However, A. salmonicida ATCC 27013 and A. hydrophila ATCC 13136 were the ones showing the highest activity, the former exhibiting the best performance (Trelles et al., 2011). The importance of the presence of phosphate in the reaction for nucleoside phosphorolysis by pyrimidine nucleoside phosphorylase (PyNP) had been previously reported (Utagawa, 1999). Preliminary tests were Rucaparib chemical structure performed to optimize different phosphate concentrations, pH values,

and stirring speed. The results obtained were not significantly different (data not shown). Therefore, we continued using 30 mM potassium phosphate buffer at pH 7 and 200 r.p.m. as standard conditions. PyNP enzyme (EC 2.4.2.2), which is responsible for transglycosylation reaction, remains active at 60 °C (Trelles et al., 2005). Biosynthesis was performed at two temperatures (30 and 60 °C) using thymidine and 5-fluorouracil to evaluate the effect of other enzymes on substrates and products. When the reaction was carried out at 60 °C, 1.5 mM of 5-fluoro-2′-deoxyuridine were obtained in 1 h in the presence of secondary products, which could be due to the effect of enzymes called dehalogenases that have been found in some mesophylic microorganisms, whose optimum temperature is between 45 and 60 °C (Liu et al., 1994). When the reaction temperature was 30 °C, 2.0 mM of 5-fluoro-2′-deoxyuridine were gained in 1 h without secondary products, while at 3 h,

the amount of 5-fluoro-2′-deoxyuridine was not significantly modified (2.1 mM; Fig. 2). The highest conversion Smad inhibitor for floxuridine biosynthesis was achieved

at 30 °C. Biosynthesis of 5-fluorouridine, 2′-deoxyuridine, and 2′,3′-dideoxyuridine counterpart by A. salmonicida ATCC 27013 was evaluated PAK5 using different nucleosides as sugar donors. These assays were performed at 30 °C and pH 7 with excess of thymidine, uridine, 2′-deoxyuridine, 2′,3′-dideoxyuridine and 2′-deoxycytidine to prevent the reaction from being limited by the production of ribose, 2′-deoxy- or 2′,3′-dideoxyribose-1-phosphate (depending on the nucleoside donor used). Aeromonas salmonicida ATCC 27013 showed activity on uridine, thymidine, 2′-deoxyuridine and 2′-deoxycytidine. When 2′,3′-dideoxyuridine was assayed, no phosphorolytic activity was detected under the conditions tested. This microorganism was able to produce 1.0 mM (40%) of 5-fluorouridine when uridine was used. Biosynthesis of 5-fluoro-2′-deoxyuridine was 2.0 mM (80%) in 1 h when thymidine and 2′-deoxyuridine were evaluated as sugar donors and 1.9 mM (76%) when 2′-deoxycytidine was used (Table 1). Owing to the fact that higher conversion was obtained when thymidine and 2′-deoxyuridine were used, it was decided to continue working with thymidine (PyNP’s natural substrate) because it reduces the costs of a subsequent scale-up of this bioprocess. It has been widely reported that transglycosylation reactions are reversible (Pugmire & Ealich, 2002).

1B). This could be caused by the use of different reporter genes (nuclear-targeted β-galactosidase

in the previous study vs. cytosolic EGFP in the current study) and the different mechanism by which genes were delivered to neurons. The efficiency of DNA entry into cells is also compromised in the IUE method, as a trade-off in preventing electroporation-induced damage to the embryo. Nevertheless, we found that transfected Purkinje BI 2536 price cells could efficiently coexpress at least three transgenes (Figs 3 and 4). This situation is quite advantageous for electrophysiological analyses, because recordings from transfected and neighboring non-transfected (control) neurons can be easily compared. In addition, EGFP introduced at E11.5 remained highly expressed 1 month after birth (Fig. 2) and was maintained at least until P90 (data not shown). Immature Purkinje cells originally have a fusiform shape with a few dendrites. Purkinje cells lose these primitive dendrites almost completely GS-1101 manufacturer by P3–P4 in rats (Sotelo & Dusart, 2009). As the virus-mediated overexpression of human RORα1 accelerates this process in wild-type and restores it in staggerer cerebellum organotypic slice cultures, RORα1 was proposed to play a crucial role in the regression of primitive dendritic branches (Boukhtouche et al., 2006). In the present study, we showed that the IUE-mediated overexpression of dominant-negative RORα1 in Purkinje cells in vivo could recapitulate the morphological

