Substantial declines in incidence were observed following introduction of a clone-specific outer membrane vesicle vaccine.62 In contrast, serogroup A disease remains a threat in China and India.63,64 Serogroup C disease has recently emerged in China.65,66 In response, bivalent (A, C) polysaccharide vaccine was introduced into the Expanded Program on Immunization.67 Meningococcal disease is reported rarely in Japan.68 Among 2,600 patients presenting with meningitis to four hospitals in Bangladesh over a 2-year period, 189 (24%) had a confirmed bacterial etiology, among which 72% were N meningitidis. Serogroup A accounted for 87% of meningococcal disease

cases.69 Crowded conditions increase the risk of meningococcal disease transmission, and travel can facilitate introduction of new strains into susceptible populations. Two major outbreaks of meningococcal disease occurred in recent years associated INK 128 cell line with the annual Hajj pilgrimage Ku-0059436 molecular weight to Mecca, Saudi Arabia.7,70,71 The first international

outbreak of meningococcal disease associated with the Hajj occurred in 1987 and was caused by N meningitidis serogroup A.72 This outbreak resulted in an attack rate of 640 per 100,000 American pilgrims. Subsequently, Saudi Arabia required vaccination against N meningitidis serogroup A as a condition for receiving a Hajj visa. In March and April 1992, the health surveillance system in Saudi Arabia detected increasing numbers of cases of N meningitidis serogroup A, but further spread was not detected.71 Serogroup W-135 was identified in 6.4% of 483 confirmed cases of meningococcal disease admitted to Mecca hospitals from 1987 through 1997.73 In the 2000 Hajj, more than 400 cases of W-135 infection in pilgrims and their close contacts were

reported from 16 countries.26,71,74–76 Attack rates in returning pilgrims of 25 to 30 per 100,000 were reported from several countries.71,77,78 The outbreak was determined to have resulted from Doxacurium chloride expansion of a hypervirulent lineage.26 Subsequently, quadrivalent vaccine has been required for entry into Saudi Arabia for the Hajj. The epidemiology of meningococcal disease exhibits remarkable diversity across the globe, with incidence rates ranging from less than one case per 100,000 in many industrialized countries to attack rates of 1% during meningitis belt epidemics. Meningitis remains prominent in the public consciousness both in industrialized settings and in the developing world. A limited number of countries have successfully implemented meningococcal conjugate vaccination programs, but more remains to be accomplished. No broadly protective serogroup B vaccines are yet available, and the countries of the African meningitis belt await a conjugate vaccine developed to end epidemic meningitis as a public health concern.79 Even as meningococcal disease epidemiology is described, the risk to travelers is incompletely understood.

These changes could lead to modifications in the structure of transmembrane α-helices of membrane proteins, altering the packing of these helices (Dowhan, 1997). As a consequence, membrane-associated functions of DBM13, Thiazovivin research buy such as motility, might be affected. Secondly, the amount of cardiolipin is strongly

reduced in the pmtA-deficient mutant. This reduction might be a direct effect of the decrease in phosphatidylcholine and the increase in phosphatidylethanolamine. Possibly, by decrease of cardiolipin, the cell size might be affected. Finally, the change in the proportion between anionic and zwitterionic lipids could be important in seemingly diverse membrane-associated processes. Financial assistance was provided by SECyT-UNRC/Argentina (PPI 18/C294 and 18/C345) and from CONACyT/Mexico (49738-Q). D.B.M. was a fellow of the CONICET-Argentina and of SRE-Mexico. M.S.D. is a member of the Research

Career from CONICET-Argentina. “
“Although it is known that a part of lactic acid bacteria can produce carotenoid, little is known about the regulation of carotenoid production. The objective of this study was to determine whether aerobic growth condition influences carotenoid production in carotenoid-producing Enterococcus gilvus. Enterococcus gilvus was grown under aerobic and anaerobic conditions. Its growth was slower under aerobic than under Protein Tyrosine Kinase inhibitor anaerobic conditions. The decrease in pH levels and production of lactic acid were also lower under aerobic than

