bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-Effectiveness of Fluvastatin following Successful First Percutaneous Coronary Intervention
Authors: Delea Thomas E , Jacobson Terry A , Serruys Patrick WJC , Edelsberg John S , Oster Gerry 
Published: March 2005

BACKGROUND: In the LIPS (Lescol Intervention Prevention Study), fluvastatin 80 mg/day reduced the risk of major adverse cardiac events (MACE) by 22% versus placebo (p = 0.01) following successful first percutaneous coronary intervention (PCI) in patients with stable or unstable angina or silent ischemia. The cost-effectiveness of such therapy is unknown. OBJECTIVE: To evaluate the cost-effectiveness of fluvastatin following successful first PCI from a US healthcare system perspective. METHODS: We used a Markov model to estimate expected outcomes and costs of 2 alternative treatment strategies following successful first PCI in patients with stable or unstable angina or silent ischemia: (1) diet/lifestyle counseling plus immediate fluvastatin 80 mg/day; and (2) diet/lifestyle counseling only, with initiation of fluvastatin 80 mg/day following occurrence of future nonfatal MACE. The model was estimated with data from LIPS and other published sources. Cost-effectiveness was calculated as the ratio of the difference in expected medical-care costs to the expected difference in life-years (LYs) and quality-adjusted life-years (QALYs) alternatively. RESULTS: Treatment with fluvastatin following successful first PCI was found to increase life expectancy by 0.78 years (QALYs 0.68). Cost-effectiveness of fluvastatin following successful first PCI is $13 505 per LY ($15 454 per QALY) saved. Ratios are lower for patients with diabetes ($9396 per LY; $10 718 per QALY) and those with multivessel disease ($9662 per LY; $11 076 per QALY). Findings were robust with respect to changes in key model parameters and assumptions. CONCLUSIONS: Fluvastatin therapy following PCI is cost-effective compared with other generally accepted medical interventions.
Esomeprazole-Induced Central Fever with Severe Myalgia
Authors: Grattagliano Ignazio , Portincasa Piero , Mastronardi Mauro , Palmieri Vincenzo O , Palasciano Giuseppe 
Published: March 2005

OBJECTIVE: To report a case of central fever associated with severe myalgia following esomeprazole. CASE SUMMARY: A 64-year-old man presented with intense cephalalgia; severe, diffuse myalgia; and fever (>40°C) after esomeprazole initiation for treatment of gastritis. Five hours after ingestion of the first esomeprazole pill (40 mg), the patient developed fever associated with cephalalgia and myalgia. This condition lasted about 40 hours and disappeared spontaneously. Symptoms partially responded to acetaminophen. Four days later, the patient received a second dose of esomeprazole 40 mg. Subsequently, 4 hours later, fever (>40°C), headache, and difficulty in the movement of all parts of the body recurred. Neurologic examination was negative except for a minor state of disorientation. All reflexes were normal or slightly decreased. No skin lesions or breathing difficulty was noted. Routine blood tests were normal. Again, symptoms resolved spontaneously about 40 hours later. DISCUSSION: The temporal connection between esomeprazole intake and the onset of fever suggests a probable causal link, as confirmed by the Naranjo probability scale. However, the pathogenic mechanism remains unclear. Considering that esomeprazole is able to cross the blood—brain barrier, its peak serum concentration is reached 90–180 minutes after oral administration, and its serum half-life is approximately 2 hours, we assume that the appearance of fever with accompanying neurologic and muscular symptoms might result from the drug interference with the hypothalamic regulatory center of body temperature. CONCLUSIONS: Hyperpyrexia of central origin associated with intense cephalalgia and myalgia may occur as an adverse effect of esomeprazole therapy.
Treatment of Seasonal Allergic Rhinitis Using Homeopathic Preparation of Common Allergens in the Southwest Region of the US: A Randomized, Controlled Clinical Trial
Authors: Kim Linda S , Riedlinger June E , Baldwin Carol M , Hilli Lisa , Khalsa Sarv Varta , Messer Stephen A , Waters Robert F 
Published: March 2005

