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Relations between fatigue, neuropsychological functioning, and physical activity after treatment for breast carcinoma

CANCER, Issue 9 2002
Daily self-report, objective behavior
Abstract BACKGROUND Previous research indicates that disease free breast carcinoma survivors who experienced severe fatigue also had many problems with regard to neuropsychological functioning and physical activity, measured with general self-report questionnaires. Both neuropsychological functioning and physical activity can be measured with daily self-report measures in addition to measures of objective behavior. The main objective of this study was to examine the relations between 1) fatigue and 2) daily self-reported and objective measures of neuropsychological functioning and physical activity. METHODS Disease free breast carcinoma survivors and age-matched women with no history of breast carcinoma filled out a daily self-observation list and wore an actometer during a period of 12 days. Furthermore, they performed two standardized tests to assess neuropsychological functioning. RESULTS No differences were found between severely fatigued disease free breast carcinoma survivors, nonseverely fatigued disease free breast carcinoma survivors, and women in a control group with regard to daily self-reported and objective physical activity. The severely fatigued disease free patients reported more impairment in neuropsychological functioning on daily questionnaires compared with nonseverely fatigued disease free patients and women in the control group. However, no differences were found between these three groups on a standardized concentration task. On a standardized reaction time task, no significant differences were found between the two groups of disease free breast carcinoma survivors: However, women in the severely fatigued group had a significantly longer reaction time compared with women in the control group. CONCLUSIONS Fatigue is correlated strongly with daily self-reported neuropsychological functioning, but not with objective neuropsychological functioning, in a laboratory setting. In the current study, fatigue was not correlated with daily self-reported and objective physical activity. Cancer 2002;95:2017,26. © 2002 American Cancer Society. DOI 10.1002/cncr.10891 [source]

Valproic acid blood genomic expression patterns in children with epilepsy , a pilot study

ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2004
Y. Tang
Objective , Valproic acid (VPA) is a commonly used anticonvulsant with multiple systemic effects. The purpose of this pilot study is to examine the blood genomic expression pattern associated with VPA therapy in general and secondly VPA efficacy in children with epilepsy. Materials and methods , Using oligonucleotide microarrays, gene expression in whole blood was assessed in pediatric epilepsy patients following treatment with VPA compared with children with epilepsy prior to initiation of anticonvulsant therapy (drug free patients). Results , The expression of 461 genes was altered in VPA patients (n = 11) compared with drug free patients (n = 7), among which a significant number of serine threonine kinases were down-regulated. Expression patterns in children seizure free on VPA therapy (n = 8) demonstrated 434 up-regulated genes, many in mitochondria, compared with VPA children with continuing seizures (n = 3) and drug free seizure patients (n = 7). Conclusion , VPA therapy is associated with two significant and unique blood gene expression patterns: chronic VPA monotherapy in general and a separate blood genomic profile correlated with seizure freedom. These expression patterns provide new insight into previously undetected mechanisms of VPA anticonvulsant activity. [source]

After discontinuation of calcineurin inhibitors, tapering of mycophenolate mofetil further impairs donor-directed cytotoxicity

CLINICAL TRANSPLANTATION, Issue 2 2008
Nicole M Van Besouw
Abstract:, Background:, Recently, we described a significant decrease in donor-specific cytotoxic T-lymphocyte precursor frequency (CTLpf) after discontinuation of calcineurin inhibitors (CNI), while the proliferative capacity in mixed lymphocyte culture (MLC), and the number of interferon-, (IFN-,) producing cells (pc) in Elispot remained unchanged. Methods:, We tested T-cell reactivity in CNI free patients with stable renal graft function, on mycophenolate mofetil (MMF) or azathioprine (AZA) plus prednisone, who were tapered to 50% of their MMF or AZA dose. Results:, Furthermore, tapering of the MMF or AZA dose resulted in a decrease of donor-reactive CTLpf in all patients with detectable CTLpf. Detectable numbers decreased from a median of 32 to 8 CTLp/106 peripheral blood mononuclear cell (PBMC). No effect on third-party reactive CTLpf was found, while the T-cell reactivity to donor and third-party cells as tested in MLC and in IFN-, Elispot was not affected either by tapering of immunosuppression. Third-party reactivity was significantly higher than donor-specific reactivity in all tests. A control group showed no changes in any of the in vitro assays. Conclusion:, Both withdrawal of CNI and tapering of MMF or AZA dose decreases the donor-specific CTLpf. Our data suggest that reduction of immunosuppression results in a specific decrease of donor-directed cytotoxic capacity of immunocompetent cells, while their proliferation and cytokine production capacity remained unchanged. Immunosuppression hinders development of cytotoxic non-responsiveness. [source]

Dopamine transporter binding in Gilles de la Tourette syndrome: a [123I]FP-CIT/SPECT study

ACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2004
J. Serra-Mestres
Objective:, To investigate dopamine transporter binding in Gilles de la Tourette syndrome (GTS) with SPECT and [123I]FP-CIT. Method:, Ten neuroleptic naïve/free patients with GTS, and 10 age- and gender-matched normal volunteers were studied. Subjects were clinically evaluated. GTS severity and affective symptoms were measured and the presence of GTS-related behaviours were recorded. Results:, The GTS group showed significantly higher binding in both caudate and putamen nuclei than the controls. No associations were found between striatal binding ratios and measures of affect or GTS-related behaviours. Conclusion:, Patients with GTS show higher striatal binding of FP-CIT to the striatum in comparison with age- and gender-matched control subjects, indicating that dopamine transporter abnormalities are involved in the pathophysiology of GTS. These abnormalities appear to be distributed across both caudate and putamen. [source]