under anaerobic conditions. In contrast, the amount of carotenoid pigments produced by E. gilvus was significantly higher under aerobic than under anaerobic conditions. Further, real-time quantitative reverse transcription PCR revealed that the expression level of carotenoid biosynthesis genes crtN and crtM when E. gilvus was grown under aerobic conditions was 2.55–5.86-fold higher than when it was grown under anaerobic conditions. Moreover, after exposure to 16- and 32-mM H2O2, the survival rate of E. gilvus grown under aerobic conditions was 61.5- and 72.5-fold higher, respectively, than when it was grown under anaerobic conditions. Aerobic growth conditions Phospholipase D1 significantly induced carotenoid production and the expression of carotenoid biosynthesis genes in E. gilvus, resulting in increased oxidative stress tolerance. “
“The correlation between the taxonomic composition of Alphaproteobacteria,Burkholderia and nitrogen fixers associated with the lichen Lobaria pulmonaria and the geographical distribution of the host was studied across four sites in Europe. Results proved that the diversity of Alphaproteobacteria is affected by geography, while those of Burkholderia and nitrogen fixers were mostly driven by local habitat.

As shown in Fig. 4, a 92-kDa protein band (between two nonspecific protein bands that are represented by * in Fig. 4) was detected in the outer membrane fraction of W83 (lane 5) but not of mutant 83K25 (lane 6) or other fractions (lanes 1–4, 7 and 8) (the expected molecular weight of PG534 click here is calculated as 92 000). This result suggests that PG534 is an outer membrane protein. A recent study revealed 13 proteins involved in gingipain secretion (PorK-N, PorP, PorQ, PorT, PorU,

PorW-Y, Sov, and PG27 (Sato et al., 2005, 2010; Saiki & Konishi, 2007; Ishiguro et al., 2009). Homologues of the Por proteins, Sov, and PG27 are found in Cytophaga–Flavobacterium–Bacteroidetes phylum members. Importantly, bioinformatics analyses also identified PG534 homologues in Cytophaga–Flavobacterium–Bacteroidetes phylum members Bacteroides spp., Parabacteroides spp., Prevotella spp., Flavobacterium spp., and Cytophaga spp (data not shown). In this study, we found that PG534 is required for normal gingipain activity (Fig. 1c). 83K3 (Δsov) and 83K10

(ΔPG0027) secrete few gingipains into the extracellular milieu. However, appreciable amounts of abnormal learn more forms of Arg-gingipains were detected in the HSP fraction from 83K25 (Fig. 2a, lane 8). Lysis of 83K25 cells was unlikely because 60- and 62-kDa forms of Lys-gingipain (Fig. 2b, lane 4) were not well-detected in the HSS or the HSP fraction from 83K25 (lanes 8 and 12). This suggests Casein kinase 1 that 83K25 still contains gingipain secretory activity, unlike 83K3 or 83K10. The observed phenotypes of 83K25 resemble those of the vimA, vimE, or vimF mutants that are defective in carbohydrate biogenesis of gingipains (Abaibou et

al., 2001; Vanterpool et al., 2004, 2005a, b). The mechanism of action is unclear, but the vimA, vimE, and vimF defective mutants all share the production of truncated forms of lipopolysaccharide. In contrast, 83K25 produced normal lipopolysaccharide, suggesting that PG534 affects the biogenesis of gingipains, but not lipopolysaccharide. Therefore, the function of PG534 is likely different from that of proteins shown to be involved in gingipain biogenesis: Por proteins, Sov, PG27, or Vim proteins. In Fig. 3, there appears to be a difference in the signal intensity of lipopolysaccharide bands; 83K3, 83K10, and 83K25 likely exhibited denser lipopolysaccharide bands than those of W83. The generation and/or the glycosylation of lipopolysaccharide might be facilitated by a defect of glycosylation in gingipains (Fig. 2a, lanes 2–4). In this study, we showed that PG534 is an outer membrane protein (Fig. 4).

As shown in Fig. 4, a 92-kDa protein band (between two nonspecific protein bands that are represented by * in Fig. 4) was detected in the outer membrane fraction of W83 (lane 5) but not of mutant 83K25 (lane 6) or other fractions (lanes 1–4, 7 and 8) (the expected molecular weight of PG534 www.selleckchem.com/screening/inhibitor-library.html is calculated as 92 000). This result suggests that PG534 is an outer membrane protein. A recent study revealed 13 proteins involved in gingipain secretion (PorK-N, PorP, PorQ, PorT, PorU,

PorW-Y, Sov, and PG27 (Sato et al., 2005, 2010; Saiki & Konishi, 2007; Ishiguro et al., 2009). Homologues of the Por proteins, Sov, and PG27 are found in Cytophaga–Flavobacterium–Bacteroidetes phylum members. Importantly, bioinformatics analyses also identified PG534 homologues in Cytophaga–Flavobacterium–Bacteroidetes phylum members Bacteroides spp., Parabacteroides spp., Prevotella spp., Flavobacterium spp., and Cytophaga spp (data not shown). In this study, we found that PG534 is required for normal gingipain activity (Fig. 1c). 83K3 (Δsov) and 83K10

