Interprofessional Education: Models That Promote Shared Clinical Decision-Making.

Description Interprofessional education continues to be emphasized as an area that needs to continue to grow by agencies that accredit higher education professional degree programs. Teams of healthcare professionals need to learn more about each other, collaborate, and understand what matters most to the patient when care is needed in an acute or ambulatory care setting. Settings that promote clinical shared decision-making and collaboration with pharmacists among the team and increase communication between members and the patient will decrease medical errors, increase patient safety, and improve the quality of life for the patient.

A pilot study on the use of the nominal group technique to refine core pharmacy roles and to determine what competencies may be missing from pharmacy education.

Introduction: To describe the use of the nominal group technique (NGT) to refine pharmacy core roles and to compare these roles with current pharmacy outcomes and other literature to highlight potential deficiencies.

Methods: The NGT process was used for this proposal review. The process was conducted in four key stages: silent generation, round-robin, clarification, and voting.

Pneumococcal pulmonary valve endocarditis.

Pulmonary valve endocarditis is an rare type of infective endocarditis (IE). Streptococcus pneumoniae is a pathogen that is uncommonly associated with IE. A 50 year-old man was referred to us to an incidental echocardiographic finding of a pulmonary valve vegetation.

The prevalence and characteristics of dual PharmD/MPH programs offered at US colleges and schools of pharmacy.

Objective: To assess the prevalence and characteristics of curriculum in dual doctor of pharmacy (PharmD)/master of public health (MPH) degree programs offered by US pharmacy programs.

Methods: An 18-item survey instrument was developed and distributed online to faculty members at US colleges and schools of pharmacy.

Results: Of the 110 colleges and schools that responded, 23 (21%) offered a PharmD/MPH degree.

Educating Pharmacy Students to Improve Quality (EPIQ) in colleges and schools of pharmacy.

Objective: To assess course instructors' and students' perceptions of the Educating Pharmacy Students and Pharmacists to Improve Quality (EPIQ) curriculum.

Methods: Seven colleges and schools of pharmacy that were using the EPIQ program in their curricula agreed to participate in the study. Five of the 7 collected student retrospective pre- and post-intervention questionnaires.

Antibiotic resistance in microbial keratitis: ten-year experience of corneal scrapes in the United Kingdom.

Purpose: To determine the scale of antibiotic resistance in microbial keratitis in East Kent, United Kingdom.

Design: Retrospective, observational case series.

Participants: Corneal scrapes over a 10-year period to December 2008 were identified using the local microbiology database, which provided culture results and antibiotic sensitivity-resistance profiles.

Linezolid-resistant ST36 methicillin-resistant Staphylococcus aureus associated with prolonged linezolid treatment in two paediatric cystic fibrosis patients.

Objectives: To describe the emergence of linezolid-resistant methicillin-resistant Staphylococcus aureus (MRSA) of sequence type (ST)36 lineage in two paediatric patients with cystic fibrosis, after long-term low-dose linezolid treatment.

Methods: Two paediatric males with cystic fibrosis had sputum samples quantitatively cultured during hospitalization. After the isolation of MRSA from both patients, oral treatment with 300 mg linezolid twice daily was initiated for periods of 1-2 months separated by up to 6 months.

Diagnostic delay in a case of herpes simplex encephalitis.

Herpes simplex encephalitis (HSE) is the most frequent cause of sporadic fatal encephalitis in the Western world. Definitive diagnosis by viral PCR of cerebrospinal fluid (CSF) and treatment with aciclovir have improved the prognosis significantly. Nevertheless, the condition is rare and presents with non-specific symptoms that can easily be mistaken for systemic infection or non-infective encephalopathy.

The triglyceride-lowering effects of a modest dose of docosahexaenoic acid alone versus in combination with low dose eicosapentaenoic acid in patients with coronary artery disease and elevated triglycerides.

Background: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD.

Methods: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL.

Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization.

Purpose: A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described.

Summary: Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes.

The peptidoglycan-degrading property of lysozyme is not required for bactericidal activity in vivo.

Lysozyme is an abundant, cationic antimicrobial protein that plays an important role in pulmonary host defense. Increased concentration of lysozyme in the airspaces of transgenic mice enhanced bacterial killing whereas lysozyme deficiency resulted in increased bacterial burden and morbidity. Lysozyme degrades peptidoglycan in the bacterial cell wall leading to rapid killing of Gram-positive organisms; however, this mechanism cannot account for the protective effect of lysozyme against Gram-negative bacteria.

An unusual pathogen causing microbial keratitis.

Introduction: We report a rare case of Mycobacterium fortuitum affecting the corneal graft of a patient 6 years post-graft, possibly associated with contact lens use.

Conclusions: This case shows the need for careful microbiological techniques when dealing with patients presenting with microbial keratitis. It must be kept in mind that unusual and slow growing organisms may also be responsible for corneal ulceration.

von Hippel-Lindau protein binds hyperphosphorylated large subunit of RNA polymerase II through a proline hydroxylation motif and targets it for ubiquitination.

The transition from transcription initiation to elongation involves phosphorylation of the large subunit (Rpb1) of RNA polymerase II on the repetitive carboxyl-terminal domain. The elongating hyperphosphorylated Rpb1 is subject to ubiquitination, particularly in response to UV radiation and DNA-damaging agents. By using computer modeling, we identified regions of Rpb1 and the adjacent subunit 6 of RNA polymerase II (Rpb6) that share sequence and structural similarity with the domain of hypoxia-inducible transcription factor 1 alpha (HIF-1 alpha) that binds von Hippel-Lindau tumor suppressor protein (pVHL).

Outcome and treatment of Bartonella endocarditis.

Background: Endocarditis caused by Bartonella species is a potentially lethal infection characterized by a subacute evolution and severe valvular lesions.

Objectives: To evaluate the outcome of patients with Bartonella endocarditis and to define the best antibiotic regimen using the following measures: recovery, relapse, or death.

Methods: We performed a retrospective study on 101 patients who were diagnosed in our laboratory as having Bartonella endocarditis between January 1, 1995, and April 30, 2001.

Regulation of gene expression for neurotransmitters during adaptation to hypoxia in oxygen-sensitive neuroendocrine cells.

Reduced oxygen tension (hypoxia) in the environment stimulates oxygen-sensitive cells in the carotid body (CB). Upon exposure to hypoxia, the CB immediately triggers a reflexive physiological response, thereby increasing respiration. Adaptation to hypoxia involves changes in the expression of various CB genes, whose products are involved in the transduction and modulation of the hypoxic signal to the central nervous system (CNS).

Effect of fluvastatin and pravastatin, HMG-CoA reductase inhibitors, on fluconazole activity against Candida albicans.

Synergy between fluvastatin, at clinically unachievable concentrations, and fluconazole against Candida albicans has been reported. The purpose of the present study was to evaluate the in-vitro activity of fluconazole alone and in combination with clinically achievable concentrations of pravastatin and fluvastatin against C. albicans.