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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Results(1-25 of 581) Sort By: Publication Date Relevance Took: 3.287 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 24 1 2 3 4 > Last >> (581 articles found) 1alpha,25-Dihydroxyvitamin D3-induced down-regulation of the checkpoint proteins, Chk1 and Claspin, is mediated by the pocket proteins p107 and p130. Mar 2007 Lieve Verlinden,Guy Eelen,Ruth Van Hellemont,Kristof Engelen,Ine Beullens,Mark Van Camp,Kathleen Marchal,Chantal Mathieu,Roger Bouillon,Annemieke Verstuyf A previous cDNA microarray analysis in murine MC3T3-E1 osteoblasts revealed a cluster of genes involved in cell cycle progression that was significantly down-regulated after a single treatment with 1alpha,25-dihydroxyvitamin D(3) [1,25(OH)(2)D(3)] [L. Verlinden, G. Eelen, I. Beullens, M. Van Camp, ... ( view more )P. Van Hummelen, K. Engelen, R. Van Hellemont, K. Marchal, B. De Moor, F. Foijer, H. Te Riele, M. Beullens, M. Bollen, C. Mathieu, R. Bouillon, A. Verstuyf, Characterization of the condensin component Cnap1 and protein kinase Melk as novel E2F target genes down-regulated by 1,25-dihydroxyvitamin D3, J. Biol. Chem. 280 (45) (2005) 37319-37330]. Among those genes were the DNA replication and DNA damage checkpoint proteins, Chk1 and Claspin, of which the human homologues were recently shown to be E2F-responsive. Quantitative real-time PCR experiments in 1,25(OH)(2)D(3)-treated MC3T3-E1 cells confirmed the down-regulation observed in the microarray experiment. Moreover, Chk1 and Claspin promoter activities were also reduced after incubation with 1,25(OH)(2)D(3), and this reduction was mediated through the E2F recognition motifs within their promoters because mutation of these motifs almost completely abolished the repressive effect of 1,25(OH)(2)D(3). The antiproliferative effect of 1,25(OH)(2)D(3) as well as its potential to down-regulate the expression of Chk1 and Claspin depended on the pocket proteins p107 and p130 because 1,25(OH)(2)D(3) lost its antiproliferative action and failed to repress these E2F-target genes in p107(-/-);p130(-/-)-cells, but not in pRb(-/-)-cells. ( view less ) View Full Abstract View Article Details   Related Articles 2-bromo-6-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)pyridine, a new unexpected bifunctional building block for combinatorial chemistry. Oct 2003 Jana Sopková-de Oliveira Santos,Alexandre Bouillon,Jean-Charles Lancelot,Sylvain Rault The first reported structure of a pyridin-2-ylboron derivative, viz. the title compound, C(11)H(15)BBrNO(2), (I), is compared with its regioisomer 2-bromo-5-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-2-yl)pyridine, (II) [Sopková-de Oliveira Santos, Lancelot, Bouillon & Rault (2003). Acta Cryst. C59, o... ( view more )111-o113]. Structural differences are observed, firstly in the orientation of the dioxaborolane ring with respect to the pyridine ring and secondly in the bond angles of the BO(2) group. These differences do not explain the experimentally observed differences in chemical reactivity between (I) and (II) but do confirm the relatively lower stability of (I). However, ab initio calculations of the HOMO (highest occupied molecular orbital) and LUMO (lowest unoccupied molecular orbital), based on the known crystal structures of the two compounds, show different distributions, which correspond to the differences observed during chemical reactions. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Advanced trauma life support, 8th edition, the evidence for change. Jun 2008 John B Kortbeek,Saud A Al Turki,Jameel Ali,Jill A Antoine,Bertil Bouillon,Karen Brasel,Fred Brenneman,Peter R Brink,Karim Brohi,David Burris,Reginald A Burton,Will Chapleau,Wiliam Cioffi,Francisco De Salles Collet e Silva,Art Cooper,Jaime A Cortes,Vagn Eskesen,John Fildes,Subash Gautam,Russell L Gruen,Ron Gross,K S Hansen,Walter Henny,Michael J Hollands,Richard C Hunt,Jose M Jover Navalon,Christoph R Kaufmann,Peggy Knudson,Amy Koestner,Roman Kosir,Claus Falck Larsen,West Livaudais,Fred Luchette,Patrizio Mao,John H McVicker,Jay Wayne Meredith,Charles Mock,Newton Djin Mori,Charles Morrow,Steven N Parks,Pedro Moniz Pereira,Renato Sergio Pogetti,Jesper Ravn,Peter Rhee,Jeffrey P Salomone,Inger B Schipper,Patrick Schoettker,Martin A Schreiber,R Stephen Smith,Lars Bo Svendsen,Wa'el Taha,Mary van Wijngaarden-Stephens,Endre Varga,Eric J Voiglio,Daryl Williams,Robert J Winchell,Robert Winter The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the c... ( view more )ourse content. New materials related to principles of disaster management have been added. ATLS is a common language teaching one safe way of initial trauma assessment and management. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Computer assisted percutaneous placement of augmented iliosacral screws: a reasonable alternative to sacroplasty. Jun 1, 2008 Thorsten Tjardes,Thomas Paffrath,Holger Baethis,Sven Shafizadeh,Eva Steinhausen,Toni Steinbuechel,Dieter Rixen,Bertil Bouillon STUDY DESIGN: A technical report of fluoroscopy guided placement of augmented iliosacral screws in osteoporotic insufficiency fractures of the sacrum. OBJECTIVE: To describe a combined approach of navigated iliosacral screw placement and screw augmentation as an option for osteosynthesis of sacral ... ( view more )insufficiency fractures in the elderly. SUMMARY OF BACKGROUND DATA: The incidence of sacral insufficiency fractures is increasing. Outcome of conservative treatment is inconsistent. Recently sacroplasty is propagated as an interventional therapy but the long-term outcome is still unknown. Evidence from finite element models suggests that stabilization of the sacrum achieved by sacroplasty is insufficient to restore the weight bearing capacity of the sacrum permanently. METHODS: We suggest a minimally invasive fluoroscopically navigated iliosacral screw osteosynthesis with cement augmentation of the screws for treatment of insufficiency fractures of the sacrum. RESULTS: The procedure, especially fluoroscopic visualization and navigation of the osteoporotic sacrum is technically feasible. A total radiograph time of 7,4 minutes, including image acquisition for navigation and fluoroscopic control of cement injection, is acceptable and can be expected to be significantly reduced with repeated applications of the procedure. The patient presented in the report was discharged to rehabilitation soon after the operation. An assistive device (delta wheel) is only needed for longer walking distances. Pain was reduced drastically immediately after surgery. CONCLUSION: In general, fractures are treated by reduction and fixation to restore the biomechanical function of the injured bone. These principles should be applied to elderly patients with osteoporotic fractures as well. The technique reported here is adapted to the special demands of the elderly patient, i.e., minimally invasive, support of the weakened bone by cement augmentation, bone protective screw positioning and safety due to navigation support. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Active intestinal calcium transport in the absence of transient receptor potential vanilloid type 6 and calbindin-D9k. Jun 2008 Bryan S Benn,Dare Ajibade,Angela Porta,Puneet Dhawan,Matthias Hediger,Ji-Bin Peng,Yi Jiang,Goo Taeg Oh,Eui-Bae Jeung,Liesbet Lieben,Roger Bouillon,Geert Carmeliet,Sylvia Christakos To study the role of the epithelial calcium channel transient receptor potential vanilloid type 6 (TRPV6) and the calcium-binding protein calbindin-D9k in intestinal calcium absorption, TRPV6 knockout (KO), calbindin-D9k KO, and TRPV6/calbindin-D(9k) double-KO (DKO) mice were generated. TRPV6 KO, c... ( view more )albindin-D9k KO, and TRPV6/calbindin-D9k DKO mice have serum calcium levels similar to those of wild-type (WT) mice ( approximately 10 mg Ca2+/dl). In the TRPV6 KO and the DKO mice, however, there is a 1.8-fold increase in serum PTH levels (P < 0.05 compared with WT). Active intestinal calcium transport was measured using the everted gut sac method. Under low dietary calcium conditions there was a 4.1-, 2.9-, and 3.9-fold increase in calcium transport in the duodenum of WT, TRPV6 KO, and calbindin-D9k KO mice, respectively (n = 8-22 per group; P > 0.1, WT vs. calbindin-D9k KO, and P < 0.05, WT vs. TRPV6 KO on the low-calcium diet). Duodenal calcium transport was increased 2.1-fold in the TRPV6/calbindin-D9k DKO mice fed the low-calcium diet (P < 0.05, WT vs. DKO). Active calcium transport was not stimulated by low dietary calcium in the ileum of the WT or KO mice. 1,25-Dihydroxyvitamin D3 administration to vitamin D-deficient null mutant and WT mice also resulted in a significant increase in duodenal calcium transport (1.4- to 2.0-fold, P < 0.05 compared with vitamin D-deficient mice). This study provides evidence for the first time using null mutant mice that significant active intestinal calcium transport occurs in the absence of TRPV6 and calbindin-D9k, thus challenging the dogma that TRPV6 and calbindin-D9k are essential for vitamin D-induced active intestinal calcium transport. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion. May 2008 C Roux,H A Bischoff-Ferrari,S E Papapoulos,A E de Papp,J A West,R Bouillon BACKGROUND: Adequate vitamin D and calcium nutrition play a critical role in the maintenance of musculoskeletal health and are considered the first step in osteoporosis treatment. ROUNDTABLE DISCUSSION: In February 2008 Merck Sharp & Dohme sponsored a 2-day, evidence-based expert panel on the benef... ( view more )its of vitamin D for the patient with osteoporosis and the role of vitamin D in combination with antiresorptive therapy for the management of osteoporosis. One of the primary objectives of the meeting was to review new data on the optimal serum 25-hydroxy vitamin D [25(OH)D] levels. The symposium was attended by 29 researchers and clinicians from Europe and the Middle East. The discussion focused on optimizing vitamin D and calcium nutrition and reducing falls and fractures in osteoporotic patients. CONCLUSIONS: Current evidence and expert opinion suggests that optimal serum 25(OH)D concentrations should be at least 50 nmol/L (20 ng/mL) in all individuals. This implies a population mean close to 75 nmol/L (30 ng/mL). In order to achieve this level, vitamin D intake of at least 20 microg daily is required. There is a wider therapeutic window for vitamin D than previously believed, and doses of 800 IU per day, regardless of sun exposure, season or additional multivitamin use, appear to present little risk of toxicity. Apart from fracture and fall prevention, optimization of vitamin D status may also have additional general health benefits. Based on newly emerging data regarding calcium supplementation, and recommendations for increased vitamin D intake, the current recommendations for calcium intake in postmenopausal women may be unnecessarily high. In addition to vitamin D and calcium, treatment of patients with osteoporosis at high risk of fractures should also include pharmacologic agents with proven vertebral and non-vertebral fracture efficacy. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Population pharmacokinetics of sevoflurane in conjunction with the AnaConDa: toward target-controlled infusion of volatiles into the breathing system. Apr 2008 M Enlund,D Kietzmann,T Bouillon,K Züchner,I Meineke BACKGROUND: The Anesthetic Conserving Device (AnaConDa) uncouples delivery of a volatile anesthetic (VA) from fresh gas flow (FGF) using a continuous infusion of liquid volatile into a modified heat-moisture exchanger capable of adsorbing VA during expiration and releasing adsorbed VA during inspir... ( view more )ation. It combines the simplicity and responsiveness of high FGF with low agent expenditures. We performed in vitro characterization of the device before developing a population pharmacokinetic model for sevoflurane administration with the AnaConDa, and retrospectively testing its performance (internal validation). MATERIALS AND METHODS: Eighteen females and 20 males, aged 31-87, BMI 20-38, were included. The end-tidal concentrations were varied and recorded together with the VA infusion rates into the device, ventilation and demographic data. The concentration-time course of sevoflurane was described using linear differential equations, and the most suitable structural model and typical parameter values were identified. The individual pharmacokinetic parameters were obtained and tested for covariate relationships. Prediction errors were calculated. RESULTS: In vitro studies assessed the contribution of the device to the pharmacokinetic model. In vivo, the sevoflurane concentration-time courses on the patient side of the AnaConDa were adequately described with a two-compartment model. The population median absolute prediction error was 27% (interquartile range 13-45%). CONCLUSION: The predictive performance of the two-compartment model was similar to that of models accepted for TCI administration of intravenous anesthetics, supporting open-loop administration of sevoflurane with the AnaConDa. Further studies will focus on prospective testing and external validation of the model implemented in a target-controlled infusion device. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Desymmetrization of a meso-allylic acetal by enantioselective conjugate elimination. Mar 6, 2008 Ling Xu,Thomas Regnier,Loïc Lemiègre,Pascal Cardinael,Jean-Claude Combret,Jean-Philippe Bouillon,Jérome Blanchet,Jacques Rouden,Anne Harrison-Marchand,Jacques Maddaluno An unprecedented enantioselective deprotonation/conjugate elimination sequence, which transforms an allylic meso-dioxepane into a chiral diene, is described. The best desymmetrization conditions (ee up to 70%) involve s-BuLi and sparteine at -78 degrees C in THF. View Full Abstract View Article Details View Coded Data Related Articles Individual and occupational risk factors for knee osteoarthritis - study protocol of a case control study. 2008 André Klussmann,Hansjuergen Gebhardt,Falk Liebers,Lars Victor von Engelhardt,Andreas Dávid,Bertil Bouillon,Monika A Rieger BACKGROUND: Knee osteoarthritis (OA) is one of the frequent and functionally impairing disorders of the musculoskeletal system. In the literature, a number of occupational risk factors are discussed as being related to the development and progress of knee joint diseases, e.g. working in kneeling or... ( view more ) squatting posture, lifting and carrying of heavy weights. The importance of the single risk factors and the possibility of prevention are currently under discussion. Besides the occupational factors, a number of individual risk factors are important, too. The distinction between work-related factors and individual factors is crucial in assessing the risk and in deriving preventive measures in occupational health. In existing studies, the occupational stress is determined mainly by surveys in employees and/or by making assumptions about individual occupations. Direct evaluation of occupational exposure has been performed only exceptionally.The aim of the research project ArGon is the assessment of different occupational factors in relation to individual factors (e.g. constitutional factors, leisure time activities, sports), which might influence the development and/or progression of knee (OA). The project is designed as a case control study. METHODS/DESIGN: To raise valid data about the physical stress associated with occupational and leisure time activities, patients with and without knee OA are questioned by means of a standardised questionnaire and an interview. The required sample size was estimated to 800 cases and an equal number of controls. The degree and localisation of the knee cartilage or joint damages in the cases are documented on the basis of radiological, arthroscopic and/or operative findings in a patient record. Furthermore, occupational exposure is analysed at selected workplaces. To evaluate the answers provided in the questionnaire, work analysis is performed. DISCUSSION: In this research project, specific information on the correlation of occupational and individual factors on the one hand and the current state of knee OA on the other will be analysed in order to describe preventive measures. In addition, information regarding a better evaluation of various forms of physical stress in different occupations will be available. This might lead to more effective prevention strategies. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Hypnotic and opioid anesthetic drug interactions on the CNS, focus on response surface modeling. 2008 T W Bouillon This chapter will present the conceptual and applied approaches to capture the interaction of anesthetic hypnotic drugs with opioid drugs, as used in the clinical anesthetic state. The graphic and mathematical approaches used to capture hypnotic/opiate anesthetic drug interactions will be presented... ( view more ). This chapter is not a review article about interaction modeling, but focuses on specific drug interactions within a quite narrow field, anesthesia. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Unaltered diabetes presentation in NOD mice lacking the vitamin D receptor. Jan 2008 Conny Gysemans,Evelyne van Etten,Lutgart Overbergh,Annapaula Giulietti,Guy Eelen,Mark Waer,Annemieke Verstuyf,Roger Bouillon,Chantal Mathieu OBJECTIVE: Vitamin D deficiency increases risk for type 1 diabetes in genetically predisposed individuals, while high doses of 1,25-dihydroxyvitamin D(3) [1,25(OH)(2)D(3)] prevent insulitis and diabetes in NOD mice. RESEARCH DESIGN AND METHODS: Since 1,25(OH)(2)D(3) regulates gene transcription thr... ( view more )ough the vitamin D receptor (VDR), we investigated the role of VDR in diabetes development by creating NOD mice without functional VDR. RESULTS: VDR(-/-) NOD mice are rachitic and have lower numbers of putative regulator cells [TCR-alpha/beta(+)CD4(-)CD8(-) (natural killer T-cells) and CD4(+)CD25(+) T-cells [in central and peripheral immune organs compared with VDR(+/+) NOD littermates. Lipopolysaccharide-stimulated VDR(-/-) NOD macrophages expressed lower interleukin (IL)-1, IL-6, and CC chemokine ligand 2 mRNA, correlating with less nuclear translocation of p65 nuclear factor-kappaB compared with VDR(+/+) NOD macrophages. Thymic and lymph node dendritic cells from VDR(-/-) NOD mice displayed an even less mature CD11c(+)CD86(+) phenotype than VDR(+/+) NOD mice. Despite this immune phenotype linked to diabetes in NOD mice, VDR(-/-) NOD mice developed insulitis and diabetes at the same rate and incidence as VDR(+/+) NOD littermates. CONCLUSIONS: Despite aggravating known immune abnormalities in NOD mice, disruption of VDR does not alter disease presentation in NOD mice in contrast to the more aggressive diabetes presentation in vitamin D-deficient NOD mice. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A thyroid thriller: acute transient and symmetric goiter after fine-needle aspiration of a solitary thyroid nodule. Jan 2008 Annick Van den Bruel,Philip Roelandt,Maria Drijkoningen,Jean-Pierre Hudders,Brigitte Decallonne,Roger Bouillon OBJECTIVE: To report a case of a patient who developed an acute and transient, tender, and bilateral swelling of the thyroid that occurred during fine-needle aspiration (FNA) of a solitary nodule in the left thyroid lobe; to add accurate ultrasound measurements to support our clinical observation; ... ( view more )and to analyze a possible underlying mechanism of this rare condition. RESULTS AND CLINICAL FOLLOW-UP: The calculated thyroid volume increased from 23 to 57 mL before and at 4 minutes, respectively, after the needle aspiration, but the thyroid volume returned to prediagnostic level after 4 hours. Cytology, serum calcitonin, and histology were concordant, and the nodule was diagnosed as a medullary thyroid carcinoma. Immunohistochemistry was positive for calcitonin, chromogranin, and the very potent vasodilator calcitonin gene-related peptide (CGRP). CONCLUSION: This is a rare case of acute and transient thyroid swelling during a common procedure as FNA of a thyroid nodule. This is the first case with documented acute volume expansion quantified by ultrasound measurements supporting our clinical observation, which is in accordance with two historical case reports. The clinical and ultrasound data support the hypothesis of vasodilation as the underlying mechanism, possibly evoked by the release of the vasodilator CGRP. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Hypogonadism in male outpatients with sarcoidosis. Dec 2007 Martijn A Spruit,Michiel J Thomeer,Rik Gosselink,Wim A Wuyts,Erik Van Herck,Roger Bouillon,Maurits G Demedts,Marc Decramer Hypogonadism is assumed to be present in sarcoidosis. Nevertheless, a comparison of circulating sex hormone concentrations of male sarcoidosis patients with those of healthy men has never been done. Moreover, it remains unknown if hypogonadism may contribute to a reduced muscle function, exercise i... ( view more )ntolerance, diminished vitality and depressed mood in male sarcoidosis patients. Pulmonary function, muscle function, exercise tolerance, vitality, mood, circulating sex hormone concentrations and C-reactive protein were assessed in 30 male sarcoidosis patients and 26 age-matched men with a normal pulmonary function. On average, patients had