(ΔPG0027) secrete few gingipains into the extracellular milieu. However, appreciable amounts of abnormal Selleck Natural Product Library forms of Arg-gingipains were detected in the HSP fraction from 83K25 (Fig. 2a, lane 8). Lysis of 83K25 cells was unlikely because 60- and 62-kDa forms of Lys-gingipain (Fig. 2b, lane 4) were not well-detected in the HSS or the HSP fraction from 83K25 (lanes 8 and 12). This suggests Casein kinase 1 that 83K25 still contains gingipain secretory activity, unlike 83K3 or 83K10. The observed phenotypes of 83K25 resemble those of the vimA, vimE, or vimF mutants that are defective in carbohydrate biogenesis of gingipains (Abaibou et

al., 2001; Vanterpool et al., 2004, 2005a, b). The mechanism of action is unclear, but the vimA, vimE, and vimF defective mutants all share the production of truncated forms of lipopolysaccharide. In contrast, 83K25 produced normal lipopolysaccharide, suggesting that PG534 affects the biogenesis of gingipains, but not lipopolysaccharide. Therefore, the function of PG534 is likely different from that of proteins shown to be involved in gingipain biogenesis: Por proteins, Sov, PG27, or Vim proteins. In Fig. 3, there appears to be a difference in the signal intensity of lipopolysaccharide bands; 83K3, 83K10, and 83K25 likely exhibited denser lipopolysaccharide bands than those of W83. The generation and/or the glycosylation of lipopolysaccharide might be facilitated by a defect of glycosylation in gingipains (Fig. 2a, lanes 2–4). In this study, we showed that PG534 is an outer membrane protein (Fig. 4).

The selleck inhibitor present study does not limit the function of the Cls1 backup system to acute low-pH stress. This study was supported in part by the Program to Disseminate Tenure Tracking System, MEXT, Japan (to RLO). R.L.O. and K.K. contributed equally to the work. “
“5′-Methylthioadenosine/S-adenosylhomocysteine nucleosidase (MTAN) plays crucial roles in the production of autoinducers and methionine metabolism. Putative genes encoding MTAN and AdoHcyase from Burkholderia

thailandensis were cloned and characterized. The Km values of MTAN for 5′-methylthioadenosine (MTA) and S-adenosylhomocysteine (SAH) were 19 and 58 μM, respectively. The catalytic efficiency of MTAN for SAH was only 0.004% of the value for MTA, indicating an almost complete substrate preference of MTAN for MTA. The results of autoinducer-2 assay of B. thailandensis and recombinants indicated that LuxS enzyme activity was lacking in Burkholderia species. Instead, AdoHcyase hydrolysed SAH directly to homocysteine and adenosine in the activated methyl cycle. Meanwhile, the Km value of AdoHcyase for SAH was determined to be 40 μM. Sequence analysis revealed that MTAN had much higher diversity than AdoHcyase, which likely contributes to its substrate preference for MTA. Furthermore, the Talazoparib purchase phylogenetic tree of MTAN sequences revealed that LuxS+ bacteria could be discriminated from LuxS− bacteria. These results suggested that the substrate preference of MTAN for MTA and SAH degradation

pathway evolved with the bacterial-activated methyl cycle. “
“The need for improved rapid diagnostic tests Adenosine triphosphate for tuberculosis disease has prompted interest in the volatile organic compounds (VOCs) emitted by Mycobacterium tuberculosis complex bacteria. We have

investigated VOCs emitted by Mycobacterium bovis BCG grown on Lowenstein–Jensen media using selected ion flow tube mass spectrometry and thermal desorption-gas chromatography-mass spectrometry. Compounds observed included dimethyl sulphide, 3-methyl-1-butanol, 2-methyl-1-propanol, butanone, 2-methyl-1-butanol, methyl 2-methylbutanoate, 2-phenylethanol and hydrogen sulphide. Changes in levels of acetaldehyde, methanol and ammonia were also observed. The compounds identified are not unique to M. bovis BCG, and further studies are needed to validate their diagnostic value. Investigations using an ultra-rapid gas chromatograph with a surface acoustic wave sensor (zNose) demonstrated the presence of 2-phenylethanol (PEA) in the headspace of cultures of M. bovis BCG and Mycobacterium smegmatis, when grown on Lowenstein–Jensen supplemented with glycerol. PEA is a reversible inhibitor of DNA synthesis. It is used during selective isolation of gram-positive bacteria and may also be used to inhibit mycobacterial growth. PEA production was observed to be dependent on growth of mycobacteria. Further study is required to elucidate the metabolic pathways involved and assess whether this compound is produced during in vivo growth of mycobacteria.