BACKGROUND: Studies using homeopathy have reported beneficial effects from treating allergy-related conditions. OBJECTIVE: To investigate the effects of a homeopathic drug prepared from common allergens (tree, grass, weed species) specific to the Southwest region of the US. METHODS: A 4-week, double-blind clinical trial comparing homeopathic preparations with placebo was conducted in the Phoenix metropolitan area during the regional allergy season from February to May. Participants included 40 men and women, 26–63 years of age, diagnosed with moderate to severe seasonal allergic rhinitis symptoms. Study outcomes included allergy-specific symptoms using the rhinoconjunctivitis quality-of-life questionnaire (RQLQ), functional quality of life using the Medical Outcomes Study Short Form-36 (MOS SF-36), and the work productivity and activity impairment (WPAI) questionnaire. RESULTS: Scales from the RQLQ, MOS SF-36, and WPAI questionnaire showed significant positive changes from baseline to 4 weeks in the homeopathic group compared with the placebo group (p < 0.05). Subjects reported no adverse effects during the intervention period. CONCLUSIONS: These preliminary findings indicate potential benefits of the homeopathic intervention in reducing symptoms and improving quality of life in patients with seasonal allergic rhinitis in the Southwestern US.
Medication Use Patterns after Gastric Bypass Surgery for Weight Management
Authors: Malone Margaret , Alger-Mayer Sharon A 
Published: March 2005

BACKGROUND: Bariatric surgery, commonly gastric bypass, is an effective intervention in achieving sustained weight loss in patients with a body mass index (BMI) >40 kg/m2. Currently, there are few data in the literature describing medication use after bariatric surgery. OBJECTIVE: To document the change in medication use patterns over a 2-year period in patients who had gastric bypass surgery. METHODS: Institutional review board approval was obtained for this ongoing, prospective longitudinal study. Adults (>18 y) scheduled for gastric bypass surgery were recruited. Clinical and demographic data, including age, gender, weight, height, BMI, number of obesity-related comorbidities, and number of medications and nutritional supplements, were obtained by medical chart review. RESULTS: One hundred fourteen patients (87 females) were recruited. The mean ± SD age was 45 ± 9 years. Patients had multiple obesity-related comorbid diseases for which they were receiving medication. Drug therapy for diabetes and hypertension was significantly reduced (p < 0.05). All patients were required to take additional nutritional supplements and medications associated with surgery postoperatively. CONCLUSIONS: Bariatric surgery has a positive benefit in terms of reduction intake of medication associated with obesity-related comorbid disease. However, there is limited reduction in the overall number of drugs and supplements being consumed by the patient, especially during the first year postoperatively.
Leflunomide and Azathioprine Combination in Refractory Adult-Onset Still's Disease
Authors: Cefle Ayse 
Published: March 2005

OBJECTIVE: To present a case of Adult-onset Still's disease (ASD) in a patient who was successfully treated with leflunomide and azathioprine. CASE SUMMARY: A 24-year-old woman with ASD was initially treated with indomethacin, corticosteroids, and hydroxychloroquine; there was no clinical improvement. Methotrexate was added to the regimen, followed by azathioprine. The patient still experienced disease flares with this treatment, and cyclophosphamide was started. However, because of persisting disease activity, leflunomide combined with azathioprine was given. Only on this regimen was complete disease control achieved, with a normal erythrocyte sedimentation rate as well as normal C-reactive protein and ferritin levels. No recurrences or adverse effects attributable to leflunomide or azathioprine were observed at the one-year follow-up. DISCUSSION: Clinical experience concerning leflunomide and azathioprine combination in ASD is limited. This combination may be modifying the clinical expression of ASD through its effects on T lymphocyte clonal expansion and production of proinflammatory cytokines. CONCLUSIONS: Leflunomide combined with azathioprine appears to be an effective and safe treatment of ASD.
Herbal Use among US Elderly: 2002 National Health Interview Survey
Authors: Bruno Jeffrey J , Ellis Jeffrey J 
Published: March 2005

