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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  Humans or Animals Humans Animals 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 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 975) Sort By: Publication Date Relevance Took: 8.235 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 39 1 2 3 4 > Last >> (975 articles found) [Safety of blood transfusion at the international level. The role of WHO] Sep 2006 N Dhingra,V Hafner Blood safety is an international public health challenge, particularly since the emergence of HIV AIDS. Recognizing the gross disparities between countries in the adequacy of national blood supplies and the risks arising from poorly organized services, particularly in developing countries, the Worl... ( view more )d Health Organization has developed a global strategy for blood safety and availability. Dr N. Dhingra, coordinator, blood transfusion safety, WHO Headquarters, and Dr V. Hafner, focal point for blood safety in the WHO regional office for Europe, present the main features of this strategy: well-organized, nationally coordinated blood transfusion services with quality systems in all areas; the collection of blood only from voluntary non-remunerated blood donors from low-risk populations; the quality-assured testing of all donated blood; the safe and appropriate use of blood and blood products; and global collaboration for blood safety. WHO's programs, some difficulties encountered and outcomes are also described in this article. ( view less ) View Full Abstract View Article Details   Related Articles Systematics and phylogeography of pocket gophers in the genera Cratogeomys and Pappogeomys. Jan 2002 James W Demastes,Theresa A Spradling,Mark S Hafner,David J Hafner,David L Reed Mitochondrial-DNA sequence data were analyzed from individuals sampled from 38 localities across the complete geographic range of the closely related pocket gopher genera Pappogeomys and Cratogeomys. Results of phylogenetic analysis of 1133 base pairs from the cytochrome b gene are consistent with ... ( view more )past hypotheses of relationships among members of the castanops species group within the genus Cratogeomys. However, phylogeographic variation within the gymnurus species group of the genus Cratogeomys differs significantly from relationships reflected by current taxonomy. The data indicate that there are five geographically distinct clades within the gymnurus species group. Members of the two nominal species C. gymnurus and C. tylorhinus are scattered among these clades. The three peripherally isolated species, C. fumosus, C. neglectus, and C. zinseri, do not appear to be genetically distinct from other gymnurus species group taxa. An historical biogeographic hypothesis is proposed that will be tested using nuclear DNA data. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pocket gophers and chewing lice: a test of the maternal transmission hypothesis. Aug 1998 J W Demastes,M S Hafner,D J Hafner,T A Spradling The life-history traits of pocket gophers and their chewing lice suggest that there is little opportunity for transmission of parasites among pocket gophers, with the exception of transmission from mother to offspring. Herein, we test the hypothesis that lice are transmitted maternally by using an ... ( view more )indirect approach that compares the distribution of louse populations to the distribution of mitochondrial DNA haplotypes in the pocket gophers. Comparison of the chewing louse distributions to the distribution of mtDNA haplotypes for the gophers revealed no significant concordance, and thus falsifies the maternal transmission hypothesis. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The karyotype of Typhlonectes compressicauda (Amphibia: Gymnophiona) with comments on chromosome evolution in caecilians. Feb 15, 1980 M H Wake,J C Hafner,M S Hafner,L L Klosterman,J L Patton Typhlonectes compressicauda has a diploid number of 28. Its karyotype, when compared to that of other caecilians, suggests some discordance in the hypothesized model of chromosome reduction in the evolution of amphibian lineages. View Full Abstract View Article Details View Coded Data Related Articles Nazi data: dissociation from evil. 1989 Jul-Aug M Sheldon,W P Whitely,B Folker,A W Hafner,W Gaylin This case study and three commentaries involve a contemporary researcher pondering the moral implications of using Nazi experimental data related to his work. How should Nazi data be regarded? Is it tainted information, or morally neutral? Should researchers today treat this data differently tha... ( view more )n more conventionally gathered information? Mark Sheldon and William Whitely cite Kristine Moe's four conditions that, if met, may justify the use of Nazi data. They conclude that, while researchers may be obliged to use the data if it can preserve life, by doing so they may be desecrating the memory of Nazi victims unless they can continually and creatively sustain a sense of condemnation. Brian Folker and Arthur Hafner reject the use of Nazi data, but conclude that each researcher must decide out of a concern for him- or herself as a moral being. Willard Gaylin argues that to use Nazi data is to legitimatize it and to become an accomplice. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The role of domestic hygiene in inflammatory bowel diseases: hepatitis A and worm infestations. Jun 2008 Stefan Hafner,Antje Timmer,Hans Herfarth,Gerhard Rogler,Jürgen Schölmerich,Andreas Schäffler,Boris Ehrenstein,Wolfgang Jilg,Claudia Ott,Ulrike G Strauch,Florian Obermeier BACKGROUND: Environmental factors are likely to be involved in the pathogenesis of inflammatory bowel disease (IBD), as the incidence of both Crohn's disease (CD) and ulcerative colitis (UC) increased with improved living standards in Europe after World War II. On the basis of earlier reports sugge... ( view more )sting that hygienic standards may also play a role in the pathogenesis of IBD, we investigated the influence of hepatitis A seroprevalence as an indicator for poorer hygienic conditions and worm infestations in IBD. METHODS: Hepatitis A seroprevalence was examined in patients with UC and CD. Patients with minor endocrinological disorders served as controls. All patients were questioned about immunizations, parasitic infections (worms), contact with animals, living on a farm, and ever traveling abroad. Patients were excluded for active hepatitis A immunization or recent passive immunization. Results are presented as Mantel-Haenszel odds ratios with 95% confidence interval, adjusted for age group. RESULTS: The sample included 307 patients (73 CD, 48 UC, and 186 controls). Hepatitis A seroprevalence was strongly associated with age older than 50 years. Age adjusted Mantel-Haenszel odds ratios were 0.25 (0.09-0.71) for UC and 0.75 (0.38-1.46) for CD versus controls. For parasitic infections, the odds ratios were 1.15 (0.52-2.53) for UC and 0.34 (0.13-0.89) for CD. CONCLUSION: We were able to demonstrate a negative association of hepatitis A infection with UC only. In contrast, a novel finding was a strong protective effect of worm infestations for the occurrence of CD, but not UC. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Codivergence in heteromyid rodents (rodentia: heteromyidae) and their sucking lice of the genus fahrenholzia (phthiraptera: anoplura). Jun 2008 Jessica E Light,Mark S Hafner Although most studies of codivergence rely primarily on topological comparisons of host and parasite phylogenies, temporal assessments are necessary to determine if divergence events in host and parasite trees occurred contemporaneously. A combination of cophylogenetic analyses and comparisons of b... ( view more )ranch lengths are used in this study to understand the host-parasite association between heteromyid rodents (Rodentia: Heteromyidae) and their sucking lice of the genus Fahrenholzia (Phthiraptera: Anoplura). Cophylogenetic comparisons based on nucleotide substitutions in the mitochondrial COI gene reveal a significant, but not perfect, pattern of cophylogeny between heteromyids and their sucking lice. Regression analyses show a significant functional relationship between the lengths of analogous branches in the host and parasite trees, indicating that divergence events in hosts and parasites were approximately contemporaneous. Thus, the topological similarity observed between heteromyids and their lice is the result of codivergence. These analyses also show that the COI gene in lice is evolving two to three times faster than the same gene in their hosts (similar to the results of studies of other lice and their vertebrate hosts) and that divergence events in lice occurred shortly after host divergence. We recommend that future studies of codivergence include temporal comparisons and, when possible, use the same molecular marker(s) in hosts and parasites to achieve the greatest insight into the history of the host-parasite relationship. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Interferon-beta increases BAFF levels in multiple sclerosis: implications for B cell autoimmunity. Jun 2008 M Krumbholz,H Faber,F Steinmeyer,L-A Hoffmann,T Kümpfel,H Pellkofer,T Derfuss,C Ionescu,M Starck,C Hafner,R Hohlfeld,E Meinl B cells are increasingly recognized as major players in multiple sclerosis pathogenesis. The BAFF/APRIL system is crucial for B cell homoeostasis and may drive B cell-dependent autoimmunity. We asked whether this system is affected by Interferon (IFN)-beta therapy. We analysed transcription of the ... ( view more )ligands (BAFF, APRIL, TWE-PRIL) and the corresponding receptors (BAFF-R, TACI and BCMA) by TaqMan-PCR ex vivo in whole blood and in immune cell subsets purified from IFN-beta-treated multiple sclerosis patients. Serum BAFF concentrations