Group C streptococci (GCS) AZD2281 ic50 were found in porcine β-hemolytic GCSE strains and in bovine, porcine, and piscine α-hemolytic GCSD strains (Nomoto et al., 2004; Brandt & Spellerberg, 2009). Compared with those of other GCS members, little is known of the virulence factors of α-hemolytic GCSD. Within GCS, superantigenic exotoxins (seeH, seeI, seeL, and seeM) were characterized for the animal pathogenic species

Streptococcus equi ssp. equi, while S. equi ssp. zooepidemicus has been shown to possess seeL and seeM (Holden et al., 2009; Paillot et al., 2010). Chénier et al. (2008) and Brandt & Spellerberg (2009) reported that bovine α-hemolytic GCSD screening failed to reveal any superantigen genes. In the present study, GCSD fish isolates were revealed to be PCR negative for emm, speA, speB, speC, speM, smeZ,

and ssa when annealing structural gene sequence primers were used. This result indicated that either these genes did not exist within the isolates or that the isolates possessed BMS-907351 cost gene variants that could not be detected by the primers that had been designed based on S. pyogenes sequences. On the other hand, 28 isolates of fish GCSD, one isolate of pig GCSD, and three isolates of pig GCSE were found to contain the spegg gene. Previous studies revealed that only spegg was detected from the clinical isolates of β-hemolytic S. dysgalactiae ssp. equisimilis (Hashikawa et al., 2004; Ikebe et al., 2004; Zhao et al., 2007), but not from α-hemolytic S. dysgalactiae ssp. dysgalactiae (Zhao et al., 2007). The spegg gene of β-hemolytic S. dysgalactiae was found to have properties similar to those of superantigens, and it is likely that the spegg genes play a pathogenic role in animals through having mitogenic activity toward bovine peripheral blood mononuclear cells and selectively activating bovine T cells bearing Vβ1,10 and Vβ4 (Zhao et al., 2007).

In the present study, we observed size variation of the spegg locus in positive fish and pig strains. IS981SC was confirmed to be inserted into the spegg locus of positive fish isolates of GCSD by PCR and sequencing of spegg genes. Dichloromethane dehalogenase The insertion site of IS981SC was identical in all of the investigated isolates. Another interesting feature is the existence of the IS981SC–IS1161 hybrid IS element inserted into the spegg locus of two fish isolates of GCSD collected from Malaysia. All fish isolates and one isolate of pig GCSD carried the IS981SC–IS1161 hybrid IS-like element, except for other pig GCSD and GCSE. This finding suggested that the IS981SC–IS1161 hybrid IS-like element prevailed in fish GCSD isolates collected in various Asian countries. IS981 was a widespread insertion element in Lactococcus lactis, Streptococcus thermophilus (Bourgoin et al., 1999; Bongers et al., 2003), S. iniae (Lowe et al., 2007), and fish isolates of GCSD. IS1161 was also a widespread insertion element in S.

5 mM imidazole, 0.5 M NaCl, 20 mM Tris-HCl, pH 7.9), and then sonicated. After centrifugation at 10 000 g for 10 min at 4 °C, the insoluble fraction was solubilized in the binding buffer with 6 M urea during an overnight incubation on ice. The His(6)-tagged XrvB protein, which was included in the soluble fraction,

was purified using a His-Bind Resin column (Merk). The target plasmid, which is a pBluescript II SK+ derivative with the Selleckchem BMS 354825 putative promoter region of hrpG (−686 to +56) amplified by PCR (Table S2 for primers), was digested with SspI, PvuII and BamHI, and incubated with the purified His(6)-tagged XrvB for 15 min at 37 °C in the reaction buffer described by Soutourina et al. (1999). After the reaction, the samples were loaded onto a 1% TBE-agarose gel, followed by staining with ethidium bromide. First, we examined the expression this website of xrvB under culture conditions.

