bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parents of children with cerebral palsy: a review of factors related to the process of adaptation
Authors: Rentinck I. C. M. , Ketelaar M. , Jongmans M. J. , Gorter J. W. 
Published: June 2006

AbstractBackground  Little is known about the way parents adapt to the situation when their child is diagnosed with cerebral palsy.Methods  A literature search was performed to gain a deeper insight in the process of adaptation of parents with a child with cerebral palsy and on factors related to this process. The selected articles were examined with respect to (i) the type and purpose of the study, (ii) study sample, (iii) variables and instruments and (iv) results on adaptation and stress of the parents.Results  Twenty‐two studies were found, which showed a large variety in research designs, instruments and populations. Despite methodological differences, it was possible to extract a number of factors related to resources of individual family members, the family unit as a whole and in the community, family appraisal and adaptive coping.Conclusion  It is important to realize that parents’ adaptation may change as a function of their child’s development and changing stages of family life over time. Until now cross‐sectional studies have dominated this area of research, but in order to understand the process of adaptation over time, longitudinal studies are needed.
22q11.2 deletion syndrome: behaviour problems of infants and parental stress
Authors: Briegel W. , Schneider M. , Schwab K. O. 
Published: June 2006

AbstractBackground 22q11.2 deletion syndrome (22q11.2 DS) can be associated with a variety of somatic symptoms, developmental delays and psychiatric disorders. At present, there is little information on early behaviour problems, and nothing is known about parental stress and possible relations between these factors. Therefore, the aim of this study was to investigate behaviour problems of infants with 22q11.2 DS, and their primary caregivers’ stress.Methods Parents of infants with 22q11.2 DS known to the German 22q11.2 deletion syndrome foundation were anonymously asked to fill out several questionnaires, e.g. the Child Behavior Checklist (CBCL) 1.5–5.Results The primary caregivers of 22/30 children [12 boys and 10 girls aged 1 year 8 months to 3 years 11 months (mean age: 2 years 9 months)] sent back filled‐out questionnaires. Seventeen out of 21 children showed motor, and 15/21 language delay. Five out of 21 children were rated as clinical on at least one CBCL 1.5–5 scale. The patients’ age was correlated with anxiety problems, and girls had significantly more sleep problems than boys. Compared with the general population, the primary caregivers did not experience higher levels of strain, and compared with parents of mentally and/or physically handicapped children, their parental stress was significantly lower. Parental stress and strain were correlated to a variety of child behaviour problems, e.g. externalizing and anxious/depressed behaviour.Conclusions Longitudinal studies are required to show whether behaviour problems and parental stress worsen when 22q11.2 DS patients grow older.
Mothers’ psychological distress 1 year after very preterm childbirth. Results of the epipage qualitative study
Authors: Garel M. , Dardennes M. , Blondel B. 
Published: June 2006

AbstractBackground  The objectives of this study were to assess qualitatively mothers’ physical and psychological health, their perception of their child’s health and development, and their difficulties with childcare from 2 months post discharge to 1 year after a very preterm delivery.Methods  The study population included all mothers who delivered before 33 weeks of amenorrhea between November 1998 and November 1999 in a Parisian maternity unit and between February 2000 and February 2001 in a maternity unit located in Rouen (France). Twenty‐one of the 38 mothers contacted agreed to participate (55%). Semi‐structured interviews were conducted by a clinical psychologist at the woman’s home. They were taped, fully transcribed and subjected to content analysis.Results  The main difficulties reported by mothers at 1 year were fatigue, depressive mood, anxiety and physical symptoms. Depressive mood was associated with social isolation, post‐traumatic symptoms, withdrawal and feelings of guilt. Most mothers also described their child as being difficult and tiring. Mothers’ reports about their own health and difficult behaviour of their child were more negative at 1 year than at 2 months post discharge.Conclusions  The mothers’ psychological distress following a very preterm birth did not improve between 2 months post discharge and 1 year after delivery. Comprehensive follow‐up care programmes should take into account this consequence of a very preterm birth and provide access to adequate psychological support, care or treatment.
A qualitative investigation of school‐aged children’s answers to items from a generic quality of life measure
Authors: Cremeens J. , Eiser C. , Blades M. 
Published: June 2006

