bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Time–Kill Evaluation of Clarithromycin and Azithromycin against Two Extracellular Pathogens and the Development of Resistance
Authors: Burgess David S , Hastings Rhonda W , Horan Jennifer L 
Published: March 2004

OBJECTIVE: To determine the activity of clarithromycin, its metabolite (14-hydroxyclarithromycin), and azithromycin against Haemophilus influenzae and Staphylococcus aureus using time–kill methodology and to evaluate the susceptibility of the organisms following exposure to various concentrations of the azalide macrolides. DATA SOURCES AND METHODS: Clinical isolates of H. influenzae and S. aureus were obtained from the Clinical Microbiology Laboratory at University Hospital, San Antonio, Texas. Susceptibility testing was performed according to National Committee for Clinical Laboratory Standards guidelines. 14-Hydroxyclarithromycin was added to clarithromycin solutions used for H. influenzae. Time–kill studies were performed using antimicrobial concentrations of 0.25–8 x minimum inhibitory concentration (MIC) and an initial inoculum of ∼105 CFU/mL. Samples were plated onto solid agar at 0, 4, 8, 12, and 24 hours. At 0, 12, and 24 hours, samples were then plated onto solid agar incorporated with antibiotic. After incubating plates at 35 °C for 24 hours, colony counts were determined. RESULTS: The MICs of clarithromycin and clarithromycin plus 14-hydroxyclarithromycin for H. influenzae were 4 and 2 μg/mL, respectively. For S. aureus, the MIC of clarithromycin was 0.25 μg/mL, and the MIC of azithromycin for both organisms was 1 μg/mL. H. influenzae developed resistance to both macrolides within 12 hours when exposed to sub-MICs of clarithromycin plus 14-hydroxyclarithromycin. However, when exposed to concentrations less than or equal to the MIC of azithromycin, resistance was not conferred to clarithromycin. S. aureus, on the other hand, became resistant to azithromycin and less susceptible to clarithromycin following exposure to sub-MICs of either macrolide. CONCLUSIONS: Clarithromycin and azithromycin elicited a concentration-independent bacteriostatic effect against H. influenzae and S. aureus at concentrations at least two times the MIC. In addition, concentrations maintained above the MIC prevented changes in the susceptibility of H. influenzae and S. aureus to both macrolides.
Pharmacologic Considerations for Therapeutic Success with Antiretroviral Agents
Authors: Fletcher Courtney V 
Published: March 2004

OBJECTIVE: To explore pharmacologic elements that contribute to therapeutic success with agents used for the treatment of HIV infection. DATA SOURCES: Primary articles were identified through MEDLINE (January 1990–January 1999) and secondary sources. Conference abstracts were selected by review of published proceedings. STUDY SELECTION AND DATA EXTRACTION: The author evaluated all articles, and relevant information was selected for incorporation into this review. DATA SYNTHESIS: Heterogeneity in the response to antiretroviral therapy has been attributed to virologic, immunologic, behavioral, and pharmacologic differences among patients. Patients receiving the same dose of an antiretroviral agent will not have the same systemic or intracellular concentration because of interpatient variability in drug absorption, distribution, metabolism, and excretion. Pharmacologic theory and available clinical data support relationships between drug concentration and anti-HIV effect. Thus, variability in drug concentrations contributes to variability in antiviral effect. Desirable pharmacologic characteristics for an antiretroviral drug include high oral bioavailability, a long elimination half-life, low intra- and interpatient pharmacokinetic variability, and a predictable dose–concentration–effect relationship. CONCLUSIONS: Treatment of the individual who is infected with HIV is a challenging long-term undertaking. Optimal management requires synthesis of a rapidly evolving base of basic and clinical knowledge. The selection of an antiretroviral regimen based on an understanding of the degree to which each individual agent possesses the desired pharmacologic characteristics should help the healthcare provider to translate the therapeutic principles of treatment of HIV infection into clinical reality for all patients.
Is Valproate Pharmacotherapy Associated with Polycystic Ovaries?
Authors: Chappell Kimberly A , Markowitz John S , Jackson Cherry W 
Published: March 2004