Semi-qRT-PCR analysis using total RNA extracted from bacteria after a 16-h incubation in the hrp-inducing (XOM2) or the hrp-noninducing medium (NBY) as templates revealed that xrvB is expressed under both conditions (data not shown). To investigate the involvement of XrvB in the expression of hrp regulatory gene hrpG, we transformed MAFF/XrvB∷Km with a plasmid that harbored the GUS gene preceded by the hrpG promoter (pHMHrpG∷GUS) (Tsuge et al., 2006). The transformant was incubated in XOM2 for 16 h, and then GUS activity was measured. GUS activity was approximately two times higher in the mutant strain than in the parental strain (Table 1), indicating higher hrpG

expression in MAFF/XrvB∷Km. The expression level of a phosphoglucose isomerase gene (pgi) in the mutant, which is independent of the hrp-regulatory system (Tsuge et al., 2004, 2006) and was used as a control, was similar to that in the wild type. Semi-qRT-PCR using bacterial total RNA extracted after a 16-h incubation in XOM2 revealed that more hrpG transcript was produced in MAFF/XrvB∷Km with the empty vector pHM1 than in the wild-type derivative and that the hrpG transcript NADPH-cytochrome-c2 reductase was reduced by the introduction of the complementary plasmid pHMXrvB harboring a PCR-amplified 550-bp fragment containing xrvB and the preceding putative promoter region (−93 to −1) (Fig. 1). The results suggest that, unlike another H-NS protein, XrvA, XrvB is involved in the negative regulation of hrpG expression. We also investigated the expression of another hrp-regulatory gene, hrpX, which is regulated by HrpG and regulates other hrp genes and T3S protein genes (Furutani et al., 2006, 2009; Wengelnik & Bonas, 1996), in MAFF/XrvB∷Km. When MAFF/XrvB∷Km with pHMHrpX∷GUS, harboring the GUS gene controlled by the hrpX promoter (Tsuge et al., 2006), was incubated in XOM2, GUS activity was higher than that for the wild-type derivative, indicating that the expression of hrpX also increases from the lack of XrvB (Table 1).

Complete resolution of the side effect with efficacy has been reported in 72% and 86% of patients treated in this way.[49, 53] Thiopurine-induced pancreatitis occurs in approximately 4% of patients[38] Quizartinib nmr and has been considered a strict contraindication to subsequent treatment with an alternative thiopurine.[75] Three small retrospective case series (< 10 patients each) have examined rechallenging patients with 6MP after AZA-induced pancreatitis, with overall success rates varying from 29% to 100%.[76-78] There are no data regarding the use of allopurinol to overcome thiopurine-induced pancreatitis. Thus, if an adverse event occurs on AZA, it is worthwhile to have a trial of 6MP (initially at low dose) and, if that

fails, then the addition of low-dose allopurinol with 6MP, but only if a recurrence of the adverse event would be tolerated by the patient. If the adverse event occurs on 6MP

as the initial drug, anecdotal experience suggests a trial of AZA may also be worthwhile, followed by combination therapy if unsuccessful. Thiopurines have been the mainstay CYC202 cost of treatment in IBD for many years and have also been extensively used in various rheumatological conditions. With the ability to measure thiopurine metabolites, important strides have been made in the IBD world to improve efficacy and optimize dosing of thiopurines, including in combination with low-dose allopurinol. In IBD, a therapeutic window of 230–260 to 450 pmol/10 × 88 RBCs has been established. Above this level, there are significantly

increased risks of side effects, including myelotoxicity, without any gain in efficacy. Flavopiridol (Alvocidib) Studies in IBD have shown that over 30% of patients who would previously have been declared ‘refractory’ or ‘intolerant’ to thiopurines are now otherwise able to remain on monotherapy with improved clinical outcomes. Much of this work has yet to be undertaken within the rheumatology community. While the upper limit of 6TGN is a relevant threshold to apply in rheumatology due to the risk of universal side effects, the minimum effective 6TGN level is yet to be determined in different rheumatological conditions. The addition of allopurinol should also improve thiopurine metabolic profiles in rheumatology patients who are thiopurine shunters. It may be prudent for a rheumatology patient failing thiopurines to have their metabolites checked prior to drug cessation. “
“Hydrogen sulfide (H2S) is a gaseous mediator produced in the body. In experimental models, endogenously produced H2S has been shown to have pro-inflammatory effects. The aim of this study was to investigate whether H2S is present in three common rheumatic diseases, rheumatoid arthritis (RA), gout and osteoarthritis (OA) and to determine if H2S levels correlate with disease activity. Patients with RA, gout, OA, and healthy controls (n = 30 each) were recruited. Plasma and where possible, synovial fluid (SF), were obtained.