BACKGROUND: Use of herbal products among the elderly is an important concern for healthcare professionals. The presence of polypharmacy and multiple comorbidities places the elderly at high risk for herb—drug and herb—disease interactions. Limited data exist regarding herbal use among the US elderly population. OBJECTIVE: To evaluate the incidence of and attitudes toward herbal use in a nationally representative sample of US elderly patients ⩾65 years of age. METHODS: We performed a descriptive analysis of public domain data collected in the 2002 National Health Interview Survey. Statistical analyses were conducted through use of SUDAAN software with Taylor series linearization for variance estimation. RESULTS: Analysis of weighted data revealed that 12.9% ± 0.5% (mean ± SE) of US elderly people had used an herbal supplement within the past 12 months. Use was greatest among individuals 65–69 years of age, females, Hispanic and non-Hispanic ethnic minorities, and respondents with a greater income, higher education level, or more positive self-reported health status. Among elderly people purchasing over-the-counter and prescription drugs, herbal use was 13.9% ± 0.6% and 12.8% ± 0.6%, respectively. Glucosamine, echinacea, and garlic supplements represented the most common herbals used. Benefit from combined herbal and conventional therapy was the most common reason cited for use; however, 50.9% ± 2.2% of users did not discuss herbal therapy with a medical professional. Several theoretical herb—disease interactions were identified. CONCLUSIONS: The use of herbal products among the US elderly has risen over the past 5 years, whereas discussion of such use with medical professionals remains suboptimal.
When Does Pharmaceutical Care Impact Health Outcomes? A Comparison of Community Pharmacy—Based Studies of Pharmaceutical Care for Patients with Asthma
Authors: McLean William M , MacKeigan Linda D 
Published: March 2005

BACKGROUND: Pharmaceutical care (PC) as a philosophy of care and practice model is now >14 years old. It is important to determine whether PC influences health outcomes. Such outcomes are best studied in specific disease states where variables are minimized and specific outcomes have been established. We analyzed 4 multi-site controlled studies that evaluated PC in community pharmacies for patients with asthma. Study results varied widely. OBJECTIVE: To understand factors contributing to positive outcomes from PC for asthma. METHODS: The 4 studies were compared on the basis of 10 aspects of their research design, as well as 10 elements of PC. Dr. McLean conducted the initial analysis, and his assessments were confirmed by Dr. MacKeigan. RESULTS: Important differences were found in the type of pharmacy where PC was delivered (chain vs independent), how pharmacies were selected (required vs volunteered), patient selection (on asthma medication vs uncontrolled disease), pharmacist training (4-h workshop vs certification over several weeks), the nature of PC protocol (computer reminders vs detailed care protocol), rigor of the protocol (intervention vs requirement to reach self-management), and the level of pharmacist adherence to the PC protocol (<50% vs 90%). Differences were also found in study design. CONCLUSIONS: More favorable PC outcomes were associated with use of all elements of PC, independent pharmacies, pharmacist certification, a detailed PC protocol, targeting patients with uncontrolled asthma, and a practice system facilitating PC.
Including the Assessment of Nontraditional Factors in Pharmacy School Admissions
Authors: Latif David A 
Published: March 2005

OBJECTIVE: To review the relevant literature regarding the predictive ability of cognitive measures (ie, Pharmacy College Admissions Test [PCAT] scores and prepharmacy grade point average [GPA]) on both academic and clinical performance and discuss the inclusion of nontraditional assessment during the admissions process. DATA SOURCES: Articles were identified through searches of International Pharmaceutical Abstracts (1970–April 2004), MEDLINE (1966–January 2004), and ERIC (1966–April 2004) using the key words admissions variables, predictors of success, Pharmacy College Admissions Test, grade point average, cognitive variables, and noncognitive variables. STUDY SELECTION AND DATA EXTRACTION: Cross-sectional, longitudinal, and retrospective studies, as well as reviews, regarding pharmacy school and other higher education admissions' variables were included in this review. DATA SYNTHESIS: Many pharmacy school admissions committees give a majority weight to the traditional cognitive markers of prepharmacy GPA and PCAT scores when selecting viable applicants. Doing so may be problematic due to the magnitude of the relationship between traditional cognitive predictors and pharmacy school performance. CONCLUSIONS: Based on this review, a cogent argument is advanced for the need to examine, in addition to PCAT scores and GPAs, such nontraditional factors as empathy, citizenship, and ethical behavior. This may increase the predictive ability of preadmission factors on pharmacy school didactic and clinical performance. Schools of pharmacy can do this through questionnaires and interviews designed to assess nontraditional variables.
Interventions to Improve Treatment of Respiratory Infections in Ambulatory Managed-Care Patients
Authors: Raebel Marsha A 
Published: March 2005

