Can parents believe websites' information about methylphenidate's side effects?

BACKGROUND: Attention deficit and hyperactivity disorder (ADHD) is one of the most common behavioural disorders, affecting around 5% of the global population. Methylphenidate is recommended as the first-line drug treatment for ADHD for children over the age of 5 in the UK. It can have many side effects and it is important that families are well informed. Other than their healthcare professionals and friends, the major information source for families is the internet. AIMS: To evaluate the validity of online information regarding the adverse effects of methylphenidate. METHODS: Side-effects of methylphenidate hydrochloride listed in the British National Formulary for Children (BNFC) were taken as the 'gold standard' and compared with online websites for accuracy. The first 10 websites found on each of nine different search engines were used as comparators. RESULTS: From the 90 hits, 10 top hits found in each of 9 search engines, 25 unique websites were identified. A quarter (six sites; 24%) documented only side-effects that all appeared in the BNFC. Three quarters (19 websites; 76%) had at least one side-effect that did not appear in the BNFC; with six websites documenting more than five side-effects not found in the BNFC. CONCLUSIONS: Methylphenidate's frequent use makes it important that the general public are provided with accurate, reliable and easily accessible information. Most websites have dependable quality information on side effects, but several seem to list excessive side-effects.

HIV resistance testing in the USA--a model for the application of pharmacogenomics in the clinical setting.

Although there is debate about how and when the medical community will readily adopt pharmacogenomics into clinical practice, HIV genotyping has become an integral part of AIDS patient management in the USA since 1996. Genotyping for HIV-1 drug resistance serves as a paradigm for the way pharmacogenomics is likely to be introduced into patient care. This review discusses the unique role that HIV-1 genotype testing plays in identifying resistance in patients and how that information is used to modify therapy selection and impact the progression of disease. In addition, the important issues relating to reimbursement and the cost-effectiveness of genotyping are also discussed.

Diagnostic value of detection of IgM antibodies to Helicobacter pylori.

This report describes the diagnostic value of anti-Helicobacter pylori IgM detection. Serum samples from 9043 symptomatic and asymptomatic individuals were evaluated with ELISA for the presence of anti-H. pylori IgG, IgM, and IgA. The specificity of detected IgM was confirmed by inhibition and cross-reactivity assays. Treatment of IgM-positive specimens with 1% 2-mercaptoethanol resulted in approximately 90% inhibition. Our data suggest a low level of cross-reactivity (5%) between H. pylori and four different enteropathogenic bacteria tested. The specificity of anti-H. pylori IgM was also demonstrated by Western blot and linearity studies. Data show that the detected IgM is highly specific. Western blot analysis revealed a variable IgM response to H. pylori antigens among patients, with the most reactive antigenic fractions being in the range of 55- to 100-kDa. Overall, the data confirm the diagnostic value of anti-H. pylori IgM detection. The prevalence of IgM antibodies to H. pylori in tested sera was significantly higher in symptomatic patients (10.4%) than in asymptomatic individuals (1.1%). Likewise, the percentage of sera positive for IgM alone was higher in symptomatic than in asymptomatic groups (3.8 vs 0.22%). About 5% of sera were positive only for IgA. We concluded that ELISA can be used for the detection of specific IgM to H. pylori and that the presence or absence of IgM antibodies to H. pylori may reflect whether or not an acute infection exists.