bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genotyping and drug resistance patterns of M. tuberculosis strains in Pakistan
Authors: Tanveer Mahnaz , Hasan Zahra , Siddiqui Amna R , Ali Asho , Kanji Akbar , Ghebremicheal Solomon , Hasan Rumina 
Published: December 2008

Abstract

Background
The incidence of tuberculosis in Pakistan is 181/100,000 population. However, information about transmission and geographical prevalence of Mycobacterium tuberculosis strains and their evolutionary genetics as well as drug resistance remains limited. Our objective was to determine the clonal composition, evolutionary genetics and drug resistance of M. tuberculosis isolates from different regions of the country.

Methods

M. tuberculosis strains isolated (2003–2005) from specimens submitted to the laboratory through collection units nationwide were included. Drug susceptibility was performed and strains were spoligotyped.

Results
Of 926 M. tuberculosis strains studied, 721(78%) were grouped into 59 "shared types", while 205 (22%) were identified as "Orphan" spoligotypes. Amongst the predominant genotypes 61% were Central Asian strains (CAS ; including CAS1, CAS sub-families and Orphan Pak clusters), 4% East African-Indian (EAI), 3% Beijing, 2% poorly defined TB strains (T), 2% Haarlem and LAM (0.2). Also TbD1 analysis (M. tuberculosis specific deletion 1) confirmed that CAS1 was of "modern" origin while EAI isolates belonged to "ancestral" strain types.
Prevalence of CAS1 clade was significantly higher in Punjab (P < 0.01, Pearsons Chi-square test) as compared with Sindh, North West Frontier Province and Balochistan provinces. Forty six percent of isolates were sensitive to five first line antibiotics tested, 45% were Rifampicin resistant, 50% isoniazid resistant. MDR was significantly associated with Beijing strains (P = 0.01, Pearsons Chi-square test) and EAI (P = 0.001, Pearsons Chi-square test), but not with CAS family.

Conclusion
Our results show variation of prevalent M. tuberculosis strain with greater association of CAS1 with the Punjab province. The fact that the prevalent CAS genotype was not associated with drug resistance is encouraging. It further suggests a more effective treatment and control programme should be successful in reducing the tuberculosis burden in Pakistan.
The cancer translational research informatics platform
Authors: McConnell Patrick , Dash Rajesh C , Chilukuri Ram , Pietrobon Ricardo , Johnson Kimberly , Annechiarico Robert , Cuticchia A Jamie 
Published: December 2008

Abstract

Background
Despite the pressing need for the creation of applications that facilitate the aggregation of clinical and molecular data, most current applications are proprietary and lack the necessary compliance with standards that would allow for cross-institutional data exchange. In line with its mission of accelerating research discoveries and improving patient outcomes by linking networks of researchers, physicians, and patients focused on cancer research, caBIG (cancer Biomedical Informatics Grid™) has sponsored the creation of the caTRIP (Cancer Translational Research Informatics Platform) tool, with the purpose of aggregating clinical and molecular data in a repository that is user-friendly, easily accessible, as well as compliant with regulatory requirements of privacy and security.

Results
caTRIP has been developed as an N-tier architecture, with three primary tiers: domain services, the distributed query engine, and the graphical user interface, primarily making use of the caGrid infrastructure to ensure compatibility with other tools currently developed by caBIG. The application interface was designed so that users can construct queries using either the Simple Interface via drop-down menus or the Advanced Interface for more sophisticated searching strategies to using drag-and-drop. Furthermore, the application addresses the security concerns of authentication, authorization, and delegation, as well as an automated honest broker service for deidentifying data.

Conclusion
Currently being deployed at Duke University and a few other centers, we expect that caTRIP will make a significant contribution to further the development of translational research through the facilitation of its data exchange and storage processes.
Splenic rupture, secondary to G-CSF use for chemotherapy induced neutropenia: a case report and review of literature
Authors: Masood Nehal , Shaikh Asim Jamal , Memon Wasim Ahmed , Idress Romana 
Published: December 2008

Abstract

Introduction
Chemotherapy Induced neutropenia is a frequent and serious complication of cytotoxic cancer treatment.
Granulocyte colony stimulating factors (G-CSF) are frequently used to counter neutropenia, attempt rapid recovery of patients and allow for continuation of treatment without compromise on dose, especially in curative malignancies. Generally regarded as safe, G-CSF use has been very rarely reported to have resulted in serious side effects, such as, splenic rupture.

