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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 84) Sort By: Publication Date Relevance Took: 2.522 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 4 1 2 3 4 > (84 articles found) Scavenger receptor gp340 aggregates group A streptococci by binding pili. Jun 2008 Andrew M Edwards,Andrea G O Manetti,Fabiana Falugi,Chiara Zingaretti,Sabrina Capo,Scilla Buccato,Giuliano Bensi,John L Telford,Immaculada Margarit,Guido Grandi Group A streptococci (GAS) are the most frequent cause of bacterial pharyngitis. The first obstacle to GAS colonization of the pharynx is saliva. As well as forming a physical barrier, saliva contains components of innate and acquired immunity. Previous work has shown that saliva induces bacterial ... ( view more )aggregation, which may serve as a clearance mechanism. As the aggregation of some oral streptococci in saliva is mediated by long proteinaceous appendages, we hypothesized that pili of GAS might behave similarly. Wild-type GAS M1 strain SF370 aggregated in saliva, while pilus-defective mutants did not. Similarly, heterologous expression of diverse GAS pili on the surface of Lactococcus lactis induced aggregation in saliva, while control strains were unaffected. Further studies revealed that aggregating bacteria bound salivary component gp340. Purified gp340 aggregated wild-type GAS and L. lactis expressing GAS pili, but not control strains. GAS pilus-defective mutants were abrogated in gp340 binding and aggregation. Furthermore, gp340-mediated aggregation reduced bacterial adhesion to human epithelial cells, suggesting a role in host defence. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Promoter influences transcription elongation: TATA-box element mediates the assembly of processive transcription complexes responsive to cyclin-dependent kinase 9. Mar 21, 2008 Immaculada Montanuy,Rosana Torremocha,Cristina Hernández-Munain,Carlos Suñé Pausing of RNA polymerase II (RNAPII) during transcript elongation is an important mechanism for regulating gene expression at many genes. In this study we investigated the mechanism of regulated elongation of c-myc and human immunodeficiency virus-1 (HIV-1) using an in vitro elongation assay that ... ( view more )reproduces the conditional block to elongation. We found that HIV-1 Tat can activate the RNAPII transcription complexes paused on c-myc by enhancing their elongation efficiency. We determined that cyclin-dependent kinase 9 (CDK9), the kinase subunit of positive transcription elongation factor b (P-TEFb) complex, regulates transcriptional elongation of c-myc and is present in transcription pre-initiation complexes formed on the c-myc promoter, which emphasizes a common mechanism of elongation control between HIV-1 and c-myc genes. We also investigated the roles of upstream elements of the HIV-1 and c-myc promoters in CDK9-activated transcriptional elongation. We found that the TATA-box element mediates the assembly of processive transcription complexes responsive to CDK9 and that specific combinations of upstream activation binding sites contribute to the recruitment of these complexes. We propose a common mechanism for elongation control at the c-myc and HIV-1 genes with an essential role for the TATA-box and specific modulatory contribution of upstream regulatory sequences, derived from the unique structure of the promoters, to form a composite surface for efficient recruitment of elongation-competent transcription complexes. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Psychopathological and nutritional correlates of plasma homovanillic acid in adolescents with anorexia nervosa. Feb 2008 Josefina Castro-Fornieles,Ramón Deulofeu,Immaculada Baeza,Vanessa Casulà,Begoña Saura,Luisa Lázaro,Josefina Puig,Josep Toro,Miquel Bernardo Dopaminergic abnormalities have been described in anorexia nervosa but studies about plasma level of homovanillic acid (pHVA) have yielded conflicting results probably due to the small number and the heterogeneity of patients. Plasma HVA, nutritional and hormonal parameters and several scales - the... ( view more ) Eating Attitudes Test (EAT), the Beck Depression Inventory (BDI), the Leyton Obsessional Inventory-child version (LOI-C) and the State and Trait Anxiety Inventory (STAI) - were assessed in 44 adolescent anorexia nervosa patients (mean age 14.7 years, SD 1.7) consecutively admitted to an Eating Disorder Unit. They were evaluated at admission, at discharge and, in 34 cases, after 9 months of follow-up. pHVA was also assessed in 16 control adolescents. Patients had significantly higher pHVA than controls (p = .002). About 31% of patients had a very high level of pHVA, a significantly higher (p = .006) mean score in the BDI and a non significantly higher mean score in the EAT. After weight recovery some laboratory parameters improved as well as the EAT (p = .019), the BDI (p = 001) and the Interference score of the LOI-C (p = .004). Moreover, pHVA decreased significantly (p=.036). At follow-up, patients with normal weight had lower (p = .037) pHVA than patients with low weight. The conclusion would be that there is a dopaminergic dysfunction in anorexic patients, specially in a subgroup with high depressive and anorexic symptomatology. With weight recovery and psychopathological improvement, pHVA tends to normalization. