albicans, which is responsible for at least 85% of human candidia

albicans, which is responsible for at least 85% of human candidiasis (Rein, 1997), and A. neuii, which is the second most frequent microorganism isolated in the Ison and Hay grade II and III vaginal microbiota represented by bacterial vaginosis-related organisms (Verhelst et al., 2005) and has been also associated with bacterial vaginosis in women with intrauterine devices (Chatwani & Amin-Hanjani, 1994). Four of the lactobacilli enhanced the adherence of C. albicans and A. neuii to HeLa cells, which contrasts with previous findings, where pathogen adhesion inhibition was reported (Boris et al.,

1998; Osset et al., 2001). This fact suggests that this trait is strain specific. In fact, although the formation of a ternary complex pathogen–Lactobacillus–epithelial cell might enhance the antimicrobial effect of the lactic acid generated INCB024360 purchase by this learn more bacteria (Boris et al., 1997; Coudeyras et al., 2008), these ternary complexes could also enhance the pathogen adhesion as has been observed with Lactobacillus acidophilus and the adhesion of C. albicans to

the contraceptive vaginal ring (Chassot et al., 2010). Adhesion of A. neuii was very responsive to the addition of the extracellular proteins of the lactobacilli in a strain-dependent fashion. Five of them enhanced adsorption of the pathogen, thus reproducing the results obtained when whole bacterial cells were used. It is worth mentioning the extraordinary adhesion increment brought about by L. gasseri Lv19, which could be due to the secretion of an aggregation-promoting factor–like protein. In fact, it has

already been described that these factors act as bridges between pathogen and human cells (Marcotte et al., 2004). This synergistic effect has also been described for some exopolysaccharides produced by several probiotic Adenosine bacteria, including L. rhamnosus GG (Ruas-Madiedo et al., 2006). Interestingly, the extracellular proteins of L. plantarum Li69 and of L. salivarius Lv72 markedly inhibited the adhesion of A. neuii to HeLa cells. Among the different proteins secreted by these strains, several contained LysM domains, such as two peptidoglycan-binding proteins of Lv72. The LysM domain has been proposed to be the attachment site of the autolysin AcmA of Lactococcus lactis to peptidoglycan (Steen et al., 2003). Recently, an extracellular chitin-binding protein from L. plantarum, containing this domain, has been shown to attach to the cell surface and to selective bind N-acetylglucosamine-containing polymers (Sánchez et al., 2010). Notably, the Lv19 extracellular proteome, which enhanced A. neuii adhesion, did not include any LysM-bearing polypeptides. It is thus conceivable that binding of the LysM-bearing proteins to the A. neuii surface might block the ligands that recognize the surface of the HeLa cells, as already shown for other proteins (Spurbeck & Arvidson, 2010).

albicans, which is responsible for at least 85% of human candidia

albicans, which is responsible for at least 85% of human candidiasis (Rein, 1997), and A. neuii, which is the second most frequent microorganism isolated in the Ison and Hay grade II and III vaginal microbiota represented by bacterial vaginosis-related organisms (Verhelst et al., 2005) and has been also associated with bacterial vaginosis in women with intrauterine devices (Chatwani & Amin-Hanjani, 1994). Four of the lactobacilli enhanced the adherence of C. albicans and A. neuii to HeLa cells, which contrasts with previous findings, where pathogen adhesion inhibition was reported (Boris et al.,

1998; Osset et al., 2001). This fact suggests that this trait is strain specific. In fact, although the formation of a ternary complex pathogen–Lactobacillus–epithelial cell might enhance the antimicrobial effect of the lactic acid generated http://www.selleckchem.com/products/r428.html by this PR-171 datasheet bacteria (Boris et al., 1997; Coudeyras et al., 2008), these ternary complexes could also enhance the pathogen adhesion as has been observed with Lactobacillus acidophilus and the adhesion of C. albicans to

the contraceptive vaginal ring (Chassot et al., 2010). Adhesion of A. neuii was very responsive to the addition of the extracellular proteins of the lactobacilli in a strain-dependent fashion. Five of them enhanced adsorption of the pathogen, thus reproducing the results obtained when whole bacterial cells were used. It is worth mentioning the extraordinary adhesion increment brought about by L. gasseri Lv19, which could be due to the secretion of an aggregation-promoting factor–like protein. In fact, it has