abnormalities observed in staggerer mice (Fig. 5). These results not only support but also extend the hypothesis that cell-autonomous activities of RORα1 in Purkinje cells are responsible for the process controlling the regression of primitive dendrites in vivo. Notably, because of the limited migration of Purkinje cells in organotypic slice cultures, the migration defect of staggerer Purkinje cells was not analysed previously (Boukhtouche et al., 2006), and it remains unclear whether the regressive phase begins during or after the migration of Purkinje cells to their final domains. We observed that some Purkinje cells expressing dominant-negative RORα1 did not reach the Purkinje cell

layer in vivo, indicating that RORα1 regulates not Clomifene only the regression of dendrites but also the migration process of Purkinje cells. It is unclear why the phenotypes of Purkinje cells expressing dominant-negative RORα1 were variable, but small differences in transgene expression levels and/or the developmental stage of the transfected Purkinje cell progenitors could have contributed to the variation. A more robust suppression of RORα1 gene expression by IUE-based RNA interference (Matsuda & Cepko, 2004) will help clarify the role of RORα1 in the early events during Purkinje-cell development. Future studies taking advantage of IUE to enable gene expression from the early postmitotic stage will facilitate studies on the mechanisms of Purkinje cell development and migration.

One patient (patient 4; Fig. 1) had 25 negative PCR results

over a period of 71 months in the intervals between three acute episodes of visceral leishmaniasis, but after the third episode had continuous positive blood PCR results (19 positive tests over 54 months). Therefore, our PCR assay, with a total of 313 positive tests out of 324, showed that parasites persisted and circulated in the PB even during relapse-free periods. These positive results cannot be considered as falsely positive, for reasons that have been explained previously [4]. Moreover, they were confirmed by in vitro positive culture of Leishmania in 38 of 133 PB and BM samples (see in particular patient 3 in Fig. 1), attesting to the presence of viable circulating parasites in these patients. The PCR assay used here in routine practice targeted nuclear FK506 order (ribosomal) CP-673451 cost DNA, and hence could not identify the healthy carriers of Leishmania who exist in populations living in areas endemic for Leishmania [6–8]. We completed this study by retrospectively performing a quantitative real-time ‘ultrasensitive’ PCR assay, targeting the highly repetitive kinetoplast minicircle [7], on 71 PB samples collected during the study period from three patients (7, 20 and 44 samples, respectively, were tested per patient). All the samples that had been tested positive with the routine PCR assay were found to be positive when tested with this second assay, thus confirming

the first set of data. Moreover, this method allowed quantification of the parasitaemia, which was found to be much higher (10- to 100-fold) during secondary visceral leishmaniasis episodes than during relapse-free periods (data not shown). Only one sample (from patient 2; Fig. 1) that was negative

using the first test was found to be positive in the second PCR assay, but it had the lowest parasite concentration detected of all. Therefore, relapsing clinical episodes coincided with marked increases in the concentration of circulating parasites, which varied depending on the patient, whereas in relapse-free periods circulating parasite concentrations were lower, but remained above the detection limit of our routine PCR assay, estimated to be five parasites per mL of PB [6]. These results support the findings Chloroambucil of the studies by Bossolasco et al. [9] and Mary et al. [7], who estimated the threshold above which visceral leishmaniasis symptoms developed to be 10 and 42 parasites/mL, respectively. Our data demonstrate that these patients coinfected with HIV-1 and Leishmania never cleared their leishmaniasis, presenting episodes of clinical, oligosymptomatic visceral leishmaniasis and asymptomatic periods. Parasitological treatment failure was observed in all cases, as Leishmania circulated in the PB almost constantly for several years. It is noteworthy that no in vitro resistance to amphotericin B was ever detected in the parasites isolated from these patients [10].

