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PubMed2000

Antimicrobial susceptibility of Abiotrophia adiacens and Abiotrophia defectiva.

The susceptibilities of 27 Abiotrophia adiacens (proposed reclassification Granulicatella adiacens comb.nov., Collins & Lawson, 2000) and 12 Abiotrophia defectiva isolates were tested by microdilution in pyridoxal hydrochloride and lysed horse blood supplemented Mueller-Hinton broth. According to NCCLS interpretative criteria for Streptococcus spp. not Streptococcus pneumoniae, the susceptibilities of A. adiacens and A. defectiva were, respectively: penicillin, 55% and 8%; amoxicillin, 81% and 92%; ceftriaxone, 63% and 83%; meropenem, 96% and 100%; and 100% for both species with clindamycin, rifampin, levofloxacin, ofloxacin, quinupristin/dalfopristin, and vancomycin.

Anti-Bacterial Agents↗
PubMed1993

Quantitative evaluation of phonetograms in the case of functional dysphonia.

According to the laryngeal clinical findings, figures making up a scale were assigned to vocally trained and vocally untrained persons suffering from different types of functional dysphonia. The different types of dysphonia--from the manifested hypofunctional to the extreme hyperfunctional dysphonia--were classified by means of this scale. Besides, the subjects' phonetograms were measured and approximated by three ellipses, what rendered possible the definition of phonetogram parameters. The combining of selected phonetogram parameters to linear combinations served the purpose of a phonetographic evaluation. The linear combinations were to bring phonetographic and clinical evaluations into correspondence as accurately as possible. It was necessary to use different kinds of linear combinations for male and female singers and nonsingers. As a result of the reclassification of 71 and the new classification of 89 patients, it was possible to graduate the types of functional dysphonia by means of computer-aided phonetogram evaluation with a clinically acceptable error rate. This method proved to be an important supplement to the conventional diagnostics of functional dysphonia.

Female↗
PubMed1997

Oral tylosis: a re-appraisal.

The oral lesions in patients with tylosis (palmoplantar keratoderma) associated with oesophageal cancer, are evaluated, based on their clinical presentation, histological features and long term follow-up. The terminology of these lesions is discussed, together with a proposed reclassification of some forms of palmoplantar keratoderma.

Adolescent↗
PubMed2002

[Pseudoperiodic and paroxysmal electroencephalographic activities].

Periodic and paroxysmal EEG patterns are frequent and easily recognized. They often correlate with particular neurological or systemic conditions. We propose a reclassification and critical examination of these periodic EEG patterns by reviewing the original work presented by J. Gaches in this journal some thirty years ago. Periodic EEG activity is still classified by its localisation--generalised or focal--and by its periodicity--long or short. Periodic long-interval diffuse paroxysmal patterns are reported with rare pathologies such as SSPE, trypanosomiasis or intoxication with phencyclidine. Suppression bursts (SB) may be found in two main situations post-anoxic encephalopathies and drug-induced comas. Ohtahara syndrome is a very rare childhood epileptic syndrome with SB. Periodic short-interval diffuse pattern have been reported in Creutzfeldt-Jakob disease but also in toxic encephalopathies, such as lithium intoxication or as recently reported in acute Cefepime intoxication as well as with metabolic encephalopathies and rarely during AIDS. Periodic lateralized epileptiform discharges (PLEDs) have been classified according to their morphology and the associated condition (epileptic seizures, subtle status, "vascular" seizure). The principal etiology is cerebro-vascular disease and herpes encephalitis but it has also been reported in several other neurological diseases.

Animals↗
PubMed1993

One units experience in instigating change in an intensive therapy unit.

Critical care management and staffing levels are under constant review to ensure efficient staff utilisation and to apply structural efficiency principles. The staffing of our general intensive care unit was reviewed and reorganised creating what we believed to be an unsafe environment. As a group of Clinical Nurse Specialists (CNS) and critical care Registered Nurses (RN) we investigated the after hours management of the unit using a retrospective study and a current practice survey which we submitted to our administration. The data collected provided us with a strong case against reclassification of the Team Leader position and illustrates the need for clinicians to look objectively into current issues to support all discussions and concerns.

Humans↗
PubMed2002

Phylogenetics of asterids based on 3 coding and 3 non-coding chloroplast DNA markers and the utility of non-coding DNA at higher taxonomic levels.