Case presentation
We are reporting a case of a twenty years old man, who was being treated for T cell acute lymphoblastic leukemia and received colony stimulating factors for treatment of severe neutropenia and suffered from splenic rupture, He was treated with splenectomy.

Conclusion
Although extremely rare, splenic rupture can be a serious and sometimes life threatening complication of high dose colony stimulating factors therapy.
Sex between men in the context of HIV: The AIDS 2008 Jonathan Mann Memorial Lecture in health and human rights
Authors: Saavedra Jorge , Izazola‐Licea Jose Antonio , Beyrer Chris 
Published: December 2008

Gay, bisexual, and other men who have sex with men (MSM) have been among the most affected populations by HIV since the AIDS pandemic was first identified in the 1980s. Evidence from a wide range of studies show that these men remain at the highest risk for HIV acquisition in both developed and developing countries, and that despite three decades of evidence of their vulnerability to HIV, they remain under‐served and under‐studied. Prevention strategies targeted to MSM are markedly under‐funded in most countries, leading to limited access to health services including prevention, treatment, and care. We explore the global epidemic among MSM in 2008, the limited funding available globally to respond to these epidemics, and the human rights contexts and factors which drive HIV spread and limit HIV responses for these men.What do we mean by the term MSM? MSM is a construct from the 1990s that tries to capture behavior and not identity. It was crafted to avoid stigmatizing and culturally laden terms such as gay or bisexual, which do not capture the wide diversity of orientations, sexual practices, cultures, and contextual settings in which male same‐sex behaviors occur, and where HIV transmission and acquisition risks are centered. MSM includes both gay and non‐gay identified men, bisexual men, and MSM who identify themselves as heterosexuals. It also includes men engaging in “situational” sex between men, such as can occur in prisons, schools, militaries or other environments; and it includes male sex workers who may be of any orientation but are often at very high risk for HIV. MSM may include some biologically male transgender persons, though some do not identify as male. And MSM includes a wide array of traditional and local terms worldwide–with enormous cultural diversity in Asia, Africa, Latin America and elsewhere. We use the term MSM here at its most inclusive.
Induction of caspase- and reactive oxygen species-independent phosphatidylserine externalization in primary human neutrophils: role in macrophage recognition and engulfment
Authors: Jitkaew Siriporn , Witasp Erika , Zhang Shouting , Kagan Valerian E , Fadeel Bengt 
Published: December 2008

AbstractMacrophage recognition and disposal of neutrophils are important steps in the resolution of inflammation. Externalization of phosphatidylserine (PS) on the cell surface serves as a common recognition signal for macrophages and is associated with the apoptosis program in neutrophils. Here, we report that macrophage-differentiated PLB-985 cells induce rapid, caspase-independent PS externalization in human neutrophils. A similar degree of PS externalization was seen when neutrophils were cocultured with gp91phox-deficient PLB-985 macrophages, thus demonstrating that macrophage-induced PS externalization was NADPH oxidase-independent. Macrophage-induced PS externalization required cell-to-cell contact and kinase activation and was shown to correlate with neutrophil degranulation. Of note, the degree of engulfment of such PS-positive neutrophils by activated human monocyte-derived macrophages was considerably lower than for neutrophils undergoing constitutive apoptosis, indicating that PS externalization alone is not sufficient for macrophage disposal of neutrophils. However, addition of recombinant milk fat globule epidermal growth factor 8, a PS-binding protein, restored engulfment of the macrophage-cocultured target cells. Finally, neutrophils undergoing spontaneous apoptosis but not macrophage-cocultured neutrophils displayed surface expression and release of annexin I, and the addition of N-t-Boc-Phe-D-Leu-Phe-D-Leu-Phe (Boc1), a formyl peptide receptor/lipoxin receptor antagonist, suppressed clearance of apoptotic neutrophils. Conditioned medium from apoptotic neutrophils also promoted the engulfment of macrophage-cocultured neutrophils, and Boc1 blocked this process. Taken together, these studies highlight a novel pathway of PS externalization in primary human neutrophils and also provide evidence for an auxiliary function of annexin I in macrophage clearance of neutrophils.
Estrogen Receptor β Functions through Nongenomic Mechanisms in Lung Cancer Cells
Authors: Zhang GuangFeng , Liu Xuwan , Farkas Adam M. , Parwani Anil V. , Lathrop Kira L. , Lenzner Diana , Land Stephanie R. , Srinivas Harish 
Published: December 2008