were determined by ELISA. This cross-sectional study involved 107 donors. IFN-beta therapy strongly induced BAFF transcription proportionally to the IFN-beta biomarker MxA in monocytes and granulocytes in vivo. BAFF serum concentrations were elevated in IFN-beta-treated multiple sclerosis patients to a similar level as observed in SLE patients. In cultured PBMC, neutrophils, fibroblasts and astrocytes, BAFF was induced by IFN-beta concentrations similar to those reached in vivo in treated multiple sclerosis patients. BAFF turned out to be the main regulated element of the BAFF/APRIL system. In untreated multiple sclerosis patients, there was no BAFF increase as compared to healthy controls. Our study reveals a complex situation. We show that IFN-beta therapy induces a potent B cell survival factor, BAFF. However, B cell depletion would be desirable at least in some multiple sclerosis patients. The systemic induction of BAFF by IFN-beta therapy may facilitate the production of various autoantibodies and of IFN-neutralizing antibodies. Individual MS/NMO patients who have major B cell involvement may benefit less than others from IFN-beta therapy, thus explaining interindividual differences of the therapeutic response. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Synthetic mimetics of the gp130 binding site for viral interleukin-6 as inhibitors of the vIL-6-gp130 interaction. May 2008 Enge Sudarman,Mariela Bollati-Fogolín,Martin Hafner,Werner Müller,Jürgen Scheller,Stefan Rose-John,Jutta Eichler The transmembrane protein gp130 acts as the signal transducing receptor subunit for interleukin-6 type cytokines, including viral interleukin-6, which is encoded by the Kaposi's sarcoma-associated herpes virus. Viral interleukin-6 has been shown to mimic human IL-6 functions, including activation o... ( view more )f the JAK1 and STAT1/3 signaling pathways. Based on the crystal structure of three extracellular domains of gp130 in complex with viral interleukin-6, we have designed and synthesized a range of assembled peptides that mimic the sequentially discontinuous binding site of gp130 for viral interleukin-6. These peptides, which present the three binding site fragments of gp130 in a nonlinear, discontinuous fashion, were shown to inhibit the interaction of gp130 with viral interleukin-6, as well as the stimulation of viral interleukin-6-induced cell proliferation. These results validate the concept of synthetic mimicry of discontinuous protein-binding sites through assembled peptides, and the use of such molecules as modulators of protein-ligand interactions. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Through-space MP-CPMAS experiments between spin-1/2 and half-integer quadrupolar nuclei in solid-state NMR. May 2008 B Hu,J P Amoureux,J Trébosc,S Hafner We present a new CPMAS method that allows the acquisition of through-space 2D HETCOR spectra between spin-1/2 nuclei and half-integer quadrupolar nuclei in the solid state. It uses rotor-synchronized selective pulses on the quadrupolar nucleus and continuous-wave RF irradiation on the spin-1/2 nucl... ( view more )eus to create hetero-nuclear dipolar coherences. The method is more robust, more efficient, and easier to set up than the standard CPMAS transfer. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Interannual variations in PM2.5 due to wildfires in the Western United States. Apr 15, 2008 Dan Jaffe,William Hafner,Duli Chand,Anthony Westerling,Dominick Spracklen In this study we have evaluated the role of wildfires on concentrations of fine particle (d < 2.5 microm) organic carbon (OC) and particulate mass (PM2.5) in the Western United States for the period 1988-2004. To do this, we examined the relationship between mean summer PM2.5 and OC concentrations ... ( view more )at 39 IMPROVE sites with a database of fires developed from federal fire reports. The gridded database of area burned was used to generate a database of biomass fuel burned using ecosystem-specific fuel loads. The OC, PM2.5, and fire data were evaluated for five regions: Northern Rocky Mountains (Region 1), Central Rocky Mountains (Region 2), Southwest (Region 3), California (Region 4), and Pacific Northwest (Region 5). In Regions 1, 2, and 5, we found good correlations of seasonal mean PM2.5 concentrations among the sites within each region. This indicates that a common influence was important in determining the PM concentration at all sites across each region. In Regions 1 and 2, we found a significant correlation between PM2.5 and both the area burned and biomassfuel burned in each region. This relationship is statistically significant using either the area burned or fuel burned, but the correlations are stronger using the biomass fuel burned. In all five regions we found a statistically significant relationship between biomass burned and organic carbon. Using these relationships, we can estimate the amount of PM2.5 due to fires in each region during summer. For the Regions 1 through 5, the average summer-long enhancement of PM2.5 due to fires is 1.84, 1.09, 0.61, 0.81, and 1.21 microg/m3, respectively, and approximately twice these values during large fire years. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Close encounters between two nanoshells. Apr 2008 J Britt Lassiter,Javier Aizpurua,Luis I Hernandez,Daniel W Brandl,Isabel Romero,Surbhi Lal,Jason H Hafner,Peter Nordlander,Naomi J Halas Plasmonic nanoparticle pairs known as "dimers" embody a simple system for generating intense nanoscale fields for surface enhanced spectroscopies and for developing an understanding of coupled plasmons. Individual nanoshell dimers in directly adjacent pairs and touching geometries show dramatically... ( view more ) different plasmonic properties. At close distances, hybridized plasmon modes appear whose energies depend extremely sensitively on the presence of a small number of molecules in the interparticle junction. When touching, a new plasmon mode arising from charge transfer oscillations emerges. The extreme modification of the overall optical response due to minute changes in very reduced volumes opens up new approaches for ultrasensitive molecular sensing and spectroscopy. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Neurotoxic and neurotrophic roles of proNGF and the receptor sortilin in the adult and ageing nervous system. Apr 2008 Raya Al-Shawi,Angela Hafner,Jessica Olson,Soyon Chun,Saba Raza,Christopher Thrasivoulou,Simon Lovestone,Richard Killick,Paul Simons,Timothy Cowen The precursor form of the nerve growth factor (proNGF), forms a heterotrimeric complex with the receptors p75 and sortilin; this complex has been implicated in neuron cell death. However, it is not known whether proNGF and the receptors p75 and sortilin contribute to age- and disease-related neurod... ( view more )egeneration. Here we show that proNGF induces cell death in subpopulations of basal forebrain and peripheral sympathetic neurons of old, but not of young, adult rodents. In contrast, proNGF appears to induce neurite outgrowth rather than cell death of young adult sympathetic neurons. We have examined the neurotoxic role of proNGF in old age, and find that proNGF protein is elevated during ageing in the projection areas of some populations of vulnerable central and peripheral neurons; caloric restriction, which has known neuroprotective effects, partially prevents these increases. Sortilin was found to play a significant part in the observed patterns of age-related proNGF-mediated neurotoxicity. In particular, survival of aged neurons was rescued by neurotensin, an alternative sortilin ligand that blocks the sortilin-mediated effects of proNGF. Furthermore, sortilin immunoreactivity increases markedly in ageing rodent basal forebrain and sympathetic neurons; in contrast, p75 levels are either unchanged or reduced. From these data we propose that selective age-related neuronal atrophy and neurodegeneration may be mediated by increased sortilin expression in neurons, together with elevated levels of proNGF expression in some targets. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Fiberoptic endoscopic evaluation of swallowing in intensive care unit patients. Apr 2008 Gert Hafner,Andreas Neuhuber,Sylvia Hirtenfelder,Brigitte Schmedler,Hans Edmund Eckel Aspiration in critically ill patients frequently causes severe co-morbidity. We evaluated a diagnostic protocol using routine FEES in critically ill patients at risk to develop aspiration following extubation. We instructed intensive care unit physicians on specific risk factors for and clinical si... ( view more )gns of aspiration following extubation in critically ill patients and offered bedside FEES for such patients. Over a 45-month period, we were called to perform 913 endoscopic examinations in 553 patients. Silent aspiration or aspiration with acute symptoms (cough or gag reflex as the bolus passed into the trachea) was detected in 69.3% of all patients. Prolonged non-oral feeding via a naso-gastric tube was initiated in 49.7% of all patients. In 13.2% of patients, a percutaneous endoscopic gastrostomy was initiated as a result of FEES findings, and in 6.3% an additional tracheotomy to prevent aspiration had to be initiated. In 59 out of 258 patients (22.9%), tracheotomies were closed, and 30.7% of all 553 patients could be managed with the immediate onset of an oral diet and compensatory treatment procedures. Additional radiological examinations were not required. FEES in critically ill patients allows for a rapid evaluation of deglutition and for the immediate initiation of symptom-related rehabilitation or for an early resumption of oral feeding. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Interleukin 6-174 G/C promoter polymorphism and pregnancy complications: results of a prospective cohort study in 1626 pregnant women. Apr 2008 Felix Stonek,Martin Metzenbauer,Erich Hafner,Karl Philipp,Clemens Tempfer PROBLEM: To investigate the frequency of the interleukin-6 (IL-6) -174 G/C single nucleotide polymorphism (SNP) in women with intrauterine fetal death (IUFD), pre-eclampsia (PE), preterm delivery (PD), and small for gestational age (SGA) infants. METHOD OF STUDY: In a prospective cohort study, DNA ... ( view more )from 1626 consecutive pregnant women was analyzed for IL-6 -174 G/C. Women who developed at least one of the predefined pregnancy complications were used as cases and compared with women without pregnancy complications. RESULTS: Of 1626 women, 259 (15.9%) developed at least one pregnancy complication. IL-6 -174 G/C allele frequencies and genotype distributions were not significantly different between cases and controls. Similarly, no statistically significant difference in IL-6 -174 G/C genotype distribution in women with IUFD, PE, PD <34 weeks, PD >34 weeks and SGA infants <10th percentile was observed. CONCLUSION: IL-6 -174 G/C is not a genetic marker for identifying women at increased risk of common pregnancy complications. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Potential role of vasomotor effects of fibrinogen in bradykinin-induced angioedema. Apr 2008 Murat Bas,Nadine Kirchhartz,Jessica Hochfeld,Cornelia Tüllmann,Stephanie Kumpf,Tatsiana Suvorava,Marc Oppermann,Dieter Hafner,Henning Bier,Thomas K Hoffmann,Vera Balz,Georg Kojda BACKGROUND: Although bradykinin is known to play a major role in the pathophysiology of hereditary and angiotensin-converting enzyme inhibitor (ACEi)-induced angioedema, other factors acting as triggers or enhancers are likely important as well. OBJECTIVE: We hypothesized that fibrinogen might cont... ( view more )ribute to ACEi-induced angioedema (eg, through direct actions on vascular tone). METHODS: Plasma levels of fibrinogen were determined in 59 patients with acute angioedema. Vascular activity of human and bovine fibrinogen and its effects on bradykinin-induced vasodilation and phosphorylation of vasodilator-stimulated phosphoprotein were investigated in small (0.8-1.4 mm in diameter) porcine coronary artery and human internal thoracic artery (ITA) segments. RESULTS: In patients with ACEi-induced angioedema, fibrinogen levels (481 +/- 22 mg/dL, n = 39) were significantly higher than in patients with idiopathic angioedema (302 +/- 15 mg/dL, P < .001). Fibrinogen (1-15 mumol/L) induced a concentration-dependent vasodilation in preconstricted small porcine coronary arteries (n = 13), reaching a maximum vasodilator effect of 70% +/- 4.7%. Likewise, fibrinogen induced a 52.1% +/- 9.1% (n = 7) vasodilation in ITA rings. Fibrinogen vasorelaxations were completely inhibited by abciximab and diminished by endothelial denudation and treatment with the nitric oxide synthase inhibitor L-nitroargininemethylester and glibenclamide (P < .01). Importantly, fibrinogen increased the vasodilator potency of bradykinin by 10-fold (P < .0001) and increased bradykinin-induced vasodilator-stimulated phosphoprotein phosphorylation (P < .01). CONCLUSION: The increase of plasma fibrinogen levels, its vasodilator activity in human ITAs, and the potentiation of bradykinin-induced vasodilation suggest that fibrinogen might contribute to the pathophysiology of ACEi-induced angioedema. Thus acute-phase proteins, such as fibrinogen, might be viewed as risk factors for bradykinin-induced angioedema. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles In silico identification and in vivo analysis of a novel T-cell antigen from Chlamydia, NrdB. Mar 4, 2008 Christopher J Barker,Kenneth W Beagley,Louise M Hafner,Peter Timms Chlamydial infections are a serious economic burden and health threat to developed and developing countries. Development of an efficacious vaccine is thought to be the most convenient, potentially reliable and cost effective option to control chlamydial infection and disease complications. Currentl... ( view more )y there are very few efficacious vaccine candidates that have been identified and characterized. In this study we have identified a number of unique vaccine candidates using a novel in silico approach. The chlamydial genome was screened for proteins containing epitopes predicted to bind multiple HLA class II molecules (i.e. 'promiscuous' epitopes). A selection of target proteins were cloned, expressed, and purified. Recombinant proteins were screened against sera samples from patients with Chlamydia trachomatis genital tract infections. Two proteins, hypothetical protein CT425 and ribonucleotide reductase small chain protein (NrdB) were identified as being immunoreactive. Using a mouse model, we found that intranasal immunization with NrdB conferred a CD4+ T-cell driven degree of protection similar to that seen with CD4+ T-cells primed from a whole organism, live challenge. In addition, serum from immunized mice was found to neutralize chlamydial infection of a cell monolayer in vitro. NrdB is a highly conserved chlamydial protein with an essential role in the replication of chlamydiae and could be a useful component of a multi-subunit vaccine against chlamydial genital tract infections. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Calcium balance during calcitriol and paricalcitol administration in healthy humans. Mar 2008 V Hafner,C Rutsch,R Ding,T Heinrich,L Diedrichs,H Schmidt-Gayk,I Walter-Sack,J Bommer,G Mikus OBJECTIVE: Secondary hyperparathyroidism in hemodialysis patients requires optimal correction of vitamin D deficiency with active vitamin D and analogues. It has been postulated that new vitamin D analogues, i.e. paricalcitol, efficiently suppress parathyroid hormone serum levels (PTH), but do not ... ( view more )increase intestinal calcium absorption as much as calcitriol. The effects of calcitriol and paricalcitol on calcium balance can best be characterized under standardized conditions in healthy individuals with normal renal function, because the urinary calcium excretion at steady state corresponds to the net calcium absorption in the gut. METHODS: In a randomized, double-blind, placebo-controlled, 3-way crossover Phase I study in 13 healthy individuals we investigated the changes compared to placebo in PTH and urinary calcium excretion during 6-day treatment periods with paricalcitol (1.5 microg/day) and calcitriol (0.5 microg/day). RESULTS: 24-hour urinary calcium excretion was stable during 6 days of placebo administration. Neither paricalcitol nor calcitriol significantly changed calcium excretion. Urinary creatinine, magnesium and phosphate excretion also remained unchanged over the study periods irrespective of the treatment. However, calcitriol was shown to be effective in reducing iPTH levels during 6 days of treatment (mean reduction 4.03+/-0.69 pmol/l), whereas paricalcitol had no effect. CONCLUSION: Using a dosing ratio of 1:3 for calcitriol:paricalcitol, i.e. the same conversion factor used previously in studies on hemodialysis patients, only calcitriol was able to reduce iPTH levels in healthy individuals. Low-dose calcitriol reduced iPTH levels without raising calcium absorption and without including any hypercalcemia. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Vaccines for Chlamydia infections of the female genital tract. Feb 2008 Louise M Hafner,Celia McNeilly Genital infection with Chlamydia trachomatis is an escalating global public health concern causing considerable morbidity and socioeconomic burden worldwide. Although antibiotics are used to treat symptomatic urogenital infections, chlamydial infection remains asymptomatic in approximately 50% of i... ( view more )nfected men and 70% of infected women. The major clinical manifestations of genital chlamydial infection in women include mucopurulent cervicitis, endometritis and pelvic inflammatory disease. Genital infection with C. trachomatis markedly enhances the risk for reproductive tract sequelae in women, including tubal factor infertility, chronic pain and ectopic pregnancy. Definitive infection control of chlamydial infections will likely be achievable through a safe and efficacious vaccine. This will require identifying protective chlamydial antigens in animal models as well as identifying effective adjuvants and delivery systems that target subunit vaccines to immune inductive sites or secondary lymphoid tissues, and will be safe for use in humans. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Long-term efficacy of venom immunotherapy. Feb 2008 Tomaz Hafner,Lawrence DuBuske,Mitja Kosnik BACKGROUND: The long-term efficacy of venom immunotherapy (VIT) in patients who either prematurely discontinue VIT or who experience subsequent stings after discontinuation of VIT remains uncertain. OBJECTIVE: To survey sting reaction patterns in patients who had previously discontinued VIT. METHOD... ( view more )S: Patients who had received VIT between January 1, 1984, and December 31, 2004 were sent a questionnaire inquiring whether they had been stung by an insect to which the VIT had been directed. Symptoms that developed were assessed. The patients were subsequently contacted by telephone to clarify their responses. RESULTS: Of 227 patients who responded to the questionnaire, 181 (79.7%) received VIT for more than 3 years; 100 of these 181 patients (55.2%) were stung after discontinuing VIT. At the time of the first sting after stopping VIT, 92 patients had a local reaction and 8 had a systemic reaction. Of 40 patients who were stung more than once after ending VIT, 7 (17.5%) experienced reactions of greater severity with the subsequent stings. All the patients reported that their reactions after ending VIT were milder than before treatment. The likelihood of systemic reactions to stings was almost identical in patients treated for either longer or shorter than 3 years with VIT. CONCLUSIONS: In most patients, VIT provides long-term protection from severe systemic reactions. Risk of systemic reactions increases with subsequent stings after ending VIT. All the patients reported that symptoms experienced with stings after stopping VIT were milder than symptoms before VIT. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Immune function abnormalities in peripheral blood mononuclear cell cytokine expression differentiates stages of cutaneous T-cell lymphoma/mycosis fungoides. Feb 1, 2008 Benjamin F Chong,Adam J Wilson,Heather M Gibson,Mikehl S Hafner,Yu Luo,Carrie J Hedgcock,Henry K Wong PURPOSE: Mycosis fungoides (MF) is a cutaneous T-cell lymphoma (CTCL) characterized by neoplastic skin-homing T cells. To better understand the immunopathogenesis of MF, we analyzed the functional ability of peripheral blood mononuclear cells (PBMC) from early and late MF/CTCL patients to express c... ( view more )ytokine genes. In late stage MF/CTCL, patients were separated into those with blood involvement (+B) and without blood involvement (-B). EXPERIMENTAL DESIGN: We analyzed T(H)1 (interleukin 2 (IL-2), IFN-gamma), T(H)2 (IL-4, IL-5, IL-10, IL-13), and T(H)17 (IL-17) cytokine gene expression from activated PBMCs from normal (n = 12), psoriasis (n = 6), early MF/CTCL (n = 11), and late MF/CTCL+B (n = 4) and MF/CTCL-B (n = 3) by quantitative real-time PCR. RESULTS: PBMCs from early MF/CTCL and psoriasis showed higher induction of IL-2, IL-4, and IFN-gamma genes than those from normal and late MF/CTCL-B and MF/CTCL+B (P < 0.05) in descending order. PBMCs from late MF/CTCL-B exhibited generally the highest level of IL-5, IL-10, IL-13, and IL-17 expression compared with the other groups. PBMCs from early MF/CTCL and late MF/CTCL-B had similarly elevated IL-13 and IL-17. Of all groups, PBMCs from late MF/CTCL+B had the lowest levels of IL-2 (P < 0.05), IL-4, IFN-gamma, IL-13, and IL-17. CONCLUSIONS: The different pattern of cytokine gene expression suggests a change in immune function in MF/CTCL from early MF/CTCL to late MF/CTCL-B to late MF/CTCL+B. These stages are consistent with localized disease associated with an anti-tumor immune response and late MF/CTCL associated with a loss of immune function mediated by malignant T cells that share regulatory T cell-like properties. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Antiproliferative and proapoptotic effects of rapamycin and celecoxib in malignant melanoma cell lines. Feb 2008 Annika Bundscherer,Christian Hafner,Tim Maisch,Bernd Becker,Michael Landthaler,Thomas Vogt Inhibitors of cyclooxygenase 2 (COX 2) and the mammalian target of rapamycin (mTOR) show direct and indirect antitumor effects in a variety of cancers. This study was designed to investigate the effects of the mTOR antagonist rapamycin and the COX 2 inhibitor celecoxib on cell growth and apoptosis ... ( view more )in malignant melanoma. Cell proliferation was analysed by the cell proliferation ELISA BrdU and alamarBlue assay and apoptosis was measured by caspase 3 and 7 activity in two out of six melanoma cell lines (A375 and Mel Ho) that were selected for the heterogeneous levels of the COX 2 mRNA expression. The quantitative real-time reverse transcription polymerase chain reaction showed a 337-fold higher COX 2 mRNA level in the A375 than in the Mel Ho melanoma cells. However, both celecoxib and rapamycin caused significant growth inhibition in the two cell lines. By combining both agents, additive growth inhibitory effects were observed in the A375 cells. Treatment with celecoxib, but not rapamycin, increased apoptosis in the two cell lines. Our data indicate that rapamycin and celecoxib inhibit melanoma cell growth as single agents and a combination of both drugs have additive antitumor effects. Notably, the antiproliferative and proapoptotic effects of celecoxib seem to be independent of the COX 2 expression. Both rapamycin and celecoxib represent promising drugs for the palliative therapy of metastasised malignant melanoma and should be considered for future trials. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Measurement of genotoxicity in wastewater samples with the in vitro micronucleus test: results of a round-robin study in the context of standardisation according to ISO. Jan 8, 2008 Georg Reifferscheid,Christina Ziemann,Dagmar Fieblinger,Florian Dill,Richard Gminski,Hans-Jürgen Grummt,Christoph Hafner,Henner Hollert,Susanne Kunz,Gregory Rodrigo,Helga Stopper,Dorothea Selke In the course of standardisation of the in vitro micronucleus test for analysis of effluents according to ISO, a national round-robin study was organised by the German Federal Institute of Hydrology (BfG), involving 10 laboratories of private companies, universities and public authorities. The micr... ( view more )onucleus assay was performed with the permanently growing Chinese hamster lung fibroblast cell line V79. All