Asterids comprise 1/4-1/3 of all flowering plants and are classified in 10 orders and >100 families. The phylogeny of asterids is here explored with jackknife parsimony analysis of chloroplast DNA from 132 genera representing 103 families and all higher groups of asterids. Six different markers were used, three of the markers represent protein coding genes, rbcL, ndhF, and matK, and three other represent non-coding DNA; a region including trnL exons and the intron and intergenic spacers between trnT (UGU) to trnF (GAA); another region including trnV exons and intron, trnM and intergenic spacers between trnV (UAC) and atpE, and the rps16 intron. The three non-coding markers proved almost equally useful as the three coding genes in phylogenetic reconstruction at the high level of orders and families in asterids, and in relation to the number of aligned positions the non-coding markers were even more effective. Basal interrelationships among Cornales, Ericales, lamiids (new name replacing euasterids I), and campanulids (new name replacing euasterids II) are resolved with strong support. Family interrelationships are fully or almost fully resolved with medium to strong support in Cornales, Garryales, Gentianales, Solanales, Aquifoliales, Apiales, and Dipsacales. Within the three large orders Ericales, Lamiales, and Asterales, family interrelationships remain partly unclear. The analysis has contributed to reclassification of several families, e.g., Tetrameristaceae, Ebenaceae, Styracaceae, Montiniaceae, Orobanchaceae, and Scrophulariaceae (by inclusion of Pellicieraceae, Lissocarpaceae, Halesiaceae, Kaliphoraceae, Cyclocheilaceae, and Myoporaceae+Buddlejaceae, respectively), and to the placement of families that were unplaced in the APG-system, e.g., Sladeniaceae, Pentaphylacaceae, Plocospermataceae, Cardiopteridaceae, and Adoxaceae (in Ericales, Ericales, Lamiales, Aquifoliales, and Dipsacales, respectively), and Paracryphiaceae among campanulids. Several families of euasterids remain unclassified to order.

Chloroplasts↗
PubMed2002

A phylogeny of planorbid snails, with implications for the evolution of Schistosoma parasites.

The Planorbidae represent one of the most important families of freshwater snails. They have a wide distribution and are significant both medically and economically as intermediate hosts for trematode worms. Digenetic trematodes of the genus Schistosoma cause schistosomiasis, a disease that infects 200 million people, and domestic animals throughout the tropics. Three of the four recognized species groups of Schistosoma rely on snails of the family Planorbidae to complete their life cycles. Each species group requires a specific planorbid genus-Bulinus, Biomphalaria, or Indoplanorbis. Our understanding of the relationships among the genera within the Planorbidae is rudimentary and based solely on internal anatomy and shell morphology. Two molecular markers, ribosomal 28S and actin exon 2, were sequenced and a phylogeny constructed for 38 taxa representing 16 planorbid genera. The phylogeny supports the division of the Planorbidae into two subfamilies, the Bulininae and Planorbinae. Interestingly, two representatives of the family Ancylidae fall within the Planorbidae highlighting the need for further analysis and possible reclassification of this group. A molecular based phylogeny of the genus Schistosoma was then mapped against the snail tree. The trees indicate that planorbid-transmitted Schistosoma appear not to be co-speciating with their current snail host lineages. Rather, host switching was prominent, including a switch involving two distantly related planorbid genera, Biomphalaria and Bulinus. Our study of the Planorbidae poses fundamental questions regarding how and when Schistosoma acquired new snail hosts, including how switches to relatively distant hosts are accomplished and why some available planorbids were not colonized.

Actins↗
PubMed2004

Dissecting the ribosomal inhibition mechanisms of edeine and pactamycin: the universally conserved residues G693 and C795 regulate P-site RNA binding.

The crystal structures of the universal translation-initiation inhibitors edeine and pactamycin bound to ribosomal 30S subunit have revealed that edeine induces base pairing of G693:C795, residues that constitute the pactamycin binding site. Here, we show that base pair formation by addition of edeine inhibits tRNA binding to the P site by preventing codon-anticodon interaction and that addition of pactamycin, which rebreaks the base pair, can relieve this inhibition. In addition, edeine induces translational misreading in the A site, at levels comparable to those induced by the classic misreading antibiotic streptomycin. Binding of pactamycin between residues G693 and C795 strongly inhibits translocation with a surprising tRNA specificity but has no effect on translation initiation, suggesting that reclassification of this antibiotic is necessary. Collectively, these results suggest that the universally conserved G693:C795 residues regulate tRNA binding at the P site of the ribosome and influence translocation efficiency.

Anticodon↗
PubMedDate not supplied

Sympathetic nerve blocks: in search of a role.

