The Short Health Scale: a valid measure of subjective health in ulcerative colitis.

Objective: Assessment of health-related quality of life (HRQOL) is important in both clinical practice and clinical trials, and several multi-item questionnaires are currently in use. We have devised and evaluated a simplified four-item questionnaire, the Short Health Scale (SHS), representing each of four health dimensions: (a) symptom burden, (b) social function, (c) disease-related worry and (d) general well-being.

Material And Methods: Three hundred patients with ulcerative colitis completed the SHS and three other HRQOL questionnaires (IBDQ, RFIPC and PGWB).

Evaluation of the Inflammatory Bowel Disease Questionnaire in Swedish patients with Crohn's disease.

Objective: Health-related quality of life (HRQoL) is an important measure of inflammatory bowel disease (IBD) health outcome. The Inflammatory Bowel Disease Questionnaire (IBDQ) comprising 32 items grouped into four dimensions is a widely used IBD-specific HRQoL instrument. The purpose of this study was to evaluate the validity, reliability and responsiveness of the Swedish translation of the IBDQ in patients with Crohn's disease (CD).

RNA stability of the E2A-encoded transcription factor E47 is lower in splenic activated B cells from aged mice.

We have demonstrated previously that DNA binding and protein expression of the E2A-encoded transcription factor E47 are lower in nuclear extracts of activated splenic B cells from old mice. In the present study, we address how E47 protein expression is regulated in aging. Results herein show that E2A mRNA levels were decreased in stimulated splenic B cells from old as compared with young mice.

Humoral immune response and B-cell functions including immunoglobulin class switch are downregulated in aged mice and humans.

Vaccinations are powerful tools for combating infections. Because of the age-related impairment in immune functions, the currently available vaccines are protecting only a small proportion of the elderly population. We, here, provide an overview of age-related changes in innate and adaptive immunity with particular emphasis to changes in antibody production with aging.

Deficient B lymphopoiesis in murine senescence: potential roles for dysregulation of E2A, Pax-5, and STAT5.

B lymphopoiesis in senescent mice is typically diminished and characterized by low pre-B cell numbers. The transcription factors E2A, Pax-5, and STAT5 have been implicated in the differentiation, proliferation, and survival of B cell precursors. In this review, we discuss the impairment of B lymphopoiesis during old age in the context of mechanisms at the molecular level responsible for the handling and turnover of these key transcriptional proteins.

B cells, E2A, and aging.

Both mouse and human exhibit deficiencies in humoral immunity during 'old age'. While alterations in phenotype and function have been well documented, the molecular mechanisms that result in immune senescence remain undefined. B lymphopoiesis is suppressed in senescent mice, which may result from deficits at the pre-B-cell stage or earlier (e.

Antimicrobial resistance in urinary bacterial isolates from pregnant women in rural Tanzania: implications for public health.

Treatment of asymptomatic bacteriuria and urinary tract infections in pregnancy can prevent adverse outcome for mother and child. However, antimicrobial resistance can impede effective chemotherapy. From April 1995 to March 1996, urine specimens from 5153 pregnant women in a rural area in northern Tanzania were inoculated on dip slides.

Abrogation of the alloreactive responses of cadaveric donor intestinal lymphocytes by intraoperative Campath-1H exposure.

A number of recent reports in clinical and experimental intestinal transplantation have suggested that the donor lymphocytes present in and around the gastrointestinal system are potent mediators of graft-versus-host (GvH) reactivity and that GvH responses may contribute to posttransplant morbidity. Therefore, we have tested the proliferative and cytotoxic capabilities of gut-associated lymphocytes from cadaveric donors obtained prerevascularization (pre-r) and about 6 hours postrevascularization (post-r) in recipients pretreated with Campath-1H antibody (alemtuzumab). Mixed lymphocyte reactions (MLR) were performed with lymphoid cells isolated from intestinal epithelial mucosa, lamina propria, and lymph nodes.

Genotypic and phenotypic stability of Helicobacter pylori markers in a nine-year follow-up study of patients with noneradicated infection.

The cagA gene, alleles of the vacA gene,random amplified polymorphic DNA (RAPD), and neutrophil activating capacity (HpNAC) were used to examine paired H. pylori isolates from 10 noneradicated individuals 9 years apart. Paired isolates from each patient were indistinguishable with regard to vacA alleles, RAPD, and HpNAC.