OBJECTIVE: To review and evaluate the published data associating the use of valproate with the development of polycystic ovaries. DATA SOURCES: A computerized search of MEDLINE (1966–May 1999) and Current Contents was performed. Also, bibliographies were cross-referenced to yield additional pertinent publications. All articles written in English were considered for review. STUDY SELECTION AND DATA EXTRACTION: All pertinent clinical studies and review articles associating valproate with polycystic ovaries and other endocrinologic disorders were evaluated. DATA SYNTHESIS: Valproate is among the most commonly used medications today effective in the treatment of a variety of neurologic and psychiatric disorders. An accumulating body of literature has suggested an increase in the incidence of polycystic ovarian syndrome among women treated with valproate. The syndrome is characterized as hyperandrogenism and chronic anovulation in the absence of identifiable adrenal or pituitary pathology. It is a highly prevalent syndrome, affecting 2–22% of women in the general population. CONCLUSIONS: Although a number of studies have found clear evidence of neuroendocrine perturbations in patients treated with valproate, there are presently limited data from large controlled studies involving valproate monotherapy. Nonetheless, there appears to be a greater incidence of polycystic ovaries associated with valproate use in comparison with other anticonvulsants. The mechanism by which valproate may induce polycystic ovarian syndrome is unknown, but could possibly be secondary to valproate-induced weight gain or direct interference with steroid metabolism. Further study of the potential association of valproate treatment with the development of polycystic ovarian syndrome is warranted. Until the issue is clarified, clinicians should at least be aware of the possibility of valproate-induced polycystic ovarian syndrome and monitor patients accordingly.
Safety Issues with Herbal Products
Authors: Marrone Christopher M 
Published: March 2004

OBJECTIVE: TO review safety issues associated with the use of herbal products. DATA SOURCES: Literature accessed through MEDLINE and other Internet search engines. Key search terms included herbs, dietary supplements, and safety. DATA SYNTHESIS: A misconception exists among consumers that herbal remedies are safe because they are natural. In an effort to provide healthcare practitioners with information necessary for a patient discussion, a review of safety concerns with herbal products was conducted. CONCLUSIONS: Several safety concerns exist with herbal products including lack of safety data, absence of quality-control requirements for potency and purity, and lenient labeling standards.
Bell's Palsy in an Older Patient with Uncontrolled Hypertension Due to Medication Nonadherence
Authors: Ellis Samuel L , Carter Barry L , Leehey Maureen A , Conry Colleen M 
Published: March 2004

OBJECTIVE: To describe and inform pharmacists of a rarely reported occurrence of facial palsy in an elderly patient with uncontrolled hypertension resulting from nonadherence to blood pressure medications. CASE SUMMARY: A 62-year-old Hispanic woman presented to the hypertension clinic with left facial weakness, mild eyelid lag, and auricular pain for two days. The patient self-discontinued fosinopril and minoxidil six days and two days prior to developing these symptoms, respectively. A diagnosis of idiopathic peripheral VII cranial nerve lesion was made after ruling out other possible causes. Corticosteroids were not initiated because of this patient's labile hypertension. Palliative therapy was initiated and the left facial paralysis continuously improved during the six months after discharge. DISCUSSION: Patients have rarely presented with facial paralysis as the initial feature of severe hypertension. The relationship between facial paralysis and hypertension has been reported in a small number of cases, including several reports of recurrence of paralysis during acute exacerbations of hypertension. A variety of physiologic theories to explain the relationship between facial paralysis and hypertension have been published, including small hemorrhages into the facial canal which have been confirmed by two autopsies. However, the true etiology remains unknown. CONCLUSIONS: The possible relationship between facial paralysis and uncontrolled hypertension has not been reported in pharmacy literature and has been reported only twice in subspecialty medical journals since 1990. Pharmacists should be aware of the complications of hypertension and should question patients about signs and symptoms at each visit. While Bell's palsy complicating hypertension does not appear to be a serious complication, pharmacists must appreciate that the patient should be immediately evaluated to rule out a more serious neurologic event.
Accuracy of Measured Vancomycin Serum Concentrations in Patients with End-Stage Renal Disease
Authors: Smith Patrick F , Morse Gene D 
Published: March 2004