OBJECTIVE: The role of sympathetic blocks in pain therapy is examined in the light of changing concepts of pain pathophysiology. A critical review of the literature also sought to develop an evidence-based analysis of outcome studies to provide recommendations for appropriate applications of sympathetic blocks, together with ideas for further clinically based research. METHODS: A focus on the pathophysiology of neuropathic and inflammatory pain disorders was used to help redefine what contribution, if any, was provided by the sympathetic system, to chronic pain states. Validation of nerve block therapies based on historical practices and these newer concepts and outcome determinations has then been used to present an overview of clinical nerve block therapies as applied to the sympathetic nervous system. RESULTS: 1. Pain Diagnosis: A reclassification of reflex sympathetic dystrophy (RSD) to the new taxonomy of complex regional pain syndromes (CRPS) is supported, with evidence that only a questionable sympathetic contribution at the dorsal root ganglion level can be ascribed etiologically to this group of disorders. Sympathetic blocks can establish whether pains may be nonresponsive or variably responsive to such blocks, but are considered inappropriate in determining a clinical diagnosis. 2. Neuropathic Pain Therapy: (a) A critical review of the literature regarding the use of sympathetic blocks in the treatment of acute herpes zoster pain and in the treatment of postherpetic neuralgia found little support for the widely held view that sympathetic blocks reduced either the incidence of long-term reduction of pain in these disorders. Further attempts to reduce PHN by the combination of blocks with aggressive drug therapies during acute herpes infection are suggested. (b) CRPS (RSD) treatments are seen as evolutionary at present, with the role of sympathetic blocks being only part of a balanced pain treatment strategy aimed at getting patients activated under cover of good analgesia and improved function. These proposals come as consensus recommendations but are not substantiated by outcome studies. 3. Ischemic Pain: Permanent sympathetic block with neurolytic or thermocoagulation techniques provides up to 50% long-term improved blood flow and reduction of pain and ulceration for patients with advanced peripheral vascular disease. This is particularly appropriate at lumbar levels in which percutaneous techniques are safe when conducted with real time imaging control. CONCLUSIONS: Changes in the understanding of CRPS disorders and the role of the sympathetic nervous system in neuropathic pain has changed both the diagnostic and management strategies for these pain states. The sensitivity and specificity of response to sympathetic blocks in establishing their value at diagnostic aids will not be fully established without further clinical study. Further use of intravenous regional blocks or diagnostic intravenous infusions remains questionable. Preventive and therapeutic use of sympathetic blocks in herpes zoster pain remains open to well-controlled study.

Animals↗
PubMed2003

Complex regional pain syndrome: mystery explained?

Complex regional pain syndrome (CRPS) is the result of changes to the somatosensory systems that process noxious, tactile, and thermal information; to the sympathetic systems that innervate skin (blood vessels, sweat glands); and to the somatomotor systems. The changes suggest that the CNS representations of the systems have been altered. Patients with CRPS also have peripheral changes (eg, oedema, signs of inflammation, sympathetic-afferent coupling [the basis for sympathetically maintained pain], and trophic changes) that cannot be explained by central changes. On the basis of clinical observation and research in human beings and animals, we hypothesise that CRPS is a systemic disease involving the CNS and peripheral nervous system. The most important question for future research is what causes CRPS? In this article, we suggest a change to the focus of research efforts and treatment. We also suggest there be diagnostic reclassification and redefinition of CRPS.

Animals↗
PubMed1995

Nuclear rDNA ITS sequence variation in the trematode genus Echinostoma: an aid to establishing relationships within the 37-collar-spine group.

The taxonomic history of members of the 37-collar-spine group within the genus. Echinostoma has been very confused. We obtained DNA sequence data from the nuclear rDNA ITS1, 5.8S and ITS2 of 7 nominal species belonging to this group, Echinostoma trivolvis (Cort, 1914), E. revolutum (Frölich, 1802), E. caproni Richard, 1964, E. liei Jeyarasasingam et al. 1972, E. paransei Lie & Basch, 1967, two African isolates, E. sp.I and E. sp.II, and of one 28-collar-spined echinostome, E. hortense (Asada, 1926). Five of the eight species were clearly distinguishable using ITS data. Sequences from the remaining three taxa, E. caproni, E. sp.II and E. liei were identical to one another and the group containing these taxa was distant from other 37-collar-spine species on a phylogenetic tree. E. trivolvis and E. paraensei form a second, but less distinct group within the 37-collar-spine group. The resolution obtained using DNA sequencing will assist in the current reclassification of the group. It also provides a model for future work on sibling species.