High rate of fatal cases of pediatric septicemia caused by gram-negative bacteria with extended-spectrum beta-lactamases in Dar es Salaam, Tanzania.

Extended-spectrum beta-lactamases (ESBLs) were present in high proportions of Escherichia coli (25% [9 of 36]) and Klebsiella pneumoniae isolates (17% [9 of 52]) causing pediatric septicemia at a tertiary hospital in Tanzania. Patients with septicemia due to ESBL-producing organisms had a significantly higher fatality rate than those with non-ESBL isolates (71% versus 39%, P = 0.039).

Effect of age on the immunoglobulin class switch.

Aging represents a complex remodelling in which both specific and innate immunity deteriorate. Age-related changes in humoral immunity involve reduced vaccine responses and increased production of auto-antibodies. Although T-cell alterations play a significant role in age-related humoral immune changes, alterations in B cells also occur.

Fixed dose combinations for tuberculosis: Lessons learned from clinical, formulation and regulatory perspective.

Worldwide, tuberculosis (TB) remains one of the most important communicable diseases in terms of morbidity and mortality. Its control requires multi-drug therapy for at least six months, which could lead to patient non-compliance, failure of therapy and ultimately resulting in the emergence of drug resistance. Fixed dose combinations (FDCs) in TB therapy reduce the number of tablets to be consumed and thereby increase patient compliance with recommended treatment regimens.

Surveillance of antimicrobial resistance at a tertiary hospital in Tanzania.

Background: Antimicrobial resistance is particularly harmful to infectious disease management in low-income countries since expensive second-line drugs are not readily available. The objective of this study was to implement and evaluate a computerized system for surveillance of antimicrobial resistance at a tertiary hospital in Tanzania.

Methods: A computerized surveillance system for antimicrobial susceptibility (WHONET) was implemented at the national referral hospital in Tanzania in 1998.

Nosocomial outbreak of neonatal Salmonella enterica serotype Enteritidis meningitis in a rural hospital in northern Tanzania.

Background: Clinicians at Haydom Lutheran Hospital, a rural hospital in northern Tanzania noted an unusually high case-fatality rate of pediatric meningitis and suspected an outbreak of an unknown agent or an organism resistant to the empirical therapy.

Methods: We established a provisional microbiology laboratory to investigate the suspected outbreak. Blood and spinal fluid specimens were taken from children below the age of seven years with suspected meningitis.

Decreased E47 in senescent B cell precursors is stage specific and regulated posttranslationally by protein turnover.

The E2A-encoded transcription factor E47 is crucial to B lymphopoiesis. Senescent BALB/c mice ( approximately 2 years old) had reduced pre-B cells ex vivo. Pro-B/early pre-B cells from these aged mice, both ex vivo and in vitro, were deficient in E47 protein.

Age-related differences in the E2A-encoded transcription factor E47 in bone marrow-derived B cell precursors and in splenic B cells.

We have investigated the effects of aging on the E2A-encoded transcription factor E47, a key regulator of B cell functions, in B cell precursors and in splenic B cells. Here, we show that old mice can be classified as severely depleted, moderately depleted or not depleted mice, according to the percentage of pre-B cells in their bone marrow. IL-7-expanded populations of pro-B/early pre-B cells from bone marrow of both severely depleted and moderately depleted old mice exhibit a reduced E47 DNA-binding and expression compared to young mice, and this defect in severely depleted old mice is more dramatic than that in moderately depleted old mice.

Effects of aging on DNA-binding activity of the E47 transcription factor in splenic B cells.

In the present paper, we have investigated the DNA-binding activity of the E2A-encoded transcription factor E47 in LPS-activated splenic B cells from young and old BALB/c mice. E47 is a key regulator of B cell differentiation and function: it binds to the E-box site, found in the regulatory regions of several B cell-specific genes (immunoglobulin (Ig), mb-1, and lambda5), promotes cell survival of early pre-B cells, helps to initiate Ig rearrangements, promotes class switch and is perhaps involved in somatic mutation in mature splenic and lymph node B cells. Results show that LPS-stimulated splenic B cells from old mice display decreased E47 DNA-binding activity as compared to young mice and that in splenic activated B cells only E47 homodimers bind DNA.

