[Fluency shaping with surface electromyography: a pilot study].

Background: the use of a technological resource in fluency promotion.

Aim: to verify the effectiveness of a stuttering treatment based on the use of surface electromyography (SEMG) exclusively.

Method: participants were four stuttering adults of both genders.

Do clinicians always maximize patient outcomes? A conjoint analysis of preferences for carotid artery testing.

Objectives: The value clinicians place on diagnostic information is subject to psychological influences and systematic biases, but there is limited evidence of how these factors may affect patients' health outcomes. We assessed the relative value attached by experienced clinicians to different diagnostic test characteristics and how their preferences relate to patient outcomes, focusing on strategies for testing symptomatic patients for carotid artery stenosis.

Methods: Using conjoint analysis, experienced neurologists and vascular surgeons ranked 10 diagnostic strategies defined in terms of four characteristics.

[Speech and non-speech activities in stuttering: a preliminary study].

Background: stuttering.

Aim: to compare muscle activation in fluent and stuttering individuals during speech and non-speech tasks.

Method: six adults divided in two groups: G1 - three fluent individuals; G2 - three stuttering individuals.

Hepatitis C virus antibodies in dialysis patients in Tunisia: a single center study.

Fifty-eight patients on maintenance hemodialysis in a dialysis unit at Tunis, Tunisia were tested for anti-hepatitis C virus (anti-HCV) antibodies by second generation ELISA test, and for HCV-RNA by nested reverse transcriptase polymerase chain reaction (RT-PCR) of 5' non-coding region. Specificity of the antibodies was confirmed by immunoblot test. HCV genotype was defined using INNO-LIPA test.

[P300 event-related potentials in stutterers pre and post treatment: a pilot study].

Background: P300 event-related potential has been used as an instrument to establish the diagnosis of several disorders as well as to assess therapeutic outcomes.

Aim: to investigate the relationship between stuttering amelioration and cerebral activity.

Method: P300 event-related potentials were obtained in three adult males, all stutterers, aged 20 to 31 years, pre and post-treatment, verifying changes in wave amplitude and latency between waves.

The decision to perform Caesarean section in Russia.

Background: Clinical practice in Russia is set out in a series of centralized guidelines. However, many of these guidelines are not supported by evidence and, despite their existence, there is considerable unexplained variation in practice. This study examines the decision to recommend a Caesarean section, an intervention for which there is a solid evidence base, but whose use varies considerably among facilities in Russia.

Therapy-induced antitumor vaccination by targeting tumor necrosis factor alpha to tumor vessels in combination with melphalan.

Treatment of tumor-bearing mice with mouse (m)TNF-alpha, targeted to tumor vasculature by the anti-ED-B fibronectin domain antibody L19(scFv) and combined with melphalan, induces a therapeutic immune response. Upon treatment, a highly efficient priming of CD4+ T cells and consequent activation and maturation of CD8+ CTL effectors is generated, as demonstrated by in vivo depletion and adoptive cell transfer experiments. Immunohistochemical analysis of the tumor tissue demonstrated massive infiltration of CD4+ and CD8+ T cells 6 days after treatment and much earlier in the anamnestic response to tumor challenge in cured mice.

Lymphatic vessels assessment in feline mammary tumours.

Background: The lymphatic vessels play a crucial role in a variety of human cancers since tumour cell lymphatic invasion significantly influences prognosis. It is not known if pre-existing lymphatics are enough for tumour dissemination or de novo development is necessary. VEGFR-3 is an angiogenetic mediator for both lymphatic and blood vessels during embryonic development, and only for lymphatics after birth.

Incidence and clinical predictors of Kaposi's sarcoma among 1721 Italian solid organ transplant recipients: a multicenter study.

Kaposi's sarcoma (KS) can be a complication of solid organ transplantation, but with an important incidence rate variability in different geographical areas. Here we analyzed the incidence rate, timing and clinical correlates of KS, in a cohort of Italian solid organ transplant recipients from four distinct transplantation centers. A total of 1721 renal, heart and liver transplant recipients were recruited between 1997 and 2004.

Reducing racial/ethnic disparities in female breast cancer: screening rates and stage at diagnosis.

Objectives: We assessed whether population rates of mammography screening, and their changes over time, were associated with improvements in breast cancer stage at diagnosis and whether the strength of this association varied by race/ethnicity.

Methods: We analyzed state cancer registry data linked to socioeconomic characteristics of patients' areas of residence for 1990-1998 time trends in the likelihood of early stage diagnosis. We appended each cancer registry record with matching subgroup estimates of self-reported mammography screening.

Calculating QALYs, comparing QALY and DALY calculations.

Quality-adjusted life years (QALYs) have been used in the assessment of health interventions for three decades. The popularity of the QALY approach has been constantly increasing, although the debate on its theoretical underpinnings and practical implications is still ongoing. Disability-adjusted life years (DALYs), also widely debated, were shaped some 20 years later, broadly within the same conceptual framework but with a number of important differences.

Targeted delivery of tumor necrosis factor-alpha to tumor vessels induces a therapeutic T cell-mediated immune response that protects the host against syngeneic tumors of different histologic origin.

Purpose: We sought to demonstrate that a single systemic administration of L19mTNFalpha (a fusion protein constituted by the scFv L19 specific for the oncofetal ED-B domain of fibronectin and tumor necrosis factor alpha, TNFalpha) in combination with melphalan induced complete and long-lasting tumor eradication in tumor-bearing mice and triggered the generation of a specific T cell-based immune response that protects the animals from a second tumor challenge, as well as from challenges with syngeneic tumor cells of different histologic origin.