8. Cells were grown in 100-mL shake cultures in a shaking water bath (Shaker GFL, Burgwedel, Germany) at 200 r.p.m. in a methane–air–CO2 (9 : 9 : 2) atmosphere. Compounds were added to exponentially growing cells. Cultures were incubated in the presence of different organic solvents for 3 h. Cells were then harvested, washed twice with potassium phosphate buffer (50 mM, pH 7.0)

and stored at −20 °C before use. The toxicity of the organic compounds was quantified by the effective concentration 50% (EC50), i.e. the concentration that causes a 50% inhibition Selleckchem KPT-330 of bacterial growth as described earlier by Heipieper et al. (1995). Growth inhibition caused by the toxic compounds was measured by comparing the differences in the growth rate μ (h−1) between intoxicated cultures (μtoxin) with that of control cultures

(μcontrol). The growth inhibition of different concentrations of the organic compounds was defined as the percentage of the growth rates of intoxicated cultures and that of control cultures without toxin addition. The lipids were extracted with chloroform/methanol/water as described by Bligh & Dyer (1959). Fatty acid methyl esters (FAME) were prepared by incubation for 15 min at 95 °C in boron trifluoride/methanol applying the method of Morrison & Smith (1964). FAME were extracted with hexane. Analysis of FAME in hexane was performed using a quadruple http://www.selleckchem.com/products/gsk2126458.html GC System (HP5890, Hewlett & Packard, Palo Alto, CA) equipped with a split/splitless injector and a FID. A CP-Sil

88 capillary column (Chrompack, Middelburg, the Netherlands; length, 50 m; inner diameter, 0.25 mm; 0.25 μm film) was used for the separation of the FAME. GC conditions were: injector temperature was held at 240 °C and detector temperature was held at 270 °C. The injection was splitless, and the carrier gas was He at a flow of 2 mL min−1. The temperature program was: 40 °C, 2-min isothermal; 8 °C min−1 to 220 °C; and 15-min isothermal at 220 °C. The peak areas of the FAMEs were used to determine their relative amounts. The fatty acids were identified by GC and co-injection of authentic reference compounds obtained from Supelco (Bellefonte, PA). The degree of saturation of the membrane fatty acids was defined as the ratio between the saturated fatty acid (C16:0) and the unsaturated fatty acids (C16:1Δ9trans, C16:1Δ9cis, C16:1Δ10cis, C16:1Δ11cis) present in Y27632 these bacteria (Guckert et al., 1991). The genomic DNA of the tested stains was isolated using the DNeasy Tissue Kit (Qiagen, Hilden, Germany) following the manufacturer’s instructions. From the amino acid sequences, primer sets were designed from the cti consensus sequences from Pseudomonas fluorescens Pf-5 [YP_260763]; P. fluorescens PfO-1 [YP_348835]; Pseudomonas psychrophila [BAB41104]; Pseudomonas putida KT2440 [NP_744525]; Pseudomonas syringae pv. phaseolicola 1448A [YP_274814]; P. syringae pv. tomato str. DC3000 [NP_792539]); and M. capsulatus Bath (YP_114244).