already been described that these factors act as bridges between pathogen and human cells (Marcotte et al., 2004). This synergistic effect has also been described for some exopolysaccharides produced by several probiotic this website bacteria, including L. rhamnosus GG (Ruas-Madiedo et al., 2006). Interestingly, the extracellular proteins of L. plantarum Li69 and of L. salivarius Lv72 markedly inhibited the adhesion of A. neuii to HeLa cells. Among the different proteins secreted by these strains, several contained LysM domains, such as two peptidoglycan-binding proteins of Lv72. The LysM domain has been proposed to be the attachment site of the autolysin AcmA of Lactococcus lactis to peptidoglycan (Steen et al., 2003). Recently, an extracellular chitin-binding protein from L. plantarum, containing this domain, has been shown to attach to the cell surface and to selective bind N-acetylglucosamine-containing polymers (Sánchez et al., 2010). Notably, the Lv19 extracellular proteome, which enhanced A. neuii adhesion, did not include any LysM-bearing polypeptides. It is thus conceivable that binding of the LysM-bearing proteins to the A. neuii surface might block the ligands that recognize the surface of the HeLa cells, as already shown for other proteins (Spurbeck & Arvidson, 2010).

We analysed the effects of two different inert surfaces, glass an

We analysed the effects of two different inert surfaces, glass and zirconia/silica, on the growth and antibiotic production in Streptomyces granaticolor. The surfaces used were in the form of microbeads and were surrounded by liquid growth media. Following the production of the antibiotic granaticin, more biomass was formed as well as a greater amount of antibiotic per milligram of protein on the glass beads than on the zirconia/silica

beads. Comparison of young mycelium (6 h) proteomes, obtained from the cultures attached to the glass and zirconia/silica beads, revealed three proteins with altered expression levels (dihydrolipoamide dehydrogenase, amidophosphoribosyltransferase and cystathionine beta-synthase) and one unique protein (glyceraldehyde-3-phosphate dehydrogenase) that was present only in cells Selleckchem FDA approved Drug Library grown on glass beads. All of the identified proteins function primarily as cytoplasmic enzymes involved in different parts of metabolism; however, in several microorganisms, they are exposed on the cell surface and have been shown to be involved in adhesion or biofilm formation. “
“Free-living protozoa, such as Acanthamoeba castellanii, are environmental hosts AZD8055 datasheet for pathogenic bacteria. Protozoa have been implicated in harboring pathogenic bacteria and enhancing virulence factors and antibiotic resistance. To better understand this relationship with Escherichia coli O157:H7,

we characterized its transcriptome within A. castellanii compared with broth-grown organisms using two-color microarrays. Statistical analysis indicated that 969 genes were Osimertinib differentially expressed at P<0.018, with a false discovery rate of 1.9% and a fold change cutoff of 1.3 or greater. There were 655 upregulated transcripts that include 40 genes associated with virulence, of which 32 are encoded on O-islands, and include shiga toxin genes (stx1A, stx1B stx2A) and 14 genes involved in Type III secretion system components. Also included are SOS response genes such as lexA and recA, genes involved in or

predicted to be involved in antibiotic resistance (rarD, macAB, marABR, mdtK, yojI, yhgN), the quorum-sensing operon lsrACDB, and the efe and feo iron-acquisition systems. There were 314 downregulated transcripts that included 19 transcripts associated with virulence, seven of which are encoded on O-islands. Our results demonstrate that a significant portion of the E. coli O157:H7 genome was differentially expressed as a result of the protozoan intracellular environment. Escherichia coli O157:H7 causes food-borne illness in humans, with disease manifested as acute gastroenteritis and symptoms ranging from mild diarrhea to hemorrhagic colitis (Nataro & Kaper, 1998). A potentially fatal sequelae of E. coli O157:H7 infection, hemolytic uremic syndrome, is the leading cause of acute renal failure in children (Nataro & Kaper, 1998). While E.