a restrictive pulmonary function, worse inspiratory and quadriceps muscle function, functional exercise intolerance, diminished vitality, depressed mood and increased systemic inflammation. Moreover, patients had significantly lower circulating (free) testosterone concentrations, while circulating sex hormone-binding globulin tended to be lower (p=0.0515). Circulating gonadotrophin concentrations were comparable. Non-significant relationships were found between sex hormones, clinical outcomes and C-reactive protein in patients with sarcoidosis. A significant number of male outpatients with sarcoidosis (46.7%) had low circulating testosterone concentrations, which was most probably caused by hypogonadotrophism. The clinical relevance of hypogonadism in male outpatients with sarcoidosis, however, remains currently unknown. Indeed, poor inspiratory and quadriceps muscle function, exercise intolerance, diminished vitality and depressed mood were not related to hypogonadism in these patients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Quality of life after multiple trauma: the effect of early onset psychotherapy on quality of life in trauma patients. Nov 2007 Nicola Pirente,Christine Blum,Silja Wortberg,Sevgi Bostanci,Eva Berger,Rolf Lefering,Bertil Bouillon,Klaus E Rehm,Edmund A M Neugebauer BACKGROUND AND AIMS: The aim of this study was to improve health-related quality of life (HRQOL) related to depression, anxiety, pain, physical functioning and social aspects for severely injured trauma survivors by early onset cognitive behavioural therapy applied on the surgical ward. MATERIALS A... ( view more )ND METHODS: The study was a randomised, controlled study. Of 298 primary screened patients 171 were eligible and randomised. Ninety-two patients adhered to follow-up investigations at 6 and 12 months. Main outcome measure was a sum score according to O'Brien calculated of five different questionnaires (BDI, SF-36, STAI, SCL 90R, F-SOZU-22). RESULTS: The sum score for overall HRQOL did not show significant group differences at follow-up. Effects on HRQOL sub-dimensions within groups have been found. In the dimension of depression therapy group showed significant improvement from the first measurement to discharge from hospital (p < 0.001), 6 MFU (p = 0.004) and to 12 MFU (p = 0.013). Measures of anxiety showed significant improvement for the therapy group at discharge from hospital (p = 0.001). In the control group there was only a significant reduction in depression and anxiety from surgical ward to discharge (p = 0.013/p = 0.031). CONCLUSIONS: Early onset cognitive therapy is not effective in improving overall HRQOL of severely injured patients but shows promising effects on depression and anxiety up to 12 months after trauma. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles [Initial management of polytraumatized patients in the emergency department] Oct 2007 Frank Hokema,Bernd Donaubauer,Thilo Busch,Bertil Bouillon,Udo Kaisers Advanced Trauma Life Support (ATLS) provides a structured and efficient approach to the treatment of patients with multiple trauma in the emergency department. The performance of a well functioning interdisciplinary trauma team coordinated by an experienced trauma leader plays a pivotal role during... ( view more ) the initial phase of patient care. The team's primary task is to establish and maintain stable vital signs by ensuring adequate oxygenation and fluid resuscitation while diagnostic or immediate life saving interventions and procedures are initiated. The following article describes the management of patients with multiple injuries in the emergency department based on the ATLS algorithm. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Role of dynamic magnetic resonance imaging in the evaluation of tumor response to preoperative concurrent radiochemotherapy for large breast cancers: a prospective phase II study. Sep 1, 2007 Marc A Bollet,Fabienne Thibault,Kim Bouillon,Martine Meunier,Brigitte Sigal-Zafrani,Alexia Savignoni,Véronique Diéras,Claude Nos,Rémy Salmon,Alain Fourquet,Institut Curie Breast Cancer Study Group PURPOSE: To evaluate the accuracy of clinical examination and of three imaging modalities (ultrasound [US] scan, mammography, and magnetic resonance imaging [MRI]) to assess the tumor response of breast cancer to a preoperative regimen of concurrent radiochemotherapy for large breast cancers, using... ( view more ) pathologic data as the reference. METHODS AND MATERIALS: Sixty women were accrued. Treatment consisted of 4 cycles of (5-fluorouracil-vinorelbine) chemotherapy with, starting with the second cycle of chemotherapy, locoregional radiotherapy to the breast and the internal mammary and supraclavicular and infraclavicular lymph nodes. Breast surgery and axillary lymph node dissection were subsequently performed. Breast imaging assessments were performed both before chemotherapy and preoperatively. RESULTS: The correlation coefficients between tumor dimension at imaging and pathology were statistically significant for US scan (r = 0.4; p = 0.006) and MRI (r = 0.4; p = 0.004) but not for clinical examination (r = 0.2; p = 0.16) or mammography (r = -0.15; p = 0.31). Furthermore, the area under the receiver operating characteristic curve for MRI was 0.81, compared with 0.67 for US scan. At the optimal threshold score, MRI