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Medical student and medical school teaching faculty perceptions of conflict of interest

Background Attitudes towards conflict of interest (COI) and COI policy are shaped during medical school and influence both the education of medical students and their future medical practice. Understanding the current attitudes of medical students and medical school teaching faculty may provide insight into what is taught about COI and COI policy within the ‘hidden’ medical...

Using cheminformatics to predict cross reactivity of “designer drugs” to their currently available immunoassays

Background A challenge for drug of abuse testing is presented by ‘designer drugs’, compounds typically discovered by modifications of existing clinical drug classes such as amphetamines and cannabinoids. Drug of abuse screening immunoassays directed at amphetamine or methamphetamine only detect a small subset of designer amphetamine-like drugs, and those immunoassays designed for...

Effect of specimen type on free immunoglobulin light chains analysis on the Roche Diagnostics cobas 8000 analyzer

Matthew D. Krasowski 0 0 Department of Pathology, University of Iowa Hospitals and Clinics , Iowa City, IA 52242 , USA The measurement of free immunoglobulin light chains is typically performed on serum

A rapid analysis of plasma/serum ethylene and propylene glycol by headspace gas chromatography

Alexandra Ehlers 0 Cory Morris 0 Matthew D Krasowski 0 0 Clinical Chemistry Laboratory, Department of Pathology, University of Iowa Hospitals and Clinics , Iowa City, IA 52242, USA A rapid headspace

Clinical decision support of therapeutic drug monitoring of phenytoin: measured versus adjusted phenytoin plasma concentrations

Background Therapeutic drug monitoring of phenytoin by measurement of plasma concentrations is often employed to optimize clinical efficacy while avoiding adverse effects. This is most commonly accomplished by measurement of total phenytoin plasma concentrations. However, total phenytoin levels can be misleading in patients with factors such as low plasma albumin that alter the...

Retrospective analysis of the diagnostic yield of newborn drug testing

McMillin 1 4 Matthew D Krasowski 2 0 Stead Family Department of Pediatrics, University of Iowa Children's Hospital , Iowa City, IA 52242 , USA 1 ARUP Institute for Clinical and Experimental Pathology , Salt

Promoting improved utilization of laboratory testing through changes in an electronic medical record: experience at an academic medical center

This case study over time describes five years of experience with interventions to improve laboratory test utilization at an academic medical center. The high-frequency laboratory tests showing the biggest declines in order volume post intervention were serum albumin (36%) and erythrocyte sedimentation rate (17%). Introduction of restrictions for 170 high-cost send-out tests...

Clinical Effects and Toxicokinetic Evaluation Following Massive Topiramate Ingestion

Topiramate is used to treat a variety of neurologic and psychiatric diseases due to its benign safety profile. Data regarding the toxicity and toxicokinetics of topiramate in acute overdose are limited. A case of massive, acute ingestion resulting in the highest reported topiramate level is presented, including toxicokinetic evaluation. A 37-year-old woman presented with coma...

Evolutionary diversity of bile salts in reptiles and mammals, including analysis of ancient human and extinct giant ground sloth coprolites

Background Bile salts are the major end-metabolites of cholesterol and are also important in lipid and protein digestion and in influencing the intestinal microflora. We greatly extend prior surveys of bile salt diversity in both reptiles and mammals, including analysis of 8,000 year old human coprolites and coprolites from the extinct Shasta ground sloth (Nothrotherium shastense...

The evolution of farnesoid X, vitamin D, and pregnane X receptors: insights from the green-spotted pufferfish (Tetraodon nigriviridis) and other non-mammalian species

Background The farnesoid X receptor (FXR), pregnane X receptor (PXR), and vitamin D receptor (VDR) are three closely related nuclear hormone receptors in the NR1H and 1I subfamilies that share the property of being activated by bile salts. Bile salts vary significantly in structure across vertebrate species, suggesting that receptors binding these molecules may show adaptive...

Challenges Predicting Ligand-Receptor Interactions of Promiscuous Proteins: The Nuclear Receptor PXR

. Krasowski 0 James M. Briggs, University of Houston, United States of America 0 1 Collaborations in Chemistry, Jenkintown, Pennsylvania, United States of America, 2 Department of Pharmaceutical Sciences

Evolution of pharmacologic specificity in the pregnane X receptor

Background The pregnane X receptor (PXR) shows the highest degree of cross-species sequence diversity of any of the vertebrate nuclear hormone receptors. In this study, we determined the pharmacophores for activation of human, mouse, rat, rabbit, chicken, and zebrafish PXRs, using a common set of sixteen ligands. In addition, we compared in detail the selectivity of human and...

Functional constraints on the constitutive androstane receptor inferred from human sequence variation and cross-species comparisons

Members of the NR1I subfamily of nuclear receptors play a role in the transcriptional activation of genes involved in drug metabolism and transport. NR1I3, the constitutive androstane receptor (CAR), mediates the induction of several genes involved in drug response, including members of the CYP3A, CYP2B and UGT1A subfamilies. Large inter-individual variation in drug clearance has...

Functional evolution of the vitamin D and pregnane X receptors

Background The vitamin D receptor (VDR) and pregnane X receptor (PXR) are nuclear hormone receptors of the NR1I subfamily that show contrasting patterns of cross-species variation. VDR and PXR are thought to have arisen from duplication of an ancestral gene, evident now as a single gene in the genome of the chordate invertebrate Ciona intestinalis (sea squirt). VDR genes have...

Natural inhibitors of cholinesterases: implications for adverse drug reactions

0 Matthew D. Krasowski, Daniel S. McGehee VhD, Jonathan Moss MD PhD Purpose: Acetylcholinesterase and butyrylcholinesterase are two closely related enzymes important in the metabolism of