If so, it would offer a powerful tool to select recently exposed

If so, it would offer a powerful tool to select recently exposed patients for early treatment with artemisinin derivatives because praziquantel treatment before schistosome maturation

is ineffective.[15] The authors state they have no conflicts of interest to declare. “
“We report four cases of asymptomatic Plasmodium falciparum malaria in pregnant African women. They had immigrated to Finland 3 to 13 months earlier. The disease was revealed only by anemia. AZD8055 mouse The diagnosis relied on blood smear which showed a parasitemia <0.2% in three cases. Medical personnel should be informed about the possibility of afebrile forms of malaria in pregnant women even months after immigration. Very low levels of parasitemia may call for a more sensitive diagnostic approach such as polymerase chain reaction. In countries without indigenous malaria, medical education stresses the peril of febrile Plasmodium falciparum malaria. While this is the case in non-immune persons, such as travelers, P falciparum infection presents in semi-immune persons mostly as a chronic disease with only rare bouts of fever, if any. Women immigrating from endemic to non-endemic NVP-BKM120 clinical trial countries with no malaria transmission

are no longer considered to be at risk for the disease. The fact that they may still have persistent parasitemia after departing from their native country is not widely recognized. This report presents four afebrile pregnant women with P falciparum malaria who had emigrated from endemic countries 3 to 13 months earlier. We believe they represent only the tip of the

iceberg, and the diagnoses are often missed in pregnant immigrants: in our patients the only sign was anemia found in a routine check-up. The first patient was a 32-year-old woman from Cameroon who had not traveled abroad since moving to Finland in July 2002. While in Cameroon, she had had malaria several times, most recently 1 year before immigration. Early in her pregnancy, in June 2003, she was found to be anemic (Hb 93 g/L) and started taking iron supplements. Despite the treatment, her hemoglobin decreased to 84 g/L, and she L-gulonolactone oxidase was referred to a hematologist. Her blood smear, obtained 13 months after arrival, was positive for P falciparum ring forms with a parasitemia of <0.1%. After 7 days of oral treatment with quinine, the anemia subsided. The second patient was a 23-year-old woman who had immigrated to Finland in September 2007 from the Democratic Republic of the Congo, and had not traveled abroad since then. She had been treated for malaria about 1 year before emigrating. After living in Finland for 6 months, in week 29 of her pregnancy, she was referred to a maternity hospital owing to anemia with Hb 72 g/L. Microscopy was positive for P falciparum with a parasitemia of <0.1%. The patient was treated with oral quinine for 10 days and her anemia subsided.

The ammonium shock was achieved

The ammonium shock was achieved HIF-1 activation by adding ammonium chloride to 1 mM of the solution. Cellular fractions were obtained as follows: 50 mL of the culture was withdrawn before or 5 min after the ammonium shock. The culture was cooled by immersion in liquid nitrogen and the cells were harvested by centrifugation (5000 g for 5 min at 4 °C). The cells were resuspended in 1 mL of SP buffer (40 mM K2HPO4, 22 mM KH2PO4, 150 mM NaCl, pH 7.2) and processed exactly as described (Huergo et al. 2006). Membrane preparations were suspended in 6 M urea, 2 M thiourea, 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate 4% (w/v), Pharmalyte pH 4–7, 0.5% (v/v) and 20 mM dithiothreitol.

For isoelectrofocusing, 500 μg of protein was loaded onto a 13 cm, pH 4–7 Atezolizumab linear IPG strip (GE Healthcare). After rehydration, the isoelectrofocusing run was performed until the accumulation of 56 kVh, following the manufacturer’s instructions (GE Healthcare). The second dimension was achieved by 11% sodium dodecyl sulfate polyacrylamide gel electrophoresis

(SDS-PAGE). Gels were stained with colloidal Coomassie blue and images were analyzed using imagemaster platinum 6.0. The signal of each spot was normalized using the total density of the gel image. The experiments reported here were reproduced in two different biological replicates and two technical 2D-PAGE repetitions from the same sample. The spots were excised from the gels (ammonium shock treatment) and destained for 1 h in a solution of acetonitrile