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles The provisional Paediatric Rheumatology International Trials Organisation/American College of Rheumatology/European League Against Rheumatism Disease activity core set for the evaluation of response to therapy in juvenile dermatomyositis: a prospective validation study. Jan 15, 2008 Nicolino Ruperto,Angelo Ravelli,Angela Pistorio,Virginia Ferriani,Immaculada Calvo,Gerd Ganser,Jurgen Brunner,Guenther Dannecker,Clovis Arthur Silva,Valda Stanevicha,Rebecca Ten Cate,Lisette W A van Suijlekom-Smit,Olga Voygioyka,Michel Fischbach,Ivan Foeldvari,Odete Hilario,Consuelo Modesto,Rotraud K Saurenmann,Marie-Josephe Sauvain,Iloite Scheibel,Danièle Sommelet,Lana Tambic-Bukovac,Roberto Barcellona,Riva Brik,Stephan Ehl,Mirjana Jovanovic,Jozef Rovensky,Francesca Bagnasco,Daniel J Lovell,Alberto Martini,Paediatric Rheumatology International Trials Organisation (PRINTO) ,Pediatric Rheumatology Collaborative Study Group (PRCSG) OBJECTIVE: To validate a core set of outcome measures for the evaluation of response to treatment in patients with juvenile dermatomyositis (DM). METHODS: In 2001, a preliminary consensus-derived core set for evaluating response to therapy in juvenile DM was established. In the present study, the c... ( view more )ore set was validated through an evidence-based, large-scale data collection that led to the enrollment of 294 patients from 36 countries. Consecutive patients with active disease were assessed at baseline and after 6 months. The validation procedures included assessment of feasibility, responsiveness, discriminant and construct ability, concordance in the evaluation of response to therapy between physicians and parents, redundancy, internal consistency, and ability to predict a therapeutic response. RESULTS: The following clinical measures were found to be feasible, and to have good construct validity, discriminative ability, and internal consistency; furthermore, they were not redundant, proved responsive to clinically important changes in disease activity, and were associated strongly with treatment outcome and thus were included in the final core set: 1) physician's global assessment of disease activity, 2) muscle strength, 3) global disease activity measure, 4) parent's global assessment of patient's well-being, 5) functional ability, and 6) health-related quality of life. CONCLUSION: The members of the Paediatric Rheumatology International Trials Organisation, with the endorsement of the American College of Rheumatology and the European League Against Rheumatism, propose a core set of criteria for the evaluation of response to therapy that is scientifically and clinically relevant and statistically validated. The core set will help standardize the conduct and reporting of clinical trials and assist practitioners in deciding whether a child with juvenile DM has responded adequately to therapy. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Seroprevalence of Bartonella spp. infection in HIV patients in Catalonia, Spain. 2008 Immaculada Pons,Isabel Sanfeliu,María Mercedes Nogueras,Montserrat Sala,Manuel Cervantes,M José Amengual,Ferran Segura BACKGROUND: Although the first clinical descriptions of Bartonella infection were associated with immunocompromised patient with bacillary angiomatosis, we currently know that this organism is directly involved in diseases affecting a large number of patients, regardless of their immune status. Cat... ( view more ) scratch disease, hepatic peliosis, and some cases of bacteraemia and endocarditis, are directly caused by some species of the genus Bartonella. The purpose of this study was to determinate the prevalence of IgG antibodies against Bartonella henselae and B. quintana in HIV patients and to identify the epidemiological factors involved. METHODS: Serum samples were collected from HIV patients treated at Hospital de Sabadell. Antibodies to B. henselae and B. quintana from 340 patients were examined by indirect immunofluorescence assay (IFA). Significance levels for univariate statistical test were determined by the Mann-Whitney U test and chi2 test. RESULTS: Of 340 patients, 82 were women and 258 men, with a median age of 42.21 +/- 10.35 years (range 16-86 years). Seventy-six (22.3%) patients reacted with one or more Bartonella antigens. Of all the factors concerning the seroprevalence rate being studied (age, sex, intravenous drugs use, alcohol consumption, CD4 levels, AIDS, HCV, HBV, residential area), only age was statistically significant. CONCLUSION: A high percentage of HIV patients presents antibodies to Bartonella and is increasing with age. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care. 2008 Irene Romera,Helena Delgado-Cohen,Teresa Perez,Luis Caballero,Immaculada Gilaberte BACKGROUND: The aim of this study was to examine the symptomatic dimensions of depression in a large sample of patients with major depressive disorder (MDD) in the primary care (PC) setting by means of a factor analysis of the Zung self-rating depression scale (ZSDS). METHODS: A factor analysis was... ( view more ) performed, based on the polychoric correlations matrix, between ZSDS items using promax oblique rotation in 1049 PC patients with a diagnosis of MDD (DSM-IV). RESULTS: A clinical interpretable four-factor solution consisting of a core depressive factor (I); a cognitive factor (II); an anxiety factor (III) and a somatic factor (IV) was extracted. These factors accounted for 36.9% of the variance on the ZSDS. The 4-factor structure was validated and high coefficients of congruence were obtained (0.98, 0.95, 0.92 and 0.87 for factors I, II, III and IV, respectively). The model seemed to fit the data well with fit indexes within recommended ranges (GFI = 0.9330, AGFI = 0.9112 and RMR = 0.0843). CONCLUSION: Our findings suggest that depressive symptoms in patients with MDD in the PC setting cluster into four dimensions: core depressive, cognitive, anxiety and somatic, by means of a factor analysis of the ZSDS. Further research is needed to identify possible diagnostic, therapeutic or prognostic implications of the different depressive symptomatic profiles. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Cardiotrophin-1 is expressed in adipose tissue and upregulated in the metabolic syndrome. Jan 2008 Cristina Natal,María Antonia Fortuño,Patricia Restituto,Antonio Bazán,Immaculada Colina,Javier Díez,Nerea Varo Adipose tissue is a target for cardiotrophin-1 (CT-1), a cytokine member of the IL-6 family of cytokines that is involved in cardiac growth and dysfunction. However, it is unknown whether adipocytes are a source of CT-1 and whether CT-1 is overexpressed in diseases characterized by increased fat de... ( view more )pots [i.e., the metabolic syndrome (MS)]. Thus this work aimed 1) to test whether adipose tissue expresses CT-1 and whether CT-1 expression can be modulated and 2) to compare serum CT-1 levels in subjects with and without MS diagnosed by National Cholesterol Education Program Adult Treatment Panel III criteria. Gene and protein expression of CT-1 was determined by real-time RT-PCR, ELISA, and Western blotting. CT-1 expression progressively increased, along with differentiation time from preadipocyte to mature adipocyte in 3T3-L1 cells. CT-1 expression was enhanced by glucose in a dose-dependent manner in these cells. mRNA and protein CT-1 expression was also demonstrated in human adipose biopsies. Immunostaining showed positive staining in adipocytes. Finally, increased CT-1 serum levels were observed in patients with MS compared with control subjects (127 +/- 9 vs. 106 +/- 4 ng/ml, P < 0.05). Circulating levels of CT-1 were associated with glucose levels (r = 0.2, P < 0.05). Taken together, our data suggest that adipose tissue can be recognized as a source of CT-1, which could account for the high circulating levels of CT-1 in patients with MS. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Gene therapy for acute renal failure. 2008 Juan Torras,Josep M Cruzado,Immaculada Herrero-Fresneda,Josep M Grinyo Thanks to the progressive understanding of the cellular and molecular basis of renal function and disease, during the next several decades new therapeutic approaches to a wide range of kidney disorders, including acute renal failure (ARF), will be developed. In this regard, the repair of ischemic a... ( view more )nd toxic ARF is critically dependent on a redundant, interactive cytokine and growth factors network to return kidney function to near-normal baseline function. A newer strategy in biotechnology is the development of recombinant genetic engineered compounds and, recently, cell therapy derivatives. Gene therapy offers a novel approach for prevention and treatment of renal diseases. Technical advances in viral vector systems and the development of fusigenic liposome vectors have been crucial to the progress of effective gene therapy strategies directed at renal structures in animal models. Many investigations have provided experimental models for gene delivery systems but the most efficient renal gene transfer was obtained from intrarenal injection or perfusion of explanted kidneys in transplantation. Continued technologic advances in vector systems and promising results in human and animal gene transfer studies make the use of gene therapy an encouraging strategy. Cell therapy, a tool for gene therapy, is based on the ability to expand specific cells in tissue culture to perform differentiated tasks and to introduce these cells into the patient either in extracorporeal circuits or as implants as drug delivery vehicles of a single protein or to provide physiological functions. These new approaches may result in therapeutic modalities that diminish the degree of renal failure and the time needed to recover renal function in acute tubular necrosis. This article specifically examines the present prospects of gene developing therapies in the treatment of ARF. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Differences between prepubertal- versus adolescent- onset bipolar disorder in a Spanish clinical sample. Dec 2007 Luisa Lázaro,Josefina Castro-Fornieles,José Eugenio de la Fuente,Immaculada Baeza,Astrid Morer,Montserrat Pàmias OBJECTIVE: To examine patients attended and diagnosed with bipolar disorder (BD) at a child and adolescent psychiatry service; to record age of diagnosis and age of onset, and to study clinical differences between prepubertal and adolescent onset groups. METHODS: All patients currently attended for... ( view more ) BD type I, type II or non specified BD were reviewed and divided into two age groups: prepubertal onset (beginning before age 13) and adolescent onset (beginning at or above age 13). RESULTS: The sample were 43 patients with BD. Fourteen (32.6%) with prepubertal onset and 29 (67.4%) with adolescent onset. Time between onset of symptoms and diagnosis was longer in the prepubertal onset group (1.2 years versus 0.8 years respectively, P = .05). Patients with prepubertal onset BD more frequently presented previous symptoms such as irritability and conduct problems and had a higher rate of comorbidity (more frequently attention-deficit/hyperactivity disorder-ADHD). The adolescent onset group more often presented psychotic symptoms. CONCLUSION: The clinical characteristics of patients with bipolar disorder differ according to whether onset is prepubertal or adolescent. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles High-risk cervical epithelial neoplasia grade 1 treated by loop electrosurgical excision: follow-up and value of HPV testing. Oct 2007 Immaculada Alonso,Aureli Torné,Luis M Puig-Tintoré,Roser Esteve,Llorenç Quinto,Sonia Garcia,Elias Campo,Jaume Pahisa,Jaume Ordi OBJECTIVE: This study was undertaken to evaluate the value of high-risk human papillomavirus (HPV) testing in the follow-up of cervical intraepithelial neoplasia grade 1/low-grade squamous intraepithelial lesion treated by loop electrosurgical excision procedure because of the risk criteria establi... ( view more )shed by the American Society for Colposcopy and Cervical Pathology (ie, unsatisfactory colposcopy or positive endocervical curettage, persistence of cervical intraepithelial neoplasia grade 1/low-grade squamous intraepithelial lesion, or high-risk HPV infection for longer than 2 years and older than 40 years). STUDY DESIGN: Seventy-seven women with cervical intraepithelial neoplasia grade 1/low-grade squamous intraepithelial lesion treated by loop electrosurgical excision procedure and followed-up with colposcopy, cytology, and high-risk HPV detection using Hybrid Capture II. RESULTS: More than 67% (67.6%) of women had cervical intraepithelial neoplasia grade 1 in the specimen; 22% a cervical intraepithelial neoplasia grade 2-3; and 10.4% had no lesion. Pretreatment HPV testing was positive in 100% of cervical intraepithelial neoplasia grade 2-3, in 93.5% of cervical intraepithelial neoplasia 1, and in 14.3% of cases with no lesion (P < .01). Pretreatment high-risk HPV testing was positive in all cases eventually developing residual/recurrent disease. Fifty percent of women with pretreatment viral load more than 100 relative light units had residual/recurrent disease develop. Posttreatment high-risk HPV testing during the follow-up reached a sensitivity and negative predictive value of 100% for detecting residual/recurrent disease. CONCLUSION: Patients with low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 and risk factors have a significant risk of harboring a cervical intraepithelial neoplasia grade 2-3 lesion. A conservative approach should be considered when basal high-risk HPV test is negative. High pretreatment high-risk HPV loads should be considered a risk factor for developing residual/recurrent disease. Posttreatment Hybrid Capture II has an extremely high sensitivity for detecting recurrences. ( view less ) View Full Abstract View Article Details   Related Articles Comparison of peristrophic multiplexing and a combination of angular and peristrophic holographic multiplexing in a thick PVA/acrylamide photopolymer for data storage. Aug 1, 2007 Elena Fernández,Manuel Ortuño,Sergi Gallego,Celia García,Augusto Beléndez,Immaculada Pascual Two different types of multiplexing are used to store 90 holograms at the same location in a polyvinyl alcoholacrylamide photopolymer material. In the first, the 90 holograms are stored using only peristrophic multiplexing, whereas in the second a combination of angular and peristrophic multiplexin... ( view more )g is used. The results (diffraction efficiency and dynamic range, M#) obtained with these two multiplexing techniques are compared. With the first, the dynamic range was M# = 13 and with the second M# = 8. An exposure schedule method is used to calculate the exposure time necessary to store the holograms with a more uniform, higher diffraction efficiency. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Streptococcus pyogenes pili promote pharyngeal cell adhesion and biofilm formation. May 2007 Andrea G O Manetti,Chiara Zingaretti,Fabiana Falugi,Sabrina Capo,Mauro Bombaci,Fabio Bagnoli,Gabriella Gambellini,Giuliano Bensi,Marirosa Mora,Andrew M Edwards,James M Musser,Edward A Graviss,John L Telford,Guido Grandi,Immaculada Margarit Group A Streptococcus (GAS, Streptococcus pyogenes) is a Gram-positive human pathogen responsible for several acute diseases and autoimmune sequelae that account for half a million deaths worldwide every year. GAS infections require the capacity of the pathogen to adhere to host tissues and assembl... ( view more )e in cell aggregates. Furthermore, a role for biofilms in GAS pathogenesis has recently been proposed. Here we investigated the role of GAS pili in biofilm formation. We demonstrated that GAS pilus-negative mutants, in which the genes encoding either the pilus backbone structural protein or the sortase C1 have been deleted, showed an impaired capacity to attach to a pharyngeal cell line. The same mutants were much less efficient in forming cellular aggregates in liquid culture and microcolonies on human cells. Furthermore, mutant strains were incapable of producing the typical three-dimensional layer with bacterial microcolonies embedded in a carbohydrate polymeric matrix. Complemented mutants had an adhesion and aggregation phenotype similar to the wild-type strain. Finally, in vivo expression of pili was indirectly confirmed by demonstrating that most of the sera from human patients affected by GAS-mediated pharyngitis recognized recombinant pili proteins. These data support the role of pili in GAS adherence and colonization and suggest a general role of pili in all pathogenic streptococci. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Transcriptional and proteomic profiles of group B Streptococcus type V reveal potential adherence proteins associated with high-level invasion. Mar 2007 Atul K Johri,Immaculada Margarit,Mark Broenstrup,Cecilia Brettoni,Lei Hua,Steven P Gygi,John L Telford,Guido Grandi,Lawrence C Paoletti Group B Streptococcus (GBS) is an opportunistic organism that can harmlessly colonize the human gut, vagina, and rectum but can also cause pneumonia, sepsis, and meningitis in neonates born to colonized mothers. We have shown previously that growth rate and oxygen level regulate the ability of GBS ... ( view more )to invade eukaryotic cells in vitro. Herein we extend and expand on these observations to show that GBS type V, an emergent serotype, grown in a chemostat at a cell mass-doubling time (t(d)) of 1.8 h with oxygen invaded human ME-180 cervical epithelial cells in large numbers compared with those grown at the same t(d) without oxygen or at a slower t(d) of 11.0 h. The fact that several GBS type V cell wall-associated and membrane proteins were expressed exclusively under the invasive growth condition prompted an investigation, using genomics and proteomics, of all upregulated genes and proteins. Several proteins with potential roles in adherence were identified, including an undefined surface antigen (SAG1350), a lipoprotein (SAG0971), penicillin-binding protein 2b (SAG0765), glyceraldehyde-3-phosphate dehydrogenase (SAG0823), and an iron-binding protein (SAG1007). Mouse antisera to these five proteins inhibited binding of GBS type V to ME-180 cells by > or =85%. Recombinant undefined surface antigen (SAG1350), lipoprotein (SAG0971), and penicillin-binding protein 2b (SAG0765) each bound to ME-180 cells in a dose-dependent fashion, confirming their ability to act as ligands. Collectively, these data increase the number of potential GBS adherence factors and also suggest a role for these surface-associated proteins in initial pathogenic events. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Ischemic preconditioning in solid organ transplantation: from experimental to clinics. Mar 2007 Joan Torras Ambros,Immaculada Herrero-Fresneda,Oscar Gulias Borau,Josep M Grinyo Boira This study reviews the current understanding of ischemic preconditioning (IP) in experimental and clinical setting, and the mechanisms that mediate the complex processes involved as a tool to protect against ischemia and reperfusion (I/R) injury, but is not intended as a complete literature review ... ( view more )of preconditioning. IP has been mainly elucidated in cardiac ischemia. Recent reports confirm the efficacy of pre- and postconditioning in cardiac surgery and percutaneous coronary interventions in humans. IP utilizes endogenous as well as distant mechanisms in skeletal muscle, liver, lung, kidney, intestine and brain in animal models to convey varying degrees of protection from I/R injury. Specifically, preconditioned tissues exhibit altered energy metabolism, better electrolyte homeostasis and genetic reorganization, as well as less oxygen-free radicals and activated neutrophils release, reduced apoptosis and better microcirculatory perfusion. To date, there are few human studies, but recent trials suggest that human liver, lung and skeletal muscle acquire protection after IP. Present data address the potential therapeutic application of IP in the prevention of I/R damage specially aimed at clinical transplantation. IP is ubiquitous but more research is required to fully translate these findings to the clinical arena. ( view less ) View Full Abstract View Article Details   Related Articles The child and adolescent first-episode psychosis study (CAFEPS): design and baseline results. Mar 2007 Josefina Castro-Fornieles,Mara Parellada,Ana Gonzalez-Pinto,Dolores Moreno,Montserrat Graell,Immaculada Baeza,Soraya Otero,Cesar A Soutullo,Benedicto Crespo-Facorro,Ana Ruiz-Sancho,Manuel Desco,Olga Rojas-Corrales,Ana Patiño,Eugenio Carrasco-Marin,Celso Arango,CAFEPS group OBJECTIVE: The child and adolescent first-episode psychosis study (CAFEPS) is a multicenter, two-year, longitudinal project aiming to evaluate different clinical, neuropsychological, neuroimaging, biochemical, immunological, and genetic variables and treatment and prognostic factors in these patien... ( view more )ts. This paper describes the methods and rationale behind the study and the general characteristics of the sample. METHOD: At six different centers, from March 2003 through November 2005, we consecutively recruited 110 patients, ages 9-17 years, who presented with a first psychotic episode. Controls were recruited from the same geographic areas and were matched for gender and age. RESULTS: Patients had lower socioeconomic status (SES) (p=0.018) and parental years of education (p<0.001) than controls. The percentage of patients recruited increased with age (p<0.001) and there was a higher percentage of males (p<0.001). The total mean PANSS score was 89.03+/-20.1, the positive score 23.8+/-6.5 and the negative score 20.02+/-8.8. There were no significant differences between the genders with respect to age, parental years of education, SES, or scores in premorbid adjustment or general functioning. There were statistically significant positive correlations between age and positive symptoms and between all PANSS subscales and the Disability Assessment Schedule, and negative correlations between positive symptoms and global functioning. Diagnoses after the baseline evaluation were: psychotic disorder not otherwise specified (NOS) 35.5%, schizophreniform disorder 24.5%, mood disorder with psychotic symptoms 