OBJECTIVE: TO review information related to the accuracy of vancomycin serum drug concentrations in patients with end-stage renal disease, focusing on available assays and mechanisms of cross-reactivity. DATA SOURCES: Primary and review articles identified from a MEDLINE search (January 1980-June 1999) and through secondary sources. STUDY SELECTION AND DATA EXTRACTION: All articles identified were evaluated, and all relevant information was included in this review. DATA SYNTHESIS: Falsely elevated vancomycin serum concentrations may occur in patients with renal dysfunction. The underlying mechanism is due to the formation and accumulation of a pseudo-metabolite, the vancomycin crystalline degradation product (CDP). Vancomycin is converted to CDP when exposed to heat, including normal body temperature. Because the molecular structures of CDP and vancomycin are similar, both molecules are detected by polyclonal immunoassay systems used in clinical laboratories. This cross-reactivity leads to falsely elevated serum vancomycin concentrations in excess of 50–70%. Such large assay inaccuracies may result in improper dosage adjustments and therapeutic failures. A monoclonal immunoassay system has been developed that does not significantly cross-react with CDP. CONCLUSIONS: TO appropriately interpret laboratory results, it is essential for clinicians to be aware of the vancomycin-CDP cross-reactivity problem and to be familiar with the specific assay used to measure vancomycin concentrations in patients with renal dysfunction.
VIETNAM IN THE ERA OF DOI MOI: Issue-Oriented Organizations and Their Relationship to the Government
Authors: Wischermann Joerg 
Published: March 2004

Abstract
In spring 2000, our research team identified 322 issue-oriented organizations in Hanoi and Ho Chi Minh City, i.e., non-state, voluntary, non-profit-oriented organizations actively working on social, educational, environmental, community, and other issues. We interviewed 136 representatives of these organizations. This article presents selected findings and a theoretical analysis of the data.
MONGOLIAN-RUSSIAN RELATIONS IN THE PAST DECADE
Authors: Batbayar Tsedendamba 
Published: March 2004

Abstract
Because of its location between Russia and China, today, as in the past, Mongolia is likely to be of strategic importance to Russia. Due to its own weakened position, Moscow favors Mongolia's adopting a neutral posture vis-à-vis its two giant neighbors. This article analyzes the evolution of Moscow's policy toward Mongolia in the 1990s. Russian policy went through three stages: a breakdown of bilateral relations, stagnation, and revival of bilateral relations. Russian interests in Mongolia include both political-strategic and trade and economic aspects.
THE REVITALIZED PHILIPPINE-U.S. SECURITY RELATIONS: A Ghost from the Cold War or an Alliance for the 21st Century?
Authors: Castro Renato Cruz De 
Published: March 2004

Abstract
This article contends that the Philippine-U.S. post-9/11 security relationship is characterized by temporary and limited American troop deployment aimed at developing the Armed Forces of the Philippines' counterterrorism capability and fostering interoperability between the Philippine and American armed forces. The article concludes that the post-9/11 alliance is significantly different from the two countries' security relationship during the Cold War.
POST-SECONDARY EDUCATION IN HONG KONG: Repercussions for Inequality and Civil Society
Authors: Post David 
Published: March 2004

Abstract
Hong Kong has launched an ambitious reform of post-secondary education, expanding student access but also diversifying the missions of institutions and their finance. To illuminate repercussions for civil society, this article identifies three unresolved policy dilemmas. It then presents emergent trends in inequality of access to higher education through analysis of the 1981, 1991, and 2001 population censuses.
THE UNITED STATES AND ASIA IN 2003: All Quiet on the Eastern Front?
Authors: Pollack Jonathan D. 
Published: March 2004

