bluuebunny/crossref_metadata_2025_split huggingface dataset:
Needs‐based cognitive‐behavioural family intervention for patients suffering from schizophrenia: 5‐year follow‐up of a randomized controlled effectiveness trial
Authors: Sellwood W. , Wittkowski A. , Tarrier N. , Barrowclough C. 
Published: October 2007

Objective:  To determine whether a 24‐week, needs‐based cognitive‐behaviourally oriented family intervention for patients suffering from schizophrenia led to improved relapse profiles over a 5‐year follow‐up period.Method:  The case notes of 60 patients who had participated in a randomized, controlled effectiveness trial were examined to determine relapse rates over a 5‐year period.Results:  Patients were less likely to relapse over the 5‐year follow‐up when they received the needs‐based family intervention, especially in relation to exacerbations of symptoms not requiring inpatient admissions: 86.7% of control participants relapsed compared with 53.3% (P = 0.01). Survival analysis indicated that the relapse risk was 2.5 times higher for patients receiving routine care, compared with those receiving family intervention. A similar trend was observed for the final 4 years of follow‐up.Conclusion:  The present study provides some tentative support for the long‐term effectiveness of family‐based interventions for the management of schizophrenia in general mental health services.
Contact sensitivity in patients with venous leg ulcers in Serbia: comparison with contact dermatitis patients and relationship to ulcer duration
Authors: Jankićević Jasmina , Vesić Sonja , Vukićević Jelica , Gajić Miodrag , Adamič Metka , Pavlović Miloš D. 
Published: October 2007

Background: Contact hypersensitivity is a common occurrence in patients with chronic venous leg ulcers (CVLU) with allergen profiles depending upon the local treatment policies.Objective: This study was to determine the frequency of contact sensitivity, prevalence of individual allergens, polyvalent sensitization, and/or their relationship to ulcers duration in the population of CVLU and contact dermatitis patients in Serbia.Patients: 75 patients with CVLU and 82 patients with clinically suspected contact dermatitis were prospectively included in the study. The patients were patch tested with a series of 21 standard and 22 supplemental allergens.Results: 73% (n = 55) of CVLU and 52% (n = 43) of control subjects had 1 or more positive patch test results (P < 0.01). Polysensitization was found in 53% of patients and 21% of controls (P < 0.01). CVLU patients run 2.5 and 4.3 higher risk for contact sensitization and polysensitization, respectively. The most common allergens were Balsam of Peru (21.3%), carba mix (18.7%), fusidic acid (17.3%), colophony (13.3%), paraben mix (12%), chloramphenicol (12%), silver nitrate (12%), and neomycin (10.7%). Polivalent sensitization and higher mean number of allergens were associated with ulcer duration >5 years.Conclusions: The results confirm a high rate of contact (poly)sensitization in patients with CVLU and local variability in allergen prevalence.
The profile of patch test reactions to common contact allergens is related to sex
Authors: Brasch Jochen , Schnuch Axel , Uter Wolfgang ,   For the Information Network of Departments of Dermatology (IVDK) in Germanyand the German Contact Dermatitis Group (DKG)
Published: October 2007

Background:  Women are more often patch tested than men, and the reactivity to patch test allergens is dependent on sex. However, it is unclear whether the profiles of test reactions are also sex‐related.Objective:  To compare the profiles of patch test reactions of men and women.Methods:  Sex‐related reaction profiles of 16 common patch test allergens were analysed based on data of 47 626 patients filed by the Information Network of Departments of Dermatology in Germany. The proportions of weak positive reactions and of questionable and irritant reactions were evaluated by calculating the positivity ratio (PR) and the reaction index (RI) separately for men and women for each allergen.Results:  Of the 16 allergens evaluated, 8 had a higher PR and a higher RI in women than in men. 4 allergens had a lower PR and another 4 had a lower RI in women than in men. For allergens with similar sensitization prevalence in men and women, female sex was associated with a higher PR and RI (P < 0.01).Conclusions:  There is a marginal disparity in the reactivity of men and women to patch test allergens that is probably not of clinical relevance but constitutes a scientific challenge.
Heparin‐induced thrombocytopenia associated with interleukin‐8‐dependent platelet activation in a patient with antiphospholipid syndrome
Authors: Bounameaux Claire , Boehlen Françoise , Membré Aurélie , Genné Daniel , Pouplard Claire , Regnault Véronique , De Moerloose Philippe 
Published: October 2007