50% (v/v) and 20 mM ammonium bicarbonate. Methane monooxygenase The gel piece was immersed in pure acetonitrile for 5 min, the acetonitrile removed and the gel dried under air. In-gel digestion was performed using 0.1 μg of sequencing-grade trypsin in acetonitrile 10% (v/v) and 20 mM ammonium bicarbonate. After overnight incubation at 37 °C, aliquots of each digested sample were mixed with a saturated matrix solution of α-cyano-4-hydroxycinnamic acid (in acetonitrile 50% v/v, TFA 0.1% v/v), spotted onto the MALDI target and allowed to dry. Mass spectra were acquired using a MALDI-TOF/TOF Autoflex II (Bruker Daltonics). MS analyses were performed in a positive ion reflection mode using an accelerating voltage of 20 kV. MS/MS analyses were performed in a positive ion LIFT reflection mode. Peak lists were created using flexanalysis 3.0 software (Bruker Daltonics). Trypsin autolysis signals (842.5 and 2211.1) were used as internal standards when present. A database search was performed using mascot 2.2. Mass lists were searched against a database of H. seropedicae predicted proteins. Carbamidomethylation of cysteines was set as fixed and oxidation of methionine as variable modifications. Error tolerance was 100 p.p.m. for peptide mass fingerprint (PMF) search and for MS/MS parent ion. MS/MS ion search error was set as 0.3 Da. signalp 3.0 (Bendtsen et al., 2004) was used for prediction of Sec signal peptides. tatp 1.0 (Bendtsen et al., 2005b) was used to predict TAT-dependent signal peptides.

, 2007) As there is a possible link between the RSC subunit and

, 2007). As there is a possible link between the RSC subunit and the cell wall integrity pathway (Angus-Hill et al., 2001), negatively charged N-glycans might contribute to the cell wall properties of yeast species for their survival in the environment. As P. thermomethanolica BCC16875 is thermotolerant, it was of interest to investigate whether there is any difference in glycosylation pattern when the cell is grown at different temperatures. N-glycans from cell wall mannoproteins

extracted from PD0325901 datasheet P. thermomethanolica BCC16875 grown at 37 °C contained higher amounts of small N-glycans (Man8-14GlcNAc2) than those grown at 20 and 30 °C. In contrast, small fractions of larger glycans were produced from 37 °C cultures. This suggests that different types of glycoproteins are produced at different temperatures as part of an environmental adaptative mechanism. Different Belinostat ic50 N-glycan profiles at different temperatures have also been observed in mammalian cells (Ahn et al., 2008). In conclusion, we have demonstrated that P. thermomethanolica BCC16875 is a potential methylotrophic yeast host for heterologous expression. Both methanol-inducible and constitutive P. pastoris promoters could be used to drive efficient gene expression. An efficient heterologous

protein expression system in this Wilson disease protein thermotolerant yeast will make it another attractive host for biotechnological application, especially for large-scale production at elevated temperatures, which would help reduce cooling costs for industrial applications. In addition, the N-glycosylation profile of secreted heterologous proteins was found to be similar to that of other methylotrophs, making this yeast another attractive host for glycan modification. Further development of a P. thermomethanolica BCC16875 expression

system with its native promoters is now in progress. We are grateful to Dr Philip J. Shaw, Dr Piyanun Harnpicharnchai and Dr Somchai Pongpattanakitshote for critically editing the manuscript. We thank Mr Kittapong Sae-Tang for technical assistance. Financial support (P-09-00108) from the National Center for Genetic Engineering and Biotechnology, National Science and Technology Development Agency, Thailand, and Research Center for Medical Glycoscience, National Institute of Advanced Industrial Science and Technology (AIST), Japan, are greatly appreciated. “
“In this study we assessed the occurrence, diversity and conjugative potential of plasmids in integron-carrying Aeromonas and Enterobacteriaceae from wastewaters. Sixty-six strains were included as donors in mating assays using rifampicin-resistant Escherichia coli and Pseudomonas putida recipient strains.

, 1999) They are widespread throughout the photic regions of the

, 1999). They are widespread throughout the photic regions of the world’s oceans between 40°S and 50°N, with cell densities of up to 105 cells mL−1 in the central oligotrophic gyres (Partensky et al., 1999). They are principally distinguished

into two taxonomic AC220 supplier clades due to physiological niche adaptation to light intensity: high light- and low light-adapted ecotypes (Moore et al., 1998; West & Scanlan, 1999; Rocap et al., 2003). A great deal of interest has arisen around Prochlorococcus due to its small size and specifically its near-minimal genome. Indeed, the chromosomes of most Prochlorococcus strains demonstrate significant genomic reduction, revealing a central conserved core set of essential genes and a variable shell, which is hypothesized to reflect each individual strain’s evolutionary adaptation to a specific environmental niche (Kettler et al., 2007; Shi & Falkowski, 2008). Closer inspection of Prochlorococcus genomes reveals that selleck chemical the majority of these strain-specific genes (74% in the case of Prochlorococcus strain MED4) are located in highly variable ‘genomic islands’, suggesting a mosaic structure that continually undergoes genomic rearrangement (Coleman et al., 2006). A suggested source of pressure for these organisms to reduce genome as well as cell size is thought to be reduced nutrient