The study protocol was approved by the Danish Ethics Committee on clinical research, and written informed consent was obtained from all participants. As most variables, even after log transformation, were not normally distributed, nonparametric statistics were applied; thus, data are presented as medians and interquartile ranges (IQRs). Comparisons between controls and HIV-positive patients were performed using the Mann–Whitney test (unpaired data), and

comparisons between treatment-naïve and treatment-experienced patients were performed using the Wilcoxon signed rank test (paired data). The correlations between variables were determined using Spearman’s correlation coefficient. A value of P < 0.05 was considered significant. The baseline characteristics of selleck chemical the patient and control groups selleck are shown in Table 1. During the first 3 months, 11 patients were treated with boosted indinavir, three of whom were changed to boosted lopinavir because of side effects. One patient left the study because of side effects. Nine patients received boosted lopinavir throughout the first period. One patient was unwilling to change therapy to efavirenz

and was excluded from the second part of the study (Fig. 1). After 3 months, two-thirds of the patients had viral loads (VLs) below 50 copies/mL, and after 6 months all 18 had a VL below this value. CD4 counts G protein-coupled receptor kinase increased from a median of 160 cells/μL (IQR 125–200 cells/μL) to 220 cells/μL (IQR 160–300 cells/μL) after 3 months of treatment, and to 215 cells/μL (IQR 180–280 cells/μL) after 6 months of treatment. Controls had a median CD4 count of 770 cells/μL (IQR 730–900 cells/μL). At entry and throughout the study period, HIV-positive patients had lower haemoglobin and a lower total leucocyte count compared with controls. Platelet numbers did not differ between patients and controls (Table 2). Total cholesterol, triglyceride, and glucose levels were

normal at baseline (Table 2). During treatment with both a PI and efavirenz, total cholesterol increased significantly compared with baseline. Similarly, PI treatment led to significantly higher triglyceride levels. However, this was negated during treatment with efavirenz, and lowered again to a level comparable to that of the controls (1.47 vs. 0.83 mmol/L, respectively; P = 0.15). Body mass index (BMI) and systolic blood pressure were normal at baseline and did not change during the treatment period. Endothelial function was studied in several ways (Table 3). HIV-positive patients had significantly lower FMD at baseline compared with controls (108 vs. 111%, respectively; P = 0.043) (Table 3). After 3 months of PI-containing HAART, FMD normalized (111%) and did not change significantly after switching from a PI to efavirenz (111 vs. 109% in HIV-positive patients treated with PI vs.

tuberculosis WhiB1 does not respond to O2, which further supports the notion that SpiA is involved in the whcA-mediated stress response pathway. Collectively, our data suggest that the WhcA protein from C. glutamicum may function in a similar but unique fashion. Under normal growth conditions, SpiA may reduce apo-WhcA (S–S) to its holo form (Fe–S). During this process, the WhcA protein attains its Fe–S cluster, gains its ability to bind to DNA, and represses genes involved in oxidative stress response. However, under conditions of oxidative stress, the WhcA protein loses its Fe–S cluster, leading to the loss of its DNA-binding ability. Nevertheless,

FK228 supplier the DNA-binding activity of the WhcA protein has not yet been shown. To summarize, a regulatory model involving WhcA and SpiA is shown in Fig. 4. This work was supported by a National

Research Foundation grant (to H.-S. Lee) from the Korean Ministry of Education, Science and Technology (MEST 2010-0021994 Program of the NRF). “
“The metal-exporting systems CusCFBA of Escherichia coli and GesABC of Salmonella are resistance-nodulation-division (RND)-type DAPT price multiprotein systems responsible for detoxification during metal stress. In this study, the substrate range was determined for each metal transport system and possible amino acid residues important in substrate specificity were identified. The Ges system, previously identified as a gold-efflux system, conferred resistance to the greatest number and variety of organic chemicals including chloramphenicol, not recognized previously as a substrate. Phylogenetic analysis showed that GesB is most closely related to a class of RND transporters including MexF that have been shown to be responsible for exporting fluoroquinolones, chloramphenicol, and biocides. However, many of the closest homologs of GesABC appear to play a role in metal resistance judging from the genetic context. In contrast, CusCFBA belongs to a distinct family

