Kinetics of decomposition of rabeprazole sodium in aqueous solutions determined by high performance liquid chromatography

The kinetics of decomposition of rabeprazole sodium in aqueous solutions at elevated temperatures has been investigated by high performance liquid chromatography. The reaction is found to follow first-order kinetics and the rate constant for the degradation at 25 degrees C is estimated by extrapolation. The breakdown of rabeprazole sodium is shown to be water and hydrogen ion catalysed and the effects of ionic strength and buffer concentrations to such rate studies are discussed.     

Newcastle disease virus in West Africa: new virulent strains identified in non-commercial farms

Forty-four Newcastle disease virus (NDV) strains, obtained between 2002 and 2007 from different poultry species in Nigeria, Niger, Burkina Faso and Cameroon, were phylogenetically analysed based on partial F sequences. Lineage 2 viruses were genetically identical or similar to the locally used LaSota vaccine strain and were mostly detected in commercial farms. Lineage 1, 3 and 4 strains were only sporadically found, and their origin was less clear. Twenty-one strains from backyard farms and live bird markets formed three new clusters within lineage 5, tentatively named 5f, 5g and 5h. All of these strains were predicted to be virulent based on their F protein cleavage site sequence. Minimal genetic distances between new and previously established sublineages ranged from 9.4 to 15.9%, and minimal distances between the new sublineages were 11.5 to 17.3%. Their high genetic diversity and their presence in three different Sub-Saharan countries suggest that these new sublineages represent the NDV variants indigenous to West Africa. Nucleotide sequence data reported are available in the DDBJ/EMBL/GenBank databases under the accession numbers FM200796 to FM200839.     

Impact of Point-of-Care Implementation in Pharmacist-Run Anticoagulation Clinics Within a Community-Owned Health System: A Two-Year Retrospective Analysis

Background:

Point-of-care (POC) testing devices allow laboratory monitoring to be performed in various settings and accessed immediately.

Objective:

To evaluate the outcomes of monitoring anticoagulation patients in pharmacistmanaged, multicenter clinics utilizing i-STAT POC machines.

Methods:

This study was a retrospective, multicenter chart review of 150 patients before and after implementation of the POC intervention for anticoagulation monitoring. Data collected included international normalized ratio (INR) results, indication for warfarin, minor and major bleeds, thromboembolic events, emergency room (ER) visits, and hospitalizations before and after i-STAT POC implementation.

Results:

The time in therapeutic INR range (TTR) was significantly higher after i-STAT POC implementation than before implementation (60.4% ± 21.2% and 52.5% ± 21.5%, respectively; P = .0001). There were no reports of major bleeding during the study period. Twenty-three minor bleeds were reported after i-STAT POC implementation compared to 19 events before implementation (P < .0001). One thromboembolic event was reported after i-STAT POC implementation. There was a significant difference in the number of hospitalizations before i-STAT POC implementation as opposed to after implementation (2 and 0, respectively; P < .0001). There was also a significant increase in ER visits after i-STAT POC implementation (P < .0001).

Conclusion:

The results of the study indicate improvement in TTR in pharmacist-managed anticoagulation clinics by 7.8%. Although the use of the i-STAT POC machine detected an increase in minor bleeds, thromboembolic events, and ER visits, there was a decrease in hospitalization. The outcomes of this multicenter study indicate that implementation on this scale provides improvement in regard to safety and cost.     

Maternal HIV/AIDS Status and Neurological Outcomes in Neonates: A Population-Based Study

This study sought to examine the association between maternal HIV/AIDS infection and neonatal neurologic conditions in the state of Florida. We analyzed all births in the state of Florida from 1998 to 2007 using hospital discharge data linked to birth certificate records. The main outcomes of interest included selected neonatal neurologic complications, namely: fetal distress, cephalohematoma, intracranial hemorrhage, seizure, feeding difficulties, and other central nervous system complications. The sample size for this study was 1,645,515 records. All forms of substance abuse as well as cesarean section deliveries were more frequent in mothers with HIV/AIDS. Infants born to HIV-infected mothers showed higher proportions of feeding difficulties and seizures whereas HIV-negative mothers had a greater proportion of cases of fetal distress and cephalohematoma. Seizures and feeding difficulties are common among infants born to HIV/AIDS infected mothers. This population-based retrospective cohort study provides further understanding of the association between maternal HIV/AIDS status and neonatal neurological outcomes.     

Recurrent acute hepatitis following the use of factor VIII concentrates

During a 3-yr period, a patient with hemophilia A experienced 5 episodes of acute hepatitis within 7-16 days following 5 separate infusions of factor VIII (FVIII) concentrates. Although the exact mechanism of the recurrent hepatitis remains unclear, these episodes most likely represented repeated allergic reactions to an antigenic protein derived from the FVIII concentrates. Although no evidence was found for a specific humoral immune response to FVIII in the circulation of the patient, an isolated cellular immune response was suggested by the finding of in vitro lymphocyte stimulation in response to the FVIII concentrate. This unusual type of posttransfusion hepatitis must be added to the list of adverse responses to FVIII concentrates.     

High Genetic Diversity of Newcastle Disease Virus in Poultry in West and Central Africa: Cocirculation of Genotype XIV and Newly Defined Genotypes XVII and XVIII

Despite rampant Newcastle disease virus (NDV) outbreaks in Africa for decades, the information about the genetic characteristics of the virulent strains circulating in West and Central Africa is still scarce. In this study, 96 complete NDV fusion gene sequences were obtained from poultry sampled in Cameroon, Central African Republic, Côte d''Ivoire, and Nigeria between 2006 and 2011. Based on rational criteria recently proposed for the classification of NDV strains into classes, genotypes, and subgenotypes, we revisited the classification of virulent strains, in particular those from West and Central Africa, leading to their grouping into genotype XIV and newly defined genotypes XVII and XVIII, each with two subgenotypes. Phylogenetic analyses revealed that several (sub)genotypes are found in almost every country. In Cameroon, most strains were related to vaccine strains, but a single genotype XVII strain was also found. Only three highly similar genotype XVII strains were detected in Central African Republic. Subgenotypes XVIIa, XVIIIa, and XVIIIb cocirculated in Côte d''Ivoire, while subgenotypes XIVa, XIVb, XVIIa, XVIIb, and XVIIIb were found in Nigeria. While these genotypes are so far geographically restricted, local and international trade of domestic and exotic birds may lead to their spread beyond West and Central Africa. A high genetic diversity, mutations in important neutralizing epitopes paired with suboptimal vaccination, various levels of clinical responses of poultry and wild birds to virulent strains, strains with new cleavage sites, and other genetic modifications found in these genotypes tend to undermine and complicate NDV management in Africa.     

Cranial cystic epidermoid: Report of two cases and review of the literature

Intercranial epidermoid tumours are benign lesions of congenital origin that are potentially curable. Although computerized axial tomography (CT) and magnetic resonance imaging (MRI) are usually diagnostic, a few atypical features sometimes make pre-operative diagnosis difficult. Two cases of cystic epidermoids with peripheral ring enhancement are reported. Relevant literature has been reviewed.