Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém... more Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna. Método: estudo transversal realizado num hospital geral universitário, abrangendo todos os recém-nascidos nascidos vivos no centro obstétrico do hospital durante o período de 23 de março de 1999 a 1 de junho de 1999 (847 recém-nascidos). A presença de exposição pré-natal à cocaína foi definida por um teste de fluorescência polarizada por imunoensaio positivo para benzoilecgonina no mecônio do recém-nascido e/ou por uma entrevista materna positiva. Resultados: a taxa da exposição pré-natal à cocaína foi de 16 casos (2,4%), através da entrevista, e de 25 casos (3,4%) através da testagem do mecônio. Foram encontrados 34 casos, com uma prevalência de 4,6%, quando os métodos para a detecção foram considerados de forma complementar. Conclusões: através deste estudo, foi observado que a testagem meconial é mais eficaz que a entrevista materna no diagnóstico da exposição pré-natal à cocaína. A entrevista aumentou, em relação à testagem do mecônio, em 26% a possibilidade do diagnóstico da exposição; e a testagem do mecônio, em relação à entrevista, aumentou em 53,4% o diagnóstico da exposição.
Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém... more Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna. Método: estudo transversal realizado num hospital geral universitário, abrangendo todos os recém-nascidos nascidos vivos no centro obstétrico do hospital durante o período de 23 de março de 1999 a 1 de junho de 1999 (847 recém-nascidos). A presença de exposição pré-natal à cocaína foi definida por um teste de fluorescência polarizada por imunoensaio positivo para benzoilecgonina no mecônio do recém-nascido e/ou por uma entrevista materna positiva. Resultados: a taxa da exposição pré-natal à cocaína foi de 16 casos (2,4%), através da entrevista, e de 25 casos (3,4%) através da testagem do mecônio. Foram encontrados 34 casos, com uma prevalência de 4,6%, quando os métodos para a detecção foram considerados de forma complementar. Conclusões: através deste estudo, foi observado que a testagem meconial é mais eficaz que a entrevista materna no diagnóstico da exposição pré-natal à cocaína. A entrevista aumentou, em relação à testagem do mecônio, em 26% a possibilidade do diagnóstico da exposição; e a testagem do mecônio, em relação à entrevista, aumentou em 53,4% o diagnóstico da exposição.
Im Sommerhalbjahr wird die deutsche Konjunktur voraussichtlich eine Schwächephase durchlaufen. Da... more Im Sommerhalbjahr wird die deutsche Konjunktur voraussichtlich eine Schwächephase durchlaufen. Darauf deutet das ifo Geschäftsklima hin, das sich im Mai und Juni merklich eingetrübt hat. Maßgeblich dafür ist die anhaltende Unsicherheit über den Fortgang der europäischen Schuldenkrise. Im Jahresdurchschnitt 2012 dürfte das reale Bruttoinlandsprodukt – bei einem 67%-Unsicherheitsintervall von 0,1% bis 1,3% – daher nur um 0,7% steigen. Getragen von
Resumo: Os autores, a partir da experiencia clinica e da literatura, abordam o tema da crianca co... more Resumo: Os autores, a partir da experiencia clinica e da literatura, abordam o tema da crianca com doenca cronica e sua familia. Baseados nos estudos de Leventhal, propoem um protocolo para a avaliacao psicossocial da crianca e da familia, a fim de ...
Zusammenfassung Fragestellung. Mit zunehmendem Alter der CF-Patienten bei steigender Lebenserwart... more Zusammenfassung Fragestellung. Mit zunehmendem Alter der CF-Patienten bei steigender Lebenserwartung kommt es zu einem Ansteigen der Inzidenz und Prävalenz eines Diabetes mellitus. Eine frühzeitige Diagnosestellung des Diabetes mellitus ist wichtig, da CF-Patienten mit Diabetes mellitus in einem schlechteren klinischen Zustand sind und eine erhöhte Mortalität aufweisen.In der vorliegenden Untersuchung soll geklärt werden, mit welchem diagnostischem Test ein Diabetes mellitus frühzeitig erkannt werden kann. Methode. Bei 102 CF-Patienten wurden im Rahmen der Routineuntersuchungen eine Messung des Nüchternblutzuckers, ein HbA 1c-Wert und ein standardisierter oraler Glukosetoleranztest durchgeführt.Die Beurteilung des oralen Glukosetoleranztests (2h-Wert) wurde gemäß den WHO-Kriterien vorgenommen.Zusätzlich erfolgte eine Zuordnung nach den neuen Diagnosekriterien der American Diabetes Association (ADA) aufgrund des Nüchternblutzuckers. Ergebnisse. 65,7% der CF-Patienten hatten eine normale, 21,6% eine gestörte Glukosetoleranz und bei 12,7% der Patienten wurde ein Diabetes mellitus aufgrund eines 2-h-Blutzuckerwerts >200 mg/dl diagnostiziert. Anamnestisch ließen sich keine typischen diabetesspezifischen Symptome erfragen. Keiner der CF-Patienten hatte Nüchternblutzuckerwerte >126 mg/dl, welche nach der neuen ADA-Diabetes-Klassifikation zur Diagnose eines Diabetes ausreichen.Der Mittelwert des Nüchternblutzuckers zeigte bei CF-Originalien
Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascid... more Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna.
Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascid... more Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna.
Six gene markers have been used to map the progress of the innate immune response of the mosquito... more Six gene markers have been used to map the progress of the innate immune response of the mosquito vector, Anopheles gambiae, upon infection by the malaria parasite, Plasmodium berghei. In addition to four previously reported genes, the set of markers included NOS (a nitric oxide synthase gene fragment) and ICHIT (a gene encoding two putative chitin-binding domains separated by a polythreonine-rich mucin region). In the midgut, a robust response occurs at 24 h postinfection, at a time when malaria ookinetes traverse the midgut epithelium, but subsides at later phases of malaria development. In contrast, the salivary glands show no significant response at 24 h, but are activated in a prolonged late phase when sporozoites are released from the midgut into the haemolymph and invade the glands, between 10 and 25 days after blood feeding. Furthermore, the abdomen of the mosquito minus the midgut shows significant activation of immune markers, with complex kinetics that are distinct from those of both midgut and salivary glands. The parasite evidently elicits immune responses in multiple tissues of the mosquito, two of which are epithelia that the parasite must traverse to complete its development. The mechanisms of these responses and their significance for malaria transmission are discussed.
Progress in Industrial Ecology, An International Journal, 2005
The objective of this study is to evaluate the human dimensions of improving energy and material-... more The objective of this study is to evaluate the human dimensions of improving energy and material-use efficiency of a system through increased integration and exchange between local actors. The results are based on a case study of a Swedish municipality with a developed forest industry. The actors' views are discussed together with the most important factors to enable increased integration and for exchange to take place. The greatest barriers found were the lack of knowledge and resources, attitudes, time frames, development consent, and lack of continuity and local power for some companies. One conclusion is that the municipal authority could have a role as coordinator of local integration projects. However, this role can be impeded by the weak integration of different divisions in the municipality's organisation and it is suggested that companies with integration as their business concept can be key actors when developing more integrated networks. It was also clear that intraorganisational issues may impede interorganisational integration.
Background: Obesity is a major risk factor for fatty liver disease. The purpose of this study was... more Background: Obesity is a major risk factor for fatty liver disease. The purpose of this study was: 1) to determine the degree of steatosis, inflammation and fibrosis in liver biopsies of morbidly obese patients in relation to their body fat distribution and metabolic status, and 2) to examine the course of liver enzyme changes with surgically-induced weight loss. Methods: The study population included 179 morbidly obese bariatric surgical patients (82% female, 18% male, mean age 39±0.7 (SEM) years, BMI 52±0.6 kg/m 2 , excess body weight 80±1.8 kg). All patients tested negative for hepatitis and HIV. Liver biopsies were taken intra-operatively. Hepatic enzyme activities were measured along with lipid parameters, fasting glucose, insulin and leptin. Results: Liver biopsies showed that 47% of morbidly obese females and 85% of males had >30% of hepatocytes filled with fat droplets. Clinically significant hepatic steatosis was associated (P<0.01) with: a) metabolic aberrations, i.e. hyperlipidemia, hyperglycemia, b) male gender, c) abdominal adiposity, and d) elevated hepatic aminotransferase activities. Hepatic inflammation was found in 47% of females and 55% of males, and 'moderate' fibrosis occurred in 12% of males and 6% of females. Postoperatively, the activity of hepatic aminotransferases declined after an initial increase in response to weight loss, with normalization of values occurring at an excess weight loss of 50% (P<0.0001). Conclusion: The majority of morbidly obese patients have >30% steatosis of the liver. The incidence of steatosis is higher for males than females, possibly due to their visceral obesity and associated metabolic aberrations.