of RND-type monovalent metal-exporter systems containing a number O-methylated flavonoid of essential metal-binding methionines, resulting in a much narrower substrate range. Efflux is the most common widespread mechanism to regulate the concentration of a myriad of substances in all organisms. The substrate specificities of transporters vary widely and the mechanisms governing substrate recognition and subsequent transport are not well understood. Multiprotein complexes of the resistance-nodulation-division (RND) family in Gram-negative bacteria are both of medical and environmental importance. Within the genome of Escherichia coli, there are seven genes belonging to the RND family; acrB, acrD, acrF, cusA, mdtB, mdtC, and mdtF. Together with a membrane fusion protein (MFP) and an outer membrane factor (OMF), these inner membrane proteins form a complex responsible for the extrusion of a large variety of substrates mainly from the periplasm in a proton-gradient-dependent manner. The best-characterized member in E.

asiaticum to mimic that in F. graminearum by swapping the promoters. Additionally, the different functional requirement of MAT1-1-1

and MAT1-1-3 for sexual development between homothallic F. graminearum and S. macrospora implies that some of the regulatory networks controlled by MAT proteins may not be Roxadustat conserved among filamentous ascomycetes. This research was supported by a grant from the Next-Generation BioGreen 21 Program (No. PJ008210), Rural Development Administration, Republic of Korea, and by the Agricultural Research Center program of the Ministry for Food, Agriculture, Forestry and Fisheries, Republic of Korea. “
“We report the enhanced bactericidal activity of ofloxacin in drug-containing Eudragit E100® dispersions (EuCl-OFX) against Pseudomonas aeruginosa and Seliciclib chemical structure the effect of the cationic polymer on bacterial membrane. Organisms treated

with EuCl-OFX showed changes in cell morphology, altered outer membrane (OM) and cytoplasm with low electrodensity areas. Zeta potential of bacterial surface was shifted to positive. Sensitization to lytic agents was also observed. A profound effect on bacterial size, granularity and membrane depolarization was found by flow cytometry. Cultures exposed to drug-free polymer also showed some damaged bacterial membranes, but there was no significant cell death. Inhibition of P. aeruginosa by EuCl-OFX may involve surface effect and, to some extent, permeation effect. The cationic polymer act to mitigate the electronegativity of cell surface in the process MYO10 of disorganizing the OM, rendering it more permeable to antibiotic. In addition, cytoplasmic membrane depolarization turns bacterial cell more vulnerable. The effects on membranes combined with the mechanism of action of quinolone explain the improved bactericidal action

exhibited by EuCl-OFX. The behavior described for Eudragit E100® against P. aeruginosa may be a useful tool to broaden the spectrum of antibiotics whose clinical use is limited by the impermeability of the bacterial OM. Infections caused by Pseudomonas aeruginosa are difficult to treat due to the intrinsic resistance of this microorganism to multiple classes of antimicrobial agents and to the ability to acquire induced resistance during therapy (Aloush et al., 2006; Bertino, 2009; Giamarellou, 2010). Strategies devised to reduce microbial multiresistance include control measures for the use of antibiotics, detection of genetic resistance mechanisms, a search for new synthetic or natural substances with antimicrobial activity or those contributing to enhancing the action of known antibiotics as well as the development of new strategies of drug delivery (Wright, 2010; Moellering, 2011). The resistance of P. aeruginosa to antibiotics is primarily attributed to reduced outer membrane (OM) permeability (Nikaido, 1989; Hancock, 1998; Lambert, 2002). Strategies to minimize the low OM-permeability of P.