AbstractPlatelet factor 4 heparin enzyme immunoassay, platelet aggregation test, and serotonin release assay are commonly used to diagnose and confirm heparin‐induced thrombocytopenia. We describe a case of recurrent thrombocytopenia appearing in a few hours after each heparin administration and who tested negative for the three assays. Further analysis revealed anti‐interleukin (IL)‐8 antibodies and IL‐8‐dependent platelet activation facilitated by heparin, which may explain this unusual case of heparin‐induced thrombocytopenia.
Transforming growth factor‐beta1 affects interleukin‐10 production in the bone marrow of patients with chronic idiopathic neutropenia
Authors: Pyrovolaki Katerina , Mavroudi Irene , Papadantonakis Nicolas , Velegraki Maria , Ximeri Maria , Kalpadakis Christina , Gvazava Gilda , Klaus Mirjam , Eliopoulos George D. , Papadaki Helen A. 
Published: October 2007

AbstractBackground:  Chronic idiopathic neutropenia (CIN) is a bone marrow (BM) failure syndrome characterized by accelerated apoptosis of myeloid progenitor cells because of a local imbalance between pro‐inflammatory and anti‐inflammatory cytokines. In this study, we investigated the interplay among transforming growth factor‐beta1 (TGF‐β1), interleukin‐10 (IL‐10), and soluble flt‐3 ligand (sFL) within the BM of CIN patients and probed the role of these cytokines in the pathophysiology of CIN.Design:  We used long‐term BM cultures (LTBMC) to evaluate TGF‐β1, IL‐10, and sFL levels in CIN patients (n = 70) and healthy subjects (n = 35). Cytokine levels in LTBMC supernatants were correlated with the number of circulating neutrophils and the proportion of BM CD34+/CD33+ myeloid progenitor cells.Results:  CIN patients had increased TGF‐β1 and sFL levels in LTBMCs compared with controls and individual cytokine values were found to be correlated inversely with the number of neutrophils and the proportion of CD34+/CD33+ cells. Patients displayed low supernatant IL‐10 levels compared with controls and cytokine values were found to be correlated positively with the number of neutrophils and the proportion of CD34+/CD33+ cells. The levels of TGF‐β1 were found to be inversely correlated with IL‐10 and positively with sFL values in LTBMC, supernatants suggesting a possible interplay among these cytokines in CIN BM. Neutralization of TGF‐β1 in LTBMCs increased IL‐10 levels significantly in patients but not in controls, while neutralization had no effect on sFL levels.Conclusion:  Excessive production of TGF‐β1 within the BM microenvironment of CIN patients results in downregulation of IL‐10 and reduction of myeloid progenitor cells. Overexpression of sFL probably represents a compensatory mechanism to the low myeloid progenitor cells.
Insulin sensitivity assessment with euglycemic insulin clamp in adult β‐thalassaemia major patients
Authors: Tsapas Apostolos , Vlachaki Efthymia , Christoforidis Athanasios , Sarigianni Maria , Bekiari Eleni , Perifanis Vassilis , Tsapas Vassilis , Paletas Konstantinos , Athanassiou‐Metaxa Miranda 
Published: October 2007