AbstractBackground  The development of instruments to measure child self‐reported quality of life (QOL) is dependent on whether children can understand the concepts behind items. Researchers need more information on how children are interpreting and answering items. This paper aims to investigate the strategies school‐aged children use to answer QOL items.Methods  A generic 30‐item QOL measure (the TedQL) was administered to 266 healthy children (5–6, 7–9 years old). Children were asked to ‘think aloud’ while answering a selection of 10 TedQL items (n = 4 ability, n = 4 social, n = 2 mood items), and their responses were recorded verbatim.Results  The strategies children reported using when answering items were coded into five categories: (1) social comparisons; (2) stable character references; (3) concrete examples; (4) other reasons; or (5) no reason given. Concrete examples were used most frequently by children. Strategy type was dependent on age, with 7–9‐year‐olds reporting social comparisons and concrete examples more frequently than 5–6‐year‐olds. Five‐to‐six‐year‐olds gave no reasons for their response choices more frequently than 7–9‐year‐olds. Strategy type also differed by item type, with social comparisons used more frequently for ability items, and stable character references for social items. However, concrete examples were used consistently highly across ability and social items.Conclusions  Children aged 5–9 years most commonly report using concrete examples of specific instances when answering QOL items. However, strategy use varies as a function of age and types of items. Our results highlight the importance of keeping in mind children’s developmental age when interpreting responses from child QOL instruments.
Interaction of natural killer cells withTrypanosoma cruzi-infected fibroblasts
Authors: Lieke T , Steeg C , Graefe S E B , Fleischer B , Jacobs T 
Published: June 2006

SummaryThe protozoan parasite Trypanosoma cruzi circulates in the blood as trypomastigotes and invades a variety of cells to multiply intracellularly as amastigotes. The acute phase triggers an immune response that restricts the proliferation of the parasite. However, parasites are able to persist in different tissues causing the pathology of Chagas’ disease. Natural killer (NK) cells play an important role in innate resistance to a variety of pathogens. In the present study we demonstrate that NK cells trigger trypanocidal mechanisms in infected L929 cells that are critically dependent on inducible nitric oxide (NO) synthase (iNOS) induction which is, to a major degree, triggered by interferon (IFN)-γ provided by NK cells. This work provides a more detailed analysis of how NK cells as a part of the innate immune system participate in the control of parasites that reside intracellularly in fibroblast-like L929 cells.
Epitopes of the class I major histocompatibility complex (MHC-I) recognized in the syngeneic or allogeneic context predominantly linked to antigenic peptide loading to its binding groove
Authors: Nguyen van Binh P , Duc H T 
Published: June 2006

SummaryClass1 major histocompatibility complex (MHC-I)–antigenic peptide exposed at the target cell surface is crucial for the adaptive immune response exerted in the self/syngeneic context by cytotoxic T lymphocyte (CTL). Such a complex also provides epitopes in the allogeneic context for antibody response directed against the MHC-I polymorphic determinant. In the present report we examined the formation of the MHC-I–peptide complex leading predominantly to the expression of T and/or B cell epitopes in a process of internal versus external antigenic peptide loading onto the binding groove of MHC-I. Analyses using antibodies specific to complex MHC-I–peptide generated in the syngeneic context to mimic T cell receptor (TCR) in comparison with antibodies specific to the MHC-I polymorphic determinant allowed the observation that the external peptide loading to MHC-I, while remaining necessary for inducing the formation of B cell epitopes, was less efficient than the internal one for generating T cell epitopes. Thus, external loading of peptide to the MHC-I appeared to match more closely the allogeneic situation and the humoral immunity in general, while internal peptide loading corresponded with the self/syngeneic context of the cellular CTL response.
(–)-Epigallocatechin-3-gallate protects mice from concanavalin A-induced hepatitis through suppressing immune-mediated liver injury
Authors: Wang Y , Mei Y , Feng D , Xu L 
Published: June 2006