Sera were coagulated MK-8669 nmr overnight at 4 °C, and the clear supernatant was used for Western blotting. For this, cultures in 2 mL of M17 media were grown to an OD546 nm of 0.6–0.8, followed by induction for 90 min with either 20 μM to 3 mM CuSO4, 20 μM AgNO3 or CdSO4, 200 μM each of ZnSO4, FeSO4, NiCl2, CoCl2, nitrosoglutathione or H2O2, and 100 μM of 4-nitroquinoline-1-oxide. Cell lysates were prepared by centrifuging the cultures and treating the cell pellets with 50 μL of 10 mg mL−1 lysozyme, 1 mM EDTA and 10 mM Tris-Cl, pH 8, for 30 min at 37 °C. 10 μL of 1 mg mL−1 DNaseI in 100 mM MgCl2 was added and incubation was continued for 10 min at 25 °C. Cell debris was removed by centrifugation for 5 min at 12 000 g.

Protein concentrations in the supernatants were determined using the BioRad protein assay and 50 μg of protein resolved by electrophoresis on 12% SDS polyacrylamide

gels. Western blots were prepared as described previously (Towbin et al., 1979), using a horseradish peroxidase-coupled goat anti-rat IgG secondary antibody (Santa Cruz). Bands were visualized by chemiluminescence using 100 mM Tris-Cl, pH 8.5, 1.25 mM 3-aminophtalhydrazide, 0.2 mM p-coumaric acid and 0.01% H2O2. Chemiluminescence signals were captured using a Fuji LAS-1000 imaging system (Fuji Photo Film, Tokyo, Japan). The following commercial crystallization screens were used to look for initial crystallization conditions: Screen I and II (Hampton RGFP966 clinical trial Research), JCSG (Jena Bioscience) and PACT (Qiagen GmbH, Hilden, Germany). Flat-bottomed multi-subwell plates (Greiner, Langenthal, Switzerland) were used to set up sitting drop vapor-diffusion experiments by mixing 1 μL of 10 mg mL−1 YahD solution with 1 μL of screening solution and incubating at 18 °C. Initial conditions that yielded crystals were optimized by hanging drop vapor diffusion crystallization. Needle-shaped crystals were grown by mixing 1.5 μL of protein solution with 1 μL of well solution containing 37.5% polyethylene glycol 3350 and 150 mM of Na-dl-malate, pH 7.0. Crystals Tenoxicam grew to 50 μm in the longest direction within 3 weeks. For data collection, crystals were flash-frozen in liquid nitrogen

without the addition of a cryoprotectant. The crystals belonged to the orthorhombic space group P212121, with unit cell dimensions of a=40.67 Å, b=79.07 Å and c=130.03 Å. X-ray diffraction data were collected from a single crystal at beam line BL 14.1 at BESSY, Berlin, at 100 K and 0.918 Å wavelength. The data were integrated, reduced and scaled using XDS (Kabsch, 1993), resulting in a final data set that was fully complete at 1.88 Å resolution. A search model was built using the ccp4 suite program chainsaw (Stein, 2008), using the atomic coordinates of one monomer of the structure of the Bacillus cereus carboxylesterase (PDB accession 2HLI), which shares 32% amino acid identity with YahD. The sequence alignment of YahD to the B.

However, individual circumstances vary, and intravenous intrapartum zidovudine may be considered

as one of a number of maternal intrapartum ART options for women with VLs > 50 HIV RNA copies/mL who present in labour, or with ROMs or who are admitted for planned CS provided this does not delay other interventions. The evidence for the efficacy of intravenous zidovudine in the HAART era is generally poor. However, data from the French cohort support this practice for women on HAART with a VL >10 000 HIV RNA copies/mL. One could extrapolate that it may be of potential benefit in women presenting untreated in labour with an unknown current VL although this is not supported by the New York State data. Therefore in this setting, the Writing Group recommends the ICG-001 solubility dmso immediate administration of oral agents (see Section 5: Use of antiretroviral therapy in pregnancy) with intravenous zidovudine as an option. In women on HAART with a VL between 50 and <10 000 HIV RNA copies/mL, intravenous zidovudine can be considered. Continued oral dosing is a reasonable alternative. Intravenous zidovudine is not recommended for women taking HAART who have an undetectable VL at the time of labour or CS. Oral HAART