participants tested four encoded samples from one municipal and one industrial wastewater treatment plant with and without metabolic activation by S9-mix. Two of these samples were spiked in advance with defined concentrations of the clastogenic substances cyclophosphamide and mitomycin C, respectively. Cyclophosphamide and ethyl methanesulfonate were used as positive controls. The defined assessment criterion for genotoxicity was the lowest dilution of a sample that does not show any significant induction of micronuclei. Cytotoxicity was judged by determining the cell-survival index, i.e. the percentage growth rate of the cells compared with the corresponding negative controls. As supplementary qualitative criteria, the mitotic index and the proliferation index were assessed. All participants successfully established the method within a few weeks and generated viable test results in time. The two non-genotoxic samples were detected as negative by 90% (with S9-mix) and 95% (without S9-mix) of the participants. The mitomycin C-spiked wastewater sample (expected to be positive without S9-mix supplementation) was correctly judged as positive by all laboratories. The cyclophosphamide-spiked sample (expected to be positive with S9-mix addition) was evaluated correctly as genotoxic by 80% of the laboratories. A post-test analysis found evidence that the false negative results were due to technical failure, but not of a methodological nature. In 94% of all tests the sample LID values (lowest ineffective dilution=dilution stage of the sample in the test at which a statistically significant increase in the micronucleus rate was not detectable any more) varied by no more than one dilution step around the median LID value. The survival index was proven to be a robust measure for estimation of toxicity. This round-robin study is the first inter-laboratory comparison of the in vitro micronucleus test using wastewater samples. The test system is intended to complement the already DIN- and ISO-standardised bacterial tests, i.e. the umu-test and the Ames plate-incorporation assay. The data provide evidence that the robust and practicable in vitro micronucleus test is suitable as a routine method for wastewater testing. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Gene expression profiling of melanocytes following Q-Switched Ruby laser irradiation. 2008 Christian Hafner,Thomas Stempfl,Wolfgang Bäumler,Ulrich Hohenleutner,Michael Landthaler,Thomas Vogt BACKGROUND: The Q-switched Ruby laser (QSRL) is used for the treatment of pigmented lesions. The influence of QSRL treatment on gene expression of nontransformed primary melanocytes has not been addressed in vitro. OBJECTIVE: We investigated the gene expression profile of melanocytes following QSRL... ( view more ) irradiation. METHODS: Primary melanocytes were irradiated with the QSRL (694 nm). Early and late transcriptional effects were analyzed using the Affymetrix gene array platform. RESULTS: Laser irradiation of melanocytes had minor effects on mRNA expression. We found only 31 out of 14,500 genes which were at least twofold up- or downregulated. The differential expression of heme oxygenase 1 and galanin in QSRL-treated melanocytes was additionally confirmed by real-time RT-PCR. Analysis of a selection of 36 genes which are known to be associated with malignant melanoma development and progression revealed no significantly aberrant expression in the QSRL-treated melanocytes. CONCLUSION: Our study shows that QSRL treatment of primary melanocytes in vitro does not cause major alterations of global gene expression and particularly of genes associated with malignant melanoma. However, since QSRL treatment may have different effects on gene expression of melanocytic cells in vivo, further studies are required to evaluate QSRL treatment of (nevo-) melanocytic lesions. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Identification of microRNAs and other small regulatory RNAs using cDNA library sequencing. Jan 2008 Markus Hafner,Pablo Landgraf,Janos Ludwig,Amanda Rice,Tolulope Ojo,Carolina Lin,Daniel Holoch,Cindy Lim,Thomas Tuschl Distinct classes of small RNAs, 20-32 nucleotides long, play important regulatory roles for diverse cellular processes. It is therefore important to identify and quantify small RNAs as a function of development, tissue and cell type, in normal and disease states. Here we describe methods to prepare... ( view more ) cDNA libraries from pools of small RNAs isolated from organisms, tissues or cells. These methods enable the identification of new members or new classes of small RNAs, and they are also suitable to obtain miRNA expression profiles based on clone count frequencies. This protocol includes the use of new deep sequencing methods (454/Roche and Solexa) to facilitate the characterization of diverse sequence pools of small RNAs. 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