22.7%, schizophrenia 10%, schizoaffective disorder 2.7%, and other psychotic disorders 4.5%. Patients had worse premorbid adjustment (p<0.001) and global functioning (p<0.001) than controls after controlling for SES. CONCLUSIONS: Infancy and adolescence adjustment and global functioning are lower in children and adolescents with psychotic disorders than in controls, severity of symptoms are related to general disability, and the most frequent diagnoses are psychotic disorders NOS. ( view less ) View Full Abstract View Article Details   Related Articles Expression of TrkB in the murine kidney. Dec 2006 Olivia García-Suárez,Tatiana González-Martínez,Antonino Germana,Diego F Monjil,Juan R Torrecilla,Rosaria Laurà,Immaculada Silos-Santiago,Jose L Guate,José A Vega Neurotrophins acting through Trk signal-transducing receptors play essential roles in the nervous system, and probably in some nonneuronal tissues. In the present study we used Western-blot and immunohistochemistry to investigate the occurrence and cellular localization of TrkB in the mouse kidney.... ( view more ) Furthermore, the structure and ultrastructure of the kidney in mice carrying a mutation in the trkB gene were analyzed. TrkB in the kidney was identical to the cerebral one (145 kDa). Since the antibody used recognize a sequence within the tyrosine-kinase domain of TrkB, the renal TrkB receptor identified here must be regarded as able to mediate biological effects of their ligands. TrkB immunoreactivity was restricted to the juxtaglomerular apparatus, including differentiated vascular cells and extaglomerular mesangial cells. In these cells, TrkB colocalized with renin. The structural analysis revealed no major changes in the kidney structure of TrkB-deficient mice, with the exception of a significant reduction of the glomerular area. Nevertheless, in these animals there was an apparent increase in the number of extraglomerular mesangial cells (which retain the ability to synthesize renin) and absence of the macula densa. Taken together, these results strongly suggest a role of TrkB and their ligands in the control of the normal development and maintenance of the juxtaglomerular apparatus. ( view less ) View Full Abstract View Article Details   Related Articles Perceptions of prescribed burning in a local forest community in Victoria, Australia. Nov 2006 Tina Bell,Immaculada Oliveras The general perceptions of prescribed burning were elicited from forest users for an area that has been subject to this form of land management for at least 20 years. The largest group consisted of local residents living in and around the Wombat State Forest with two smaller groups of students from... ( view more ) a nearby university campus and local professional land managers. A questionnaire was given to each participant in order to explore how the forest was used, to determine the level of knowledge of burning in the targeted forest and Victoria and the perception of the appearance, effectiveness of protection, and accessibility to the forest after prescribed burning. Generally all groups had similar responses with community members having stronger views on the effectiveness and practicalities of prescribed burning, whereas students were more neutral in their opinions. All participants claimed knowledge of prescribed burning activities within Victoria, but fewer had experience of planned fires in the Wombat State Forest. All groups agreed that areas that had not been recently burned had a better appearance than those that had, but this result may have included a range of value judgments. Land managers had a greater understanding of the ecological importance of season and timing of burning; however, some students and community members were equally knowledgeable. Prescribed burning did not impede access to the forest, nor did smoke from prescribed burns pose any great problem. The majority of the participants felt that the amount of prescribed burning done in the forest was adequate for engendering a feeling of protection to life and property, yet many were still suspicious of this management practice. These initial findings indicate several areas in which further research would be useful including the efficacy of education programs for community members and improved communication of burn plans by land managers. ( view less ) View Full Abstract View Article Details   Related Articles Positron emission tomography/computed tomography: diagnostic accuracy in lymphoma. Nov 2006 Dolores Hernandez-Maraver,Fernando Hernandez-Navarro,Nieves Gomez-Leon,Juan Coya,Beatriz Rodriguez-Vigil,Rosario Madero,Immaculada Pinilla,Luis M Martin-Curto An accurate initial staging of patients with non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL) is critical for the selection of an appropriate treatment. Computed tomography (CT) remains the standard imaging technique, although it is based on anatomic criteria. Positron emission tomography (PET)... ( view more ) with 2-deoxy-2-[fluorine-18]fluoro-d-glucose (FDG) provides useful functional information but requires anatomical correlation to localise lesions accurately. We have prospectively compared the accuracy of combined PET/CT with that of CT and PET alone at initial staging in lymphoma patients. Forty-seven newly diagnosed patients were evaluated. PET/CT was superior compared with CT and PET in nodal evaluation and detection of extranodal disease. Using a staging algorithm with PET/CT resulted in the disease stage being increased in 11 of 47 patients (10 NHL and 1 HL) (McNemar