Furthermore, this association was not significant in the small (n = 82) group of high frequency, high duration (>6 trips per year and >5 d per trip) travelers. All groups of travelers, except for the high frequency, high duration group, had lower blood pressure than those who did not travel

at all. There was a considerable dose-response trend with frequent (>6 times/y) international travelers having an OR for hypertension of 0.34 (95% CI = 0.17–0.61). Self-reported systolic and diastolic blood pressure was quantified and if either (systolic or diastolic) met these criteria, the subject was classified as hypertensive. Several negative associations were observed between frequency and duration of travel and self-reported measures

INK 128 in vitro of health status and lifestyle choices. Although there was one exception, the high frequency, high duration LDK378 manufacturer cohort did not show any significance for any of the health measures because this group contained a small number of business travelers (n = 82); statistically, it may not have been a large enough sample size to offset the zero travel group it was compared to. All other groups of international business travelers had a higher OR of alcohol consumption over the recommended limit4 (1–2 drink equivalents per day for men and 1 per day for women), with the high frequency, low duration travel group having the highest OR of 1.63 (95% CI = 1.06–2.05). Those who traveled less frequently and had low travel duration had an OR 1.24 (95% CI = 1.09–1.41) of failing to get the recommended amount of sleep (8 h per night; average of 7–9 h for adults),5 as

compared to their non-traveling peers; the high frequency travel group with the same duration showed an even greater only OR of 1.56 (95% CI = 1.04–2.43) having a sleep deficit. International business travelers also reported a lack of confidence in their continued ability to keep up with the pace of work; there was also a notable dose response observed with the highest odds observed among the high frequency, short duration group OR 2.32 (95% CI = 1.45–3.55). Again, frequency of travel, as opposed to duration of travel, was the most significant driver associated with these adverse health effects. A wide variety of health outcomes and healthy behaviors were similar between all traveler subgroups and the control group. Self-reported overall health status and specific conditions such as back pain and migraine headaches were no different between groups. Healthy behaviors such as adequate physical activity (3–5X/wk 30 min sessions) and adherence to a low-fat diet were similar between groups. Satisfaction with life, work, and physical health status (eg, inconsistent physical activity and high total cholesterol levels) did not differ significantly between groups (Travelers vs non-travelers). Little is known about the impact of frequent or prolonged travel on the perceived health status, lifestyle choices, and personal risks of travelers.

Methods  A survey tool was developed based on previous research, validated to ensure reliability and accuracy, and administered to approximately 70 nurses on the surgery wards. Key findings  Response rates for the pre and post surveys were 75% and 67% respectively. Nurses indicated that the quality of pharmacy service improved significantly from pre to post survey (85% versus 95%; P < 0.0001). There was a statistically significant

increase in positive responses to seven out of eight statements such as accessibility of pharmacists, timely responses to drug-related questions, and timely delivery of unit doses and intravenous admixtures. Cabozantinib supplier Almost all statements about nursing staff expectations showed increases in agreement. At least 85% of nurses indicated their expectations had been met or exceeded for all but one clinical pharmacy service. A higher proportion of nurses in the post survey felt that clinical pharmacists positively impact on their roles and responsibilities as a nurse. Comments from nurses indicated enthusiastic support for clinical pharmacy services. Conclusions  A survey tool to assess the quality of pharmacy services in the hospital setting has

been developed, validated, and distributed. A high level of nurses’ satisfaction with the provision of new clinical pharmacy services on general surgery/gastrointestinal surgery wards was demonstrated. Nursing staff were more aware of the responsibilities Akt inhibitor of clinical pharmacists and how the clinical pharmacist role could assist them in their own nursing practice. The survey may be useful for other wards and other institutions to measure satisfaction with pharmacy

services. “
“Pharmacists working collaboratively with general practitioners (GPs) in primary-care settings can improve patient outcomes; however, there are challenges to the implementation of collaborative services. A possible solution is the co-location of pharmacists within general practice clinics. To elicit the views of GPs and pharmacists on the integration of pharmacists into general practice in Histamine H2 receptor Australia. Semi-structured, individual interviews with a sample of 11 GPs and 16 pharmacists. Four major themes emerged: the current GP–pharmacist relationship; the role of the general practice pharmacist; the pros and cons of integration; and the barriers to and facilitators for integration. Most participants had experienced positive inter-professional relationships, though there were limitations in the collaborative services currently provided. Various methods of integration were discussed, including the co-location of pharmacists within practices. The potential roles for practice pharmacists were deemed to be multifaceted and in some cases allowed for role expansion.