AbstractObjective:  To assess insulin sensitivity in young adult normoglycemic β‐thalassaemia major patients.Methods:  We measured insulin sensitivity with the euglycemic insulin clamp in 10 young adult (mean age 24.85 ± 2.45 yrs) normoglycemic β‐thalassaemia major patients and 10 sex‐ & age‐ matched controls. Liver iron accumulation was assessed by magnetic resonance imaging (MRI).Results:  Glucose infusion rate (M) required to maintain euglycemia was significantly reduced in thalassaemic patients compared to controls (261.5 ± 63.5 mg/m2·min vs. 355.6 ± 35.3 mg/m2·min, P = 0.008). Consequently, significantly reduced in the thalassaemic group were also tissue sensitivity to insulin (M/Is‐s) and glucose metabolic clearance rate (M/Gs‐s). There was significant negative correlation between ferritin levels and glucose infusion rate (r = −0.918 P = 0.004). No significant correlations were observed between age, body mass index, daily transfusional iron accumulation, liver iron content and any of the euglycemic clamp parameters. Fasting insulin levels were significantly increased in patients with β‐thalassaemia major compared to controls (P = 0.01), and had significant negative correlation to MRI‐derived liver iron content (r = −0.733, P = 0.03).Conclusions:  Our data indicate that reduced insulin sensitivity resulting in hyperinsulinaemia precedes the manifestation of glucose intolerance in patients with β‐thalassaemia major. Insulin resistance seems to correlate with increased serum ferritin levels.
Evaluation of Serum and Urinary Angiogenic Factors in Patients with Endometriosis
Authors: Cho Si Hyun , Oh Yoon Jin , Nam Anna , Kim Hye Yeon , Park Joo Hyun , Kim Jae Hoon , Park Ki Hyun , Cho Dong Je , Lee Byung Seok 
Published: October 2007

Problem  The aim of this study was to evaluate serum and urinary levels of vascular endothelial growth factors, tumor necrosis factor‐α (TNF‐α), and soluble fms‐like tyrosine kinase (sFlt‐1) in patients with endometriosis.Method of study  During surgery for pelvic pain, pelvic mass or infertility, serum and urine were collected. Of 70 patients, 46 had histology‐proven endometriosis and 24 patients without endometriosis participated as controls.Results  Serum TNF‐α levels and urinary sFlt‐1 levels corrected for creatinine excretion were significantly increased in the endometriosis group (P = 0.001 and P = 0.011 respectively). Serum sFlt‐1 levels and urinary sFlt‐1 levels corrected for creatinine were significantly higher in patients with minimal‐to‐mild disease (P = 0.014 and P = 0.015 respectively), where serum TNF‐α levels were increased in moderate‐to‐severe endometriosis (P < 0.001).Conclusion  The pathogenesis of minimal‐to‐mild endometriosis and moderate‐to‐severe endometriosis seems to be different. Increased sFlt‐1 levels in serum and urine of minimal‐to‐mild disease indicate that sFlt‐1 may have an important role in inhibiting angiogenic process of the disease.
Results of Immunotherapy for Patients with Unexplained Primary Recurrent Abortions – Prospective Non‐Randomized Cohort Study
Authors: Nonaka Taro , Takakuwa Koichi , Ooki Izumi , Akashi Mami , Yokoo Tomokazu , Kikuchi Akira , Tanaka Kenichi 
Published: October 2007

Problem  The present study was conducted to examine the efficacy of immunotherapy for unexplained primary recurrent aborters using paternal lymphocytes.Method of study  Two hundred and twenty‐eight recurrent aborters were prospectively followed up regarding immunotherapy. Of the 228 patients, 165 underwent immunotherapy using freshly prepared paternal lymphocytes and pregnancy outcome was analyzed. No mixed lymphocyte culture reaction‐blocking antibodies (MLR‐BAbs) were observed in these patients prior to vaccinations. Pregnancy outcome was also analyzed in such as those patients positive for MLR‐BAbs and who did not undergo immunotherapy, and in patients negative for MLR‐BAbs and who had become pregnant without immunotherapy.Results  Of the 140 newly pregnant patients after immunotherapy, the pregnancy continued successfully in 110 (78.6%), and the pregnancy continued successfully in 24 of 32 patients (75.0%) who were positive for MLR‐BAbs. The success rate of pregnancy was 30.0% in 18 non‐immunized patients. Thus, the success rate was significantly higher among patients with immunotherapy and patients positive for MLR‐BAbs than in non‐immunized patients, negative for MLR‐BAbs.Conclusion  Immunotherapy using paternal lymphocytes is considered to be effective for unexplained primary recurrent aborters negative for MLR‐BAbs.
Signaling Molecules Involved in IFN‐γ‐Inducible Nitric Oxide Synthase Expression in the Mouse Trophoblast
Authors: Leanza Eduardo Cava , Hoshida Mara Sandra , Costa Adriana Fraga , Fernandes Cristina Maria , De Fatima Pereira Teixeira Catarina , Bevilacqua Estela 
Published: October 2007