Experimental Design And Results: Treatment with L19mTNFalpha, in combination with melphalan, induced complete tumor regression in 83% of BALB/c mice with WEHI-164 fibrosarcoma and 33% of animals with C51 colon carcinoma. All cured mice rejected challenges with the same tumor cells and, in a very high percentage of animals, also rejected challenges with syngeneic tumor cells of different histologic origin.

The cost-effectiveness of neonatal screening for cystic fibrosis: an analysis of alternative scenarios using a decision model.

Background: The use of neonatal screening for cystic fibrosis is widely debated in the United Kingdom and elsewhere, but the evidence available to inform policy is limited. This paper explores the cost-effectiveness of adding screening for cystic fibrosis to an existing routine neonatal screening programme for congenital hypothyroidism and phenylketonuria, under alternative scenarios and assumptions.

Methods: The study is based on a decision model comparing screening to no screening in terms of a number of outcome measures, including diagnosis of cystic fibrosis, life-time treatment costs, life years and QALYs gained.

Conjoint analysis of preferences for cardiac risk assessment in primary care.

Objectives: Many evaluations underestimate the utility associated with diagnostic interventions by failing to capture the nonclinical value of diagnostic information. This is a cause of bias in resource allocation decisions. A study was undertaken to investigate preferences for the assessment of cardiac risk, testing the suitability of conjoint analysis, a multiattribute preference elicitation method, in the field of clinical diagnosis.

Internalization and recycling of ALCAM/CD166 detected by a fully human single-chain recombinant antibody.

Activated leukocyte cell adhesion molecule (ALCAM/CD166), a member of the immunoglobulin superfamily with five extracellular immunoglobulin-like domains, promotes heterophilic (ALCAM-CD6) and homophilic (ALCAM-ALCAM) cell-cell interactions. Here we describe a fully human single-chain antibody fragment (scFv) directed to ALCAM/CD166. We selected the I/F8 scFv from a phage display library of human V-gene segments by cell panning and phage internalization into IGROV-I human ovary carcinoma cells.

Affirmative action: the lessons for health care.

Governments are becoming more assertive about reducing ethnic inequalities

Acoustic analyses of speech naturalness: a comparison between two therapeutic approaches.

Background: acoustic analyses of speech naturalness.

Aim: to use voice onset time (VOT) measure as a parameter of speech naturalness, comparing the outcome of two stuttering treatment procedures.

Method: 12 adult stutterers were divided in two groups and submitted to the same Fluency Promotion Program (FPF).

[A congenital deficiency of the C3 fraction of complement. A familial study].

The innate deficit of the third constituent of the complement is extremely rare, it appears clinically as a deficit of the humorale immunity. We report a case of C3 deficit in a 6 year old Tunisian child, who presents a psychomotor delay and recurrent infections. The investigation of the complement system profile by an immunochemical test of the children's serum shows an absence of C3 and C3d, associated to a loss of classic and alternate hemolytic pathway activities.

Selective targeted delivery of TNFalpha to tumor blood vessels.

We sought to enhance the selective toxicity of tumor necrosis factor alpha (TNFalpha) to permit its systemic use in cancer therapy. Because ligand-targeted therapeutics have proven successful in improving the selective toxicity of drugs, we prepared a fusion protein (L19mTNFalpha) composed of mouse TNFalpha and a high-affinity antibody fragment (L19 scFv) to the extradomain B (ED-B) domain of fibronectin, a marker of angiogenesis. L19mTNFalpha was expressed in mammalian cells, purified, and characterized.

Relationship between the stuttering severity index and speech rate.

Context: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints.

Objective: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate.

Design: Cross-sectional study.

[Immunological study in sickle cell disease patients: importance of the complement system].

Ten Tunisian patients, with homozygote sickle cell disease and asplenia were studied to investigate and to determine possible immunological function defects. Obtained results directed us to an abnormality of the alternate complement pathway activation which is expressed by a decreased hémolytic activity, while the classic pathway is normal. Quantification of C3, C4, C5, C6, C7 and factor B by immunochemical assay were normal, whereas factor B functional activity was depressed to a mean level of about half of normal in eight patients, IgG was increased in one subject and IgA in two others.

A cost-utility analysis of patients undergoing orthognathic treatment for the management of dentofacial disharmony.

Introduction: Management of dentofacial discrepancies using orthognathic treatment is now a common procedure in the United Kingdom. Although the benefits of orthognathic intervention are often considered, the cost implications have not been investigated to our knowledge. This study is a cost-utility analysis of orthognathic treatment.

Setting priorities for the evaluation of health interventions: when theory does not meet practice.

Priority setting is a key component of the process of evaluating health interventions. This has traditionally been an informal process led by power and influence, but a number of explicit criteria and systematic models have been developed since the late 1980s. This paper presents a review and appraisal of these conceptual models and examines how they have influenced the practice of priority setting in the United States and Europe.

Time spent on informal and formal care giving for persons with dementia in Sweden.

The purpose of this paper was to explore the time spent on caring by families of persons with dementia in Sweden. As part of a European Commission project, interviews were carried out on a sample of 92 carers, caring for persons with dementia. The interviews focused on time spent on caring, IADL, ADL and surveillance, as well as formal support received and used.