Background: Success in bariatric surgery is most often evaluated by a sufficient loss of excess w... more Background: Success in bariatric surgery is most often evaluated by a sufficient loss of excess weight and an improvement in the medical conditions. The expected increase in quality of life (QoL) after weight loss, however, has not often been systematically analyzed. BAROS (Bariatric Analysis and Reporting Outcome System) is a scoring system which, along with easy handling, allows comparisons to be made internationally. Methods: 386 morbidly obese patients who had undergone bariatric surgery in our hospital were evaluated with BAROS. Five categories-failure, fair, good, very good, excellent-were taken from the scoring system that BAROS offers. This system has three major points: excess weight loss, medical co-morbidities and QoL. Points are subtracted for reoperations and defined complications. The operations performed were silastic ring vertical gastroplasty (72%), adjustable gastric banding (23%), biliopancreatic diversion (3%), vertical banded gastroplasty (1%) and gastric banding of Molina (1%). Results: In 1991 and 1993, we had a fair result in 3% and 10% of the patients. A good score with a mean of 3.6 to 4.1 was reached in 1992, 1994 and 1995. In the last 3 years, 1996 to 1998, the mean score was 5.0 to 5.7, which is a very good result when compared with the scoring key. Conclusion: BAROS is a valuable tool to access the QoL of patients who have undergone bariatric surgery.
Background: The reason for this inquiry was to assess the actual state of Bariatric Surgery in Ge... more Background: The reason for this inquiry was to assess the actual state of Bariatric Surgery in Germany, especially relating to the much discussed economic aspect. Method: A questionnaire was sent to those hospitals in Germany in which we knew that obesity surgery was performed, concerning the year 1997. Results: To our regret, the feedback was only 37%, although this must be considered an adequate response for Germany. Nevertheless, some interesting trends are easily seen. Conclusion: Bariatric Surgery in Germany could pay for itself by saving the costs associated with conservative therapy and preventing co-morbidities in patients with morbid obesity.
An essential outcome criterion of obesity surgery besides weight loss is the improvement of medic... more An essential outcome criterion of obesity surgery besides weight loss is the improvement of medical and psychological health status. Both dimensions influence quality of life. This study evaluates depressive symptoms, self-esteem and health-related quality of life 2 years after bariatric surgery. 149 patients (47 males (32%), 102 females (68%), mean age 38.8 +/- 10.3 years) were assessed by standardized questionnaires before and 1 and 2 years after gastric restrictive surgery. Mean BMI pre-surgery was 51.3 +/- 8.4 kg/m2. BMI decreased significantly to 38.6 +/- 6.8 kg/m2 at 1 year and to 37.9 +/- 7.4 kg/m2 at 2 years after surgery. Statistical analyses revealed a significant decrease in depressive symptoms and a significant improvement in self-esteem and the physical dimension of health-related quality of life. Pre-surgery, 40.5% (n=62) of the patients suffered from depressive symptoms of clinical relevance. These depressive symptoms persisted in 17.7% (n = 27) 1 year and in 16.4% (n = 25) 2 years after surgery. Parallel with a considerable weight loss after bariatric surgery, important aspects of mental health such as depressive symptoms and self-esteem improved significantly. These effects appear 1 year after surgery, but do not seem to change considerably afterwards.
Certain risk factors for arteriosclerosis are associated with obesity, e.g. hypertension, insulin... more Certain risk factors for arteriosclerosis are associated with obesity, e.g. hypertension, insulin resistance, the high triglyceride - low HDL pattern. One aim in treating morbid obesity is to reduce these risk factors. This study was designed to follow metabolic risk factors after weight loss in 165 morbidly obese patients who underwent a gastric restriction operation. Lipid and hormone levels were analyzed before surgery and after 25, 50, 75 and 100% loss of excess weight. Mean cholesterol and triglyceride levels were normal or slightly elevated. HDL cholesterol was also normal (41 mg/dl). Thirty eight percent of the patients had elevated cholesterol and triglyceride levels. Insulin levels were measured as an indicator of potential insulin resistance, and with a mean of 21 microU/ml it was at the upper normal level. After reaching 75% reduction of overweight in a mean time of 10 months, serum cholesterol levels were unchanged. Serum triglycerides, however, decreased by 35% (P&lt;0.0001) and HDL cholesterol increased by 24% (P&lt;0.0001). Insulin levels decreased to 8 microU/ml (P&lt;0.0001). We found an amelioration in the metabolic parameters in 75% of the patients. Nevertheless morbidly obese patients were found to have fewer abnormalities in lipid and glucose metabolism than expected from data of overweight patients with metabolic syndrome. Further long-term studies with careful evaluation of the metabolic parameters as risk factors in patients with morbid obesity need to be performed.