availability (Raven, 1998), which is a characteristic of subtropical oceans,

particularly phosphate (P). Indeed, P concentrations are hypothesized to have affected domain shifts from a eukaryotic to a prokaryotic life in these oligotrophic regions (Karl et al., 1995, 2001). Also, recent studies have found that phytoplanktonic species within nutrient-poor oceanic biomes substitute phospholipids with sulpholipids in order to conserve Linifanib (ABT-869) ambient phosphorous for more essential metabolic use in the face of competition from heterotrophic bacteria (Van Mooy et al., 2006, 2009). A recent study of MED4 showed that a unique suite of genes was upregulated under P stress (Martiny et al., 2006). Most of these genes are orthologues of Escherichia coli genes located in and around the phoB operon, but another set are located within a variable genomic island, ‘Island 5’, and unique to MED4. The function of these genes is as yet uncharacterized; however, some putative annotations are available at GenBank (http://www.ncbi.nlm.nih.gov/). It is clear that the availability and ambient concentration of inorganic P within oligotrophic regions is a crucial factor determining the success of MED4 within those environments. Therefore, this study seeks to ascertain the global quantitative proteomic response of MED4 to longer term P starvation, and thereby providing further insight into how this organism responds to P stress.

In cases with pulmonary cryptococcosis a CSF examination should b

In cases with pulmonary cryptococcosis a CSF examination should be performed to determine whether meningitis is present (category III recommendation). In general, treatment is per meningitis with a regimen including liposomal amphotericin B (see section 2.4 Cryptococcus neoformans) [102]. If the CSF exam is negative, and (1) there is no other evidence of dissemination, (2) radiological infiltrates are focal

and (3) there is no hypoxia, treatment with fluconazole, Antidiabetic Compound Library manufacturer 400 mg od for the initial 10 weeks and 200 mg od po after this, is an alternative strategy (category III recommendation) [102]. 3.6.5 Prophylaxis and 3.6.6 Impact of HAART (see section 2.4 Cryptococcus neoformans) Aspergillus spp colonize the lung, in particular of individuals with underlying lung disease. Invasive aspergillosis (IA) occurs when the fungus invades the parenchyma and dissemination to other organs may occur in HIV-seropositive individuals [107]. IA is, however, rare in individuals living with HIV-1 infection in the absence of other risk factors such as neutropenia, transplantation or glucocorticoid use. Fever, cough and dyspnoea are frequent presenting features of IA and are often insidious in onset [108]. Pleuritic chest pain may occur. Haemoptysis is rare. A rare alternative syndrome described in individuals living with HIV-1 infection

is tracheobronchitis HSP mutation due to aspergillosis [109]. These individuals have ulcerative or nodular lesions in the airway else and usually have additional risk factors for aspergillosis such as neutropenia or glucocorticoid use. Clinical symptoms include fever,

cough, dyspnoea, wheezing and stridor, while some cases may progress to IA. Diagnosis of the various forms of aspergillosis requires a combination of radiological and microbiological tests. CT scans of the chest provide better delineation of lesions and identify additional cavities or nodules [110]. Invasive pulmonary aspergillosis (IPA) is identified when either a compatible clinical syndrome is associated with a biopsy specimen that demonstrates Aspergillus spp. by culture or histopathology or alternatively is associated with both a consistent clinical plus radiological appearance and with a positive microbiological sample from sputum or BAL. Tracheobronchitis due to aspergillosis can be visualized by bronchoscopy. Special fungal stains such as KOH stains of sputum or BAL and Grocott–Gomori methenamine silver stains or equivalents on biopsy specimens should be obtained on all respiratory specimens from HIV-seropositive individuals with pulmonary syndromes of undetermined aetiology (category IV recommendation). The galactomannan test is an enzyme-linked immunosorbent assay that detects the presence of a cell wall constituent of Aspergillus spp. [111]. It is commonly used in haematology patients but few data are available in the setting of HIV infection.