Problem  We have previously shown that trophoblast can generate nitric oxide (NO) and express inducible isoform of nitric oxide synthase (iNOS). Moreover, this production was changed by the presence of interferon‐γ (IFN‐γ) establishing a relationship between trophoblast inductive response and this proinflammatory cytokine.Method of study  As the intracellular signal transduction pathway used by IFN‐γ in target cells is the Janus kinase (JAK)‐signal transducer and transcription activator (STAT), here we analyzed in the mouse trophoblast the effect of IFN‐γ and staurosporine on mRNA and protein expressions of IFN‐γ signaling molecules correlating them with iNOS expression.Results  Interferon‐γ induced iNOS expression and upregulated Jaks and Stat1, but not Stat2 transcriptions. The protein distribution matched the mRNA expression pattern. These effects were abrogated when IFN‐γ receptor was blocked by staurosporine.Conclusion  Due to the biological effects of NO‐iNOS generated on induction of apoptosis and inflammatory responses, interaction between iNOS expression and IFN‐γ‐mediated signaling is very important for understanding the physiology of trophoblast at the maternal–fetal interface. Our data indicate IFN‐γ acts specifically on trophoblast, regulating the expression of signaling molecules and is fundamental for iNOS expression.
Immunologic Principles of Allergic Disease
Authors: Averbeck Marco , Gebhardt Carl , Emmrich Frank , Treudler Regina , Simon Jan C. 
Published: October 2007

SummaryAllergy either results from a pathological excessive immune reaction, or from the defective induction of tolerance to otherwise harmless antigens. Allergic reactions are mounted by mechanisms of innate and adaptive immunity. The development of an allergic response can be divided in sensitization and elicitation phases. Immediate type allergic reactions (e.g. anaphylaxis, urticaria, rhinoconjunctivitis allergica, allergic asthma) are mediated by IgE antibodies which are produced by B cells stimulated by allergen‐specific Th2 cells. Crosslinking of allergen‐specific IgE on membrane surfaces of mast cells and basophilic granulocytes leads to release of soluble mediators which may cause systemic symptoms within minutes to hours. The following infiltration of eosinophilic granulocytes and Th2 cells directs chronic inflammation.Humoral cytotoxic immune reactions (e.g. drug induced cytopenia) are mediated by IgG and IgM antibodies which are directed against membrane associated antigens. IgG and IgM antibodies directed against soluble antigens elicit immune complex mediated cytotoxicity (e.g.drug induced vasculitis).Delayed type immune reactions (e.g.contact dermatitis) are based on the activation of antigen specific CD4+ and CD8+ T cells and need 24 h to 48 h to develop. Upon recurrent contact with identical antigens, recruitment of CD4+ and CD8+ T cells cause inflammation and cytotoxic induced apoptosis in target cells as well as cytokine mediated leukocyte infiltration. Subsequent immigration of CD4+ Th2 cells provides anti‐inflammatory mechanisms leading to resolution of the inflammatory response and tissue repair.
Re‐amputation occurrence in the diabetic population in South Wales, UK
Authors: Kanade Rajani , Van Deursen Robert , Burton Jo , Davies Vanessa , Harding Keith , Price Patricia 
Published: October 2007

AbstractThe incidence of re‐amputation following lower extremity amputations (LEA) among the diabetic patients referred to the Artificial Limb and Appliance Centers (ALAC) in South Wales, UK, was investigated. Manual and electronic data‐gathering systems were used to extract the medical records of 473 people with various causes of LEA referred to the ALAC in South Wales during 2001–2003. The data included demographic information, causes of amputation and occurrence of various levels of re‐amputation. Two hundred and five subjects with diabetes underwent 316 amputations, 44 were foot amputations and 272 major amputations on the ipsilateral and contra‐lateral sides. Of the diabetic patients, 45·9% with single LEA underwent re‐amputations with 22% incidence of contra‐lateral LEA within 2 years. In comparison, 15% underwent re‐amputations in the non diabetic dysvascular patients. Ipsilateral re‐amputations occurred much earlier (average 21 weeks) compared with the contra‐lateral amputations which took an average of 82 weeks following the first amputation. Nearly half of the diabetic patients with single LEA referred for rehabilitation underwent re‐amputations within 2 years; out of which 22% of the patients underwent contra‐lateral LEA. Although the progression of level of amputations does not follow a particular pattern, re‐amputation on the contra‐lateral side occurred almost four times later than that on the ipsilateral side.
Challenges for management of the diabetic foot in Africa: doing more with less
Authors: Abbas Zulfiqarali G , Archibald Lennox K 
Published: October 2007

