Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

The European Journal of Health Economics - Patient activation comprises the skills, knowledge and motivation necessary for patients’ effective contribution to their care. We adapted and...     

A limited antigen-specific cellular response is sufficient for the early control of Mycobacterium tuberculosis in the lung but is insufficient for long-term survival

Mice that were transgenic for a T-cell receptor (TCR) specific for ovalbumin peptide(323-339) (DO11.10) were able to survive an infection with Mycobacterium tuberculosis for approximately 80 days. This limited early control of infection was associated with gamma interferon production, inducible nitric oxide synthase expression within the lung, and an influx of clonotypic lymphocytes. The control of M. tuberculosis was lost in DO11.10 mice bred in a rag mutant background, demonstrating that the immune responsiveness was recombinase dependent and likely to be associated with the expression of an alternative alpha TCR by DO11.10 mice. A characterization of the antigen specificity in DO11.10 TCR transgenic mice demonstrated that the specificity was limited and dominated by the 26-kDa (Rv1411c) lipoprotein of M. tuberculosis. This study identifies this lipoprotein as an important and potent inducer of protective T cells within the lungs of mice infected with M. tuberculosis and therefore as a possible target for vaccination.     

Mapping the site of guanylylation on VP1, the protein primer for infectious pancreatic necrosis virus RNA synthesis

VP1, the putative virion-associated RNA-dependent RNA polymerase (RdRp) of infectious pancreatic necrosis virus (IPNV) can be guanylylated in vitro whereupon it becomes a primer for in vitro RNA synthesis [Virology 208 (1995) 19]. The role of a template or other virion polypeptides in the reaction is unknown. To shed light on this question, his-tagged recombinant VP(1) (rVP1) was expressed both in Escherichia coli and insect cells and used in the guanylylation reaction. Unlike other viral VPg polypeptides, the purified rVP1 alone could guanylylate itself in vitro in a template-independent manner. Chemical and enzymatic cleavage in combination with site-directed mutagenesis mapped the site of guanylylation to serine 163. The purified rVP1 functioned as a primer as well as an RdRp in vitro, producing labeled dsRNA in the presence of [alpha(32)P] NTP and synthetically produced viral ss + RNA as a template. Only a single cycle of replication was observed and labeled VPg could be recovered from the dsRNA by RNase V(1) digestion. Denaturation of the dsRNA yielded genome-length labeled ssRNA, indicating that RNA synthesis was not initiated by 3'-end snap-back self-priming. Mutating serine 163 to alanine of rVP1 abolished both its self-guanylylating and polymerizing activity.     

Peripheral blood and pleural fluid mononuclear cell responses to low-molecular-mass secretory polypeptides of Mycobacterium tuberculosis in human models of immunity to tuberculosis

A total of 104 polypeptides were purified from the low-molecular-mass secretory proteome of Mycobacterium tuberculosis H(37)Rv using a combination of anion exchange column chromatography and high resolution preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis followed by electroelution. The goal of this study was to identify polypeptides from a low-molecular-mass secretory proteome recognized by human subjects infected with M. tuberculosis and to ascertain the differences in specificity of antigen recognition by the peripheral blood mononuclear cells (PBMCs) and pleural fluid mononuclear cells (PFMCs) of these individuals. The study identified CFP-8 (Rv0496), CFP-11 (Rv2433c), CFP-14.5 (Rv2445c), and CFP-31 (Rv0831c) as novel T-cell antigens apart from previously characterized ESAT-6, TB10.4, CFP10, GroES, MTSP14, MTSP17, CFP21, MPT64, Ag85A, and Ag85B on the basis of recognition by PBMCs of tuberculosis contacts and treated tuberculosis patients. Further, polypeptides prominently recognized by PFMCs of tuberculous pleurisy patients were the same as those recognized by PBMCs of healthy contacts and treated tuberculosis patients. The results of our study indicate the homogeneity of antigenic target recognition by lymphocytes at the site of infection and at the periphery in the human subjects studied and the need to evaluate these antigenic targets as components of future antituberculous vaccines.     