should be taken at the normal dosing interval. “
“As Gefitinib manufacturer a proactive diagnosis of diabetes mellitus (DM) may prevent the onset of severe complications, we used an oral glucose tolerance test (OGTT) to check for impaired glucose tolerance (IGT) and DM in patients with long-standing HIV infection

and long durations of exposure to antiretroviral drugs with normal fasting plasma glucose (FPG) levels. This was a cross-sectional, single-centre study. The homeostatic model assessment for insulin resistance (HOMA-IR) and 2-h post-load glucose levels were used to evaluate patients with known HIV-1 infection since before 1988 and no previous diagnosis of DM for whom data on hepatitis C virus (HCV) and hepatitis Parvulin B virus (HBV) infection were available. Eighty-four Caucasian patients [67 (80%) male; median age 45.7 years; range 43.8–49.1 years] were able to be evaluated; 65 (77%) were coinfected with HCV, and seven (8%) were coinfected with HBV. Median (interquartile range [IQR]) exposure to antiretrovirals was 12.8 (10.4–16.5) years. Fifteen patients (18%) had a previous AIDS-defining event, 64 (76%) had HIV RNA<50 copies/mL, and the median (IQR) CD4 count was 502 (327–628) cells/μL. The median [IQR] FPG was 81 mg/dL (4.5 mmol/L) [75–87 mg/dL (4.2–4.8 mmol/L)], and the median (IQR) HOMA-IR was 2.82 (1.89–4.02). After OGTT, nine patients (11%) were diagnosed as having IGT (6) or DM (3). A first multivariable analysis showed that CD4 cell count (P=0.038) and HOMA-IR (P=0.035) were associated with IGT or DM, but a second model including only the variables with a P-value of <0.2 in the univariable analysis (CD4 cell count, HBV coinfection, and HOMA-IR) found that only HOMA-IR independently predicted IGT or DM.

The setting for this study is a student health center at a major university. The clinical pharmacists at the study setting operate a pretravel health clinic at the Student Health Center, which serves roughly 30,000 students, and have prescriptive authority for vaccines and medications under physician protocol. The objectives of this study are to compare the recommendations for travel-related medications and vaccinations of the PCPs and the pharmacists specializing in pretravel health, and also compare medication and vaccination compliance between the two groups. This was a retrospective comparison of all patients seen

by a clinical pharmacist in a pharmacist-run travel clinic (PTC) or Saracatinib manufacturer by a PCP for international travel over a 1-year period in 2007 at a University Student Health Center. The PCPs included physicians, physician assistants, and nurse practitioners. Data were obtained from an

internal quality assurance study and included information regarding itinerary, pediatric, and adult vaccination history, medical history, and recommendation and receipt of medications and vaccines during each visit. Study subjects were college students in the age group of 18 years or older who self-referred for a travel consultation. The PTC providers spent approximately 5 to 10 minutes per patient researching destination risks prior to the check details visit and had a practice limited solely to pretravel health. In addition, the pharmacist providers had post-doctoral residency training that included travel medicine and all possessed the Certificate of Knowledge in Travel Health (CTH) from the ISTM. Visits in the PTC are structured to include thorough verbal counseling, printed patient education as well as provision of necessary pretravel medications and vaccines.

In comparison, none of the PCPs had a specialty practice or special training in travel medicine, nor were they required to complete such training for their clinical practice. Pharmacists and PCPs had access to the same travel medicine electronic resources. The decision to go to the PTC or a PCP was based on appointment Monoiodotyrosine availability and scheduling preference of the student, and both the PTC and the PCPs had 30-minute appointments. During the quality assurance process, vaccine and medication recommendations were assessed for consistency with recommendations and guidelines from the CDC. Where CDC guidelines were unclear, the World Health Organization and Travax Encompass (Shoreland Inc., Milwaukee, WI, USA) were consulted as secondary sources. Medical and pharmacy records were queried to determine if students received recommended medications and vaccines prior to travel.