Abstract
U.S.-Asian relations in 2003 appeared on the cusp of major change. The Bush administration (preoccupied by far more pressing challenges in the Persian Gulf and Southwest Asia) sought to deflect potential crises in Korea and the Taiwan Strait, while also hoping to tether regional states to the new American security agenda. Although nearly all Asian states voiced assent for U.S. efforts to counter international terrorism, this support often reflected practical realities, not a deeper congruence of interests with Washington's. The path ahead for the United States in Asia remained unsettled, with crises deferred rather than resolved.
CAMBODIA IN 2003: On the Road to Democratic Consolidation
Authors: Albritton Robert B. 
Published: March 2004

Abstract
Elections in 2003, the third since the 1991 peace agreement, represent a significant step toward a multi-party democracy, but provisions of the Constitution designed to reconcile warring parties now pose problems for developing stable, democratically elected governments. Regional economic shocks to tourism have caused Cambodia to fall well below original projections for economic growth. Prospects for an international tribunal to try former Khmer Rouge leaders now appear to be moving toward limbo.
SINGAPORE IN 2003: Another Tough Year
Authors: Case William 
Published: March 2004

Abstract
During 2003, Singapore's prime minister, Goh Chok Tong, announced that he would be succeeded by Lee Hsien Loong some time before the next election. The country's economy was severely affected by falling export markets and SARS. A free trade agreement was concluded with the United States, while relations remained strained with Malaysia over a variety of issues.
AFGHANISTAN IN 2003: The Taliban Resurface and a New Constitution Is Born
Authors: Goodson Larry P. 
Published: March 2004

Abstract
The year 2003 for Afghanistan was marred by a declining security situation, as resurgent Taliban and other anti-government forces made large sections of the rural areas too dangerous for sustained reconstruction work, and powerful regional warlords continued to defy the attempts of the Kabul government to strengthen statebuilding. Recognizing the danger to its investment there, late in the year, the U.S. altered its military tactics, announced a major new reconstruction grant, and sent a new ambassador. The year ended on a high note, as Afghanistan's Constitutional Loya Jirga promulgated a new Afghan constitution, modeled on the American document, and ratified it early in the New Year on January 4, 2004.
CHINA IN 2003: From SARS to Spaceships
Authors: Kraus Richard 
Published: March 2004

Abstract
The year began ominously for China;the nation was isolated by a major public health crisis caused by the spread of SARS from Guangdong to Beijing, Taiwan, Singapore, and Toronto, to name only the most heavily impacted regions. As the crisis developed, it became perhaps inevitably involved with the ongoing transition to new political leadership. But by the end of the year, China was flexing its economic and technical muscle, as it basked in international attention from its first successful space flight.
TAIWAN IN 2003: Plenty of Clouds, Few Silver Linings
Authors: Rigger Shelley 
Published: March 2004

Abstract
Taiwan faced a difficult year in 2003. In early spring, SARS affected the island profoundly, but Taiwanese leaders were not able to leverage the outbreak into a chance at observer status in the World Health Organization. Although Taiwan's economic recession lifted somewhat, frustration over its continuing international isolation and domestic political deadlock led to calls for referendums on national policy issues and a new constitution. Both of these measures provoked concern in Washington and opposition in Beijing.
INDIA IN 2003: Pre-Electoral Maneuvering and the Prospects for Regional Peace
Authors: Sáez Lawrence 
Published: March 2004

Abstract
This article focuses on the electoral strategies adopted by the dominant national political parties in anticipation of the 2004 general election. The success of these strategies is apt to depend on the results of various state legislative assembly elections. We conclude with observations on recent realignments in India's foreign policy, particularly with respect to China and Pakistan.
NEPAL IN 2003: Another Failed Chance for Peace
Authors: Krämer Karl-Heinz 
Published: March 2004

Abstract
One year after King Gyanendra dismissed the government of Sher Bahadur Deuba and assumed executive powers in violation of the Constitution, a return to a democratic system is not in sight. The royal action of October 4, 2002, appears more and more as a royal coup d'état. The initiation of a peace process with the Maoist insurgents brought new hopes for some months, but the dialogue broke down before it really began.
MALAYSIA IN 2003: Leadership Transition with a Tall Shadow
Authors: Ganesan N. 
Published: March 2004