Summary(–)-Epigallocatechin-3-gallate (EGCG) is the major active component of green tea. Increasing evidence has suggested that EGCG exhibits anti-inflammatory, anti-oxidant and immunosuppressive effects. In this study, we investigated the effect of EGCG on concanavalin A (ConA)-induced hepatitis (CIH) in mice, a model of immune-mediated liver injury in humans. We pretreated mice with EGCG before ConA injection, and then measured alanine aminotransferase (ALT) levels in plasma, inflammatory infiltration and hepatocyte apoptosis in liver. Potential therapeutic mechanisms were elucidated further by measuring several inflammatory mediators. Mice pretreated with EGCG exhibited much less increased ALT levels in plasma, reduced inflammatory infiltration and hepatocyte apoptosis in liver compared with control mice pretreated with vehicle solutions. We further investigated the mechanisms of the protective effects of EGCG. In EGCG-pretreated mice, we found abrogated tumour necrosis factor (TNF)-α and interferon (IFN)-γ at both protein levels in plasma and mRNA levels in liver. At the same time, the concentration of nitrite in plasma and inducible nitric oxide synthase production in liver were both down-regulated in these mice. Moreover, IFN-inducible protein-10 and macrophage inflammatory protein-1α expressions in liver were decreased significantly. Therefore, EGCG is capable of regulating immune-mediated liver injury in vivo. The protective effect depended on its suppressive effect on the production of important inflammatory mediators.
Patient-centred screening for primary immunodeficiency: a multi-stage diagnostic protocol designed for non-immunologists
Authors: De Vries E ,   Clinical Working Party of the European Society for Immunodeficiencies (ESID)
Published: June 2006

SummaryEfficient early identification of primary immunodeficiency disease (PID) is important for prognosis, but is not an easy task for non-immunologists. The Clinical Working Party of the European Society for Immunodeficiencies (ESID) has composed a multi-stage diagnostic protocol that is based on expert opinion, in order to increase the awareness of PID among doctors working in different fields. The protocol starts from the clinical presentation of the patient; immunological skills are not needed for its use. The multi-stage design allows cost-effective screening for PID within the large pool of potential cases in all hospitals in the early phases, while more expensive tests are reserved for definitive classification in collaboration with an immunologist at a later stage. Although many PIDs present in childhood, others may present at any age. The protocols presented here are therefore aimed at both adult physicians and paediatricians. While designed for use throughout Europe, there will be national differences which may make modification of this generic algorithm necessary.
Mannose-binding lectin does not act as an acute-phase reactant in adults with community-acquired pneumococcal pneumonia
Authors: Perez-Castellano M , Peñaranda M , Payeras A , Milà J , Riera M , Vidal J , Pujalte F , Pareja A , Villalonga C , Matamoros N 
Published: June 2006

SummaryThe objective of this work was to study the role of mannose-binding lectin (MBL) and C-reactive protein (CRP) in pneumococcal pneumonia, to determine whether MBL acts as an acute-phase reactant and whether the severity of the disease correlates with MBL levels. The study comprised 100 patients with pneumococcal pneumonia. The pneumonia severity score was calculated and graded into a risk class of mortality (Fine scale). The MBL genotypes and the levels of MBL and CRP at the acute and recovery phases were determined. Fifty patients with the wild-type MBL genotype showed higher MBL levels in each phase (P &lt; 0·001) and an increased risk to developing bacteraemia, odds ratio (OR) 2·74, 95% confidence interval (CI) 1·01–7·52) (P = 0·02), but this did not correlate with the pneumonia severity class. CRP levels in the acute phase, 79·53 mg/l [standard deviation (s.d.) 106·93], were higher in the subjects with positive blood cultures (P = 0·003), and remained higher [20·12 mg/l (s.d. 31·90)] in the group of patients with an underlying disease (P = 0·01). No correlation was observed between the levels of MBL and CRP in each phase, or with the pneumonia severity score. We cannot conclude that MBL acts uniformly as an acute-phase reactant in pneumococcal pneumonia. MBL levels do not correlate well with the severity of the pneumonia. The risk of developing bacteraemia could be enhanced in individuals with the wild-type MBL genotype.
CD134 expression on CD4+ T cells is associated with nephritis and disease activity in patients with systemic lupus erythematosus
Authors: Patschan S , Dolff S , Kribben A , Dürig J , Patschan D , Wilde B , Specker C , Philipp T , Witzke O 
Published: June 2006