Animals↗
PubMed2005

Papain-like protease 2 (PLP2) from severe acute respiratory syndrome coronavirus (SARS-CoV): expression, purification, characterization, and inhibition.

Viral proteases are essential for pathogenesis and virulence of severe acute respiratory syndrome coronavirus (SARS-CoV). Little information is available on SARS-CoV papain-like protease 2 (PLP2), and development of inhibitors against PLP2 is attractive for antiviral therapy. Here, we report the characterization of SARS-CoV PLP2 (from residues 1414 to 1858) purified from baculovirus-infected insect cells. We demonstrate that SARS-CoV PLP2 by itself differentially cleaves between the amino acids Gly180 and Ala181, Gly818 and Ala819, and Gly2740 and Lys2741 of the viral polypeptide pp1a, as determined by reversed-phase high-performance liquid chromatography analysis coupled with mass spectrometry. This protease is especially selective for the P1, P4, and P6 sites of the substrate. The study demonstrates, for the first time among coronaviral PLPs, that the reaction mechanism of SARS-CoV PLP2 is characteristic of papain and compatible with the involvement of the catalytic dyad (Cys)-S(-)/(His)-Im(+)H ion pair. With a fluorogenic inhibitor-screening platform, we show that zinc ion and its conjugates potently inhibit the enzymatic activity of SARS-CoV PLP2. In addition, we provided evidence for evolutionary reclassification of SARS-CoV. The results provide important insights into the biochemical properties of the coronaviral PLP family and a promising therapeutic way to fight SARS-CoV.

Amino Acid Sequence↗
PubMed2004

A QSAR for baseline toxicity: validation, domain of application, and prediction.

The interest in modeling and application of structure-activity relationships has steadily increased in recent decades. It is generally acknowledged that these empirical relationships are valid only within the same domain for which they were developed. However, model validation is sometimes neglected, and the application domain is not always well-defined. The purpose of this paper is to outline how validation and domain definition can facilitate the modeling and prediction of baseline toxicity for a large database. A large number of theoretical descriptors (867) were generated from two-dimensional molecular structures for compounds present in the U.S. EPA's Fathead Minnow Database (611) and the Syracuse Research Corporation's PhysProp Database (25,000+). A quantitative structure-activity relationship model was developed for baseline toxicity (narcosis) toward the fathead minnow (Pimephales promelas) using a projection-based regression technique, PLSR (partial least squares regression). The PLSR model was subsequently validated with an external test set. The main factors of variation were related to size/shape and polar interactions. The prediction error was comparable to, or slightly better than, the ECOSAR procedures. A set of 16,805 compounds, drawn from the PhysProp Database, was projected onto the PLSR model. More than 90% (15,597) of the compounds fall within the valid model domain, defined by the residual standard deviation and the leverage. The predicted baseline toxicity indicates an acute hazard for two-thirds of these compounds, classes I-III in the OECD Globally Harmonized Classification System (LC50 < or = 100 mg L(-1)). Finally, the mode of action assigned in the U.S. EPA Fathead Minnow Database was investigated. Reclassification to narcosis as the mode of action is suggested for 92 compounds, mostly from the groups "unsure" and "mixed". The present classification into specific modes of action seems to be further strengthened by the findings in this investigation.

Animals↗
PubMed1999

Metaphors and models in medicine.

This paper aims to show how medical scientists may use metaphor in ways closely parallel to poets. Those who believe metaphor has any role at all in science may describe its use in various ways. Associationists think metaphors are based upon likenesses, and collapse the notions of model and metaphor together. But, as an example from the work of Louis Pasteur suggests, metaphor need not be based upon likenesses. Rather it may play a role in making possible a model's explanatory significance. Models may presuppose metaphors. The Pasteur example also suggests metaphor may play a part in creating likenesses through its role in classification and reclassification. It is in these ways that the use of metaphor in medical science most closely parallels that in poetry.

Humans↗
PubMed2000

Is there an association between alcohol intake or smoking and small bowel adenocarcinoma? Results from a European multi-center case-control study.

