Pharmacy patron perspectives of community pharmacist administered influenza vaccinations

Background

One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine.

Extrapontine myelinolysis in a 4 year old with diabetic ketoacidosis

Extrapontine and central pontine myelinolysis (EPM/CPM) are rare events in pediatric neurology but can have devastating consequences. They are most commonly associated with rapid correction of hyponatremia but have been reported in other situations as well. This condition is relatively more common in adult neurology, not surprisingly, as alcoholism and associated malnutrition are often predisposing conditions. There have been few case reports in children with regards to this. We describe a 4-year old who presented with focal neurological deficits in the setting of diabetic ketoacidosis and the ensuing underlying osmotic imbalances. The patient made a remarkable recovery with no deficits of note-cognitive or motor. To our knowledge this is the youngest case reported so far of EPM in a child with diabetic ketoacidosis. The history of the condition, early animal experiments, clinicopathologic correlates, previous case reports and other scenarios in which this unusual event can occur are discussed--though the exact pathogenesis of this condition still remains unclear. We hope to bring to the attention of clinicians caring for children in the acute care setting, the importance of gradual correction of serum osmolality to reduce morbidity and mortality.     

Maxillary sinusitis — A correlative study

A correlative study of the clinical findings and radiographic findings, antral lavage, bacterial flora, and antibacterial therapy was done on forty five patients with fifty six radiographically abnormal antra. Twenty six patients, thirty two maxillary antra were followed up after treatment. Clinically, purulent nasal discharge, fever, pus in the middle meatus and sinus tenderness, radiographically opacity and fluid levels, purulent or mucoid return on antral lavage yielded a significantly high positive bacterial culture justifying the treatment with antibiotics. The common organisms isolated were haemophilus influezae and streptococcus pneumonia. Mucosal thickening as observed radiographically may be an intermediary sign either in the development or in the recovery of maxillary sinusitis.     

Development of neoplastic phenotype following transfection of HNF cells with sarcoma DNA

DNA isolated from chondrosarcoma cells effectively transformedNIH-3T3 cells and human foreskin fibroblasts. The transfectedNIH-3T3 cells, directly implanted three or four passages later,formed progressively growing tumors ( 2.0 cm in diameter) subcutaneouslyin nude mice. No metastasis was evident upon pathological examinationof the tumor bearing mice. Transfected human foreskin fibroblaststhat exhibited anchorage independent growth formed only smalltumors in nude mice (<0.6 cm in diameter). The transfectedhuman cells which exhibited anchorage independent growth reactedwith the monoclonal antibody 345.134S, specific for an epitopeexpressed by human sarcoma cells. The transfected NIH-3T3 cellsdid not exhibit reactivity with the same monoclonal antibody.Southern blot analysis of the DNA prepared from the transfectedNIH-3T3 cells, that developed as a progressively growing tumorin a nude mouse, revealed the presence of human repetitive DNAsequences.     

Rapid screening of fecal samples for Vibrio cholerae by a coagglutination technique.

A coagglutination procedure for detecting Vibrio cholerae was applied directly to 125 watery fecal samples received in the laboratory for bacteriological culture: many of these were from suspected cases of cholera. Of 47 bacteriologically proved cases of cholera, 44 (93.6%) gave positive results by the coagglutination method. There was a good correlation between the coagglutination method, dark-field microscopy, and culture.     

Bacteremia due to Rhodococcus equi--a case report

Rhodococcus equi (R. equi) primarily causes zoonotic infections affecting grazing animals and is an unusual cause of infection in immunocompetent human beings. We report a case of bacteremia due to R. equi a rare isolate in a child suffering from protein energy malnutrition     

PCR-Enzyme Immunoassay for Detection of Streptococcus pneumoniae DNA in Cerebrospinal Fluid Samples from Patients With Culture-Negative Meningitis

A PCR-based assay was developed to amplify a conserved region of the pneumococcal autolysin gene. The amplified product was labelled with digoxigenin-labelled dUTP and was detected with a biotin-labelled probe in an enzyme immunoassay (EIA). The assay was initially tested with suspensions of various serotypes of Streptococcus pneumoniae and other gram-positive and gram-negative bacteria and was then applied to cerebrospinal fluid (CSF) specimens from patients with meningitis and those with other neurological disorders. The assay detected all the serotypes of S. pneumoniae tested, whereas all the other bacterial strains tested were negative. Seven of the 8 CSF specimens positive for pneumococcus by culture or latex agglutination (LA) were positive by PCR-EIA, whereas all 10 specimens positive for other organisms were negative. Among 11 patients with clinically diagnosed meningitis but with negative culture and LA results, 5 were positive by PCR-EIA. The assay was negative for all but one patient without meningitis; it was positive with the CSF from a child with immunodeficiency and pneumococcal abscesses on the scalp. PCR-EIA is a useful tool for the diagnosis of meningitis, especially when culture and LA are negative because of prior antibiotic treatment.     

Nasopharyngeal colonization of infants in southern India with Streptococcus pneumoniae

To investigate the dynamics of nasopharyngeal colonization with Streptococcus pneumoniae, and to determine the prevalent serogroups/types (SGT) and their antimicrobial susceptibility, we studied 100 infants attending our well-baby clinic. Nasopharyngeal swab specimens were obtained at 6, 10, 14, 18 and 22 weeks and at 9 and 18 months of age and submitted for culture, serotyping and antimicrobial susceptibility testing of S. pneumoniae. Colonization with pneumococcus was seen on at least one occasion in 81 infants. The median age of acquisition was 11 weeks and the median duration of carriage was 1 3 months. The common SGTs identified were 6, 19, 14 and 15. SGT 1, which was a common invasive isolate in children in our hospital during this period, was not isolated from these children. Sequential colonization by 2, 3 or 4 SGTs was observed in 18, 5 and 2 children, respectively. Resistance to penicillin, chloramphenicol, cotrimoxazole and erythromycin was observed in 0, 13 (6%) 11 (5 %) and 5 (3 %) isolates, respectively. There was a significant difference in susceptibility to cotrimoxazole between colonizing and invasive isolates (5 % vs. 40 %, P<0.0001).