[28] Trade dress demands that a product projects an image of qual

[28] Trade dress demands that a product projects an image of quality and, ultimately, that if something works (results in sales), that it should not be changed.[28] Unfortunately, adherence to this strategy for naming medications, including for brand-extension purposes, may not always serve the best interests of the consumer in terms of ensuring that they receive and take the intended medication. Underlying this problem is the argument that existing pharmaceutical systems (prescribing, dispensing, administration) are flawed because they rely on human perfection.[28] That is, they often ignore important human factor concepts such as simplicity, standardisation, differentiation,

lack of duplication and unambiguous communication Enzalutamide ic50 in the process of drug naming, labelling and packaging. The result is drug names that look and sound alike. This can lead health professionals to unintended interchanges of medications with potentially serious clinical consequences for patients.[28] Lack of differentiation of medicine names may lead to slip/lapse errors as a class of medication error that results from the performance of an action that was not the intended action.[17] This type of error is facilitated when drugs have similar names, for example, a name like the intended medicine’s name is written on a prescription;

PS-341 datasheet or when a product name that looks like the intended medicine name is selected in a dispensary. Spoken medication orders can also be a source of slip/lapse errors and ambiguous Metalloexopeptidase communication errors for both clinicians and laypersons.[27] Accuracy in

identifying spoken medicine names increases as the background noise levels decrease; when people are more familiar with a drug name; and when the national prescribing frequency of the drug is higher.[27] Other research has identified visual and auditory distractions, workflow and time pressures to be risks for the confusion of medicine names.[41] Research evidence for methods to reduce drug name confusion is rare. Nevertheless, a number of generally untested solutions to the problem of look-alike, sound-alike medication names have been promulgated. In the context of spoken medication orders, the amount of background noise and familiarity effects are seen to be important targets for intervention to reduce errors.[27] A strategy for managing look-alike, sound-alike drug name confusion used with oncology medicines[18,36] applied Levenshtein distance and Bigram similarity algorithms, same first and last letters and an online alert system to identify look-alike, sound-alike generic medicine names. Levenshtein distance is a measure of similarity in the ordering of a string of letters. It counts the total number of letter insertions, deletions or substitutions needed to change one name into the other. For example, applying the algorithm to Xanax and Zantac gives them a similarity score of three.

[28] Trade dress demands that a product projects an image of qual

[28] Trade dress demands that a product projects an image of quality and, ultimately, that if something works (results in sales), that it should not be changed.[28] Unfortunately, adherence to this strategy for naming medications, including for brand-extension purposes, may not always serve the best interests of the consumer in terms of ensuring that they receive and take the intended medication. Underlying this problem is the argument that existing pharmaceutical systems (prescribing, dispensing, administration) are flawed because they rely on human perfection.[28] That is, they often ignore important human factor concepts such as simplicity, standardisation, differentiation,

lack of duplication and unambiguous communication click here in the process of drug naming, labelling and packaging. The result is drug names that look and sound alike. This can lead health professionals to unintended interchanges of medications with potentially serious clinical consequences for patients.[28] Lack of differentiation of medicine names may lead to slip/lapse errors as a class of medication error that results from the performance of an action that was not the intended action.[17] This type of error is facilitated when drugs have similar names, for example, a name like the intended medicine’s name is written on a prescription;

Bleomycin order or when a product name that looks like the intended medicine name is selected in a dispensary. Spoken medication orders can also be a source of slip/lapse errors and ambiguous Phosphoprotein phosphatase communication errors for both clinicians and laypersons.[27] Accuracy in

identifying spoken medicine names increases as the background noise levels decrease; when people are more familiar with a drug name; and when the national prescribing frequency of the drug is higher.[27] Other research has identified visual and auditory distractions, workflow and time pressures to be risks for the confusion of medicine names.[41] Research evidence for methods to reduce drug name confusion is rare. Nevertheless, a number of generally untested solutions to the problem of look-alike, sound-alike medication names have been promulgated. In the context of spoken medication orders, the amount of background noise and familiarity effects are seen to be important targets for intervention to reduce errors.[27] A strategy for managing look-alike, sound-alike drug name confusion used with oncology medicines[18,36] applied Levenshtein distance and Bigram similarity algorithms, same first and last letters and an online alert system to identify look-alike, sound-alike generic medicine names. Levenshtein distance is a measure of similarity in the ordering of a string of letters. It counts the total number of letter insertions, deletions or substitutions needed to change one name into the other. For example, applying the algorithm to Xanax and Zantac gives them a similarity score of three.