performed with 81% sensitivity and 75% specificity. CONCLUSION: Compared with clinical examination, US scan, or mammography, MRI substantially improved the prediction of pathologic tumor response to preoperative concurrent radiochemotherapy for large breast cancers. ( view less ) View Full Abstract View Article Details   Related Articles Age-, gender-, and weight-related effects on levels of 25-hydroxyvitamin D are not mediated by vitamin D binding protein. Aug 2007 Mark J Bolland,Andrew B Grey,Ruth W Ames,Anne M Horne,Barbara H Mason,Diana J Wattie,Greg D Gamble,Roger Bouillon,Ian R Reid OBJECTIVE: 25-hydroxyvitamin D (25OHD) levels are inversely related to body weight, and have been reported to decline with age and be lower in women than men. We hypothesized that these findings might be explained by effects of these variables on vitamin D binding protein (DBP) levels. We set out t... ( view more )o determine the relationships between DBP and gender, 25OHD, body weight and body composition. DESIGN: Cross-sectional analysis. PATIENTS: One hundred healthy, middle-aged and older, community-dwelling men and women. MEASUREMENTS: All participants were measured for 25OHD, DBP, body weight, bone mineral density and body composition. RESULTS: Women had higher mean DBP levels than men but lower total 25OHD levels [DBP: women, mean (SD) 339 (36) mg/l, men 307 (71) mg/l, P = 0.005; 25OHD: women 67 (23) nmol/l, men 91 (39) nmol/l, P < 0.001]. In women, there were significant positive relationships between DBP and albumin (r = 0.33) and 25OHD (r = 0.34) whereas in men there were no significant relationships between DBP and any measured variables. There was no significant relationship between DBP and age, body weight, body mass index, fat mass or percentage fat in men or women. CONCLUSION: We found no evidence to support the hypothesis that DBP levels are related to age, or adiposity. The changes in 25OHD levels with age, gender, or fat mass are not due to underlying relationships between DBP and these variables. This suggests that the relationships consistently observed between 25OHD and body composition and gender are of biological origin and not due to adaptation to changes in transport proteins. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles [Pulmonary pseudocysts. A rare entity after thoracic injury] Aug 2007 T Steinbüchel,J Lindner,T Tjardes,E Steinhausen,B Bouillon,D Knütgen,V Keppler,M Maegele Post-traumatic pulmonary pseudocyst is a rare manifestation of blunt thoracic injury. Young adults and adolescents are predominantly affected. Here we report the successful outcome of post-traumatic pseudocysts secondary to severe lung contusion with severe intrathoracic haemorrhage in both lower l... ( view more )obes and the upper right lobe by aggressive coagulation management, kinetic therapy/postural drainage and control of secondary infection. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Differential immunoresponses following experimental traumatic brain injury, bone fracture and "two-hit"-combined neurotrauma. Aug 2007 M Maegele,S Sauerland,B Bouillon,U Schäfer,H Trübel,P Riess,E A M Neugebauer OBJECTIVE AND DESIGN: Cytokine-mediated immunoresponses are consequences of isolated traumatic brain injury (TBI) and muskuloskeletal trauma but little is known when both impacts occur simulanteously in combined neurotrauma (CNT), i. e. TBI + muskuloskeletal trauma (bone fracture). MATERIALS AND ME... ( view more )THODS: A "two-hit"-experimental model of CNT (TBI + tibia fracture) was used to investigate circulating cytokine interleukin-1-beta, -6, -10 and sTNF-R1 concentrations following peripheral bone fracture only, TBI only and CNT. Blood samples were drawn at 30 min, 6 h, 24 h, 48 h, and 7 days following trauma and circulating cytokine concentrations were determined via immunoassay. RESULTS: Circulating cytokines were increased after trauma (p <0.001 vs. controls), but peaked at different time points. sTNF R1 peaked first at 30 min, followed by IL-6 at 6 h after trauma. IL-10 levels were highest at 24 h, and those for IL-1beta at 48 h after trauma. Circulating IL-6 and IL-10 levels were highest in CNT at 8/10 time points studied (p <0.001). CONCLUSION: Circulating cytokine IL-1-beta, -6, -10 and sTNF-R1 concentrations are increased after trauma (TBI, fracture and CNT) but peak at different time points. Pronounced IL-6 and IL-10 responses after CNT may contribute to the increased susceptibility for complications in CNT versus monotrauma. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The E2F-regulated gene Chk1 is highly expressed in triple-negative estrogen receptor /progesterone receptor /HER-2 breast carcinomas. Jul 15, 2007 Lieve Verlinden,Isabelle Vanden Bempt,Guy Eelen,Maria Drijkoningen,Ilse Verlinden,Kathleen Marchal,Christiane De Wolf-Peeters,Marie-Rose Christiaens,Luc Michiels,Roger Bouillon,Annemieke Verstuyf We previously showed that checkpoint kinase 1 (Chk1) and Claspin, two DNA-damage checkpoint proteins, were down-regulated by 1,25-dihydroxyvitamin D(3), a known inhibitor of cell proliferation. In the present study, we aimed to investigate the transcriptional regulation of Chk1 and Claspin and to s... ( view more )tudy their expression levels in human breast cancer tissue. Transient transfection experiments in MCF-7 breast cancer cells showed that promoter activities of