AbstractDiabetes mellitus reached epidemic proportions in much of the less‐developed world over a decade ago. In Africa, incidence and prevalence rates of diabetes are increasing and foot complications are rising in parallel. The predominant risk factor for foot complications is underlying peripheral neuropathy, although there is a body of evidence that confirm the increasing role of peripheral vascular disease. Gangrene and infections are two of the more serious sequelae of diabetic foot ulcer disease that cause long‐standing disability, loss of income, amputation or death. Unfortunately, diabetes imposes a heavy burden on the health services in many African countries, where resources are already scarce or cut back. Reasons for poor outcomes of foot complications in various less‐developed countries include the following: lack of awareness of foot care issues among patients and health care providers alike; very few professionals with an interest in the diabetic foot or trained to provide specialist treatment; non existent podiatry services; long distances for patients to travel to the clinic; delays among patients in seeking timely medical care, or among untrained health care providers in referring patients with serious complications for specialist opinion; lack of the concept of a team approach; absence of training programs for health care professionals; and finally lack of surveillance activities. There are ways of improving diabetic foot disease outcomes that do not require an exorbitant outlay of financial resources. These include implementation of sustainable training programmes for health care professionals, focusing on the management of the complicated diabetic foot and educational programmes that include dissemination of information to other health care professionals and patients; sustenance of working environments that inculcate commitment by individual physicians and nurses through self growth; rational optimal use of existing microbiology facilities and prescribing through epidemiologically directed empiricism, where appropriate; and using sentinel hospitals for surveillance activities. Allied with the golden rules of prevention (i.e. maintenance of glycaemic control to prevent peripheral neuropathy, regular feet inspection, making an effort not to walk barefooted or cut foot callosities with razors or knives at home and avoidance of delays in presenting to hospital at the earliest onset of a foot lesion), reductions in the occurrence of adverse events associated with the diabetic foot is feasible in less‐developed settings.
A Novel Cyclic Squamosamide Analogue Compound FLZ Improves Memory Impairment in Artificial Senescence Mice Induced by Chronic Injection of D‐Galactose and NaNO2
Authors: Fang Fang , Liu Gengtao 
Published: October 2007

Abstract:  The aim of the present study was to access the protective effect of a novel synthesized squamosamide cyclic analogue, compound FLZ, on memory impairment in artificially senescent mice induced by chronic injection of D‐galactose and sodium nitrite (NaNO2). Artificially senescent mouse model was induced by consecutive injection of D‐galactose (120 mg/kg) and NaNO2 (90 mg/kg) once daily for 60 days. Compound FLZ (75 and 150 mg/kg) was orally administered once daily for 30 days after D‐galactose and NaNO2 injection for 30 days. The water maze test was used to evaluate the learning and memory function of mice. The content of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) in serum were determined using different biochemical kits. The alterations in hippocampus morphology were assessed by light and electronic microscope. Immunoreactive cells of Bcl‐2 in the hippocampus were counted by immunohistochemical staining, and Bcl‐2 protein expression was analysed by Western blot method. The results indicate that injection of D‐galactose and NaNO2 induces memory impairment and neuronal damage in hippocampus of mice. In addition, serum SOD and GSH‐Px activities decreased, while MDA level increased. Bcl‐2‐positive neurons and Bcl‐2 protein expression in the hippocampus decreased remarkably. Oral administration of FLZ for 30 days significantly improved the cognitive deficits and the biochemical markers mentioned above, and also reduced the pathological alterations in mouse hippocampus. The results suggest that FLZ ameliorates memory deficits and pathological injury in artificially senescent mice induced by chronic injection of D‐galactose and NaNO2, indicating that FLZ is worth further studies for fighting antisenescence and dementia.