The aim of the study was to evaluate the prevalence rates of mental disorders in normal-weight in... more The aim of the study was to evaluate the prevalence rates of mental disorders in normal-weight individuals and obese individuals with and without weight loss treatment. A sample of 251 participants in a conventional weight loss treatment, 153 pre-bariatric surgery patients, 174 normal-weight control participants, and 128 obese control participants not actively losing weight at the time of the investigation were examined. Lifetime prevalence rates of mental disorders in obese women ranged from 46.7% to 60.1% compared with 41.7% in normal-weight women and from 48.0% to 54.4% in obese men compared with 29.8% in normal-weight men. Prevalence rates of mental disorders did not differ significantly between normal-weight and obese women not currently in weight loss treatment; however, the rates were significantly lower compared with both obese treatment groups. Compared with normal-weight men, obese men not currently in weight loss treatment and obese men participating in conventional weight loss treatment showed significantly higher prevalence rates of mental disorders. Unlike obese male individuals, obese female participants not currently in weight loss treatment did not differ from normal-weight participants with regard to comorbidity of mental disorders. However, obese female participants who were engaged in weight loss treatment exhibited significantly higher prevalence rates than normal-weight participants.
Seventy-four apparently well, healthy persons age 20-90 years were included in the study. Before ... more Seventy-four apparently well, healthy persons age 20-90 years were included in the study. Before bleeding, a health check was performed in each participant. All participants had given their informed written consent, and the study was approved by the local ethical committee. Peripheral blood was taken by venipuncture and preparation of PBMCs was performed by standard Ficoll-Paque gradient centrifugation (Amersham Biosiences,
Background/Aims: Recent reports suggest that the adipose tissue and adipokines are potent modulat... more Background/Aims: Recent reports suggest that the adipose tissue and adipokines are potent modulators of inflammation. However, there is only scarce knowledge on the functional role and regulation of endogenous adiponectin in non-fat tissues such as the liver under conditions of acute inflammation. Methods: In the present study, we investigated adiponectin expression in healthy murine liver tissue and under inflammatory conditions in vivo. Results: Adiponectin mRNA was readily detectable in healthy liver tissue and further increased in ConA-mediated acute liver failure. Adiponectin protein expression was mainly found in hepatic endothelial cells. In vitro adiponectin mRNA expression was detectable in several cell types, including primary hepatic sinusoidal endothelial cells, stellate cells, and macrophages. Mice pretreated with adiponectin before ConA administration developed reduced hepatic injury as shown by decreased release of transaminases and reduced hepatocellular apoptotis. Of note, TNF-a levels were not affected by adiponectin, whereas IL-10 production was increased. Neutralisation of IL-10 diminished the protective effect of adiponectin. Conclusions: Adiponectin expression is up-regulated in ConA-mediated acute liver failure. Therefore, adiponectin might play a role in the control and limitation of inflammation in the liver. Moreover, our data suggest a role for IL-10 in adiponectin-mediated hepatoprotection.
Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real-time... more Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real-time mechanical sector-scanner (5 MH transducer). Compared with age-matched controls, each CF patient showed morphologic changes in the pancreas on abdominal ultrasound examination. A very common finding was a decrease in organ anterior-posterior diameters (CF versus controls: head, 1.25 +/- 0.38 cm versus 2.44 +/- 0.39 cm; body, 0.56 +/- 0.35 cm versus 0.98 +/- 0.3 cm; tail, 0.83 +/- 0.28 cm versus 1.81 +/- 0.38 cm) and a pronounced, age-independent increase in tissue echogenicity. In younger patients, small cystic degenerations could be observed in the pancreatic tail. No correlation could be found between ultrasound morphology, especially pancreatic duct imaging, and exocrine pancreatic function.
Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém... more Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna. Método: estudo transversal realizado num hospital geral universitário, abrangendo todos os recém-nascidos nascidos vivos no centro obstétrico do hospital durante o período de 23 de março de 1999 a 1 de junho de 1999 (847 recém-nascidos). A presença de exposição pré-natal à cocaína foi definida por um teste de fluorescência polarizada por imunoensaio positivo para benzoilecgonina no mecônio do recém-nascido e/ou por uma entrevista materna positiva. Resultados: a taxa da exposição pré-natal à cocaína foi de 16 casos (2,4%), através da entrevista, e de 25 casos (3,4%) através da testagem do mecônio. Foram encontrados 34 casos, com uma prevalência de 4,6%, quando os métodos para a detecção foram considerados de forma complementar. Conclusões: através deste estudo, foi observado que a testagem meconial é mais eficaz que a entrevista materna no diagnóstico da exposição pré-natal à cocaína. A entrevista aumentou, em relação à testagem do mecônio, em 26% a possibilidade do diagnóstico da exposição; e a testagem do mecônio, em relação à entrevista, aumentou em 53,4% o diagnóstico da exposição.
Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém... more Resumo Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna. Método: estudo transversal realizado num hospital geral universitário, abrangendo todos os recém-nascidos nascidos vivos no centro obstétrico do hospital durante o período de 23 de março de 1999 a 1 de junho de 1999 (847 recém-nascidos). A presença de exposição pré-natal à cocaína foi definida por um teste de fluorescência polarizada por imunoensaio positivo para benzoilecgonina no mecônio do recém-nascido e/ou por uma entrevista materna positiva. Resultados: a taxa da exposição pré-natal à cocaína foi de 16 casos (2,4%), através da entrevista, e de 25 casos (3,4%) através da testagem do mecônio. Foram encontrados 34 casos, com uma prevalência de 4,6%, quando os métodos para a detecção foram considerados de forma complementar. Conclusões: através deste estudo, foi observado que a testagem meconial é mais eficaz que a entrevista materna no diagnóstico da exposição pré-natal à cocaína. A entrevista aumentou, em relação à testagem do mecônio, em 26% a possibilidade do diagnóstico da exposição; e a testagem do mecônio, em relação à entrevista, aumentou em 53,4% o diagnóstico da exposição.
Im Sommerhalbjahr wird die deutsche Konjunktur voraussichtlich eine Schwächephase durchlaufen. Da... more Im Sommerhalbjahr wird die deutsche Konjunktur voraussichtlich eine Schwächephase durchlaufen. Darauf deutet das ifo Geschäftsklima hin, das sich im Mai und Juni merklich eingetrübt hat. Maßgeblich dafür ist die anhaltende Unsicherheit über den Fortgang der europäischen Schuldenkrise. Im Jahresdurchschnitt 2012 dürfte das reale Bruttoinlandsprodukt – bei einem 67%-Unsicherheitsintervall von 0,1% bis 1,3% – daher nur um 0,7% steigen. Getragen von
Resumo: Os autores, a partir da experiencia clinica e da literatura, abordam o tema da crianca co... more Resumo: Os autores, a partir da experiencia clinica e da literatura, abordam o tema da crianca com doenca cronica e sua familia. Baseados nos estudos de Leventhal, propoem um protocolo para a avaliacao psicossocial da crianca e da familia, a fim de ...
Zusammenfassung Fragestellung. Mit zunehmendem Alter der CF-Patienten bei steigender Lebenserwart... more Zusammenfassung Fragestellung. Mit zunehmendem Alter der CF-Patienten bei steigender Lebenserwartung kommt es zu einem Ansteigen der Inzidenz und Prävalenz eines Diabetes mellitus. Eine frühzeitige Diagnosestellung des Diabetes mellitus ist wichtig, da CF-Patienten mit Diabetes mellitus in einem schlechteren klinischen Zustand sind und eine erhöhte Mortalität aufweisen.In der vorliegenden Untersuchung soll geklärt werden, mit welchem diagnostischem Test ein Diabetes mellitus frühzeitig erkannt werden kann. Methode. Bei 102 CF-Patienten wurden im Rahmen der Routineuntersuchungen eine Messung des Nüchternblutzuckers, ein HbA 1c-Wert und ein standardisierter oraler Glukosetoleranztest durchgeführt.Die Beurteilung des oralen Glukosetoleranztests (2h-Wert) wurde gemäß den WHO-Kriterien vorgenommen.Zusätzlich erfolgte eine Zuordnung nach den neuen Diagnosekriterien der American Diabetes Association (ADA) aufgrund des Nüchternblutzuckers. Ergebnisse. 65,7% der CF-Patienten hatten eine normale, 21,6% eine gestörte Glukosetoleranz und bei 12,7% der Patienten wurde ein Diabetes mellitus aufgrund eines 2-h-Blutzuckerwerts >200 mg/dl diagnostiziert. Anamnestisch ließen sich keine typischen diabetesspezifischen Symptome erfragen. Keiner der CF-Patienten hatte Nüchternblutzuckerwerte >126 mg/dl, welche nach der neuen ADA-Diabetes-Klassifikation zur Diagnose eines Diabetes ausreichen.Der Mittelwert des Nüchternblutzuckers zeigte bei CF-Originalien
Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascid... more Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna.
Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascid... more Objetivo: verificar a prevalência da exposição pré-natal à cocaína em uma amostra de recém-nascidos utilizando dois métodos: a fluorescência polarizada por imunoensaio no mecônio e a entrevista materna.
Six gene markers have been used to map the progress of the innate immune response of the mosquito... more Six gene markers have been used to map the progress of the innate immune response of the mosquito vector, Anopheles gambiae, upon infection by the malaria parasite, Plasmodium berghei. In addition to four previously reported genes, the set of markers included NOS (a nitric oxide synthase gene fragment) and ICHIT (a gene encoding two putative chitin-binding domains separated by a polythreonine-rich mucin region). In the midgut, a robust response occurs at 24 h postinfection, at a time when malaria ookinetes traverse the midgut epithelium, but subsides at later phases of malaria development. In contrast, the salivary glands show no significant response at 24 h, but are activated in a prolonged late phase when sporozoites are released from the midgut into the haemolymph and invade the glands, between 10 and 25 days after blood feeding. Furthermore, the abdomen of the mosquito minus the midgut shows significant activation of immune markers, with complex kinetics that are distinct from those of both midgut and salivary glands. The parasite evidently elicits immune responses in multiple tissues of the mosquito, two of which are epithelia that the parasite must traverse to complete its development. The mechanisms of these responses and their significance for malaria transmission are discussed.
Progress in Industrial Ecology, An International Journal, 2005
The objective of this study is to evaluate the human dimensions of improving energy and material-... more The objective of this study is to evaluate the human dimensions of improving energy and material-use efficiency of a system through increased integration and exchange between local actors. The results are based on a case study of a Swedish municipality with a developed forest industry. The actors' views are discussed together with the most important factors to enable increased integration and for exchange to take place. The greatest barriers found were the lack of knowledge and resources, attitudes, time frames, development consent, and lack of continuity and local power for some companies. One conclusion is that the municipal authority could have a role as coordinator of local integration projects. However, this role can be impeded by the weak integration of different divisions in the municipality's organisation and it is suggested that companies with integration as their business concept can be key actors when developing more integrated networks. It was also clear that intraorganisational issues may impede interorganisational integration.
Background: Obesity is a major risk factor for fatty liver disease. The purpose of this study was... more Background: Obesity is a major risk factor for fatty liver disease. The purpose of this study was: 1) to determine the degree of steatosis, inflammation and fibrosis in liver biopsies of morbidly obese patients in relation to their body fat distribution and metabolic status, and 2) to examine the course of liver enzyme changes with surgically-induced weight loss. Methods: The study population included 179 morbidly obese bariatric surgical patients (82% female, 18% male, mean age 39±0.7 (SEM) years, BMI 52±0.6 kg/m 2 , excess body weight 80±1.8 kg). All patients tested negative for hepatitis and HIV. Liver biopsies were taken intra-operatively. Hepatic enzyme activities were measured along with lipid parameters, fasting glucose, insulin and leptin. Results: Liver biopsies showed that 47% of morbidly obese females and 85% of males had >30% of hepatocytes filled with fat droplets. Clinically significant hepatic steatosis was associated (P<0.01) with: a) metabolic aberrations, i.e. hyperlipidemia, hyperglycemia, b) male gender, c) abdominal adiposity, and d) elevated hepatic aminotransferase activities. Hepatic inflammation was found in 47% of females and 55% of males, and 'moderate' fibrosis occurred in 12% of males and 6% of females. Postoperatively, the activity of hepatic aminotransferases declined after an initial increase in response to weight loss, with normalization of values occurring at an excess weight loss of 50% (P<0.0001). Conclusion: The majority of morbidly obese patients have >30% steatosis of the liver. The incidence of steatosis is higher for males than females, possibly due to their visceral obesity and associated metabolic aberrations.
