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21.
Maaike D. van Vugt Hans Kroon Philippe A. E. G. Delespaul Cornelis L. Mulder 《Community mental health journal》2014,50(4):460-465
This study examined the associations between substance abuse problems in severely mentally ill patients, outcome and Assertive Community Treatment (ACT) model fidelity. In a prospective longitudinal study, ACT model fidelity and patient outcomes were assessed in 20 outpatient treatment teams using the Health of the Nation Outcome Scales, Camberwell Assessment of Needs short appraisal schedule and measures of service use. Five hundred and thirty severely mentally ill patients participated in the study. Substance abuse problems were assessed three times during a 2-year follow-up period. This study found that among patients with severe mental illness, patients with an addiction problem had more serious psychosocial problems at baseline. Substance abuse problems showed improvement over time, but this was not associated with ACT model fidelity. The study indicates that investment by teams to improve a patient’s psychosocial situation can lead to improvements on substance problems. 相似文献
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Activation/modulation of adaptive immunity emerges simultaneously after 17DD yellow fever first-time vaccination: is this the key to prevent severe adverse reactions following immunization? 下载免费PDF全文
Martins MA Silva ML Marciano AP Peruhype-Magalhães V Eloi-Santos SM Ribeiro jG Correa-Oliveira R Homma A Kroon EG Teixeira-Carvalho A Martins-Filho OA 《Clinical and experimental immunology》2007,148(1):90-100
Over past decades the 17DD yellow fever vaccine has proved to be effective in controlling yellow fever and promises to be a vaccine vector for other diseases, but the cellular and molecular mechanisms by which it elicits such broad-based immunity are still unclear. In this study we describe a detailed phenotypic investigation of major and minor peripheral blood lymphocyte subpopulations aimed at characterizing the kinetics of the adaptive immune response following primary 17DD vaccination. Our major finding is a decreased frequency of circulating CD19+ cells at day 7 followed by emerging activation/modulation phenotypic features (CD19+interleukin(IL)10R+/CD19+CD32+) at day 15. Increased frequency of CD4+human leucocyte antigen D-related(HLA-DR+) at day 7 and CD8+HLA-DR+ at day 30 suggest distinct kinetics of T cell activation, with CD4+ T cells being activated early and CD8+ T cells representing a later event following 17DD vaccination. Up-regulation of modulatory features on CD4+ and CD8+ cells at day 15 seems to be the key event leading to lower frequency of CD38+ T cells at day 30. Taken together, our findings demonstrate the co-existence of phenotypic features associated with activation events and modulatory pathways. Positive correlations between CD4+HLA-DR+ cells and CD4+CD25high regulatory T cells and the association between the type 0 chemokine receptor CCR2 and the activation status of CD4+ and CD8+ cells further support this hypothesis. We hypothesize that this controlled microenviroment seems to be the key to prevent the development of serious adverse events, and even deaths, associated with the 17DD vaccine reported in the literature. 相似文献
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Fleur M. van der Valk Jeffrey Kroon Wouter V. Potters Rogier M. Thurlings Roelof J. Bennink Hein J. Verberne Aart J. Nederveen Max Nieuwdorp Willem J.M. Mulder Zahi A. Fayad Jaap D. van Buul Erik S.G. Stroes 《Journal of the American College of Cardiology》2014
Background
Understanding how leukocytes impact atherogenesis contributes critically to our concept of atherosclerosis development and the identification of potential therapeutic targets.Objectives
The study evaluates an in vivo imaging approach to visualize peripheral blood mononuclear cell (PBMC) accumulation in atherosclerotic lesions of cardiovascular (CV) patients using hybrid single-photon emission computed tomography/computed tomography (SPECT/CT).Methods
At baseline, CV patients and healthy controls underwent 18fluorodeoxyglucose positron emission tomography-computed tomography and magnetic resonance imaging to assess arterial wall inflammation and dimensions, respectively. For in vivo trafficking, autologous PBMCs were isolated, labeled with technetium-99m, and visualized 3, 4.5, and 6 h post-infusion with SPECT/CT.Results
Ten CV patients and 5 healthy controls were included. Patients had an increased arterial wall inflammation (target-to-background ratio [TBR] right carotid 2.00 ± 0.26 in patients vs. 1.51 ± 0.12 in controls; p = 0.022) and atherosclerotic burden (normalized wall index 0.52 ± 0.09 in patients vs. 0.33 ± 0.02 in controls; p = 0.026). Elevated PBMC accumulation in the arterial wall was observed in patients; for the right carotid, the arterial-wall-to-blood ratio (ABR) 4.5 h post-infusion was 2.13 ± 0.35 in patients versus 1.49 ± 0.40 in controls (p = 0.038). In patients, the ABR correlated with the TBR of the corresponding vessel (for the right carotid: r = 0.88; p < 0.001).Conclusions
PBMC accumulation is markedly enhanced in patients with advanced atherosclerotic lesions and correlates with disease severity. This study provides a noninvasive imaging tool to validate the development and implementation of interventions targeting leukocytes in atherosclerosis. 相似文献28.
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van Rijk MC Tanis PJ Nieweg OE Loo CE Olmos RA Oldenburg HS Rutgers EJ Hoefnagel CA Kroon BB 《Annals of surgical oncology》2007,14(2):627-632
Background Preliminary data have shown encouraging results of a single intratumoral radiopharmaceutical injection that enables both sentinel
node biopsy and probe-guided excision of the primary tumor in patients with nonpalpable breast cancer. The aim of the study
was to evaluate this approach in a large group of patients.
Methods Lymphoscintigraphy was performed in 368 patients with nonpalpable breast cancer after intratumoral injection of 99mTc-nanocolloid (.2 mL, 123 MBq, 3.3 mCi) guided by ultrasound or stereotaxis. The sentinel node was pursued with the aid of
vital blue dye (1.0 mL, intratumoral) and a gamma ray detection probe. In case of breast-conserving surgery, the probe was
used to guide the excision.
Results At least one sentinel node could be identified intraoperatively in 357 patients (97%), of whom 69 had involved nodes (19%).
Age over 60 years was associated with less frequent nonaxillary lymphatic drainage and absence of internal mammary chain dissemination.
Tumor-free margins were obtained in 262 (89%) of the 293 patients who underwent segmental excision. Re-excision of the primary
tumor bed was performed in six patients (2%). During a median follow-up of 22 months, one breast recurrence and one axillary
recurrence were observed.
Conclusions Lymphatic mapping and probe-guided tumor excision of nonpalpable breast cancer by intralesional administration of a single
dose of 99mTc-nanocolloid and blue dye resulted in 97% identification of the sentinel node and in tumor-free margins in 89% of the patients
who underwent breast-conserving surgery. Longer follow-up is needed to substantiate the accuracy and safety of this technique. 相似文献
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