OBJECTIVE: To review the literature on managed-care initiatives to improve antimicrobial use in respiratory tract infections (RTIs) and examine whether efforts were successful in decreasing antibiotic prescribing when an antibiotic was not indicated or in increasing the frequency with which a preferred antimicrobial agent was chosen when an antibiotic was appropriate. DATA SOURCES: A computerized search of Ovid MEDLINE was conducted for research articles published between 1966 and September 2004 using a key word search of MeSH subject headings and titles. Search terms included managed care or health maintenance organization and antibacterial agents or antibiotic or antimicrobial. STUDY SELECTION AND DATA EXTRACTION: Studies evaluating initiatives in ambulatory managed-care environments and the effects of managed care on treatment of RTIs were chosen. Articles addressing both population and individual level tools were included. DATA SYNTHESIS: Initiatives have been attempted in a variety of managed-care models. In some studies, multidimensional educational interventions were effective in decreasing antimicrobial prescribing rates for RTIs. However, in other studies, no decrease in antimicrobial prescribing after implementation of an evidence-based guideline or initiation of an educational intervention was observed. In one successful study, patient satisfaction was similar between groups. Each study had limitations in design or generalizability. Several studies had strengths, including using randomized groups or offering multidimensional educational efforts. CONCLUSIONS: Randomized prospective studies of interventions to improve antimicrobial prescribing for RTIs in managed care have been variably successful. Because the topic is one of ongoing importance, it will continue to be an area of research.
Single zinc-finger extension: enhancing transcriptional activity and specificity of three-zinc-finger proteins
Authors: Smith Alexander E.F. , Farzaneh Farzin , Ford Kevin G. 
Published: March 2005

AbstractIn order to demonstrate that an existing zinc-finger protein can be simply modified to enhance DNA binding and sequence discrimination in both episomal and chromatin contexts using existing zinc-finger DNA recognition code data, and without recourse to phage display and selection strategies, we have examined the consequences of a single zinc-finger extension to a synthetic three-zinc-finger VP16 fusion protein, on transcriptional activation from model target promoters harbouring the zinc-finger binding sequences. We report a nearly 10-fold enhanced transcriptional activation by the four-zinc-finger VP16 fusion protein relative to the progenitor three-finger VP16 protein in transient assays and a greater than five-fold enhancement in stable reporter-gene expression assays. A marked decrease in transcriptional activation was evident for the four-zinc-finger derivative from mutated regulatory regions compared to the progenitor protein, as a result of recognition site-size extension. This discriminatory effect was shown to be protein concentration-dependent. These observations suggest that four-zinc-finger proteins are stable functional motifs that can be a significant improvement over the progenitor three-zinc-finger protein, both in terms of specificity and the ability to target transcriptional function to promoters, and that single zinc-finger extension can therefore have a significant impact on DNA zinc-finger protein interactions. This is a simple route for modifying or enhancing the binding properties of existing synthetic zinc-finger-based transcription factors and may be particularly suited for the modification of endogenous zinc-finger transcription factors for promoter biasing applications.
Pre-steady-state kinetic analysis of riboflavin synthase using a pentacyclic reaction intermediate as substrate
Authors: Illarionov Boris , Haase Ilka , Fischer Markus , Bacher Adelbert , Schramek Nicholas 
Published: March 2005