Background: Success in bariatric surgery is most often evaluated by a sufficient loss of excess w... more Background: Success in bariatric surgery is most often evaluated by a sufficient loss of excess weight and an improvement in the medical conditions. The expected increase in quality of life (QoL) after weight loss, however, has not often been systematically analyzed. BAROS (Bariatric Analysis and Reporting Outcome System) is a scoring system which, along with easy handling, allows comparisons to be made internationally. Methods: 386 morbidly obese patients who had undergone bariatric surgery in our hospital were evaluated with BAROS. Five categories-failure, fair, good, very good, excellent-were taken from the scoring system that BAROS offers. This system has three major points: excess weight loss, medical co-morbidities and QoL. Points are subtracted for reoperations and defined complications. The operations performed were silastic ring vertical gastroplasty (72%), adjustable gastric banding (23%), biliopancreatic diversion (3%), vertical banded gastroplasty (1%) and gastric banding of Molina (1%). Results: In 1991 and 1993, we had a fair result in 3% and 10% of the patients. A good score with a mean of 3.6 to 4.1 was reached in 1992, 1994 and 1995. In the last 3 years, 1996 to 1998, the mean score was 5.0 to 5.7, which is a very good result when compared with the scoring key. Conclusion: BAROS is a valuable tool to access the QoL of patients who have undergone bariatric surgery.
Background: The reason for this inquiry was to assess the actual state of Bariatric Surgery in Ge... more Background: The reason for this inquiry was to assess the actual state of Bariatric Surgery in Germany, especially relating to the much discussed economic aspect. Method: A questionnaire was sent to those hospitals in Germany in which we knew that obesity surgery was performed, concerning the year 1997. Results: To our regret, the feedback was only 37%, although this must be considered an adequate response for Germany. Nevertheless, some interesting trends are easily seen. Conclusion: Bariatric Surgery in Germany could pay for itself by saving the costs associated with conservative therapy and preventing co-morbidities in patients with morbid obesity.
An essential outcome criterion of obesity surgery besides weight loss is the improvement of medic... more An essential outcome criterion of obesity surgery besides weight loss is the improvement of medical and psychological health status. Both dimensions influence quality of life. This study evaluates depressive symptoms, self-esteem and health-related quality of life 2 years after bariatric surgery. 149 patients (47 males (32%), 102 females (68%), mean age 38.8 +/- 10.3 years) were assessed by standardized questionnaires before and 1 and 2 years after gastric restrictive surgery. Mean BMI pre-surgery was 51.3 +/- 8.4 kg/m2. BMI decreased significantly to 38.6 +/- 6.8 kg/m2 at 1 year and to 37.9 +/- 7.4 kg/m2 at 2 years after surgery. Statistical analyses revealed a significant decrease in depressive symptoms and a significant improvement in self-esteem and the physical dimension of health-related quality of life. Pre-surgery, 40.5% (n=62) of the patients suffered from depressive symptoms of clinical relevance. These depressive symptoms persisted in 17.7% (n = 27) 1 year and in 16.4% (n = 25) 2 years after surgery. Parallel with a considerable weight loss after bariatric surgery, important aspects of mental health such as depressive symptoms and self-esteem improved significantly. These effects appear 1 year after surgery, but do not seem to change considerably afterwards.
Certain risk factors for arteriosclerosis are associated with obesity, e.g. hypertension, insulin... more Certain risk factors for arteriosclerosis are associated with obesity, e.g. hypertension, insulin resistance, the high triglyceride - low HDL pattern. One aim in treating morbid obesity is to reduce these risk factors. This study was designed to follow metabolic risk factors after weight loss in 165 morbidly obese patients who underwent a gastric restriction operation. Lipid and hormone levels were analyzed before surgery and after 25, 50, 75 and 100% loss of excess weight. Mean cholesterol and triglyceride levels were normal or slightly elevated. HDL cholesterol was also normal (41 mg/dl). Thirty eight percent of the patients had elevated cholesterol and triglyceride levels. Insulin levels were measured as an indicator of potential insulin resistance, and with a mean of 21 microU/ml it was at the upper normal level. After reaching 75% reduction of overweight in a mean time of 10 months, serum cholesterol levels were unchanged. Serum triglycerides, however, decreased by 35% (P&lt;0.0001) and HDL cholesterol increased by 24% (P&lt;0.0001). Insulin levels decreased to 8 microU/ml (P&lt;0.0001). We found an amelioration in the metabolic parameters in 75% of the patients. Nevertheless morbidly obese patients were found to have fewer abnormalities in lipid and glucose metabolism than expected from data of overweight patients with metabolic syndrome. Further long-term studies with careful evaluation of the metabolic parameters as risk factors in patients with morbid obesity need to be performed.