Abstract
Recent studies have shown that estrogens promote the growth of lung cancer cells and may potentially be responsible for increased susceptibility to lung cancer in women. These observations raise the possibility of using antiestrogens in treating and preventing lung cancer. However, it is not clear how estrogen receptors (ERs) modulate the growth of non-small cell lung cancer (NSCLC) cells. Our Western blotting and real-time PCR analysis showed that NSCLC cells expressed ERβ, but not ERα. In addition, ERβ-specific ligands, but not ERα-specific ligands, promoted the growth of lung cancer cells. Furthermore, knockdown of ERβ by short hairpin RNA constructs resulted in loss of estrogen-dependent growth of lung cancer cells. Interestingly, endogenous ERβ failed to transcriptionally activate estrogen response element (ERE)-luciferase constructs in NSCLC cells, suggesting a lack of genomic function. Upon further investigation, ERβ was found to be in the cytoplasm in all lung cancer cells and failed to translocate to the nucleus in the presence of estrogen, as observed by biochemical, ArrayScan, and confocal microscopy experiments. Nonetheless, estrogen caused rapid activation of cAMP, Akt, and MAPK signaling pathways in lung cancer cells. Immunohistochemical analysis of lung tumor biopsies showed strong ERβ staining in the cytoplasm, whereas no staining was observed for ERα. In conclusion, our results suggest that that proliferative effects of estrogen in lung cancer cells is mediated primarily, if not exclusively, by the nongenomic action of ERβ.
Pharmacist-led medication review for knee pain in older adults: content, process and outcomes
Authors: Phelan Mike , Foster Nadine E , Thomas Elaine , Hay Elaine M , Blenkinsopp Alison 
Published: December 2008

Abstract

Objective
To describe the content and evaluate the effects of pharmacist-conducted medication review delivered in the context of a randomised controlled trial. The intervention aimed to optimise the pharmacological management of knee pain in older adults by negotiating an individualised treatment plan with patients.

Method
A structured medicines review was conducted by a pharmacist in the general practice setting for patients aged over 55 years with knee pain in a randomised controlled trial. According to patients' needs they could receive three to six consultations of approximately 20 minutes' duration over a 10 week period. During reviews the patients' use of prescribed and over-the-counter medicines was explored and perceived effectiveness in pain control was discussed. The pharmacist made treatment recommendations based on an algorithm previously agreed with the participating general practitioners. The pharmacist also provided education and advice on medicines and relevant lifestyle aspects. Patients in the comparison group received a control intervention (information leaflet and telephone call).

Key findings
One hundred and eight patients from 13 general medical practices were randomised to the enhanced pharmacy review group and 106 attended. Knee-pain scores showed significant improvement at 3 but not 12 months compared with the control intervention. The pharmacist made treatment recommendations for all patients and provided advice and education to over 90%. For eight out of 10 patients the treatment recommendation was for changes to treatment. Of the 36 patients for whom a non-steroidal anti-inflammatory drug was being prescribed at baseline the pharmacist recommended discontinuation in 17 cases and change to intermittent use in three cases. The mean amount of time spent per patient was around 60 minutes in three sessions.