Cognitive-behavioral stress management increases benefit finding and immune function among women with early-stage breast cancer.

Objective: This study examined the effect of a cognitive-behavioral stress management (CBSM) intervention on emotional well-being and immune function among women in the months following surgery for early-stage breast cancer.

Method: Twenty-nine women were randomly assigned to receive either a 10-week CBSM intervention (n=18) or a comparison experience (n=11). The primary psychological outcome measure was benefit finding.

Reduced Ig class switch in aged mice correlates with decreased E47 and activation-induced cytidine deaminase.

The capacity to class switch the IgH chain is critical to the effectiveness of humoral immune responses. We show that in vitro-stimulated splenic B cells from senescent mice are deficient in production of multiple class switch isotypes (IgG1, G2a, G3, and E), class switch recombination (CSR), and induction of the E2A-encoded transcription factor E47. E47 has previously been shown to be required for CSR, at least in part via expression of the activation-induced cytidine deaminase.

Aged mice exhibit distinct B cell precursor phenotypes differing in activation, proliferation and apoptosis.

Senescence in murine models is associated with a reduction, albeit heterogeneous, in bone marrow pre-B cells. We have categorized aged BALB/c mice into two phenotypes based on their patterns of pre-B/pro-B cell loss. Each phenotype is characterized by distinct responses to the growth cytokine IL-7 and capacity for survival in vitro.

Immune responses and their regulation by donor bone marrow cells in clinical organ transplantation.

Infusions of donor bone marrow derived cells (DBMC) continue to be tested in clinical protocols intended to induce specific immunologic tolerance of solid organ transplants based on the observations that donor-specific tolerance is induced this way in animal models. We studied the immunological effects of human DBMC infusions in renal transplantation using modifications in lymphoproliferation (MLR) and cytotoxicity (CML) assays. The salient observations and tentative conclusions are summarized in this review.

The influence of demographic and disease-related factors on health-related quality of life in patients with ulcerative colitis.

Objective: The aims of this study were to analyse the health-related quality of life of patients with ulcerative colitis and to assess in what way demographic and disease-related factors influence patients' experiences of this, in order to interpret the results of health-related quality of life assessment more correctly.

Patients And Methods: We carried out a cross-sectional evaluation of 300 consecutive patients with ulcerative colitis from the catchment areas of Linköping University Hospital and Orebro University Hospital in Sweden. Health-related quality of life was measured using four questionnaires: the IBDQ, the RFIPC, the SF-36 and the PGWB.

Effects of aging on proliferation and E47 transcription factor activity induced by different stimuli in murine splenic B cells.

In the present paper, we have investigated the effects of aging on the expression and function of the E2A-encoded transcription factor E47 in splenic B lymphocytes, unactivated or activated with different stimuli (LPS, anti-CD40, anti-IgM, alone or in combination with IL-4). Results indicate that unstimulated splenic B cells show very low E47 protein levels as well as E47 DNA-binding activity and that, upon B cell activation, E47 expression and DNA-binding activity are strongly induced in young and, to a significantly lesser extent, in old mice. The level of E47 protein expression in stimulated splenic B cells was found significantly higher in young than in old mice, suggesting that DNA-binding activity correlates with protein expression.

The age-related decrease in E47 DNA-binding does not depend on increased Id inhibitory proteins in bone marrow-derived B cell precursors.

Our previous results showed that decreased numbers of pre-B cells in aged mice were associated with decreases in surrogate light chain, lambda5, and transcription factors E47/E12. In the present paper, we have analyzed IL-7-expanded populations of pro-B/early pre-B cells to evaluate whether the age-related reduction in E47 DNA-binding could be attributed to reduced E47 expression and/or increased Id expression. According to the percentage of pre-B cells present in their bone marrow, old mice were classified as severely depleted (>80% loss in pre-B cells, 50% loss in pro-B cells), or moderately depleted (20-80% loss in pre-B cells).

Fixed-dose combination drugs for tuberculosis: application in standardised treatment regimens.

Short-course chemotherapy is highly efficacious in treating tuberculosis (TB). However, the length (>/=6 months) and complexity (three or four different drugs) of the treatment makes adherence difficult. Erratic treatment not only fails to cure patients but also creates chronically contagious cases, who may excrete drug-resistant TB bacteria.