneumonitis in a patient with metastatic melanoma. Case Summary: A 74-year-old woman with metastatic melanoma presented to the emergency department with progressive shortness of breath and dyspnea of 1 week's duration following her third cycle of ipilimumab. Upon presentation, she was hypoxic, with oxygen saturation of 66% on room air. After stabilization, she was transferred to the inpatient unit where she was placed on broad-spectrum antibiotics (intravenous vancomycin, piperacillin/tazobactam, oral ciprofloxacin, and oral trimethoprim/sulfamethoxazole) and a high-dose corticosteroid (intravenous methylprednisolone 30 mg every 6 hours). Bronchoscopy was negative for infection, and results of blood, urine, and respiratory cultures were negative. Antibiotics were eventually stopped and the patient responded to a high-dose corticosteroid for probable ipilimumab-induced pneumonitis. Discussion: Ipilimumab is a recombinant, human monoclonal antibody that was approved for the treatment of metastatic melanoma. A black-box warning exists for immune-mediated adverse reactions, which can involve any organ system and are a result of T-cell activation and proliferation. The most common sites for these reactions are the gastrointestinal tract, skin, liver, and pituitary gland. The Naranjo probability scale indicated a probable relationship between the development of pneumonitis and ipilimumab therapy. Review of the literature through October 2012 did not yield any reports of single-agent, ipilimumab-associated pneumonitis in patients with metastatic melanoma. Infection was ruled out, and no other etiology was identified for the patient's acute symptoms. Furthermore, she responded quickly to a high-dose corticosteroid. Conclusions: Ipilimumab is associated with immune-mediated toxicities that can be severe or fatal. Prompt recognition and treatment of these reactions is necessary to prevent morbidity or mortality. This is the first reported case of single-agent, ipilimumab-associated pneumonitis in a patient with metastatic melanoma.
Gingival Hypertrophy Associated with Amlodipine Use in an HIV-Infected Woman
Authors: Jacobs David M , Duggan Joan M , Sahloff Eric G 
Published: September 2013

Objective: To report the case of a 46-year-old woman with HIV infection who developed gingival hypertrophy while taking amlodipine for hypertension and review the literature discussing gingival hypertrophy associated with amlodipine and other calcium channel blockers. Case Summary: A 46-year-old HIV-infected female was taking amlodipine 5 mg daily to manage hypertension. After 4 1/2 years of exposure to amlodipine, the patient presented with new-onset gingival hypertrophy. Concurrent medications included atazanavir, ritonavir, tenofovir/emtricitabine, a multivitamin, and ibuprofen and tramadol as needed. Amlodipine was discontinued and lisinopril was initiated to manage hypertension. Resolution of gingival hypertrophy was noted at 3- and 12-month follow-up visits. Discussion: Drug-induced gingival hypertrophy has been associated with anticonvulsants, immunosuppressants, and calcium channel blockers. Cases of gingival hypertrophy are uncommon, especially after such extended exposure. The Naranjo probability scale classified the reaction as probable. Discontinuation of amlodipine led to resolution of gingival hypertrophy. Conclusions: Patients with new-onset gingival hypertrophy should have a complete medication review to identify potential causative agents. Development of gingival hypertrophy may present acutely or with extended exposure. Resolution of gingival hypertrophy generally occurs with discontinuation of the inciting agent.
Compliance with Renal Dosing Guidelines for Outpatient Antiinfective Prescriptions
Authors: Durand Cheryl R , Carr Robert J , Boudreau Samantha M 
Published: September 2013