Chk1 and Claspin were regulated by the E2F family of transcription factors. Subsequently, transcript levels of Chk1, Claspin, and E2F1 were determined by quantitative reverse transcriptase-PCR analysis in 103 primary invasive breast carcinomas and were compared with several clinicopathologic variables in breast cancer. A strong correlation was found between Chk1 and Claspin transcript levels. Transcript levels of Chk1, Claspin, and E2F1 were highest in histologic grade 3 tumors and in tumors in which the expression of estrogen receptor (ER) and progesterone receptor (PR) was lost. Moreover, Chk1 expression was significantly elevated in grade 3 breast carcinomas showing a triple-negative ER-/PR-/HER-2- phenotype compared with other grade 3 tumors. Further research is warranted to validate the use of Chk1 inhibitors in triple-negative breast carcinomas for which treatment strategies are limited at present. ( view less ) View Full Abstract View Article Details   Related Articles Monocytes from type 2 diabetic patients have a pro-inflammatory profile. 1,25-Dihydroxyvitamin D(3) works as anti-inflammatory. Jul 2007 Annapaula Giulietti,Evelyne van Etten,Lut Overbergh,Katinka Stoffels,Roger Bouillon,Chantal Mathieu The exact factors contributing to the pathogenesis of type 2 diabetes remain elusive. Lately, it was suggested that inflammation and activation of the innate immune system could be linked to type 2 diabetes pathogenesis and also to the development of common diabetic complications, mainly atheroscle... ( view more )rosis. The aim of this study was to investigate the role of monocytes in this sub-clinical inflammatory state and test 1,25-dihydroxyvitamin D(3), the active form of Vitamin D, as an anti-inflammatory agent. For this purpose, monocytes from type 2 diabetic patients were compared to monocytes from healthy controls and type 1 diabetic patients. The expression profile of inflammatory markers in freshly isolated and immune-stimulated monocytes was measured by quantitative real-time RT-PCR. Type 2 diabetic patients showed significantly higher expression levels of TNF-alpha, IL-6, IL-1, IL-8, COX-2, ICAM-1 and B7-1 compared to controls and type 1 diabetic patients. 1,25-Dihydroxyvitamin D(3) was able to down-regulate the expression of TNF-alpha, IL-6, IL-1, and IL-8, confirming its immunomodulatory properties. From these data we concluded that monocytes from type 2 diabetic patients have a pro-inflammatory profile. In addition, 1,25-dihydroxyvitamin D(3) was able to modulate inflammation in these monocytes. ( view less ) View Full Abstract View Article Details   Related Articles [Pharmacokinetic-pharmacodynamic models for inhaled anaesthetics] Jun 2007 S Kreuer,J Bruhn,W Wilhelm,T Bouillon Pharmacokinetic models can be differentiated into two groups: physiological-based models and empirical models. Traditionally the pharmacokinetics of volatile anaesthetics are described using physiological-based models together with the respective tissue-blood distribution coefficients. The compartm... ( view more )ents of the empirical model have no anatomical equivalents and are merely the product of the mathematical procedure for parameter estimation. The end expiratory concentration of volatile anaesthetics is approximately equal to the arterial concentration and, therefore, the description of the transition between plasma and effect site for volatile anaesthetics plays a central role. The most important parameter here is the k(e0) value which is a time constant and describes the time delay for the transition from the central compartment to the calculated effect compartment. The k(e0) values for sevoflurane and isoflurane are the same but the concentration balance between the end-tidal concentration and the effect compartment occurs twice as quickly with desflurane. In clinical practice volatile anaesthetics are normally combined with N(2)O and/or opioids. This results in an additive interaction between volatile anaesthetics and N(2)O but a synergistic interaction of volatile anaesthetics with opioids. However, there are relatively few investigations on the interactions between the clinically widely used combination of volatile anaesthetics, N(2)O and opioids. ( view less ) View Full Abstract View Article Details   Related Articles Removal of C-ring from the CD-ring skeleton of 1alpha,25-dihydroxyvitamin D3 does not alter its target tissue metabolism significantly. Apr 15, 2007 G Satyanarayana Reddy,Matthew Robinson,Guochun Wang,G Tayhas R Palmore,Lynn Gennaro,Paul Vouros,Pierre De Clercq,Maurits Vandewalle,Wu Young,Shi Ling,Annemieke Verstuyf,Roger Bouillon It is now well established that 1alpha,25(OH)2D3 is metabolized in its target tissues through the modifications of both side chain and A-ring. The C-24 oxidation pathway is the side chain modification pathway through which 1alpha,25(OH)2D3 is metabolized into calcitroic acid. The C-3 epimerization ... ( view more )pathway is the A-ring modification pathway through which 1alpha,25(OH)2D3 is metabolized into 1alpha,25(OH)2-3-epi-D3. During the past two decades, a great number of vitamin D analogs were synthesized by altering the structure of both side chain and A-ring of 1alpha,25(OH)2D3 with the aim to generate novel vitamin D compounds that inhibit proliferation and induce differentiation of various types of normal and cancer cells