Psychological and quality-of-life outcomes from a comprehensive stress reduction and lifestyle program in patients with coronary artery disease: results of a randomized trial

BACKGROUND: Stress reduction and comprehensive lifestyle modification programs have improved atherosclerosis and cardiac risk factors in earlier trials. Little is known about the impact of such programs on quality-of-life (QoL) and psychological outcomes. Given recent significant improvements in cardiac care, we evaluated the current benefit of stress reduction/lifestyle modification on QoL and emotional distress in patients with coronary artery disease (CAD). METHODS: 101 patients (59.4 +/- 8.6 years, 23 female) with CAD were randomized to a 1-year lifestyle/stress management program (n = 48) or written advice (n = 53). QoL and psychological outcomes were assessed with the SF-36, Beck Depression, Spielberger State/Trait Anxiety, Spielberger State/Trait Anger and Perceived Stress Inventories. Group repeated-measures analyses of variance were performed for all measures. RESULTS: Adherence to the program was excellent (daily relaxation practice 39 +/- 5 vs. 5 +/- 8 min, respectively; p < 0.001). Both groups improved comparably in most dimensions of QoL, and significantly greater improvements for the lifestyle group were found for physical function and physical sum score (p = 0.046 and p = 0.045). Depression, anxiety, anger and perceived stress were reduced similarly in both groups. However, intervention x gender interaction effects revealed greater benefits among women in the lifestyle intervention vs. advice group for depression and anger (p = 0.025 and p = 0.040), but no effects for men. CONCLUSIONS: A comprehensive lifestyle modification and stress management program did not improve psychological outcomes in medically stable CAD patients. The program did appear to confer psychological benefits for women but not men. Further trials should investigate gender-related differences in coronary patient responses to behavioral interventions.     

Anemia and iron metabolism in patients with type-2 diabetes mellitus

INTRODUCTION: Nowadays the iron status in chronic illnesses can be judged by non-invasive methods, too. The soluble transferrin receptor, that is also measurable in most laboratories, means a leap forward among the new markers. AIMS: The authors examined the prevalence of anemia and the iron status of type-2 diabetic patients with markers of the iron metabolism. They studied the clinical applicability of these laboratory procedures. METHODS: Concentration of iron, transferrin, ferritin and soluble transferrin receptor levels of healthy and diabetic patients were compared with a Mann-Whitney U-test. They examined the incidence and the type of anemia, the cause of the elevation in soluble transferrin receptor levels, and the effect of inflammation and nephropathy on the iron status. Relationship of the transferrin saturation, the concentration of ferritin and soluble transferrin receptor levels were depicted by graphic representations. RESULTS: The authors have found difference between the transferrin levels of women and men in contrast to the literature (z = 3.56; p < 0.05). The reference intervals of the ferritin levels of the control and patient groups also showed a significant difference between women and men (z = 7.59; z = 5.69; p < 0.05). 7% of the patients have suffered from anemia. 23% of the patient group had nephropathy, 10% of this subgroup was anemic, and further 8% of this subgroup had iron distribution disorder. 6% of the patients had elevated soluble transferrin receptor levels. Anemia or iron metabolism alteration was found only in 14% of the cases with elevated C-reactive protein levels. CONCLUSIONS: According to these findings ferritin reference levels of healthy people can not be used in diabetes mellitus similarly to other chronic illnesses. It seems that anemia is not frequent in diabetes mellitus. There is no connection between nephropathy and anemia, and not all of the inflammatory conditions are accompanied with iron metabolism disturbance. The soluble transferrin receptor can be interpreted only together with the other markers. In the opinion of the authors, the iron status of an individual can be judged with the collective use of all markers in chronic diseases, too.     

A systematic review and meta‐analysis of exercise interventions for colorectal cancer patients

The aim of this systematic review and meta‐analysis was to investigate the effectiveness of exercise for colorectal cancer patients. Pubmed/Medline, Scopus and the Cochrane Library were searched through December 2012 without language restrictions. Randomised controlled trials (RCTs) comparing exercise interventions to control conditions were analysed when they assessed health‐related quality of life, fatigue, physical fitness, survival and/or tumour‐associated biomarkers in colorectal cancer patients. Risk of bias was assessed using the risk of bias tool recommended by the Cochrane Back Review Group. Literature search identified 342 non‐duplicate records of which five RCTs with a total of 238 patients were included; three RCTs had low risk of bias. No evidence was found for short‐term effects on quality of life [standardised mean difference (SMD) = 0.18; 95% confidence interval (CI) ?0.39, 0.76; P = 0.53] or fatigue (SMD = 0.18; 95% CI ?0.22, 0.59; P = 0.38). There was strong evidence for short‐term improvements of physical fitness after aerobic exercise compared with controls (SMD = 0.59; 95% CI 0.25, 0.93; P < 0.01). One RCT each assessed immune parameters and oxidative DNA damage. No study reported survival rates or safety data. Given this insufficient evidence and the lack of safety data, no recommendation can be made regarding exercise interventions as a routine intervention for colorectal cancer patients.