Background: More than 80–95% of adverse drug events occurring among renally impaired patients are related to excessive dosing. Objective: To assess current prescribing practices with antiinfectives for patients with estimated creatinine clearance (CrCl) less than 51 mL/min who were in a local health care system. Methods: Outpatient antiinfective prescriptions written during a 10-day period in July 2012 were reviewed. The following information was collected for each patient: age, sex, serum creatinine, weight, height, drug dose and schedule, and discharge unit/outpatient service. Kidney function was estimated by calculating CrCl using either the Cockcroft-Gault or the Jelliffe equation. Two resources were used to identify appropriate dosing for renal function; if the 2 resources differed, the stricter of the 2 was used for assessment. Institutional review board approval was obtained for this study. Results: A total of 91 prescriptions, written for 87 different patients, met inclusion criteria and were reviewed. Average CrCl and age among the study population was 37.82 mL/min, and 75.7 years, respectively. Doses were excessive in 30% of outpatient prescriptions. The most common medications involved in excessive dosing were trimethoprim/sulfamethoxazole (TMP/SMX), cephalexin, fluconazole, and acyclovir. TMP/SMX was dosed excessively in 80% of prescriptions. Both fluconazole and acyclovir were dosed excessively in 75% of prescriptions, while cephalexin was dosed in excess in 36% of prescriptions. A comparison of discharge units/outpatient services revealed that 56% of prescriptions from urgent care centers were dosed in excess, compared with 30% from hospital discharge, 20% from emergency department discharge, and 25% from outpatient services. Conclusions: Our study indicates that there is room for improvement when dosing antiinfective medications for outpatients with renal insufficiency. Appropriate renal dosing can help protect patients from dangerous toxicities and other adverse drug events.
Worsening of Myasthenia Gravis following the Addition of Gabapentin for Essential Tremor
Authors: Seymour Nicole , Patel Tejal , Dixon Heather 
Published: September 2013

Objective: To report a case of worsening myasthenia gravis after the initiation of gabapentin for treatment of essential tremor. Case Summary: A 69-year-old man experienced minor ptosis of the left eyelid, slight neck weakness, and transient difficulties in chewing food on day 6 of a slow gabapentin dosage titration. As the titration continued, the myasthenia symptoms progressed to bilateral ptosis, and there was dramatic worsening of weakness by day 23. He was taking gabapentin 1500 mg daily at the time; the drug was then tapered to discontinuation. All myasthenia gravis symptoms were reported as resolved 3 days after discontinuation of gabapentin. The initiation and discontinuation of gabapentin also coincided with improvement, then worsening of the patient's tremor. Discussion: Three published case reports describe worsening of myasthenia gravis during use of gabapentin for the treatment of various neuropathies. To the best of our knowledge, this is the first case report of a patient experiencing worsening of myasthenia gravis upon initiation of gabapentin for essential tremor. The Naranjo probability scale suggests a probable association between gabapentin and worsening of myasthenia gravis symptoms in our patient. Several myasthenia-like symptoms are listed in the gabapentin mongraph as low-frequency adverse events, increasing the possibility that gabapentin may have been unmasking or worsening myasthenia gravis in clinical trials. However, myasthenia gravis is not identified as a contraindication or caution for gabapentin use. Conclusions: Gabapentin should be used with caution in patients with myasthenia gravis, and clinicians must be aware of the potential risks of this therapy.
Phylogeographic evidence of cognate recognition site patterns and transformation efficiency differences in H. pylori: theory of strain dominance
Authors: Maldonado-Contreras Ana , Mane Shrinivasrao P , Zhang Xue-Song , Pericchi Luis , Alarcón Teresa , Contreras Monica , Linz Bodo , Blaser Martin J , Domínguez-Bello María Gloria 
Published: September 2013

Abstract

Background

Helicobacter pylori has diverged in parallel to its human host, leading to distinct phylogeographic populations. Recent evidence suggests that in the current human mixing in Latin America, European H. pylori (hpEurope) are increasingly dominant at the expense of Amerindian haplotypes (hspAmerind). This phenomenon might occur via DNA recombination, modulated by restriction-modification systems (RMS), in which differences in cognate recognition sites (CRS) and in active methylases will determine direction and frequency of gene flow. We hypothesized that genomes from hspAmerind strains that evolved from a small founder population have lost CRS for RMS and active methylases, promoting hpEurope’s DNA invasion. We determined the observed and expected frequencies of CRS for RMS in DNA from 7 H. pylori whole genomes and 110 multilocus sequences. We also measured the number of active methylases by resistance to in vitro digestion by 16 restriction enzymes of genomic DNA from 9 hpEurope and 9 hspAmerind strains, and determined the direction of DNA uptake in co-culture experiments of hspAmerind and hpEurope strains.