without causing significant hypercalcemia. Previously, we used some of these analogs as molecular probes to examine how changes in 1alpha,25(OH)2D3 structure would affect its target tissue metabolism. Recently, several nonsteroidal analogs of 1alpha,25(OH)2D3 with unique biological activity profiles were synthesized. Two of the analogs, SL 117 and WU 515 lack the C-ring of the CD-ring skeleton of 1alpha,25(OH)2D3. SL 117 contains the same side chain as that of 1alpha,25(OH)2D3, while WU 515 contains an altered side chain with a 23-yne modification combined with hexafluorination at C-26 and C-27. Presently, it is unknown how the removal of C-ring from the CD-ring skeleton of 1alpha,25(OH)2D3 would affect its target tissue metabolism. In the present study, we compared the metabolic fate of SL 117 and WU 515 with that of 1alpha,25(OH)2D3 in both the isolated perfused rat kidney, which expresses only the C-24 oxidation pathway and rat osteosarcoma cells (UMR 106), which express both the C-24 oxidation and C-3 epimerization pathways. The results of our present study indicate that SL 117 is metabolized like 1alpha,25(OH)2D3, into polar metabolites via the C-24 oxidation pathway in both rat kidney and UMR 106 cells. As expected, WU 515 with altered side chain structure is not metabolized via the C-24 oxidation pathway. Unlike in rat kidney, both SL 117 and WU 515 are also metabolized into less polar metabolites in UMR 106 cells. These metabolites displayed GC and MS characteristics consistent with A-ring epimerization and were putatively assigned as C-3 epimers of SL 117 and WU 515. In summary, we report that removal of the C-ring from the CD-ring skeleton of 1alpha,25(OH)2D3 does not alter its target tissue metabolism significantly. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Duodenal calcium absorption in dexamethasone-treated mice: functional and molecular aspects. Apr 15, 2007 Sophie J Van Cromphaut,Ingrid Stockmans,Sophie Torrekens,Erik Van Herck,Geert Carmeliet,Roger Bouillon Reduced intestinal calcium absorption may be part of the pathogenesis of glucocorticoid-induced osteoporosis. 1,25(OH)2D3 is the major regulator of the expression of the active duodenal calcium absorption genes: TRPV6 (influx), calbindin-D9K (intracellular transfer) and PMCA1b (extrusion). We inves... ( view more )tigated the influence of dexamethasone (5 days: 2 mg/kg bw) on calcium absorption in vivo and on the expression of intestinal and renal calcium transporters in calcium-deprived mice. Total and free 1,25(OH)2D3-concentrations were halved, in line with decreased 25(OH)D3-1-alpha-hydroxylase and increased 24-hydroxylase expression. Nevertheless, no difference in duodenal or renal calcium transporter expression pattern could be detected between vehicle and dexamethasone-treated mice. Accordingly, dexamethasone did not affect in vivo calcium absorption. By contrast, increased calcemia and collagen C-terminal telopeptide levels reflected increased bone resorption. Decreased osteocalcin levels suggested impaired bone formation. Hence, short-term glucocorticoid excess in young animals affected bone metabolism without detectable changes in intestinal or renal calcium handling. ( view less ) View Full Abstract View Article Details   Related Articles Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. Apr 2007 Steven Boonen,Paul Lips,Roger Bouillon,Heike A Bischoff-Ferrari,Dirk Vanderschueren,Patrick Haentjens PURPOSE: The purpose of this study was to extend the metaanalysis of Bischoff-Ferrari et al., which found that 700-800 IU/d vitamin D reduced hip fracture risk in elderly individuals by 25%, by defining the need for additional calcium supplementation in individuals receiving vitamin D for the preve... ( view more )ntion of hip fractures. DATA SOURCES: MEDLINE and EMBASE.com (search terms: "vitamin D" and "hip fracture"), bibliographies of articles retrieved, and the authors' reference files were used as data sources. Study Selection: Selected studies were randomized controlled trials (RCTs) of oral vitamin D with or without calcium supplementation vs. placebo/no treatment in postmenopausal women and/or older men (>or=50 yr) specifically reporting a risk of hip fracture. DATA EXTRACTION: Independent extraction was performed by two authors using predefined criteria, including study quality indicators. DATA SYNTHESIS: All pooled analyses are based on random-effects models. Based on four RCTs (9083 patients), the pooled relative risk (RR) of hip fracture for vitamin D alone was 1.10 [95% confidence intervals (CI) 0.89, 1.36]. No between-trial heterogeneity was observed. For the six RCTs (45,509 patients) of vitamin D with calcium supplementation, the pooled RR for hip fracture was 0.82 (95% CI 0.71, 0.94). There was no heterogeneity between trials. In an adjusted indirect comparison of the summary RRs from the two metaanalyses, the RR for hip fracture for vitamin D with calcium vs. vitamin D alone was 0.75 (95% CI 0.58, 0.96). CONCLUSIONS: Our analyses, designed to extend the findings of Bischoff-Ferrari et al., suggest that oral vitamin D appears to reduce the risk of hip fractures only when calcium supplementation is added. ( view less ) View Full Abstract View Article Details   Related Articles Page 1 of 24 1 2 3 4 > Last >> (581 articles found)

      
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