Conclusion
Pharmacist-conducted medicines review identified substantial opportunities to improve pharmacological treatment for knee pain, and to reduce side effects from analgesic medicines. The findings of this study suggest that pharmacists can make a positive contribution to the management of patients with knee pain in primary care in the short-term. These findings support the wider implementation of pharmacist-led medicines review for patients with knee pain.
Effect of prescribed minimum benefits on the prevalence of possible drug-drug interactions of antiretroviral agents in a section of the private health care sector in South Africa: a 2 year comparative study
Authors: Katende-Kyenda Norah L , Lubbe Martie S , Serfontein Jan H P , Truter Ilse 
Published: December 2008

Abstract

Objective
The aim of this study was to determine the impact of prescribed minimum benefits (PMBs) after implementation, on the prevalence of possible drug-drug interactions (DDIs) between antiretrovirals (ARVs) themselves and other drugs on prescriptions claimed in a section of the private health care sector in South Africa.

Setting
A section of the private health care sector in South Africa.

Method
A comparative, retrospective drug-utilisation study was performed using 2004 and 2005 data from a medicine claims database. Possible DDIs found were classified according to Tatro (2005).

Key findings
The data consisted of 43 482 ARV prescriptions claimed during 2004 and 51 613 for 2005. A total of 5 305 882 and 3 606 992 medicine items were claimed during 2004 and 2005 respectively, of which 1.92% were ARVs for 2004 and 3.38% for 2005. Of 18 035 DDIs identified, 83.89% were between ARVs and other medications, and 16.11% were between ARVs themselves for 2004. Of 25 130 DDIs identified for 2005, 92.59% were between ARVs and other medications, and 7.41% were between ARVs themselves.

Conclusions
The decrease in DDIs between ARVs alone for 2005 as compared to 2004 could indicate a possible impact of PMBs on HIV/AIDS, as a chronic disease in which management programmes were introduced to ensure the appropriateness and effectiveness of drugs in HIV/AIDS. It is therefore recommended that further investigations be done on the management of the most important DDIs between ARVs alone and other drugs prescribed on the same prescription.
Pharmacist Involvement in Improving Asthma Outcomes in Various Healthcare Settings: 1997 to Present
Authors: Benavides Sandra , Rodriguez Juan Carlos , Maniscalco-Feichtl Maria 
Published: December 2008

OBJECTIVE To evaluate pharmacists’ impact on asthma management outcomes in various healthcare settings on the basis of updated guidelines set by the National Heart, Lung, and Blood Institute (NHLBI). DATA SOURCES A search of MEDLINE (1997–April 2008) and International Pharmaceutical Abstracts (1997–April 2008) was conducted using the MeSH terms asthma, community pharmacy services, pharmacists, pharmacies, clinic, hospital, disease state management, medication therapy management, emergency department, and community. STUDY SELECTION AND DATA EXTRACTION Articles were included if pharmacists participated in the intervention and the report measured outcomes of asthma as defined by symptoms, pulmonary function, asthma severity, quality of life (QOL), or healthcare utilization. DATA SYNTHESIS Since January 1997, a substantial number of studies have been published examining pharmacists’ impact on asthma clinical outcomes. Twenty-five studies were included in this review: 15 were conducted in community pharmacies, 5 in ambulatory clinics, 2 in an in-patient hospital setting, and 3 as various community initiatives. The studies varied in the type of intervention provided and outcomes measured. The most common outcome in community pharmacies was pulmonary function measures, in which all but one trial found improvements. Half of the community pharmacy trials found improvements in asthma severity, 75% found improvements in healthcare utilization, and although some trials found improvements in QOL, 2 trials found decreases in QOL. Ambulatory clinics reported improvements in asthma symptoms and pulmonary function and decreased healthcare utilization. Most trials in the ambulatory care setting reported decreases in QOL postintervention. Trials in the hospital setting most often reported decreases in healthcare utilization. Limitations of the studies, however, included varying definitions of asthma control, methodologies used in the studies, and the lack of long-term follow-up. CONCLUSIONS Future study designs may require larger sample size and measure outcomes that better assess disease severity in asthma, such as impairment and risk domains. This review supports the National Heart, Lung, and Blood Institutes of the National Institutes of Health Expert Panel Report 3 guidelines in recognizing pharmacists as accessible healthcare practitioners who, via patient education and medication management, may help patients with asthma attain better control of their disease state.
Perceived Advantages and Disadvantages of Using Drug Samples in a University Hospital Center: A Case Study
Authors: Tardif Lyne , Bailey Benoît , Bussières Jean-François , Lebel Denis , Soucy Geneviève 
Published: December 2008