Results
Most of the CRS were underrepresented with consistency between whole genomes and multilocus sequences. Although neither the frequency of CRS nor the number of active methylases differ among the bacterial populations (average 8.6 ± 2.6), hspAmerind strains had a restriction profile distinct from that in hpEurope strains, with 15 recognition sites accounting for the differences. Amerindians strains also exhibited higher transformation rates than European strains, and were more susceptible to be subverted by larger DNA hpEurope-fragments than vice versa.

Conclusions
The geographical variation in the pattern of CRS provides evidence for ancestral differences in RMS representation and function, and the transformation findings support the hypothesis of Europeanization of the Amerindian strains in Latin America via DNA recombination.
Assessment of quality of life of the children and parents affected by inborn errors of metabolism with restricted diet: preliminary results of a cross-sectional study
Authors: Fabre Alexandre , Baumstarck Karine , Cano Aline , Loundou Anderson , Berbis Julie , Chabrol Brigitte , Auquier Pascal 
Published: September 2013

Abstract

Introduction
The development in therapeutic strategies has increased survival of children affected by inborn errors of metabolism with restricted diet (IEMRD). These diseases have mild- and long-term consequences on the health. Little is known about the impact on the quality of life (QoL) of children and their families. The aims of this study were: to compare the QoL of the children and parents affected by IEMRD with the QoL of the general population and one pathology associated with long-term consequences.

Patients and methods
This cross-sectional study was performed at the French Reference Center for inborn metabolic disorders (Marseille, France). Inclusion criteria were: a child with a diagnosis of organic aciduria, urea cycle defect, or maple syrups urine disease (MSUD). Socio-demographics, clinical data, and QoL were recorded.

Results
Twenty-one of 32 eligible families were included during a planned routine visit. Ten (47%, 95% CI 27-69%) children were affected by organic aciduria, six (29%, 95% CI 10-48%) by urea cycle defects, and five (24%, 95% CI 6-42%) by MSUD. Among the younger children, the general well-being was significantly lower in the children with IEMRD than in the leukemia children (58 ± 16 versus 76 ± 15, p = 0.012), and among the older children, the leisure activities were significantly lower in the children with IEMRD than in the leukemia children (29 ± 18 versus 62 ± 22, p < 10-3), while the relationships with teachers were better (76 ± 23 versus 60 ± 23, p = 0.01). The physical QoL score was lower in the parents than in the French norms (66 ± 21 versus 75 ± 1, p = 0.05). Factors modulating QoL were: eating and neurologic disorders, enteral nutrition, and feeding modalities.

Conclusion
The children and the parents of children affected presented altered ‘physical’ and ‘social’ QoL scores compared with the norms and patients with leukemia and their families. Future studies based on larger cohort studies should determine the different weights of potential predictive factors of QoL.
The existence of solutions to a class of boundary value problems with fractional difference equations
Authors: Pan Yuanyuan , Han Zhenlai , Sun Shurong , Hou Chuanxia 
Published: September 2013

Abstract
In this paper, we study the existence and uniqueness of solutions for the boundary value problem of fractional difference equations

{

−

Δ
ν

y
(
t
)
=
f
(
t
+
ν
−
1
,
y
(
t
+
ν
−
1
)
)
,

y
(
ν
−
3
)
=
0
,

Δ
y
(
ν
−
3
)
=
0
,

y
(
ν
+
b
)
=
g
(
y
)

and

{

−

Δ
ν

y
(
t
)
=
λ
f
(
t
+
ν
−
1
,
y
(
t
+
ν
−
1
)
)
,

y
(
ν
−
3
)
=
0
,

Δ
y
(
ν
−
3
)
=
0
,

y
(
ν
+
b
)
=
g
(
y
)
,

respectively, where

t
=
1
,
2
,
…
,
b

,

2
<
ν
≤
3

,

f
:
{
ν
−
1
,
…
,
ν
+
b
}
×
R
→
R

is a continuous function and

g
∈
C
(

[
ν
−
3
,
ν
+
b
]

Z

ν
−
3

,
R
)

is a continuous functional. We prove the existence and uniqueness of a solution to the first problem by the contraction mapping theorem and the Brouwer theorem. Moreover, we present the existence and nonexistence of a solution to the second problem in terms of the parameter λ by the properties of the Green function and the Guo-Krasnosel’skii theorem. Finally, we present some examples to illustrate the main results.