AbstractRiboflavin synthase catalyses a mechanistically complex dismutation affording riboflavin and 5-amino-6-ribitylamino-2,4(1H,3H)-pyrimidinedione from 6,7-dimethyl-8-ribityllumazine. A pentacyclic adduct (compound2) of two substrate molecules was used as substrate for pre-steady-state kinetic analysis. Whereas the wild-type enzyme catalyses the decomposition of compound2into a mixture of riboflavin and 5-amino-6-ribitylamino-2,4(1H,3H)-pyrimidinedione, as well as into two equivalents of 6,7-dimethyl-8-ribityllumazine, a H102Q mutant enzyme predominantly catalyses the former reaction. Stopped-flow experiments with this mutant enzyme failed to identify a reaction intermediate between compound2and riboflavin. However, the apparent rate constants for the formation of riboflavin as observed by stopped-flow and quenched-flow experiments were significantly different, thus suggesting that the reaction proceeds via a significantly populated intermediate, the absorbance of which is similar to that of compound2. An F2A mutant enzyme converts compound2predominantly into 6,7-dimethyl-8-ribityllumazine. Stopped-flow experiments using compound2as substrate indicated a slight and rapid initial increase in absorbance at 310 nm, followed by a slower decrease. This finding, in conjunction with different apparent rates for the formation of 6,7-dimethyl-8-ribityllumazine, suggests the involvement of a significantly populated intermediate in the transition between compound2and 6,7-dimethyl-8-ribityllumazine, the optical spectrum of which is similar to that of compound1.
Lactoferrampin, an antimicrobial peptide of bovine lactoferrin, exerts its candidacidal activity by a cluster of positively charged residues at the C-terminus in combination with a helix-facilitating N-terminal part
Authors: van der Kraan Marieke I.A. , Nazmi Kamran , Teeken Afke , Groenink Jasper , van 't Hof Wim , Veerman Enno C.I. , Bolscher Jan G.M. , Nieuw Amerongen Arie V. 
Published: March 2005

AbstractThe antimicrobial activity of bovine lactoferrin (bLF) is attributed to lactoferricin, which is situated in the N1-domain of bLF. Recently, another antimicrobial domain consisting of residues 268–284, designated lactoferrampin (LFampin), has been identified in the N1-domain of bLF, which exhibited antimicrobial activity againstCandida albicansand several bacteria. In the present study, the candidacidal activity of a series of peptides spanning this antimicrobial domain was investigated in relation to the charge and the capacity to form a helical conformation in hydrophobic environments. C-Terminal truncation of LFampin resulted in a drastic decrease in candidacidal activity. Positively charged residues clustered at the C-terminal side of the LFampin domain appeared to be crucial for the candidacidal activity. The ability to adopt helical conformations did not change when LFampin was truncated at the C-terminal side. N-Terminally truncated LFampin peptides, truncated up to the sequence 270–284, were more reluctant to adopt a helical conformation. Therefore, we conclude that the C-terminal part of LFampin 265–284, which is the most active peptide, is crucial for its candidacidal activity, due to the presence of clustered positive charges, and that the N-terminal part is essential for activity as it facilitates helix formation.
Ceramides induce programmed cell death in Arabidopsis cells in a calcium-dependent manner
Authors: Townley Helen E. , McDonald Kerrie , Jenkins Gareth I. , Knight Marc R. , Leaver Christopher J. 
Published: March 2005

AbstractWhile the role of C2-ceramide in the induction of programmed cell death (PCD) in animal systems has been well documented, little is known of its role in plant cells. Here we show that C2-ceramide induces PCD inArabidopsissuspension cultures, which is preceded by the generation of a calcium transient and an increase in reactive oxygen species (ROS). Inhibition of the calcium transient prevented cell death, whereas inhibition of ROS had no effect on cell survival. These observations suggest that calcium signalling plays a role in ceramide-induced PCD but is independent of the generation of ROS.
A Small True Triaxial Apparatus with Wave Velocity Measurement
Authors: Ismail MA , Sharma SS , Fahey M 
Published: March 2005

Abstract
This paper describes a new cubical, true triaxial apparatus recently developed at the University of Western Australia (UWA). The apparatus is a stand-alone unit of the rigid type, where three pairs of pistons can be pressurized to impose three independent, rectilinear stresses on a sample of 250 mm side length. The sample can be tested either dry or saturated. Both drained and undrained shearing can be carried out with maximum pressure of about 1.5 MPa and maximum linear strain of about 8% in any of the three principal directions. A wave velocity measurement system is incorporated so that both elastic shear (Vs) and compression (VF) wave velocities can be measured, with the wave travelling between any two opposite faces of the device, or along skew paths. The elastic waves are generated and detected using “in house” manufactured wave transducers, which can access the sample externally. This feature enables the shear transducers to be rotated 90° degrees to change the polarization direction, enabling Vs to be measured in inclined planes. Additionally, the device enables accurate measurement of Ko. The paper presents results obtained from a silica sand to show the capability of the new device.