Abstract
Abdullah Badawi's replacement of Mahathir Mohamad as prime minister leaves him with many challenges. These include the anointing of a deputy, healing rifts within the United Malays National Organization and the Malay community, and preparing for a general election by 2004. While Malaysia has posted positive economic growth, there is some concern over regular deficit spending. With the country at the head of the Non-Aligned Movement and the Organization of Islamic Conference, Malaysia saw some turbulence in its relations with the United States and Australia.
MYANMAR IN 2003: Frustration and Despair?
Authors: Hlaing Kyaw Yin 
Published: March 2004

Abstract
The diminished prospect for reconciliation between the government, the State Peace and Development Council (SPDC), and the main opposition party, the National League for Democracy (NLD), at the year's outset led to frustration and despair for the people of Myanmar (Burma) in 2003. Throughout the year, Myanmar was beset with political impasse and economic difficulties triggered by a violent clash between NLD members and government supporters, as well as by the government's third detention of Daw Aung San Suu Kyi and U.S. economic sanctions. Myanmar's political future remains precarious; those anticipating democracy and prosperity were left feeling frustrated and desolate.
The grandfather of the hydrogen bomb?: Anglo-American intelligence and Klaus Fuchs
Authors: GOODMAN MICHAEL S. 
Published: March 2004

ABSTRACT:
It has been assumed that Klaus Fuchs could not have provided significant information to the Soviet Union regarding the hydrogen bomb because the calculations he took with him from Los Alamos were flawed. Recent evidence from British, American and former Soviet sources suggest that Fuchs played an invaluable role in the early development of thermonuclear weapons in all three countries. This article considers this new evidence and places Fuchs' role in the development of the H-bomb in the context of intelligence estimates that arose following his arrest.
Fundamental physics and its justifications, 1945-1993
Authors: STEVENS HALLAM 
Published: March 2004

ABSTRACT:The justifications for public expenditure on accelerator laboratories that high energy physicists deployed over the course of the Cold War are examined.It is shown how legitimization in terms of Cold War economic and national security aims was rendered ineffective during the 1960s anti-science movements. As a consequence high energy physicists framed a response that emphasized the elegance and cultural value of their work. Their story vaunted universal and fundamental concepts that could be appreciated by even an anti-scientific audience. In particular, the concept of “symmetry,” which had become a powerful tool of high energy physics, was utilized to communicate the aesthetic qualities toward which the physicists aspired. Robert Wilson realized this vision in his design and successful construction and operation of the Fermi National Accelerator Laboratory (1967-1974). During the 1980s, renewed Cold War tensions, string theory, and challenges from condensed matter physicists fragmented the physics community and broke down the high energy physicists' symmetry narrative. The multiplicity of competing stories about fundamental physics that resulted are considered as one cause of the 1993 cancellation of the Superconducting Super Collider.
If we build it, who will come? Radio astronomy and the limitations of “national” laboratories in Cold War America
Authors: MUNNS DAVID 
Published: March 2004

ABSTRACT:
The history of big science, especially physics, informs historians that the instrument is at the heart of Cold War science. This article presents the National Radio Astronomy Observatory (NRAO), which was consciously modeled on the Brookhaven National Laboratory and where the choice of instrument was of only secondary importance. During the planning for the NRAO, which took place from 1954 until 1956, mostly in offices in Washington, D.C. and New York, an extended debate emerged over the place of “national” facilities in science, and their relationship to established university programs, particularly those concerned with graduate student instruction. The case of the NRAO reveals the resilience of notions of dispersed scientific community, emphasizing smaller programs in many universities, as well as the perceived necessity of continued participation from a wide disciplinary array of practitioners who, cooperatively, forged radio astronomy. This essay illustrates substantial resistance to the model of scientific practice advocated by the national laboratories when applied to radio astronomy. Critics of a national facility for radio astronomy charged that the substantial funds could be better utilized within existing university-based programs, which would need to be expanded in any event to provide the researchers for the national facility. The senior researchers in radio astronomy were not American, highlighting the fallacy of the notion of national science.