MSC:34A08, 34B18, 39A12.
Altered inflammatory responsiveness in serotonin transporter mutant rats
Authors: Macchi Flavia , Homberg Judith R , Calabrese Francesca , Zecchillo Claudia , Racagni Giorgio , Riva Marco A , Molteni Raffaella 
Published: September 2013

AbstractBackgroundGrowing evidence suggests that alterations of the inflammatory/immune system contribute to the pathogenesis of depression. Indeed, depressed patients exhibit increased levels of inflammatory markers in both the periphery and the brain, and high comorbidity exists between major depression and diseases associated with inflammatory alterations. In order to characterize the link between depression and inflammation, we aimed to investigate whether an altered inflammatory system is present in a genetic model of vulnerability for depression, namely rats with partial or total deletion of the serotonin transporter (SERT) gene.MethodsWild-type, heterozygous and homozygous SERT rats were analyzed under basal condition or following a challenge with an acute injection of lipopolysaccharide (LPS) and killed 24 h or 5 days later.ResultsWe found that SERT mutant rats show altered cytokine expression in the dorsal and ventral hippocampus at basal conditions, and they also display an exacerbated cytokine response to the LPS challenge. Moreover, mutant rats exhibit differences in the expression of markers for microglia activation.ConclusionBased on these data, we suggest that basal or functional alterations of immune/inflammatory systems might contribute to the phenotype of SERT rats and to their heightened susceptibility to depressive-like behavior.
Effects of global changes on the climatic niche of the tick Ixodes ricinus inferred by species distribution modelling
Authors: Porretta Daniele , Mastrantonio Valentina , Amendolia Sara , Gaiarsa Stefano , Epis Sara , Genchi Claudio , Bandi Claudio , Otranto Domenico , Urbanelli Sandra 
Published: September 2013

AbstractBackgroundGlobal climate change can seriously impact on the epidemiological dynamics of vector-borne diseases. In this study we investigated how future climatic changes could affect the climatic niche ofIxodes ricinus(Acari, Ixodida), among the most important vectors of pathogens of medical and veterinary concern in Europe.MethodsSpecies Distribution Modelling (SDM) was used to reconstruct the climatic niche ofI. ricinus, and to project it into the future conditions for 2050 and 2080, under two scenarios: a continuous human demographic growth and a severe increase of gas emissions (scenario A2), and a scenario that proposes lower human demographic growth than A2, and a more sustainable gas emissions (scenario B2). Models were reconstructed using the algorithm of “maximum entropy”, as implemented in the softwareMaxent3.3.3e; 4,544 occurrence points and 15 bioclimatic variables were used.ResultsIn both scenarios an increase of climatic niche of about two times greater than the current area was predicted as well as a higher climatic suitability under the scenario B2 than A2. Such an increase occurred both in a latitudinal and longitudinal way, including northern Eurasian regions (e.g. Sweden and Russia), that were previously unsuitable for the species.ConclusionsOur models are congruent with the predictions of range expansion already observed inI. ricinusat a regional scale and provide a qualitative and quantitative assessment of the future climatically suitable areas forI. ricinusat a continental scale. Although the use of SDM at a higher resolution should be integrated by a more refined analysis of further abiotic and biotic data, the results presented here suggest that under future climatic scenarios most of the current distribution area ofI. ricinuscould remain suitable and significantly increase at a continental geographic scale. Therefore disease outbreaks of pathogens transmitted by this tick species could emerge in previous non-endemic geographic areas. Further studies will implement and refine present data toward a better understanding of the risk represented byI. ricinusto human health.