SummarySystemic lupus erythematosus (SLE) is characterized by a deviation of the immune system that involves T cell-dependent autoantibody production. The aim of this study was to investigate the role of co-stimulatory markers on T cells in this disease. Twenty-eight patients with SLE as defined by the American College of Rheumatology (ACR) criteria and 11 healthy controls were included into the study. Eleven patients had biopsy-proven lupus nephritis while 17 patients had no clinical evidence of lupus nephritis. Clinical disease activity was assessed according to the systemic lupus erythematosus disease index (SLEDAI). CD4+ T cell populations in the peripheral blood were analysed for the expression of co-stimulatory markers CD45RO, CD70, CD80, CD86, CD137, CD137L, CD134, CD152, CD154 and ICOS. SLE patients showed an increased frequency of peripheral CD4+ T cells expressing high levels of CD80, CD86 and CD134 compared to healthy controls (7·1 ± 1·5%versus 1·7 ± 0·9%; P &lt; 0·005; 2·3 ± 0·4%versus 1·0 ± 0·2%; P = 0·008, 20·2 ± 2·0%versus 10·6 ± 1·9%; P &lt; 0·005, respectively). Significantly higher levels of CD80 on CD4+ T cells were detected in SLE patients with lupus nephritis compared to patients without nephritis (11·9 ± 3·3%versus 4·0 ± 0·7%; P &lt; 0·005). There was an increased presence of CD134+ CD4+ cells in SLE patients with lupus nephritis (27·5 ± 4·0%versus 15·5 ± 1·3%; P &lt; 0·005). CD80 and CD134 expression was significantly correlated with SLEDAI (r = 0·42, P = 0·03; r = 0·56, P &lt; 0·005). Co-stimulatory molecules on CD4+ T cells are associated with renal disease and disease activity in patients with systemic lupus erythematosus.
Echinococcus multilocularis metacestodes modulate cellular cytokine and chemokine release by peripheral blood mononuclear cells in alveolar echinococcosis patients
Authors: Hübner M P , Manfras B J , Margos M C , Eiffler D , Hoffmann W H , Schulz-Key H , Kern P , Soboslay P T 
Published: June 2006

Summary
Infection with the cestode Echinococcus multilocularis causes human alveolar echinococcosis (AE), a life-threatening disease affecting primarily the liver. Despite the severity of AE, clinical symptoms often develop only many years after infection, which suggests that E. multilocularis has developed mechanisms which depress anti-parasite immune response, thus favouring immune evasion. In this study we examined the production of cytokines, chemokines and the expression of CD molecules on peripheral blood mononuclear cells (PBMC) from AE patients and healthy controls in response to E. multilocularis metacestode culture supernatant, viable E. multilocularis vesicles and E. multilocularis vesicle fluid antigen in vitro. After 48 h of co-culture, E. multilocularis metacestode culture supernatant and E. multilocularis vesicles depressed the release of the proinflammatory cytokine interleukin (IL)-12 by PBMC. This effect was dose-dependent and a suppression of tumour necrosis factor (TNF)-α and IL-12 was observed even when PBMC were activated with lipopolysaccharide (LPS). Comparing proinflammatory cytokine release by AE patients and controls showed that the release of IL-12 and TNF-α was reduced in AE patients, which was accompanied by an increased number of CD4+ CD25+ cells and a reduced release of the Th2 type chemokine CCL17 (thymus and activation regulated chemokine, TARC), suggesting an anti-inflammatory response to E. multilocularis metacestode in AE patients. Instead the production of interferon (IFN)-γ and the expression of CD28 on CD4+ T cells were increased in PBMC from AE patients when compared to controls. This was accompanied by a higher release of the Th2-type chemokine CCL22 (macrophage derived chemokine, MDC) supporting that E. multilocularis also generates proinflammatory immune responses. These results indicate that E. multilocularis antigens modulated both regulatory and inflammatory Th1 and Th2 cytokines and chemokines. Such a mixed profile might be required for limiting parasite growth but also for reducing periparasitic tissue and organ damage in the host.
Highly active anti-retroviral therapy (HAART)-induced maintenance of adaptive but not innate immune parameters is associated with protection from HIV-induced mortality
Authors: Stebbing J , Bower M , Mandalia S , Nelson M , Gazzard B 
Published: June 2006