test P = 0.012). Therefore, a different treatment strategy based on PET/CT findings was suggested for seven patients (14.8%). PET/CT markedly improves accuracy in the diagnostic work-up of patients with lymphoma. ( view less ) View Full Abstract View Article Details   Related Articles Pre- and post-conization high-risk HPV testing predicts residual/recurrent disease in patients treated for CIN 2-3. Nov 2006 Immaculada Alonso,Aureli Torné,Luis M Puig-Tintoré,Roser Esteve,Llorenç Quinto,Elias Campo,Jaume Pahisa,Jaume Ordi OBJECTIVE: To evaluate whether high-risk human papillomavirus (HR-HPV) detection and viral load prior to treatment and status of cone margins can predict residual/recurrent disease as well as the ability of current diagnostic tools to identify residual/recurrent disease during follow-up of high-gra... ( view more )de cervical intraepithelial neoplasia (CIN) treated by conization using loop electrosurgical procedure (LEEP). METHODS: Two hundred and three women (mean age 38.6 +/- 9.7; range 22-83) with CIN2-3 treated by LEEP conization and confirmed in the surgical specimen, attending follow-up visits were included. Age, HR-HPV detection and viral load determined by HybridCapture 2, and cone margins were evaluated as possible predictors of residual/recurrent disease. Value of single and repeated cytology as well as HR-HPV detection and viral load during follow-up were analyzed as screening tools of recurrence. RESULTS: Residual/recurrent disease was demonstrated by colposcopy guided biopsy in 36 patients (17.7%). High HR-HPV load (>1000 RLU) prior to LEEP and positive cone margins were significantly associated with higher risk of recurrence (31.8% vs. 9.4%, P = 0.005; and 36.4% vs. 11.9%, P < 0.001 respectively). HR-HPV detection at 6-12 m after LEEP showed higher sensitivity than a single or repeated cytology (97.2% vs. 83.3% and 94.4% respectively) although it showed less specificity (81.4% vs. 92.2% and 82.6%). The combination of HR-HPV detection and the first cytology during follow-up detected all patients with residual/recurrent disease (sensitivity 100%, negative predictive value 100%) with an acceptable specificity (76.6%). CONCLUSION: The inclusion of HR-HPV testing with cytology in follow-up of patients treated for CIN2-3 would allow for fewer post-treatment visits and avoid unnecessary cytologies. High HR-HPV load prior to LEEP or positive margins should be considered as risk factors for developing residual/recurrent disease. ( view less ) View Full Abstract View Article Details   Related Articles Sexually transmitted infections among urban shelter clients. Nov 2006 Diane M Grimley,Lucy Annang,Ivey Lewis,Rev William Smith,Immaculada Aban,Terry Hooks,Samantha Williams,Edward W Hook,Janet St Lawrence BACKGROUND: Sexually transmitted infections (STIs) remain common in the United States. One contributor to this persistent problem is pockets of infection among persons who may not have regular access to health care, a group that includes those who seek services at shelters. OBJECTIVE: The goals of ... ( view more )the study were to: 1) determine the acceptability of STI testing among individuals seeking services at shelters in 2 midsized southeastern cities; 2) evaluate the prevalence of chlamydia, gonorrhea, syphilis, and HIV among these individuals; and 3) assess the proportion that subsequently learned their test results and received timely and appropriate treatment if warranted. STUDY DESIGN: Using a cross-sectional design, 430 individuals between the ages of 19 and 45 seen at 3 shelters in 2 cities were approached for participation. After completing a brief behavioral assessment, each participant provided a urine specimen for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) testing, blood for syphilis serologic testing, and an oral sample for HIV testing. RESULTS: The overall recruitment rate was 97% (96% in city A and 98% in city B). Seventy-eight percent were black with a mean age of 35.1 years. STI prevalence among those reporting sexual activity in the past 2 months was 12.9% in city A and 19.9% in city B (P = 0.04). The rate of CT in city B was significantly higher than city A (15.0% vs. 6.4%, P = 0.02); however, similar rates were found for GC (5.0% vs. 3.2%), primary and secondary syphilis (0.08% vs. 1.4%), and HIV (0.07% vs. 0.06%). Overall, 91.5% of the positive cases (89.0% in city A and 94.0% in city B) learned their test results and were successfully treated. CONCLUSION: We found that shelter clients were receptive to STI testing, even for HIV, with most positive cases notified and successfully treated. ( view less ) View Full Abstract View Article Details   Related Articles Sublingual versus vaginal misoprostol (400 microg) for cervical priming in first-trimester abortion: a randomized trial. Oct 2006 Josep Lluis Carbonell Esteve,Jose Maria Marí,Francisco Valero,Margardel Llorente,Immaculada Salvador,Lidia Varela,Pedro Leal,Ana Candel,Ana Tudela,Maria Serrano,Eva Muñoz OBJECTIVE: Our objective was to compare the sublingual administration and the vaginal administration of misoprostol for cervical priming before first-trimester surgical abortion. DESIGN: We used an open, multicenter, randomized trial. LOCATIONS: We conducted the study in four clinics (in Valencia, ... ( view more )Castelló, Murcia and Murcia Capital) in Spain. PARTICIPANTS: A total of 1424 healthy pregnant women with amenorrhea of ( view less ) View Full Abstract View Article Details   Related Articles [Bupropion use for smoking cessation in HIV-infected patients