BACKGROUND The distribution of drug samples is both permitted and a common practice in Canada and the US. The impact of this strategy on healthcare workers’ opinions and habits is a reason for concern. OBJECTIVE To evaluate the perceived advantages and disadvantages of using drug samples in a university hospital center. METHOD An observational, descriptive case study was conducted in a 500-bed university hospital center between October 18 and November 1, 2007. To obtain feedback from the healthcare staff, our research team, which was made up of a physician, pharmacy resident, 2 pharmacists, and a student in health administration, designed a 26-question survey using a Likert scale (fully agree, partially agree, partially disagree, totally disagree, do not know). The questions focused on 8 different variables (rapid treatment initiation, free cost and availability, practicality of use, patient risk, pharmacist's role, impact on choice of treatment, storage and stock management, risk of pilfering). RESULTS In total, 39 physicians, 18 medical residents, 17 medical clerks, 83 nurses, and 23 pharmacists working in various healthcare units and outpatient clinics (N = 180) agreed to take part in the survey and fill out the questionnaire. Generally speaking, there was a high degree of variation among the professional groups in their levels of agreement with the statements on the questionnaire. For example, 71% of the nurses, 43% of the physicians, 71% of the medical residents, and 36% of the medical clerks believed that drug samples encouraged treatment adherence, whereas only 17% of the pharmacists were of this opinion. CONCLUSIONS Our results show that the perceived advantages and risks of using drug samples vary by healthcare provider group and in terms of exposure or nonexposure to their use. Concerned professionals must be provided with this information and strict measures must be instituted to ensure patient security.
Probable Trimethoprim/Sulfamethoxazole–Induced Higher-Level Gait Disorder and Nocturnal Delirium in an Elderly Man
Authors: Dakin Lucy E 
Published: December 2008

OBJECTIVE To report a case of probable trimethoprim/sulfamethoxazole (TMP/SMX)– induced higher-level gait disorder (HLGD) and nocturnal delirium in an elderly patient on high-dose oral therapy. CASE SUMMARY An 82-year-old man with a recent history of depression became comatose following an overdose of escitalopram and oxazepam. He was admitted, ventilated for 7 days in the intensive care unit, and treated with piperacillin/tazobactam and cefepime for aspiration pneumonia. Following discharge to a medical ward, respiratory symptoms persisted and imaging confirmed pulmonary abscesses. Stenotrophomonas maltophilia was isolated from sputum and, on day 15, TMP/SMX 800 mg/160 mg 1 tablet every 12 hours was initiated. On day 35, the dose was increased to 800 mg/160 mg 2 tablets every 12 hours. By day 37, the patient was unsteady when attempting to stand. From day 40, he was noted to have features of HLGD with gait ignition failure, poor balance, and frequent falls. His other medications at this time were thiamine 100 mg daily, multivitamin 1 tablet daily, omeprazole 20 mg every 12 hours, and modified-release venlafaxine 150 mg daily. Investigation did not reveal any cause for his acute gait disturbance. TMP/SMX was stopped on day 48 and, by day 51, the patient's gait had returned to normal. DISCUSSION Neuropsychiatric adverse reactions with TMP/SMX have been infrequently reported. The Naranjo probability scale indicated that TMP/SMX was the probable cause of HLGD in this patient. CONCLUSIONS At time of writing, this was the first reported case of HLGD associated with TMP/SMX. Clinicians should consider this adverse reaction as a potential cause of HLGD, especially in the elderly and those with malnutrition and hepatic or renal dysfunction.