Summary
Immunosuppression induced by the human immunodeficiency virus (HIV-1) increases the risk of death. We measured the influence of immunological and virological factors and the type of highly active anti-retroviral therapy (HAART) on this risk. Adaptive (lymphocyte) and innate (natural killer) immune correlates and maximum HIV viral loads were assessed for association with mortality using univariate and multivariate analyses. The protective effect of HAART regimens, containing protease inhibitors (PI) and/or non-nucleoside reverse transcriptase inhibitors (NNRTI) on mortality were also examined in a prospectively recorded cohort of 9621 HIV-infected individuals. From this entire cohort, 5873 HIV infected individuals (61%) have been followed-up in the HAART era and of these 499 (8·5%) have died. In multivariate analyses, CD4 counts below the 50th centile and CD8 and CD19 counts below the 25th centile were significantly associated with mortality, as was increased age (P &lt; 0·001). Innate immune subset levels had no effect on mortality. A maximum HIV viral load greater than the 75th centile was also associated independently with mortality (P &lt; 0·035). Exposure to either a PI or an NNRTI-containing HAART regimen, or both together, was protective against death compared with no anti-retrovirals (P &lt; 0·001). Effective HAART-induced maintenance of the adaptive immune system (CD4, CD8 and CD19 counts) protects from HIV-related mortality.
Levels of serum chemokines discriminate clinical myelopathy associated with human T lymphotropic virus type 1 (HTLV-1)/tropical spastic paraparesis (HAM/TSP) disease from HTLV-1 carrier state
Authors: Guerreiro J B , Santos S B , Morgan D J , Porto A F , Muniz A L , Ho J L , Teixeira A L , Teixeira M M , Carvalho E M 
Published: June 2006

SummaryApproximately 5% of people infected with human T lymphotropic virus type 1 (HTLV-1) develop clinical myelopathy or tropical spastic paraparesis (HAM/TSP) that is associated with high-levels of Th1 cytokines, interferon (IFN)-γ and tumour necrosis factor (TNF)-α. Chemokines are known to induce cytokine secretion and direct the trafficking of immune cells to sites of disease. The present study measured serum chemokines correlated with autonomously released IFN-γ in cell cultures. HTLV-1 infection was defined by enzyme-linked immunosorbent assay (ELISA) and confirmed by Western blot. Subjects included HTLV-1 carriers (n = 56), patients with HAM/TSP (n = 31) and healthy HTLV-1 seronegative volunteer controls (n = 20). Serum chemokines and IFN-γ autonomously released by mononuclear cells in culture were quantified by ELISA. Compared to HTLV-1 carriers, serum chemokines in HAM/TSP patients showed significantly increased levels of CXCL9 and CXCL10, significantly diminished levels of CCL2 and similar amounts of CCL11 and CCL24. In contrast, CCL11 and CCL24 were significantly lower in serum of HAM/TSP patients than either control. IFN-γ was positively correlated with CXCL9 and CXCL10 when HAM/TSP and HTLV-1 carriers were used as a combined group. However, despite a large proportion of HTLV-1 carriers having high IFN-γ levels, these chemokines were not increased in carriers. This study showed that high levels of CXCL9 and CXCL10 in the systemic circulation and low serum CCL2 levels are features of HAM/TSP. HTLV-1 infection and Tax and/or additional viral encoded factor-mediated pathological processes triggering T cell activation with autogenous IFN-γ release are probably involved in regulating chemokine release.
Association between mannan-binding lectin and impaired lung function in cystic fibrosis may be age-dependent
Authors: Muhlebach M S , MacDonald S L , Button B , Hubbard J J , Turner M L , Boucher R C , Kilpatrick D C 
Published: June 2006

Summary
An association between mannan-binding lectin (MBL) status and severity of lung function impairment in cystic fibrosis (CF) has been found in several studies, but not in others. To explore the possible basis for discrepancies in the literature, we related both MBL and l-ficolin concentrations to lung function and examined the results in relation to the age of the patients. For patients under 15 years of age, those with MBL &lt; 200 ng/ml had better lung function than those with MBL &gt; 200 ng/ml [median forced expiratory volume in 1 s (FEV1), 99%versus 83%; P = 0·05]. For patients over 15 years of age, those with MBL &lt; 200 ng/ml had poorer lung function than those with MBL &gt; 200 ng/ml (median FEV1, 44%versus 55%; P = 0·1). Also, for the over 15-year-olds, the proportion of patients with FEV1 values below the median was greater in the MBL-insufficient subgroup (P &lt; 0·04). In other words, relative deficiency of MBL appears to accelerate the age-related decline in lung function in CF patients. No corresponding relationships could be found between l-ficolin concentration and lung function. These findings and interpretation lend support to the potential value of MBL replacement therapy in a small minority of cystic fibrosis patients.