OBJECTIVE: To discover whether tobacco smoking and intake of different types of alcoholic drinks are associated with small bowel adenocarcinoma (SBA). METHODS: A population-based European multi-center case-control study was conducted from 1995 to 1997. RESULTS: After a histological review using uniform diagnostic criteria, 47 (33%) of the 142 identified cases of SBA were excluded due to reclassification as either tumors of the papilla of Vater (n = 22), stromal tumors, or metastases; 95 cases were accepted for study. In all, 70 cases of SBA together with 2070 controls matched by age, sex, and region were interviewed. A high intake (more than 24 g alcohol per day) of beer or spirits was associated with SBA, an odds ratio (OR) of 3.5 and 95% confidence intervals (CI) of 1.5-8.0 and 3.4 (95% CI 1.3-9.2), respectively). There was no association with wine intake or total alcohol intake. Tobacco smoking was probably unrelated to SBA. CONCLUSIONS: A high intake of beer or spirits seems to be a risk factor for SBA. Since this association was not seen for wine drinkers, protective components of wine may counterbalance a carcinogenic effect of alcohol on the small bowel. Alternatively, the result may be confounded by other factors, e.g. dietary factors.

Adenocarcinoma↗
PubMed2002

The impact of the legal system on educational programming for young children with autism spectrum disorder.

Since 1990, State Educational Agency (SEA) and Local Educational Agency (LEA) policies and practices of educational programming for young children with autism have evolved in response to the due process system and court decisions. This has become an issue because of an increase in the identification of children with autism, reclassification of children previously reported under other disability categories, publicity about the competition between methodologies, parent advocacy for specific methodologies, shortages of qualified personnel, and the demand for due process to ensure appropriate services. A review is made of substantive and procedural issues presented in due process and court cases, the legal standards used by hearing officers and judges, and a synthesis of the case law. It is recommended that school districts consider legal standards as programs are designed, that programs fit the unique needs of the child, that programs ensure appropriate progress educationally and socially, and that communication between parents and school districts be open and honest so that the due process system is used as the last resort.

Adolescent↗
PubMed2003

Evidence-based guidelines for non-prescription treatment of vulvovaginal candidiasis (VVC).

In the UK, there has been a rapid increase in the reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sales list (GSL) status. This means that community pharmacy staff have a greater range of non-prescription medicines to recommend for the treatment of minor illness. Strategies are needed to promote good professional practice in the supply of non-prescription medicines. Guidelines have been shown to promote quality of care in other health care settings. In this article, we present evidence based guidelines for the treatment of vulvovaginal candidiasis using non-prescription anti-fungal medicines.

Antifungal Agents↗
PubMed2002

T-cell-rich B-cell lymphoma - diagnostic and therapeutic aspects.

BACKGROUND: Morphologically, T-cell-rich B-cell lymphoma (TCRB-NHL) may be indistinguishable from Hodgkin's disease (HD). Immunophenotyping may be helpful in the separation of these entities. TCRB-NHL is occasionally misdiagnosed and treated as HD. However, information is limited regarding clinical characteristics and outcome of this patient population. Furthermore, knowledge concerning any association with Epstein-Barr virus (EBV) in TCRB-NHL, as well as the immunophenotype of reactive T-cells and the expression of T-cell intracellular antigen-1 (TIA-1), granzyme B (GrB) and the CD3-zeta-chain is limited. PATIENTS AND METHODS: We have re-evaluated 251 tumour biopsies from patients aged > or =15 years with HD diagnosed 1985-1994. Reclassification from HD to TCRB-NHL was done in 12 cases (5%). Six TCRB-NHL patients initially diagnosed and treated as B-NHL were also included. All TCRB-NHL biopsies were analysed for latent membrane protein 1 (LMP-1), CD4, CD8, CD56, CD57, TIA-1, GrB and CD3-zeta-chain. RESULTS: Twelve cases of TCRB-NHL were initially subclassified as HD (lymphocyte predominance 5, nodular sclerosis 3, and mixed cellularity 4). Of these 12 TCRB-NHL patients, 6 were given radiotherapy alone, 5 MOPP/ABVD or similar combination chemotherapy, and one patient combined modality treatment. Male sex (p<0.05) and inguinal involvement (p<0.001) were significantly more frequent when TCRB-NHL patients receiving HD treatment (n=12) were compared with the remaining patients with confirmed (conf) HD, while no significant differences were seen with regard to stage, bone marrow infiltration, splenomegaly or cause-specific survival. Similar results were achieved when all TCRB-NHL patients (n=18) were compared to conf HD patients. Lymphoma cells in three samples stained positively for LMP-1. A decreased expression of CD3-zeta-chain was seen in 9/14 tumour biopsies. CONCLUSION: Immunohistochemistry makes it possible to identify cases of TCRB-NHL that are morphologically difficult to distinguish from HD. The outcome of TCRB-NHL patients treated as having HD was comparable with that of the remaining HD population.

Adaptor Proteins, Signal Transducing↗