receiving antiretroviral therapy] Oct 2006 Enric Pedrol-Clotet,Elisabet Deig-Comerma,Mónica Ribell-Bachs,Immaculada Vidal-Castell,Pedro García-Rodríguez,Anna Soler Smoking is the most important modifiable cardiovascular risk factor. Bupropion administration is an effective method to achieve smoking cessation (SC), but the drug is metabolized by the cytochrome P450 enzyme system and this might cause interactions with antiretroviral drugs. We present a prospect... ( view more )ive study of bupropion SC therapy in HIV-positive patients under antiretroviral treatment. A total of 21 patients were studied; 38% of them stopped smoking for more than one year. No clinically significant drug interactions were found. Bupropion SC therapy was effective in HIV-positive patients and did not cause significant clinical interactions with antiretroviral drugs. ( view less ) View Full Abstract View Article Details   Related Articles Use of Lactococcus lactis expressing pili from group B Streptococcus as a broad-coverage vaccine against streptococcal disease. Aug 1, 2006 Scilla Buccato,Domenico Maione,Cira Daniela Rinaudo,Gianfranco Volpini,Anna Rita Taddei,Roberto Rosini,John L Telford,Guido Grandi,Immaculada Margarit Recent data indicate that the human pathogen group B Streptococcus (GBS) produces pilus-like structures encoded in genomic islands with similar organization to pathogenicity islands. On the basis of the amino acid sequence of their protein components, 3 different types of pili have been identified ... ( view more )in GBS, at least 1 of which is present in all isolates. We recently demonstrated that recombinant pilus proteins protect mice from lethal challenge with GBS and are thus potential vaccine candidates. Here, we show that GBS pilin island 1, transferred into the nonpathogenic microorganism Lactococcus lactis, leads to pilus assembly. We also show that systemically or mucosally delivered Lactococcus expressing pilin island 1 protects mice from challenge with GBS isolates carrying pilus 1. Furthermore, lactococci engineered to express hybrid pili containing GBS pilus 1 and pilus 2 components confer protection against strains expressing either of the 2 pilus types. These data pave the way to the design of pilus-based, multivalent live vaccines against streptococcal pathogens. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pili in gram-positive pathogens. Jul 2006 John L Telford,Michèle A Barocchi,Immaculada Margarit,Rino Rappuoli,Guido Grandi Most bacterial pathogens have long filamentous structures known as pili or fimbriae extending from their surface. These structures are often involved in the initial adhesion of the bacteria to host tissues during colonization. In gram-negative bacteria, pili are typically formed by non-covalent int... ( view more )eractions between pilin subunits. By contrast, the recently discovered pili in gram-positive pathogens are formed by covalent polymerization of adhesive pilin subunits. Evidence from studies of pili in the three principal streptococcal pathogens of humans indicates that the genes that encode the pilin subunits and the enzymes that are required for the assembly of these subunits into pili have been acquired en bloc by the horizontal transfer of a pathogenicity island. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Comparison of different clinical diagnostic criteria for depression in Alzheimer disease. Jul 2006 Joan Vilalta-Franch,Josep Garre-Olmo,Secundino López-Pousa,Antoni Turon-Estrada,Manoli Lozano-Gallego,Marta Hernàndez-Ferràndiz,Immaculada Pericot-Nierga,Regina Feijóo-Lorza OBJECTIVE: Data in the literature show different estimates of the prevalence of depression in patients with Alzheimer disease (AD) when different classification systems are used. This study describes the prevalence and clinical features of depression in AD based on five different depression classif... ( view more )ication systems. METHODS: This was a cross-sectional, observational study of 491 patients with probable AD. Depression was diagnosed using five classification systems (International Classification of Diseases, 10th Revision [ICD-10], Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV], Cambridge Examination for Mental Disorder of the Elderly [CAMDEX], Provisional Diagnostic Criteria for depression in AD [PDC-dAD], Neuropsychiatric Inventory [NPI]). RESULTS: The prevalence of depression was 4.9% (95% confidence interval [CI]: 3.2-7.1) according to ICD-10 criteria; 9.8% (95% CI: 7.3-12.6) according to CAMDEX; 13.4% (95% CI: 10.6-16.6) according to DSM-IV; 27.4% (95% CI: 23.6-31.5) according to PDC-dAD criteria; and 43.7% (95% CI: 39.4-48.2) when using the screening questions from the NPI depression subscale. The level of agreement between the classification systems was low to moderate (kappa <0.52). The characteristics associated with the most diagnostic disagreement were loss of confidence or self-esteem and irritability. CONCLUSIONS: This study shows that there is a high variability in the prevalence rates of depression in AD depending on the diagnostic criteria used and that there is a low rate of agreement among the diagnostic criteria analyzed. The results suggest that the use of generic diagnostic criteria such as the ICD-10, the CAMDEX, or DSM-IV provides low prevalence rates of depression in patients with AD compared with specific diagnostic criteria such as the PDC-dAD. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 4 1 2 3 4 > (84 articles found)

      
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