The aim of the study was to evaluate the prevalence rates of mental disorders in normal-weight in... more The aim of the study was to evaluate the prevalence rates of mental disorders in normal-weight individuals and obese individuals with and without weight loss treatment. A sample of 251 participants in a conventional weight loss treatment, 153 pre-bariatric surgery patients, 174 normal-weight control participants, and 128 obese control participants not actively losing weight at the time of the investigation were examined. Lifetime prevalence rates of mental disorders in obese women ranged from 46.7% to 60.1% compared with 41.7% in normal-weight women and from 48.0% to 54.4% in obese men compared with 29.8% in normal-weight men. Prevalence rates of mental disorders did not differ significantly between normal-weight and obese women not currently in weight loss treatment; however, the rates were significantly lower compared with both obese treatment groups. Compared with normal-weight men, obese men not currently in weight loss treatment and obese men participating in conventional weight loss treatment showed significantly higher prevalence rates of mental disorders. Unlike obese male individuals, obese female participants not currently in weight loss treatment did not differ from normal-weight participants with regard to comorbidity of mental disorders. However, obese female participants who were engaged in weight loss treatment exhibited significantly higher prevalence rates than normal-weight participants.
Seventy-four apparently well, healthy persons age 20-90 years were included in the study. Before ... more Seventy-four apparently well, healthy persons age 20-90 years were included in the study. Before bleeding, a health check was performed in each participant. All participants had given their informed written consent, and the study was approved by the local ethical committee. Peripheral blood was taken by venipuncture and preparation of PBMCs was performed by standard Ficoll-Paque gradient centrifugation (Amersham Biosiences,
Background/Aims: Recent reports suggest that the adipose tissue and adipokines are potent modulat... more Background/Aims: Recent reports suggest that the adipose tissue and adipokines are potent modulators of inflammation. However, there is only scarce knowledge on the functional role and regulation of endogenous adiponectin in non-fat tissues such as the liver under conditions of acute inflammation. Methods: In the present study, we investigated adiponectin expression in healthy murine liver tissue and under inflammatory conditions in vivo. Results: Adiponectin mRNA was readily detectable in healthy liver tissue and further increased in ConA-mediated acute liver failure. Adiponectin protein expression was mainly found in hepatic endothelial cells. In vitro adiponectin mRNA expression was detectable in several cell types, including primary hepatic sinusoidal endothelial cells, stellate cells, and macrophages. Mice pretreated with adiponectin before ConA administration developed reduced hepatic injury as shown by decreased release of transaminases and reduced hepatocellular apoptotis. Of note, TNF-a levels were not affected by adiponectin, whereas IL-10 production was increased. Neutralisation of IL-10 diminished the protective effect of adiponectin. Conclusions: Adiponectin expression is up-regulated in ConA-mediated acute liver failure. Therefore, adiponectin might play a role in the control and limitation of inflammation in the liver. Moreover, our data suggest a role for IL-10 in adiponectin-mediated hepatoprotection.
Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real-time... more Eighteen patients (3 months to 16 years) with cystic fibrosis (CF) were examined with a real-time mechanical sector-scanner (5 MH transducer). Compared with age-matched controls, each CF patient showed morphologic changes in the pancreas on abdominal ultrasound examination. A very common finding was a decrease in organ anterior-posterior diameters (CF versus controls: head, 1.25 +/- 0.38 cm versus 2.44 +/- 0.39 cm; body, 0.56 +/- 0.35 cm versus 0.98 +/- 0.3 cm; tail, 0.83 +/- 0.28 cm versus 1.81 +/- 0.38 cm) and a pronounced, age-independent increase in tissue echogenicity. In younger patients, small cystic degenerations could be observed in the pancreatic tail. No correlation could be found between ultrasound morphology, especially pancreatic duct imaging, and exocrine pancreatic function.
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Papers by Ana Luíza Wolf